In a recently published article, Dr. Marie Bodack describes a program at the Herbert Birch Childhood Center in NYC in which 273 children with special needs received eye examinations.  These children, between the ages of 3 and 5 years, had been diagnosed with developmental delays and were enrolled in early intervention programs. Diagnoses included Down Syndrome, cerebral palsy and autism.  The occupational therapists at the school were instrumental in bringing optometric care to the Birch School because they felt that many of the students had undiagnosed vision problems.  Through an affiliation with SUNY State College of Optometry, optometric care was provided to the children during their school day.

The provision of eye care to these children was very collaborative and very flexible.  The children were accompanied to the eye examination by either their occupational, physical or speech therapist.  The therapists’ presence was very comforting to many of the children, and often they were able to assist during the examination process.  The therapists often made suggestions on how to modify procedures in order to obtain responses or helped prepare the children for the examination experience.  They were also instrumental in facilitating communications between doctor, parents and teachers.  If a child was having a “bad day,” or follow-up care was needed, a 2nd appointment was scheduled.

Research has shown that children with special needs have a higher incidence of vision problems, and this population was no exception.  More than 10% of the children required glasses; 6% had strabismus, and 3.7% had amblyopia.  An additional 2.5% were referred for additional evaluation for potential ocular health problems.  ALL children with special needs should have comprehensive vision examinations ASAP!  Dr. Bodack’s research has reaffirmed this.

Many children with special needs are unable to express their discomfort or explain their symptoms.  Their comorbidities often require large investments of time and money to manage.  The examination of pre-school children with special needs is often difficult.  Therefore, they do not receive the comprehensive vision care that they desperately need, and their vision problems remain undiagnosed.   This project is an example of what can be accomplished when the services are brought to these children instead of waiting for them to seek care.  The interdisciplinary environment facilitated the diagnosis and management of vision problems at an early age.  Most importantly, communication between optometrist, therapists and teachers created a better understanding of each child’s visual functioning and how to help that child reach his or her full potential.

Read Dr. Bodack’s description of the characteristics of strabismus here.

Read more about autism and vision here.