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Baltimore School Vision Program Misses the Mark in Raising Most Test Scores

— A fleeting reading benefit suggests modifications to the intervention may help, however

Last Updated September 15, 2021
Ƶ MedicalToday
A young African American girl with her hand covering her right eye next to an eye chart.

An intervention bringing vision screening and free eyeglasses to schools had limited success raising children's academic performance, a cluster-randomized trial found.

The first 41 Baltimore public schools randomized to receive the intervention had a few points added to i-Ready reading test results from 2016 to 2017 for their elementary and middle school students (effect size 0.09 SD units, P=0.02). Girls and special education students were among those deriving particularly large benefit from the program during the 2016-2017 school year, according to Megan Collins, MD, MPH, of Johns Hopkins University School of Medicine in Baltimore.

Yet reading on the Partnership for Assessment of Readiness for College and Careers (PARCC) test did not budge for students as a whole, nor did math scores on either i-Ready or PARCC tests. Ultimately, the intervention, known as Vision for Baltimore, failed to show any significant academic benefit after 2 years, the researchers noted in their study of 2,304 children in .

"These findings underscore that for SBVPs [school-based vision programs] to maximize impact, they must not only provide eyeglasses but also ensure mechanisms for monitoring wear, replacement, and connection to community eye care clinicians for long-term care," the investigators argued.

"Now we have very compelling evidence that kids who get glasses through school-based programs can do better academically," Collins told Ƶ in a phone interview. "It really is a call-to-action for us as a community to think about how we can expand and build upon programs like this."

The program provided vision screenings for all students in the Baltimore City Public Schools, as well as eye examinations and Warby Parker eyeglasses free-of-charge to those who required them through a mobile in-school eye-care program.

"Vision for Baltimore demonstrated success in identifying and correcting vision deficits for students in Baltimore, many of whom may have never previously accessed vision care," the study authors wrote.

In the U.S., vision screenings are . However, past studies have shown that children of lower socioeconomic status may be .

School-based vision programs may be all the more important during the COVID pandemic, Collins suggested.

"Across the country, we have a large number of kids who missed their vision screenings last year that would have been screened at the state-mandated levels," she said. "We're also seeing way more nearsightedness in kids than we've ever seen before, largely felt to be attributed to so much screen time."

"So we have kids who haven't been screened, we have kids who are more likely to be myopic, and throw in the picture the learning loss that has happened over the past year, school-based vision programs have a very important place as we pivot towards the talk of recovery," she emphasized.

Her group's ran from 2016 to 2019 and comprised three groups of schools from the Baltimore City School District:

  • 41 schools starting the intervention in the 2016-2017 school year (n=964)
  • 41 schools starting in 2017-2018 (n=775)
  • 38 schools starting in 2018-2019 (n=565)

Only students in grades 3-7 who required eyeglasses and whose parents consented were included in the study. Girls represented 54.7% of the study population, and Black and Hispanic students made up 77.6% and 16.8%, respectively.

In Baltimore, the i-Ready reading and math tests are given three times a year in addition to the state-mandated annual PARCC test.

Collins and colleagues noted that compliance data, whether individuals wore their eyeglasses, were not collected, which could have affected the results of the study.

In addition, they were unable to measure the impact of the program on students in kindergarten through second grade due to lack of pretest data.

"The critical years that a child is learning to read is kindergarten through third grade, and there are a lot of predictive indicators in how well [a student] is reading in third grade for their academic trajectory beyond. So one of the opportunities for future work, given that we now know that glasses help kids read, would be looking at a younger population," Collins said.

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    Lei Lei Wu is a staff writer for Ƶ Medical Today. She is based in New Jersey.

Disclosures

The study was funded by the Abell Foundation, Laura and John Arnold Foundation, and Hackerman Foundation.

Collins reported receiving personal fees from and previously serving as a consultant for Warby Parker, a company that manufactures the eyeglasses provided in the Baltimore vision program.

Primary Source

JAMA Ophthalmology

Neitzel AJ, et al "Effect of a randomized interventional school-based vision program on academic performance of students in grades 3 to 7: a cluster randomized clinical trial" JAMA Ophthalmol 2021; DOI: 0.1001/jamaophthalmol.2021.3544.