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REPORT
to

The 1960 White House Conference on

CHILDREN AND YOUTH

from

The American Optometric Association

Committee on Visual Problems of Children and Youth

THE IMPORTANCE OF VISION TO A CREATIVE LIFE IN

FREEDOM AND DIGNITY

P. N. DeVere, O.D., President
American Optometric Association

Committee on Visual Problems of Children and Youth

Lois B. Bing, O.D., Chairman
Shaker Heights, Ohio

Marguerite Eberl, O.D., Milwaukee, Wisconsin
Lawrence N. Gould, O.D., East Setauket, New York
Alfred L. Klein, O.D., Spirit Lake, Iowa
R. W. Knight, O.D., Morgantown, West Virginia
J. A. Potter, O.D., Peoria, Illinois

Daniel Woolf, O.D., New York, New York

H. Ward Ewalt, Jr., O.D., Trustee Consultant, Pittsburgh, Pa.

FOREWORD

Once a decade, since 1909, the President of the United States has met with leaders in the child health and welfare fields to consider ways and means for making this a better country for all children, and thus a happier society and a more effective democracy. The American Optometric Association is proud to participate in the 1960 White House Conference on Children and Youth as the representative of a profession whose members believe deeply in the concept of this Conference that every child deserves the fullest possible opportunity to achieve a creative life in freedom and dignity.

In company with other groups participating in the Conference, however, we are profoundly aware of the wide gap which still exists between the achievement of the goal we seek for all children and the hard realities of our society. The obstacles to the goal are economic, social, educational, psychological and physiological, varying from child to child, from family to family, and from area to area.

Fortunately, many, if nct most, of the obstacles to full development of every child can be removed, if knowledge and techniques now available to us are put to full use. In the field of visual abilities, for instance, there is no longer any valid reason why millions of children handicapped by defects in vision or retarded visual development cannot be helped to achieve a better or a complete adjustment to their learning problems or to other problems caused by vision difficulties, if only professional examiners can have the opportunity to uncover the children needing help. It is truly tragic that any child should be deprived of his heritage, an opportunity for a good life, because of a correctable but neglected or undetected vision difficulty, yet this is happening to untold numbers of children throughout the country because of parental and community failure to understand and to take advantage of vision care now available.

The 21,000 members of the optometric profession, located close to the child's home in every locality in the nation, have dedicated their art and science to the goal of removing correctable vision inadequacies from among the obstacles which still bar many children's path to their full development. The progress which has been made in this field in the last few years has been heartwarming, dramatic, when children once thought hopeless from an educational standpoint have been helped into becoming contributors to society rather than "problems" to it. In the brief 10 years since the last White House Conference on Children and Youth, optometry working closely with pediatricians, psychologists and educators helped produce the first blueprint of the development of visual performance in children, making possible the developmental appraisal of vision from 16 weeks to 10 years through a series of visual performance tests. This, in turn, has led to improved guidance programs and methods of preventive care, as well as new techniques not only in the education of children with visual deficiencies (as the result of brain injury) but in the establishment of guideposts toward improved learning procedures for all children.

At least 80 percent of all learning takes place through the visual process. A process which develops through maturation and learning experience. Yet millions of children with seemingly good eyesight, perhaps even the so-called "perfect vision" of 20/20 visual acuity at distance, have not learned to see efficiently at near-point, that is, to maintain binocular visual performance so as to make effective use of the impulses signalled by the eyes to the brain. Often, these children are scolded and humiliated as "lazy" in their school efforts when actually they desperately require professional vision training to learn how to use their eyes more effectively. It is urgent that parents, educators and the community generally recognize the existence of this all-too-common but often neglected problem in an area of vision care which optometry has pioneered and developed as a distinct and unique professional specialty.

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Of great social import at this time is the startling relationship which has been found to exist between vision difficulties and the baffling problem of juvenile delinquency. Statistics reveal that more than 80 percent of delinquent and pre-delinquent children have not achieved satisfactorily in reading. Research further reveals that in 50 percent of those encountering reading difficulty, vision is a contributing factor. Certainly this does not indicate that every child with a reading problem is a potential delinquent. Rather, it does indicate that such children should always be examined promptly for the existence of a vision difficulty, and particularly those children whom society has not been able to "reach." It is not enough to know if the child can see and read a one-third-inch-high letter on a Snellen chart at 20 feet with or without correction. It must also be determined whether the child can focus readily on the printed words of a book held at 12 to 16 inches and maintain binocular vision for long periods of time. So many children with behavior problems have been discovered to be unable to accomplish this feat without special lenses and/or visual training, that their misbehavior may well have stemmed from a desperate effort to escape from an intolerable school situation.

