81). Ambrose and Corn (1997) further define "functional vision" as vision that can be used to derive input for planning and performing tasks; the extent to which one uses his or her available vision is referred to as "visual efficiency."
Reading Skills. According to Carver (2002), "reading usually means to attempt to comprehend language in the form of printed words"; therefore, for the purposes of this study, the term "reading skills" will refer to an individual's ability to comprehend language in the form of printed words.
This chapter provided an introduction to the study, including the background and a statement of the problem of vision impairment on students' academic performance; a discussion of the purpose and significance of the study was followed by a description of the research questions that will guide the research process. An assessment of the study's limitations and delimitations was followed by a delineation of key terms used.
Chapter 2: Preliminary Review of the Literature
Background and Overview
Among the many serious problems facing American society today is the need to deliver effective educational services to an increasingly diverse population of students, both in terms of cultural and ethnic background as well as their levels of learning abilities. In an effort to "mainstream" as many learning disabled and minority children as possible into American classrooms, educators have been faced with a wide range of challenges and obstacles to providing this equitable distribution of educational services in a meaningful way. One of the major problems facing educators at all levels is students' ability to read in the first place. Without the ability to read efficiently, students are unable to achieve academic proficiency in almost any subject area without significant tutorial assistance and even then, the chances of success are not as great as if a child has already acquired the ability to read efficiently before entering the classroom. In this environment, what are teachers to do to help children whom they suspect of being unable to read because of a learning disability associated with visual acuity problems? Further, studies have shown time and again that diagnose and referrals for treatment interventions for visual acuity problems are the "easy part," with future follow-up being essential for any substantive gains in academic achievement to be possible.
Perhaps the most alarming part of this problem is its pervasiveness, particularly among low-income, minority, and English as a second language (ESL) students who are confronted with a wide range of additional obstacles to learning how to read. Low income families do not have as much access to literary materials to retain in the home as their more affluent counterparts, certainly, but parents and educators can help these children - even the visually impaired - learn how to read more efficiently and by so doing, they can help also them achieve success in almost every other academic endeavor, as well as securing gainful and meaningful employment later in life. In a day and age characterized by an increasing "digital divide" already, it is vitally important then to understand the extent and nature of the profound problems facing visually impaired students in American schools today. These issues are discussed further below.
Incidence and Impact of Vision-Impaired Children in American Schools
As noted above, several studies have clearly associated visual acuity problems with poor academic outcomes; however, a number of studies have also found a clear link between uncorrected vision problems and juvenile delinquency as well. "One rather alarming statistic is that in the population of all school-age students, 25% suffer from undiagnosed vision problems; however, among juvenile offenders, it is estimated that 70% have undiagnosed vision problems" (Gould & Gould, 2003, p. 327). Because it is reasonable to assume that such vision problems will naturally result in skill deficiencies, difficulty in reading and learning, and poor academic performance, it is also reasonable to assume these in turn will lead to feelings of failure, low self-esteem, and lack of interest in academics. Therefore, the association between vision impairment and juvenile delinquency becomes readily apparent.
In their study "Abandoned in the Back Row: New Lessons in Education and Delinquency Prevention," the Coalition for Juvenile Justice determined that the "biggest finding is that school failure is one of the earliest and best predictors for future delinquent and criminal behavior" (Gould & Gould, 2003, p. 328). Another study cited by these authors entitled, "The Prevalence of Visual Conditions in a Population of Juvenile Delinquents," found that juvenile delinquents were a "population of nonreaders": "Poor and nonreaders frequently exhibit poor academic performance; lack interpersonal problem-solving skills; demonstrate problem behaviors in school, such as aggressiveness and disobedience; and become delinquent" (Gould & Gould, 2003, p. 329). Poor reading skills clearly have serious and long-lasting consequences, but here again there remains much to be done in terms of developing effective screening techniques and treatment interventions that can be used in the school setting.
Effective Diagnoses and Interventions Identified to Date
In response to the growing recognition that there is an increasingly severe visual acuity problem among marginalized students, in early 2001, educators and optometrists shared their findings on the topic of "Visual Problems of Children in Poverty and Their Interference with Learning" at a conference hosted by the Harvard Graduate School of Education. At this conference, Dr. Antonia Orfield, an optometrist at the Harvard University Health Services Eye Clinic and chief investigator of the Inner-City Vision and Learning Project at the Boston Mather School, addressed the high incidence of visual problems in urban poor children and reported that fully 53% of the children tested at one school had vision problems that could constrain their ability to learn how to read, and would further affect their ability to read efficiently in the future.
According to Gould and Gould (2003), though, school vision screenings ordinarily only check for nearsightedness (which affects reading at a distance such as looking at chalkboards or whiteboards). "Dr. Orfield recommended expanding the screenings to test for conditions that affect close-up (book) reading, such as farsightedness and problems with tracking" (p. 327). While this common-sense approach would appear obvious to most observers, improving the screening process itself is just the first part of the problem. Understanding how and when children learn how to read has been the source of much controversy in recent years.
According to Pollatsek and Rayner (1995), from a developmental perspective, because the question of how words are identified is clearly central to understanding reading, it would appear reasonable to assume that recognizing the printed word is the central problem of reading. For example, an otherwise-normal 6-year-old child already possesses a well-developed system for language understanding, and the major obstacle to be overcome to achieve reading coherency would be to learn how to interpret the letters that are on the page into that existing system. "If the child can learn to access the words of the spoken language from the written representation, then he or she should be able to understand the written representation. This suggests one central question about reading: Is word recognition all that needs to be learned?" (Pollatsek & Rayner, 1995, p. 61). The growing body of evidence suggests that there is a consistent point in time where there is sufficient overlap between stimulus-driven information and some internal lexical representation that the individual is then able to recognize the word (Balota, D'Arcais & Rayner, 1990). For example, there is Morton's (1969) logogen model that suggest "this magic moment is the point in time where a logogen's threshold is surpassed"; Becker's (1980) verification model ascribes this "magic moment" to the point in time "when there is sufficient overlap with a sensory-defined internal representation and the information residing in sensory memory about the stimulus word"; finally, in Forster's (1985) bin model, the "magic moment" refers to the point in time at which there is a sufficient match between an orthographic representation derived from operations on the stimulus word and a representation in an orthographically defined access bin. "In each of these models, it is only after this magic moment in word processing that the subject can access the goodies associated with the word, for example, meaning and syntactic class" (Balota et al., 1990, p. 24).
Unfortunately, the research into this aspect of language acquisition and comprehension remains unclear, with some children apparently being able to make the mental leap between the formerly incomprehensible squiggles on the written page and actual words and others struggling over interpreting these symbols in a meaningful way. In fact, Gallimore (1999) suggests that the most salient academic difficulty experienced by children with reading disabilities involves learning to understand and apply the alphabetic principle in translating between the written and oral languages. Given this level of importance, it is somewhat surprising to find that it has been only recently that researchers have gained any true understanding of the underlying process involved. "One of the great discoveries in the study of reading in the last 25 years," Hulme and Joshi report, "is the realization that learning to…