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Emma McConnell, Shelley Black, Julie-Anne Little, Julie McClelland, Lynne McKerr, Karola Dillenburger, Pamela Anketell, Jonathan Jackson, Kathryn Saunders; Testing a framework for eye care provision in special educational schools in the UK: are there measurable benefits?. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5450.
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Eye care provision in special schools is inconsistent across the United Kingdom. As such, professional bodies have created a proposed framework for in-school vision care. We performed a quasi-experimental study to test if this framework has measurable benefits to children’s vision, behaviour and classroom engagement.
Children with learning disability (n=200; mean age 10.75yrs; range 3-19yrs; 140 males) attending a special school in Northern Ireland were recruited. Behaviour and classroom engagement were measured using time-sampling methodology and administration of the Strengths and Difficulties Questionnaire (SDQ) to parents and teachers. Awareness of each child’s visual needs was gathered. Children then received a full vision assessment at school. Visual deficits which were previously unknown or not accounted for were defined as unmet visual needs (UVN). Parents and teachers were given a jargon-free written report detailing visual status and highlighting interventions needed to alleviate UVN (e.g. spectacle correction, environmental changes). Baseline measures were re-evaluated 2-5 months later. Evidence for implementation of interventions was captured from parents and teachers. Non-parametric tests (Wilcoxon-signed rank) were used for statistical analysis.
At baseline, 94 (47%) children had one or more UVN. Post-assessment and reporting, this reduced to 15.5%. Residual UVN were mainly due to poor spectacle compliance. Children issued and compliant with new spectacles had improved near acuity at follow-up (n=12; p=0.018). Children who were given an intervention spent more time ‘on-task’ in class (n=107; p=0.019), compared to children with no intervention (n=93; p=0.949). Where parents implemented interventions at home, teachers noted improved classroom behaviour using the SDQ (n=30; p=0.007) compared to children whose parents had not implemented these (n=30; p=0.136). The in-school assessment was seen as a benefit for children by parents (82.4%) and teachers (83.3%). The report was classified as useful day-to-day by parents (88.7%) and teachers (100%).
The framework for provision of vision care in special schools has measurable benefits in terms of vision and behaviour. Parents and teachers report positively on the in-school service and reporting. Further work is needed to increase spectacle compliance in children with learning disability.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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