Dear Colleagues,
(Apologies for cross-posting)
Attached are a set of guidance notes following the inquiry into the issues and provision of advice and services for students experiencing visual stress. (The notes are also pasted below in case anyone has difficulty in downloading the document.)
Thanks are due to Paul Dilley for his invitation to undertake this as well as to all those who put in considerable time and effort into this over the past year, as well as to colleagues who emailed off list raising questions, offering information and in general supporting the progress of this delicate and complex question. The project was underwritten by the Central London Assessment Service and the North London Regional Access Centre.
Regards,
Penny Georgiou
CLASS/NLRAC
Reading Difficulties in Higher Education:
To Colour or Not to Colour
Guidance Notes
Reading Difficulties and Higher Education:
Reading difficulties, usually presenting within a context of specific learning difficulties, are often exacerbated by visual processing issues.
These guidance notes have emerged from a discussion by practitioners in the field wanting to know how best to advise students presenting with reading difficulties. There have also been questions about what cannot and cannot be funded under the DSA, as well as question about what to look for in identifying discreet problems in visual processing.
Discussion has revealed that a much higher proportion of students at university (with SLD, as well as some without) who are experiencing difficulties than was previously thought. This is probably due to the emphasis on both volume and detailed understanding of text-based information required in education, which is much more exacting than in everyday life.
The distinction between problems arising in everyday life and what is due to the demands of the programme of study has been a key principle in establishing the logic followed by these guidance notes.
Visual processing issues often remain discreet; either due the inhibiting effects on reading activity through avoidance, or because the demands of study have been manageable within the bounds of these inhibiting effects.
Problems with the visual processing of text can arise from many conditions, the most common of which are visual acuity, binocularity and accommodation. In addition to these, and of particular interest here, is the condition variously named as: Meares-Irlen Syndrome; Scotopic Sensitivity Syndrome; Colour Sensitivity and Asfedia. For the purposes of this paper, the term that will be used to refer to these conditions is “Visual Stress”.
For a more information about the various conditions:
http://ncs-video.wmin.ac.uk/class.html
DfES and DSA:
The enquiry into reading problems within an HE context included consultation with the DfES, who have now clarified further what can be funded by the DSA. This being any expense which precisely arises from the programme of study, rather than what can be deemed to be adjustments that affect everyday life. Assessment for and treatment of problems of binocularity, accommodation and visual acuity are part of everyday life and so cannot be funded by the DSA. What can be funded by the DSA is the assessment and adjustments arising from Visual Stress, which is deemed to arise as a consequence of the programme of study.
There is also a question about what kinds of adjustments can be funded. Those that are specific to reading and other study activities, such as coloured overlays and adjustments to background colours of the computer screen, as well as the assessment identifying the problems and adjustments
Identifying possible signs of visual stress:
It is important for us to bear in mind that students are often not aware of having difficulties, or even that problems such as weekly headaches are unusual. If students exhibit uncertainty or hesitation when replying to the yes/no we need to ask for further clarification/detail.
o blurring of text or other visual phenomena, text moves etc.
o losing of place in text
o skipping lines
o needing to track text with a ruler or pen.
o headaches, migraines, eye fatigue
o chronic avoidance of reading – hence, possibly, no headaches.
o not being able concentrate on reading for extended periods
o difficulties with reading speed, with discerning meaning from text; with remembering, or retaining what has been read.
o difficulties with lighting: bright lights; artificial lighting (lectures); glare from white boards; or at a brightness or crowding on a computer screen; dance or art studios with white walls.
o compensating strategies, such as use of high zoom size, large fonts, sans serif fonts, such as arial or comic sans, highlighter pens to give text perspective and so enable meaning to emerge.
Referral for diagnostic assessment:
If it looks likely that visual stress may be a component of reading difficulties, then a referral should be made to an optometrist with knowledge and experience of learning difficulties and the relation with colour.
* Broadly speaking, this may either identify or rule out other possible issues, such as visual acuity, ocular accommodation, binocular vision, or problems with eye movements. Possible interventions could be
o Spectacles for acuity
o Referrals for other medical problems that may be occasionally identified as a consequence.
o Eye exercises
If colour is considered to be an issue, the interventions may include:
o Coloured overlays
o RGB values for the computer screen
o Tinted spectacles
· The optometric assessment to rule out other conditions would not be funded by the DSA, as it comes into the domain of a ‘medical intervention’. As indicated above, the DfES has taken the view that they eye-care aspect of the adjustment falls within the remit of a ‘medical’ intervention, as well as being of a more general, rather than study specific nature and, therefore, cannot be funded by the DSA. Hence, students should be advised that they need to discuss possible costs with the optometrist prior to the assessment. Prices vary between suppliers.
· What can be funded by the DSA is the screening for colour sensitivity and the adjustments arising therefrom. Such as,
* tinted lenses, (where problems are ‘global’, going beyond working at a desk with paper or at a computer screen.)
* coloured overlays
* adjustment to background colours, as well as other advice related to this issue.
· Providers of services who are not eye-care specialists will be expected to see evidence of an eye care examination prior to providing DSA funded services for colour sensitivity.
· Some referral pathways:
Eye-care practitioners
* Optometric practitioners, who have been trained to identify a range of other conditions that may cause visual stress. This website provides contact details of some local practitioners:
http://www.ceriumvistech.co.uk/Specialists.htm
Colour sensitivity screening and adjustment:
* Optometric practitioners- coloured overlays/tinted spectacles
* Irlen UK - tinted spectacles/overlays.
* Tintavision – coloured overlays, RGB values for background colours.
· Some further points to bear in mind:
* ‘The blue light problem’: recent research has indicated that blue light may be more likely to accelerate macular degeneration, which affects us all and is linked to ageing.
* The optimum shade of filter may shift, rendering the need for a reassessment. Hence, there may be a need for review as the need arises.
* The optimum shade may vary due to changes in ambient lighting.
Penny Georgiou
On behalf of
Central London Assessment Service: CLASS &
North London Regional Access Centre: NLRAC
