A vision checklist as a vision screening tool by Grade R to Grade 3 teachers in Quintile 1 schools
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Date
2020-08
Authors
Ramantsi, Boitumelo Monica Loraincia
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
Background: Vision screening in schools has been shown to identify children with visual disorders who are thereafter referred for a comprehensive eye examination with an optometrist and or ophthalmologist. In South Africa, the government has introduced an integrated school health policy that includes vision screening which is conducted by few school health nurses, who cannot screen all school children. Teachers spend most of the time with children in their classrooms and thus, educating them on common vision disorders and training them to screen the learners in their classrooms can help identify children with vision disorders. Aim: This research aimed to investigate the use of a vision checklist as a screening tool by Grade R to Grade 3 teachers to detect visual disorders among learners in Bloemfontein. Methods: The study population comprised of 41 teachers and 1360 learners from the 11 Quintile 1 schools. Convenience sampling was done to enrol 36 teachers from 11 Quintile 1 schools and 1360 Grade R to Grade 3 learners aged between five and thirteen years around the Bloemfontein area in the study. The study was done in three phases. In the first phase of the research study, the researcher administered the first questionnaire with nine items to evaluate baseline teachers' knowledge and thereafter an educational session was done covering the most common visual disorders in children. A second questionnaire with nine items was administered after the educational session to assess the acquired knowledge of visual disorders and their management. The teachers were classified as having good knowledge if they obtain seven or more correct answers. The teachers were also trained on how to use the vision checklist in their classrooms as a vision screening tool. In the second phase of the study, the teachers screened the learners in their classrooms using the vision checklist. The learner would fail the screening if the teacher recorded any "no" response. In the last phase of the study, the research team screened learners from the two randomly selected schools (School A and School B) using the basic optometric vision screening tests to validate the screening results of the teachers. The two schools had 8 teachers and 261 learners from Grade R to Grade 3. The learner would fail the screening if any of the tests conducted were recorded as “fail”. The descriptive statistics and diagnostic tests were calculated per group. A p -value of less than 0.05 was considered to indicate statistical significance. Results: Phase 1: All 36 teachers who participated in this study were female whose ages ranged between 27 and 36 years. Most of the participants (n=16, 44.44 %) had been teaching for more than 10 years. The highest qualification attained by the participants was Bachelor of Education Honours (n=2, 5.56%), and most participants (n=10, 27.78 %) had an Advanced Certificate in Education. Thirty-four participants (94.44%) obtained a score of seven and higher in the first educational questionnaire. The second questionnaire results showed that all participants obtained a score of seven and higher. Twenty-one participants (58.33%) showed improvement in knowledge, while two participants (5.56%) regressed. Overall, there was a statistically significant difference ( p <0.0001) between the scores of participants before and after the educational. Phase 2 : A total number of 1360 Grade R to Grade 3 learners whose ages ranged from five to thirteen years old were screened by the 36 teachers using the vision checklist, five hundred and forty learners (39.7%) failed the screening. Phase 3 : The total number of children tested by both the teachers and the research team was 221; this was (84.67%) of the total amount of 261 learners in those schools. The research team found that 102 learners failed the vision screening, as a result the prevalence of the vision disorders in learners was 46% (95% CI: 39% – 53%). The teachers only identified 20 learners out of 102 to have vision disorders therefore, missed 82 learners with vision disorders. The sensitivity of the screening with a vision checklist was 19.61% (95% CI: 12% – 29%) and specificity of 83.19% (95% CI: 75% – 89%). Conclusion: The current study showed that teachers had adequate knowledge of common vision disorders in children which was improved through the educational session. However, the teachers missed 80% of the learners who had vision disorders when using the vision checklist as a screening tool. Thus, the results showed that the vision checklist used in this study was not a sensitive screening tool as it could only identify 19.61% of learners with vision disorders. It can be speculated that teachers’ current workload, large numbers of learners in classes and lack of motivation could have resulted in the high false-negative rate found in the study.
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Keywords
Dissertation (M. Optometry (Optometry))--University of the Free State, 2020, Vision screening, Quintile 1 Schools, Preschool teachers, Primary education, Vision checklist, Optometry - Children, Visual disorders in children