Meanwhile, the incidence of need for professional vision care for children is increasing at a rapid pace. Extensive research is necessary to provide us with clear explanations for such phenomena as the increasing incidence of myopia, particularly at college-age levels. Optometry is pioneering in efforts for the control and reduction of this widespread problem with encouraging hope for improved preventive and corrective measures, including some promise in the new contact lenses. Furthermore, it is initiating new programs of specialized help for college students and pre-school children, supplementing its expanding and highly successful program for elementary and secondary school children.

But to be effective, new knowledge and new techniques bearing on factors affecting children in their growth and development must be shared broadly with all professions and disciplines concerned in this vital matter. They must be understood by the general public. It is particularly important for parents to become aware of early danger signs in visual growth patterns in their children so as to seek professional help promptly. Moreover, we need greater public recognition of the importance of effective and reliable mass screening programs as described in this report, to identify school children needing vision care. We need greatly expanded research into all phases of visual development. Preventively, we must determine if we can do a better job of designing classrooms, school furniture and equipment for maximum visual comfort and efficiency. We must find out whether we are attempting to teach children reading skills before many of them are visually ready for reading. These are some of the issues which we seek to explore within the context of the 1960 White House Conference.

In the preparation of this report, the optometric profession has undertaken a critical and comprehensive self-appraisal of its services to children and the public generally, of its standards of professional training, and of the degree to which it has succeeded in its conscientious efforts to achieve with other disciplines an interprofessional approach to the problems of children, even when that sometimes entails some compromise of professional prerogatives for the sake of the public good.

Optometry looks back upon the 10 years since it last participated in the White House Conference on Children and Youth as years of great progress in concepts of vision care, and in the effectiveness of its services to children and youth particularly. We regard the next 10 years as a period of even greater challenge to our profession and to every profession dedicated to the welfare of children and to service in behalf of humanity. Obviously, if the challenge is to be met, all groups working with children must keep open the channels of communication and the avenues of cooperation one with the other. We pledge our continued full efforts in that direction.

LOIS B. BING, O. D., CHAIRMAN
Committee on Visual Problems of
Children and Youth

American Optometric Association

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THE IMPORTANCE OF VISION TO A CREATIVE LIFE IN FREEDOM AND DIGNITY

Report to the 1960 White House Conference on Children and
Youth by the American Optometric Association's Committee
on Visual Problems of Children and Youth

Page

FOREWORD

PART I

New Concepts and New Techniques --Identifying and Minimizing
Visual Handicaps to the Learning Process

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Learning to See . . .

Millions Fail to Learn to See Effectively.

Changing Concepts in Vision Care.

Attitudes Before World War II.

Present-day Concept of Vision Care

Eyes and Vision Not Synonomous

Reading and Anti-Social Behavior

Significance of Studies to Parents, Teachers

The "Phenomenon" of Reading

Distinctive Patterns for Each Child
Vision is a Learned Skill And Can Be Taught.
Categories of Visual Training.

The Serious Problem of Progressive Myopia.
Effects of School Work Upon Vision
Reports on Myopia Control .

Expanding Popularity of Contact Lenses
Contact Lenses and Progressive Myopia
Vision Problems at the College Level

Optometry's Preventive Care Program

Special Vision Problems ..

1. Squint or Strabismus (Crossed Eyes).

Investigation of Lenses and Visual Training
Encouraging Progress in Helping Crossed-Eye Condition

2. The Partially-Seeing Child.

A Normal Environment.

Need For a Team Approach by Several Professions 3. Visual Care for the Brain-Injured or Retarded Child. New Testing Technique.

Research in Vision Care--Gaps in Our Knowledge
Areas in Which We Need More Information
The Challenge of the Next Decade

The Prevention of Vision Problems in Children and Youth.
The Challenge Facing America and the Free World.
Utilizing Preventive Vision Care Knowledge
Environmental Factors in Preventing Vision Difficulties
"Vision-Conditioning" the Classroom

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PART II

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