I have been in the field of adult education for over 40 years and operated ABLE, GED, ESOL and/or Family Literacy programs for two counties in the various communities within those counties and three jails. The single most important factor in my career and what, I believe, was the single most important factor impacting the success of the students in my programs has been VISION. Vision is the ability to not only see, but to use both eyes together with the brain to process information. Vision is much more than 20/20!!

I had just finished a “London Procedure” training with Dr. Laura Weisel, Ph.D., which included a Bernell-o-scope for vision screening. As I implemented my new knowledge into our programs, I was amazed at the number of students with vision problems. I needed to pursue this. I was fortunate enough to find a Developmental Optometrist in our area, Dr. Barr, O.D., who was familiar with education because he served on the SERRC (Special Educational Resource Center) for our area in Ohio. This was in about 1974. At that time Developmental Optometry was new and not many doctors specialized in this area.

I asked him to serve on our board and asked him to train my staff. Over many years, he graciously provided us with day long trainings at no cost. I also was allowed to spend part of a summer in his therapy room and he recommended books for me to read. He was a tremendous help. Now he has retired. However, over the years, many other optometrists began to specialize in this area due to the need and the successful results with patients. (See the Lucy Johnson Nugent story below.) I have received help from them over the years even to the present as I am doing this blog. I truly want to thank them for their help and their dedication.

Now back to my story… I prevailed upon Dr. Barr many years ago to train my staff and myself so that we could better serve our students. In about 1974 or 75, he shared some statistics from two studies done in 1973. One was on the Incidence of Vision Problems among Children Ages 5-19 which provided vision problem statistics for the overall population by G.N. Getman and G.M. Milkie in the American Optometric Association publication Vision Consultant to Educational Programs. The other for the same subject provided statistics for the Learning Disabled population by A. Sherman published in the Journal of the American Optometric Association, 44 (2) In their article titled “Relating to Learning Disability.” I found this information fascinating and while I cannot find more recent statistics, believe this information to be the same or greater. I also believe that many of our students left school because they were unsuccessful and vision was a major factor. I share these statistics with you.

The Incidence of Vision Problems among Children Ages 5-19
(In cases where criteria for reporting varied, ranges are indicated instead of whole number percentages.)

   Vision Problems Overall Population “LD” Only
Eye Disease 1% 2%
Refractive Error(Near-sighted, Far-sighted, Astigmatism) 3-9% 4-8%
Amblyopia (Lazy Eye) 2% 2%
Strabismus (Crossed Eyes) 4% 8%
Functional Skills 17% 92-96%
Perceptual Skills 3-8% 70-90%


Examples of…
Functional Skills are the inability to use both eyes together: to converge to see the same thing, to track across a page on the same line, to look at a white board and then back to a page and focus quickly, etc.
Visual Perceptual Skill problems are reversals, trouble with likeness and differences, inability to visualize, lack of orientation on a page, visual sequential memory, visual motor integration, etc.
The data presented here gave me insight as to why many adult students struggled and quit school in first place.
Stated in another way, 70-90% (85%) of students with labels have a vision perception problem, many of which go undetected.

Another factor in lack of student success is misdiagnosis or lack of diagnosis for specific vision problems, especially for functional and perceptual problems. Not all eye exams are the same.

I seriously thought about this information and reasoned that if a child had any one of these vision problems and they were not taken care of, he/she would still have it. It was likely a factor in their decision to quit school and it would very likely affect their retention and success in adult education. Because of this, we implemented various policies that I will share with you.

I highly recommend a vision screening for all adult education students. I found that the quickest (The screening takes between 5 and 10 minutes.), most cost effective and most comprehensive vision screening was the Power Path Vision Screening. The various component parts could be purchased separately from the Bernell Corp., but it was easier, less complicated and worth the little extra expense to buy the equipment that came with directions and was appropriate for the purpose from Power Path, the revised and updated London Procedure.

Once we had the screening results, we could refer students for refractive error problems to local optometrists. We could refer students for binocularity problems to developmental optometrists. If however, a student had an eye injury or eye disease he/she would have been referred to an ophthalmologist, a medical doctor specializing in eye diseases, injuries and surgeries. In order to not appear to favor one eye doctor over another, it was important to provide, at least 3 names or refer them to websites to find a professional.

