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Maureen K. Powers, Yoshie Morita, Robert A. Hoffman; Symptoms of Visual Skill Problems in US Students Grades 3-12. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5726.
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To consolidate data from multiple administrations of the Convergence Insufficiency Symptom Survey (CISS), an instrument that was developed during the Convergence Insufficiency Treatment Trial (CITT). The CISS accurately discriminates individuals ages 9-18 for convergence and/or accommodative insufficiency.
The CISS was administered in the recommended manner to 1063 students in eleven (11) US schools. 452 were in elementary grades 3 through 6, 460 were in middle grades 7 and 8, 90 were in high school, grades 9 through 12, and 61 were incarcerated juvenile offenders, grades 9 through 12. Administration was at the school site. A trained individual read the questions and gathered responses on paper from each student. Responses were recorded via computer database and analyzed off site.
Four curves, representing the number of students scoring in each of 13 categories of visual skill discomfort, were generated for the different school groups (elementary, middle, high, and juvenile offenders). Every curve, in each school group, showed evidence of two peaks. One peak was consistently at 11-15 points on the CISS scale, indicating low symptomatology. The other was at 21-30 points, indicating symptomatic convergence and/or accommodative insufficiency. The percent of students scoring 11-15 was approximately the same for all grade levels (15-20%). However, the percent of students of high school age scoring 26-30 was twice as large as the percent scoring 26-30 in elementary and middle school (15% in the older groups compared to 7% in the younger groups). The percent of students scoring 16 or higher in each group was 44% (elementary), 41% (middle), 51% (high) and 49% (juvenile offenders).
The CISS assesses visual skill problems that are associated with reading. However, more refinement may be needed to determine a cutoff score that is useful in practical situations.
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