Effects of a Vision Intervention Program on Intervention Program on Academic Performance International Congress on Behavioral Optometry April 2010 • Ontario, California US US A A
Ai H Ai Hong Chen, B Optom, Ch B O PhD, F AAO, FCOVD - A Head, Department of H d D t t f Optometry Faculty of Health S Faculty of Health S ciences ciences Universiti of Teknologi MARA UiTM Kampus Puncak Alam k l S elangor, Malaysia
Where in the World is Malaysia?
Now find Selangor, please!
I t Introduction d ti Vi i Vision plays an important role in the learning process l i t t l i th l i g Children need good distant vision to see the blackboard; near vision is essential for reading and writing at a desk near vision is essential for reading and writing at a desk The ability of the visual system to maintain clear and single binocular vision while changing focus from near to far and conversely is essential to insure the efficiency of the learning process Anomalies in the accommodative and vergence system Anomalies in the accommodative and vergence system could interrupt these skills and therefore affect the decoding (bottom-up) and comprehension (top-down) process during reading and learning process during reading and learning
I t Introduction d ti Both the decoding and comprehension process operate B h h d di d h i and interact with each other during the reading process Only one is ‘ dominant’ at any one time Only one is ‘ dominant’ at any one time The decoding process plays the downward role in letter discrimination left-right fixation assembles the discrimination, left-right fixation, assembles the alphabet to form a word, and combines words to construct a sentence The comprehension process enables a reader to extract meaning from text
I t Introduction d ti When a child starts reading, he should be able to Wh hild di h h ld b bl decode before the comprehension process takes place Any vision problems affecting the decoding process Any vision problems affecting the decoding process might j ust as well affect the comprehension process Therefore the role played by the visual system is Therefore, the role played by the visual system is essential for new readers
Introduction ti d I t
Ai Aim of S f S t d tudy In this study we investigate the short-term and long- I hi d i i h h d l term effects of a vision intervention program on academic achievement This addresses the question; if the visual system can be made to operate more effectively, what impact would it h have upon academic performance? d i f ?
Methods ampling ubj ect S S
M th d S bj Methods • S ubj ect S t S ampling li Random sampling was carried out throughout the R d li i d h h h S elangor (Malaysia) area under the approval of the Minister of Education 20 schools were chosen with further approval from the Education Department of S elangor Random sampling narrowed this to 8 schools and approval was gained from the headmaster of each Consent letters were sent to parents and 85% agreed for their children to take part in the proj ect
M th d S bj Methods • S ubj ect S t S ampling li Children were in Y Child i Y ear 3 of school, classified into two 3 f h l l ifi d i groups based upon their scores on year-end examinations of Y ear 2 One group represented those with below average academic achievement; the other with good academic achievement hi t S orting of subj ects was based upon scores in mathematics and language skills mathematics and language skills Test scores less than 50% were classified as low achievers achievers
Methods Procedures
M th d P Methods • Procedures d All All participants were given a vision assessment ti i t gi i i t Acuity S tatic retinoscopy (dry) Dynamic retinoscopy Direct ophthalmoscopy Vergence ranges g g NPC Phoria posture Randot stereopsis Randot stereopsis Accommodative ranges and facility S accades (DEM)
M th d P Methods • Procedures d (Vision assessment continued) (Vi i i d) Gross motor skills (S tanding in S now Test) Fine motor skills (Grooved Pegboard) ( g ) S patial Orientation S kills (Gardner Reversal Frequency Test) Visual Motor Integration S kills (Beery VMI) Vi Visual Perception (S l P ti (S b ubsets of Kaufman Assessment Battery) t f K f A t B tt ) Detroit Test of Learning Aptitude (DTLA)
M th d P Methods • Procedures d 78 ‘ low achievers’ were approached to be part of the 78 ‘ l hi ’ h d b f h intervention study: 50 males – 28 females They were assigned evenly into three groups (n 26) and They were assigned evenly into three groups (n=26) and matched in age, gender, ethnicity, and visual perception status Experimental Group Hawthorne Group Control Group
M th d P Methods • Procedures d The visual intervention program included: prescription Th i l i i i l d d i i lenses; binocular vision therapy; and, perceptual training Intervention was carried out over a period of 3 months; July – S eptember 2002 Therapy consisted of 8 total hours of preplanned procedures The Experimental Group subj ects were assigned into subgroups of perceptual therapy based on the processing mode and speed processing mode and speed
M th d P Methods • Perceptual Therapy t l Th Si Simultaneous lt S Sequential ti l S Speed d Th Therapy High High High S pecific deficits Low Low Low All processes High High Low S peed Low Low High S equential- S imultaneous High High Low Low Low Low S S equential equential High Low High S equential - S peed Low High High S imultaneous Low High h Low S imultaneous - S l peed d
Methods • Perceptual Therapy for E Experimental Group i t l G Types of Therapy T f Th N Number of Subjects b f S bj t S imultaneous 6 S equential-simultaneous 5 All processes 4 S imultaneous - speed 3 S S peed peed 2 2 S pecific deficits 2 S pecific deficit - speed 1 S equential - speed l d 1 S equential 0 Total 24
M th d P Methods • Procedures d Nine optometrists were involved in supervising the Ni i i l d i i i h therapy all following a set protocol designed by the author Overall completion times ranged from one month to two months and from 4 sessions to 8 sessions This variation was largely due to absence from school and the need to work around scheduled classroom examinations examinations
M th d P Methods • Procedures d Those assigned to the Hawthorne Group spent time with Th i d h H h G i i h a non-optometrist doing activities such as sharing stories on visual hygiene and eye-care, storytelling, random painting activities or time socializing with each other Those in the Control Group remained ‘ untouched’ – no activity was given ti it i
Results Analysis
R Results • Analysis lt A l i All students were low achievers and enrolled in Y All d l hi d ll d i Y ear 3 3 of their studies Only test scores for Mathematics and Language (Malay) Only test scores for Mathematics and Language (Malay) were used in the evaluation of school achievement Only national-type (public) schools were used in the Only national-type (public) schools were used in the study as Malay represented the language of instruction and such schools follow a standard curriculum All students were matched on age, gender, ethnicity, and visual perception status
R Results • Analysis lt A l i Examination scores were collected twice; first for the E i i ll d i fi f h short-term effect and second for the long-term effect The short term effect was assessed within a month after The short-term effect was assessed within a month after completion of the vision intervention program; results were taken from the Y ear 3 final examinations The long-term effect was assessed 9 months after completion of the vision intervention program; results were taken from the Y were taken from the Y ear 4 mid year examinations ear 4 mid-year examinations
Results Visual Processing
R Results • Visual Processing lt Vi l P i In general, process problems seemed to be twice as I l bl d b i common as specific deficit problems S S imultaneous related visual processing problems such imultaneous related visual processing problems, such as simultaneous, sequential-simultaneous and simultaneous-speed was relatively more common and made up about 54% d b t 54% of the entire visual processing f th ti i l i concerns S S peed related and sequential related processing peed-related and sequential-related processing problems were 27% and 23% respectively
Academic Outcome Measures Results
R Results • Academics lt A d i S S tudents in the Experimental Group showed a d i h E i t l G h d statistically significant improvement in Mat hemat ics in long t erm measures (p=0.04), but not in short term measures S tudents in the Experimental Group showed a statistically significant improvement in Language skills t ti ti ll i ifi t i t i L kill in short t erm measures (p=0.02) but not long term measures
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