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M.K. Powers, Y. Morita, R.A. Hoffman; Convergence Insufficiency Symptom Survey (CISS): Results of Administration to Students in Middle School, High School, and Juvenile Offender Facilities . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3146.
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To determine the distribution of scores on the CISS when administered to large numbers of students with histories of poor reading
The CISS (Borsting et al., 2003) is a clinically validated instrument for determining whether children have problems with visual skills, and is the primary outcome measure for a large–scale NIH–funded clinical trial of the effectiveness of in–office vision therapy compared to placebo vision therapy and pencil pushups (Scheiman et al., 2005). Although the title of the CISS emphasizes convergence insufficiency, other visual skill problems, such as accommodative facility, could contribute to a high (symptomatic) score. Thus, the number of individuals identified as having visual skill problems might be higher than typically cited in the literature for CI alone. In the present study the CISS was administered by nurses or other trained school personnel to a total of 603 students who were struggling with reading in 3 public middle schools, 2 public high schools, and 2 county schools for juvenile offenders. Completed CISS forms were mailed to Gemstone Foundation, where statistics were tabulated. Results were transmitted to each school.
43% of students scored 16 or higher on the CISS, indicating symptomatic CI or other visual skills problems. The symptomatic percentage varied significantly with school level (Χ2=0.015): In middle school, 42% scored 16 or higher; in high school, 49% scored 16 or higher; and among juvenile offenders, 55% scored 16 or higher. These percentages are higher than reported in the literature for convergence insuffiency. The higher percentage reported here may reflect either a higher percentage of CI incidence in poor readers than in other individuals, or a more inclusive catchment population of the CISS survey than originaly intended.
Students who read poorly may score especially high on the CISS. There may be a "funneling" effect, so that as students continue in the educational system as poor readers, relatively more of them are identified as having visual skill problems. The results point to a need for re–evaluation of the role of visual skill in reading proficiency. Acknowledgments: Supported by grants from the Ford Motor Company and the College of Optometrists in Vision Development.
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