Purchase this article with an account.
Phillippa Cumberland, Jugnoo Rahi; School readiness, behavioural and emotional difficulties: the impact of strabismus and its treatment. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5961.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate emergence/development of poor school readiness and/or behavioural or emotional problems in pre-school age children with strabismus. These factors may influence the peer victimisation reported in school-age children with strabismus, glasses or occlusion treatment.
Participants: Three year olds in a national cohort of children born in the UK in 2000/1 (Millennium Cohort Study), identified as having ‘isolated’ strabismus (without associated neurological/neurodevelopmental disorders). Outcomes: Bracken test of formal school readiness. By convention, the lowest decile of age and gender standardised scores indicates poor school readiness. Children with lowest 3% Bracken test scores and/or known neurological or neurodevelopmental conditions were excluded. Parent-reported behavioural or emotional problems. Lowest decile scores on the Strengths and Difficulties questionnaire (SDQ) indicates poor ‘ability’ (conduct, hyperactivity, peers, emotional, prosocial domains). Analysis: Logistic regression with adjustment for treatment (glasses, occlusion, or surgery) as well as birthweight, gestational age, birth order, and maternal factors (education, age at time of child’s birth, ethnicity and occupation-based socio-economic status).
258 of 11,583 (weighted 2%) of 3 year olds had ‘isolated’ strabismus. Poor school readiness was associated with strabismus independent of the effect of treatment; OR=1.9 [95% confidence interval 1.1, 3.2]. Poor SDQ ‘peers’ score was associated with strabismus in univariable analysis but the effect was attenuated and the association not significant after adjustment for treatment and other factors. However, children wearing glasses (with or without strabismus) were more likely to have a poor hyperactivity score (OR=2.0 [1.3, 3.1]) and poor peers score (overall; OR=1.7 [1.1, 2.6], girls; OR=2.3 [1.3, 4.3]), independent of strabismus and other factors.
Early support for children with strabismus may be required to minimise its impact on school readiness, which appears to be independent of a ‘social/cosmetic’ effect. A different approach is likely to be required to address parental concerns about social and behavioural problems in preschool age children who wear glasses.
This PDF is available to Subscribers Only