The Underreporting of Visual Issues in Statutory Education Documents: Comment on Harvey et al. (2020)

Harvey et al. (2020) note in their paper, “The main limitation of this work is that we would ideally have been able to verify the actual visual status of all children reported on in this study via a full optometric assessment; rather than relying on parental report. Future work could therefore aim to carry out a more comprehensive study to include such an assessment.” We would like to direct Harvey and her colleagues to the work undertaken by our group which addresses this limitation. Little and Saunders (2015) investigated how visual deficits were represented in the statutory documents of children with special educational needs and, furthermore, included a comparison with the clinical information on children’s visual status held in hospital records. As anticipated, visual deficits were relatively common in this group of children with learning disability, with diagnoses including Autism spectrum disorder, Down syndrome and global developmental delay. While these visual deficits were explicit in the hospital eye clinic notes, the majority (55%) of Education, Health and Care plans (referred to as Statements of Educational Need in Northern Ireland at the time of publication) did not contain any information regarding either reduced visual acuity or significant refractive error. Table 1, modified from this work, presents participant information for children whose Education, Health and Care plans failed to record any visual needs, but whose clinical records identify visual deficits meeting the criteria of visual impairment as defined by the World Health Organisation, significant refractive error, and/or significant ocular pathology (World Health Organisation 2010). In other cases, where information on visual deficits was included in Education, Health and Care plans, it was generally limited to technical descriptions of visual acuity measures, presence of strabismus (squint) or refractive status in a way that has little meaning for a non-eyecare professional unless supplemented with information explaining what these metrics translate to in lay terms. …