Support from other professionals

The survey showed that professionals from other disciplines provided support to pupils and staff in special schools.

Some specialist teachers (QTVIs) regularly supported pupils in special schools, e.g. weekly or half-termly. Others provided intermittent support, e.g. as and

in Braille, touch-typing and listening and comprehension skills. Specialist teachers also trained pupils how to use their low vision aids. It is encouraging that pupils in special schools were reported to be receiving the specialist support that they needed.

Some specialist teachers were also reported to provide support to special school staff, mainly by offering advice and delivering training. Some training was delivered as INSET (In Service Educational Training), which allows all members of staff to undertake Continuing Professional Development activities.

It was also reported that mobility specialists provided support to pupils and staff, e.g. teaching cane skills and delivering training respectively. This is re-assuring, indicating that the pupils' educational and non-educational needs are being met.

Optometrists and orthoptists were reported as providing a range of support in a few schools. This included assessing and testing pupils' vision, briefing staff about how to assist pupils with visual difficulties and providing information and advice. It is encouraging that there are already links between some eye health care services and special schools. This may be particularly useful if the vision care programme is subsequently rolled-out throughout Wales.

5.5 Strengths and limitations of the study

One of the main strengths of the study was that most special schools in Wales engaged with the questionnaire, resulting in an overall high response rate. However, some schools, which did not complete the initial postal questionnaire, provided only core information during a telephone interview with the author. The result of this was that the sample size for some questions was too low to allow any firm conclusions to be made.

The results of the questionnaire indicated that some special schools

misinterpreted some of the questions. In particular, there was concern about the results of the question about screening: some schools reported that screening did not take place but subsequently noted that QTVIs carried out screening.

that was perhaps not entirely accurate. In addition, some schools reported estimates rather than accurate data. For example, two schools recorded the number of pupils with visual impairment as 'approximately 31' and 'less than 10'.

It is also worth noting that one of the limitations of postal questionnaires is the lack of control over who completes them (Williams 2003). In this study, different members of staff completed the questionnaires, including head teachers,

teachers, school nurses and members of the administration team. This can be problematic because the school nurse or head teacher, for example, may have a more robust understanding of the vision screening processes in school than some other members of staff.

Despite the limitations, the survey provided a useful insight about current vision screening practices in special schools in Wales, the number of pupils with sight problems and the support provided by professionals from different disciplines.

5.6 Conclusions and future work

The survey showed that there is a need to offer training to special school staff, notably teachers and learning support assistants, about how to support pupils with sight problems.

The survey also showed that there was little uniformity in the provision of vision screening in special schools in Wales. It also highlighted that there are likely to be children and young people in special schools with uncorrected refractive error or undiagnosed visual impairment, sight problems or ocular disorders.

The results of the survey provided the impetus for the pilot vision care

programme for pupils in special schools in Wales. Five special schools took part in the pilot project in which an optometrist carried out sight tests with all the pupils who had consent to take part. The results of the pilot confirmed initial concerns about the number of pupils in special schools with uncorrected refractive error and undiagnosed or undetected sight problems and ocular disorders. For example, 38% (n=58) of pupils who had a sight test in the pilot project had never had a sight test. Moreover, 53% (n=80) of pupils who had a sight test during the pilot received a prescription for glasses. This included 36

pupils who received a prescription for the first time. In addition, 47% (n=71) of pupils who had a sight test were found to have at least one ocular disorder.

At the time of writing, the evaluation report for the pilot project has been

submitted to the Welsh Government. A number of recommendations have been made in the report, including that an optometric service should be provided to pupils in special schools. It is hoped that the evidence base provided by the pilot project will determine the future provision of eye care services for pupils in special schools in Wales.

Chapter 6

Reflection

6.1 Introduction

This chapter reflects on various elements of the thesis, including a description of the link between the two studies and a commentary about the ways in which some data were analysed and reported.

6.1.1 The common link between the two studies

The author acknowledges that the two studies presented in the thesis are different in terms of subject matter and research techniques. In the first study, a multi-disciplinary training programme was evaluated. This included collecting and reporting some longitudinal data (one year after the training). The second study focused on the provision of eye care services in special schools in Wales.

Although the two studies are different, the common link between them is the Children’s Low Vision Project in Wales.

The multi-disciplinary training programme was provided as part of the Welsh Low Vision Service (now Low Vision Service Wales) and the Children’s Low Vision Project in Wales. These two projects, both funded by the Welsh

Government, run alongside each other as part of the Welsh Eye Care Initiative (WECI). When planning the training programme, it was acknowledged that it needed to include objectives relating to children and young people, e.g. to improve referral processes for children and young people. The training also provided an opportunity for Qualified Teachers of pupils with Visual Impairment (QTVIs) to interact with eye health professionals (optometrists) and colleagues from social care and vice-versa. The reported usefulness of the multi-

disciplinary approach of the training programme, along with data that showed that the training increased referrals of children and young people, confirmed that the training was beneficial to the Children’s Low Vision Project.

The Children’s Low Vision Project in Wales, which started in 2004, had focused mainly on the provision of low vision services for children and young people in mainstream schools, e.g. the production of the Low Vision Toolkit. However, as the prevalence of sight problems is higher among children and young people

with special educational needs than among the general childhood population, it was appropriate that the Children’s Low Vision Project acknowledged this. The author, the Children’s Low Vision Advocate for Wales, carried out the special school study to collect and present data about eye care services in special schools in Wales. These baseline data provided the evidence base for the implementation of a pilot eye care service in special schools in Wales. The pilot was carried out as part of the Children’s Low Vision Project. The results of the pilot provided further evidence for the need for a ‘vision care programme’ for all special schools in Wales. The vision care programme is currently being

developed by a planning group on behalf of Welsh Government.

Therefore, the two studies both benefited the Children’s Low Vision Project in Wales and, ultimately, contributed to improving and developing eye care services for children and young people.