The Special Education Eyecare (SEE) Project

: Exploring the impact of in-school vision care for children in special education

Abstract

Background
Children with special educational needs (SpEN) are more likely to have a serious vision problem compared to their typically developing peers. Studies have identified the difficulties that this group of children have in accessing regular eyecare. It has also been reported that the visual limitations of children with SpEN are not being effectively communicated to key stakeholders involved in their care and education.
Aims
The overall aim was to determine whether implementation of a comprehensive in-school eyecare service model, designed by professional bodies and charities in the UK, results in measurable benefits in terms of visual status and how well visual needs are recognised and addressed by parents and education providers.A secondary aim was to determine the current in-school eyecare provision available to children attending special schools in Northern Ireland.
Methods
A four phase quasi-experimental mixed methods design was adopted. The first phase examined the extent of in-school vision services available to children attending 36 special schools in Northern Ireland. The second phase tested the feasibility of research protocol,recruitment strategies and instruments used for data collection. The third experimental phase assessed visual function and determined parental and teacher knowledge of visual limitations for 200 children at baseline. Measures were re-evaluated 2-5 months after the comprehensive in-school eyecare model had been implemented. The fourth phase examined the Statements of Educational Need (SEN) for information and support on how to manage visual limitations in an educational setting for children who were identified as having a visual deficit at baseline. SEN were reviewed 12 months later to determine if there had been any amendments following recommendations included in written reports issued to parents and teachers at baseline.
Results
Inequalities were identified in the in-school vision services available to special schools in Northern Ireland. The extent to which eye health and visual status are investigated and outcomes communicated to stakeholders also varied vastly between and within Health and Social Care Trusts. Overall unmet visual need significantly reduced and visual status improved following the implementation of the comprehensive in-school eyecare model. However, a third of unmet need remained and was predominantly attributed to non-compliance of spectacle
wear. In addition, all SEN remained unchanged despite recommendations for the
inclusion of strategies to account for visual limitations.
Conclusions
This study has, for the first time, demonstrated measurable visual benefits to children in special education settings when they receive comprehensive in-school eyecare. However, further directions for policy and research are suggested for implementing the in-school eyecare framework at an organisational level.

Date of Award	Oct 2019
Original language	English
Supervisor	Julie McClelland (Supervisor) & Kathryn Saunders (Supervisor)