title: A lack of vision: evidence for poor communication of visual problems and support needs in education statements/plans for children with SEN.
abstract: OBJECTIVE
  Visual dysfunction is more common in children with neurological impairments and previous studies have recommended such children receive visual and refractive assessment. In the UK, children with neurological impairment often have educational statementing for Special Educational Needs (SEN) and the statement should detail all health care and support needs to ensure the child's needs are met during school life.
  
  
  METHODS
  This study examined the representation of visual information in statements of SEN and compared this to orthoptic visual information from school visual assessments for children in a special school in Northern Ireland, UK.
  
  
  METHODS
  The parents of 115 school children in a special school were informed about the study via written information. Participation involved parents permitting the researchers to access their child's SEN educational statement and orthoptic clinical records.
  
  
  RESULTS
  Statement information was accessed for 28 participants aged between four and 19 years; 25 contained visual information. Two participants were identified in their statements as having a certification of visual impairment. An additional 10 children had visual acuity ≥ 0.3 logMAR. This visual deficit was not reported in statements in eight out of these 12 cases (67%). 11 participants had significant refractive error and wore spectacles, but only five (45%) had this requirement recorded in their statement. Overall, 10 participants (55%) had either reduced visual acuity or significant refractive error which was not recorded in their statement.
  
  
  CONCLUSIONS
  Despite additional visual needs being common, and described in clinical records, the majority of those with reduced vision and/or spectacle requirements did not have this information included in their statement. If visual limitations are not recognized by educational services, the child's needs may not be met during school life. More comprehensive eye care services, embedded with stakeholder communication and links to education are necessary to improve understanding of vision for children with neurological impairments.
authors.affiliation: Vision Science Research Group, Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, BT52 1SA, United Kingdom. Electronic address: ja.little@ulster.ac.uk.
authors.forename: J-A
authors.initials: JA
authors.lastname: Little
authors.affiliation: Vision Science Research Group, Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, BT52 1SA, United Kingdom.
authors.forename: K J
authors.initials: KJ
authors.lastname: Saunders
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003142:Communication; D004519:Education, Special / Q000458:organization & administration*; D005139:Eyeglasses; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D009660:Northern Ireland; D012030:Refractive Errors; D012574:Schools / Q000458:organization & administration*; D014786:Vision Disorders; D014792:Visual Acuity; D055815:Young Adult
keywords: Co-ordinated support plan; Education health and care plan; Educational statement; SEN; Statutory assessment; Vision; Visual impairment