BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 430
AUTHOR: Wright
AMENDED: April 18, 2013
HEARING DATE: May 1, 2013
CONSULTANT: Robinson-Taylor
SUBJECT : Pupil health: vision appraisal: binocular function.
SUMMARY : Adds the assessment of a pupil's binocular function to
the existing vision appraisal currently conducted on school
campuses.
Existing law:
1.Requires, upon first enrollment in a California school
district of a child at an elementary school, and at least
every third year thereafter until the child has completed the
eighth grade, the child's vision to be appraised by the school
nurse or other authorized person, as specified. Requires
results of the appraisal to be entered in the health record of
the pupil.
2.Requires the appraisal referenced in 1) above to include tests
for visual acuity and color vision. Requires color vision to
be appraised once and only on male children in the first
grade.
3.Permits the appraisal referenced in 1) above to be waived, if
the child's parents so desire, by presenting a certificate
from a physician and surgeon, a physician assistant, or an
optometrist providing the results of a determination of the
child's vision, including visual acuity and color vision.
4.Requires a report to be made to a child's parent or guardian
when a visual defect has been noted as a result of the
appraisal referenced in 1) above. Requires the report, if
made in writing, to request the parent or guardian to take
action to correct the defect. Requires the report to be made
on a form prescribed or approved by the Superintendent of
Public Instruction. Prohibits the report from including any
recommendation suggesting or directing the pupil to a
designated individual or class of practitioner for the purpose
of curing or correcting any defect referred to in the report.
Continued---
SB 430 | Page 2
This bill:
1.Adds the assessment of a pupil's binocular function to the
existing vision appraisal currently conducted on school
campuses every three years until the student completes eighth
grade.
2.Specifies that binocular function appraisals need not begin
until the student has reached third grade.
3.Authorizes the binocular function appraisal to include a
validated symptom survey developed during a National Institute
of Health clinical trial and published for use in the public
domain.
4.Adds binocular function to the list of appraisals that may be
completed by a physician and surgeon, a physician assistant or
an optometrist in lieu of the appraisals completed at school.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
1.Author's statement. According to the author, school vision
testing relates to distance vision, basic refraction, and eye
health but does not address vision needs for reading which
require testing of vision closer to the face. Current testing
in schools is limited to using the eye chart for acuity one
eye at a time, which cannot reveal problems of eye
coordination that can impact reading. The author maintains
there are a significant number of students who are not
identified and cannot tell us they have reading problems. A
child can have perfect 20/20 acuity and have vision problems
that keep them from reaching their full potential. The result
is less reading, more required time to do homework, behavior
problems and possibly poorer grades. The best teachers in the
world cannot help this student. The author argues that by
conducting a simple survey to evaluate binocular function
during the vision appraisal that is already required under
existing law, parents can be informed if their child is
identified as having a problem with binocular function
potentially getting the student the appropriate assistance
that they need.
2.Vision problems in children. According to the National
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Association of School Nurses (NASN), vision problems are the
fourth most prevalent class of disability in the United States
and one of the most prevalent conditions in childhood. NASN
maintains that this is an extremely important statistic
considering that 80 percent of what children learn comes
through their visual processing of information. According to
the Centers for Disease Control and Prevention (CDC) impaired
vision can affect a child's cognitive, emotional, neurologic
and physical development by potentially limiting the range of
experiences and kinds of information to which the child is
exposed. Despite the importance of appropriate vision
testing, the CDC reports that nearly two in three children
enter school without ever having had a vision screening.
3.Binocular function. According to the College of Optometrists
in Vision Development (COVD), binocular function is the
coordinated movement and focus of two eyes working together.
Close work requires focus of both eyes inward on close
objects, such as when reading books, writing papers, and
viewing computer screens. Binocular function skills are
learned and developed during early childhood. According to
COVD, convergence insufficiency is the inability to maintain
binocular function while working at a near distance. When the
eyes are unable to converge easily and accurately, problems
may develop such as: eye strain; headaches; double vision;
difficulty reading and concentrating; avoidance of near work;
poor sports performance; and, dizziness or motion sickness.
Convergence insufficiency is diagnosed by an ophthalmologist,
optometrist or orthopist after both obtaining a history of the
patient's symptoms and measuring convergence ability.
Binocular function generally cannot be improved with eye
glasses or surgery. A program of vision therapy may be needed
to improve eye coordination abilities and reduce symptoms and
discomfort when doing close work.
4.Double referral. This bill was heard in the Senate Education
Committee on April 10, 2013, and passed with a 9-0 vote.
5.Prior legislation. SB 606 (Vasconcellos) of 2001 would have
required the existing student eye examination to include
screening for binocular function, ocular alignment, ocular
motility, and near visual acuity. SB 606 was held on the
Assembly Appropriations Committee's suspense file.
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AB 1095 (Wright) of 2001 would have required every student,
within 90 days of entering grade 1, to undergo a comprehensive
eye exam that includes, in addition to ocular health and
distance and near visual acuity, additional evaluations of
visual skills such as eye teaming, focusing and tracking that
may impact a child's ability to read. AB 1095 was held in the
Senate Appropriations Committee's suspense file.
AB 1096 (Wright) of 2001 would have established a pilot program
for schools scoring in the bottom 20% on state achievement
tests, to administer to poor readers a comprehensive eye
screening and remedial vision training. AB 1096 died on the
Senate Floor's inactive file.
6.Support. According to the California Pan Ethnic Health
Network (CPEHN), while testing for acuity is important in
identifying children who may need glasses, it does not address
how well the two eyes work together while reading. Emerging
data shows that reading speed and fluency are impacted by poor
eye coordination. Research also indicates, according to
CPEHN, that reading abilities in third grade act as a
barometer for later school success, since children who read at
grade level are more likely to graduate from high school,
pursue further education or get a job. The California
Teachers Association (CTA) writes in support that the results
of a limited pilot project validated that low performing
elementary school students who participated in the project
demonstrated an average of 25 percent improvement in their
reading fluency in just two months. CTA maintains that
studies from around the country confirm that many students
with poor or below grade level reading skills suffer low
"eye-brain coordination" and often have problems with
coordinating their eyes, tracking and scanning, or re-focusing
their eyes rapidly.
SUPPORT AND OPPOSITION :
Support: California Teachers Association (sponsor)
Advancement Project
Congress of Racial Equality
California Pan-Ethnic Health Network
California Federation of Teachers
Disability Rights California
Hintha Consultant Company
Los Angeles Tenth District PTA/PTSA
Los Angeles Unified School District Board of Education
Small School Districts' Association
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The Honorable Diane Watson, US Congress, Retired
The Willie L Brown Jr. Institute on Politics and
Public Service
27 individuals
Oppose: None on file
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