In addition, I did and I recommend:

  • having a developmental optometrist on your advisory board.
  • working with your local Job and Family Services, social service clubs like Kiwanis, United Way, etc. to refer your student for financial assistance to get appropriate eye care. (Unfortunately the student may not choose the type of eye specialist which can be a problem, if that doctor does not work with their type of need.)
  • for those who need help, but cannot or will not get it, provide a container of glasses of different strengths for students to choose and use in your classroom to magnify what they need to read. This is not a fix, but a compensation and the instructor must allow the student to choose any strength of glasses for him/herself or to not use them at all.

As indicated above, I promised to share the Lucy Johnson Nugent story with you. Here it is…

The Story of Lucy Johnson Nugent
The Optometric Extension Foundation has generously given us their permission to reprint it.

When President Lyndon Johnson was in office, his daughter, Lucy Johnson, suffered from poor grades and learning difficulties due to learning related vision problems. Her story shows us that anyone, regardless of status or income, may struggle with visual or perceptual dysfunction. Due to poor vision screenings, most of these problems are missed in childhood, and continue through adulthood. The following story was written by Lucy Johnson Nugent and appeared in “Family Circle” Magazine. The Optometric Extension Foundation has generously given us their permission to reprint it.

At 16, I was an underachiever in school and had been most of my life. I had been told- as the result of every kind of test imaginable- that I was a relatively bright child. There were times when I actually believed it and would go home and spend hours writing a paper I thought so brilliant a special assembly would be called to have it read- only to have my teacher tell me, “Oh, Lucy can’t you see where you made mistakes?” (But that was the crux of the problem. I couldn’t really see.)

The fact that we use the word “see” to mean understand indicates just how important vision is to our learning process. Here I was, the younger daughter of the man who was then Vice President – and a few months later became President- of the United States. My father certainly had the desire and the means to have my health problems diagnosed and treated. And yet, I had a major visual problem that went undetected for many years. I came from a family of achievers and worked diligently at school, but no matter how hard I tried, I found it impossible to rise from C to even a C+. Not only were my academic abilities affected, but because my eyes did not work well together, my total coordination was poor. And because I was physically uncoordinated, I was inevitably the last choice for team games throughout my childhood. And so, at 16, I was on my way to dropping out. You can’t face the frustration of not being able to succeed indefinitely without wanting to run from the scene of you failure.

Fortunately for me, my problem became so acute that I started blacking out during tests. Finally, as a last-ditch effort, Dr. Janet Travell, then White House physician and a lovely lady, suggested that I visit a local optometrist, Dr. Robert A. Kraskin. We had never considered going this route before because I apparently had no acuity problem. (In fact, the Snellen eye chart indicated that I had 20/20 vision.) Dr. Kraskin told me that my eye coordination was poor. In response to my request, he supplied me with the following information about my type of visual difficulty:
“This type of problem arises initially as a reaction to stress created by the use of the eyes for close work and, in turn, brings about an interference in the coordination of the visual system. In other words, there results a dysfunction in the coordination of both eyes which reduces and lessens the ability to derive meaning from that which is seen. Not only is reading efficiency restricted, but there is also difficulty in general coordination activities, such as sports, which are highly dependent upon the use of visual information. Thus, hand-eye activities are limited. More frequently than not, there are no measureable ocular defects (such as nearsightedness) and 20/20 visual acuity usually is measured. “Fortunately, this type of visual problem can be alleviated. Generally, glasses alone will not solve the problem, although the use of proper glasses for close work is an essential aspect of the proper therapy. To alleviate the problem, a program of activities and exercises is recommended.”

When I began my visual training course I was probably the most belligerent patient Dr. Kraskin ever knew. (Since I later worked in his office, I can tell you this attitude is not uncommon among people who are frustrated by visual difficulties.) I complained constantly. I couldn’t see the sense of being yanked from my study hall to do seemingly senseless exercises- like drawing circles on chalk boards, or writing down numbers flashed from a tachistoscope onto a screen, or putting pegs in proper holes, or tracing pictures through a machine called a cheiroscope. (Actually Dr. Kraskin was teaching me to use my eyes as a team.) Then came that November day in 1963 that none of us will forget. As a nation we endured great trauma and transition. As an individual whose father’s responsibility it was to lead our nation, I felt the tension of the time acutely. My adjustment was quite a demanding one. In fact, my teacher expected my grades to stay on the low level they were- or even go down. Instead they rose a grade point per subject- and then kept on rising! From then on, my grades improved and a year-and-a-half later I had gone from Ds to Bs. During my freshman year at college, I made the honor roll- and for someone who had been on scholastic probation for so long, this achievement was a thrilling one indeed. Also, my physical coordination noticeably improved. I was still far from being an athlete- but I’d come a long way. Then, I had a long way to come.

During the summer of 1964, I began to reflect on how my life had been radically changed by my visual training. The memory of my early resentment and rebelliousness was still vivid- and I felt that I could not just reap the benefits I’d had and walk away. I knew the frustration that students in visual training were going through- having faced these problems myself- and decided to work for Dr. Kraskin as an assistant during the summer. I worked that summer and the following summer, while I continued to take training myself. During that time, I saw a bright little boy who was having difficulty in kindergarten transformed from an angry failure into a happy, successful student. I saw youngsters like myself go from failing grades to the honor roll. I saw young men eager to be military pilots make such marked improvement that they finally achieved their wish. One young girl who won my heart had had two unsuccessful operations to correct strabismus (crossed eyes). With persistent effort, she achieved a marked degree of control. Out of my own personal experience first as a patient and then later as assistant, I found a permanent vocation in helping the visually disadvantaged child. When a preschool vision screening program, Volunteers for Vision, was born I was asked to be national honorary chairman and later became a member of their board of directors.

Since the time I first saw Dr. Kraskin, I have graduated from high school, have attended college, have married and have been blessed with two lovely children. As a mother, my interest in VFV has not dimmed at all; it has only grown. In 1969 I formed a local chapter of VFV in Austin, Texas where I now live. During our first six months in operation, we screened 2100 children. I speak as an interested mother, but I am by no means an authority in this field. My only hope is that this simple testing, which only detects gross visual problems, will serve as an impetus to get parent to take their children to a vision specialist of their own choosing. For, just because your child passes a test, he is not necessarily problem free. The three major tests- the Keystone Telebinocular, the Titmus Vision Screener, and the Massachusetts Vision Test Screener- are not substitutes for a professional examination. As a parent, there are many things you can do to promote good vision. Start at birth by hanging toys and mobiles over the crib to develop hand-eye coordination. Later, encourage your child to use proper lighting and posture when he reads, and to maintain adequate distance for reading, studying or watching TV. There are also danger signals a parent can look for. Do your child’s eyes frequently “run,” as if he were crying? Does one eye turn involuntarily? Does your child have persistent sties about his eyes? What about his reading habits? Does he (or she) experience headaches or nausea; does print blur after only short reading periods? Does he see double, squint or omit words or letters when writing? Does he have hand-eye coordination problems? One indication of this is a need to touch things in order to understand or interpret information. Helping someone to see better is a magnificent achievement, particularly since seeing and understanding are considered synonymous in our society. For as I once pointed out in a speech I made a few years ago, if the key to a better society is education, then the key to a better education is better vision. If you don’t have that key, you can’t open the door to a better life.

For further information or research on vision go to: (What is said about children usually applies to adults as well.)

  • Parent Advocates for Vision Education pavevision.org
    • (Example of a vision problem; Hidden Disability Pamphlet and Testimonial DVD; Find a doctor)
  • College of Optometrist in Vision Development covd.org
  • YouTube- Vision Therapy Videos – Yahoo Search (Lots of information)
  • Wow Vision Therapy http://wow.vision.net
    • (Lots of information, facts and figures, research and videos, even Skype distance therapy)
  • Vision Therapy Institute visiontherapysc.com
    • (Adult checklist; Vision Therapy and Vision terms explained; Find a doctor; etc.)
  • Optometrists Network children-special-needs.org (Vision Therapy; Find a Doctor; Vision and Learning; Vision and Reading, etc.)
  • Optometric Extension Program Foundation http://www.oepf.org