Learning Disabilities

LEARNING DISABILITIES

The Role Of the Ophthalmologist in the Management of Children with Learning Difficulties/Learning Disabilities:

Following requests from many Ophthalmologists, the Visual Development in Childhood Committee has been looking at the management of children with learning difficulties. The Royal Australian and New Zealand College of Ophthalmologists and the Australian College of Paediatrics have endorsed a joint statement of the American Academy of Paediatrics, American Association of Paediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology on Learning Disabilities, Dyslexia and Vision.

The College also held a media conference on this subject in conjunction with the Department of School Education in NSW, the Australian College of Paediatrics, and the Orthoptic Association of Australia.

It is important that the ophthalmologist communicate in writing with the child's school. This may best be done by providing a written report to the child's parents and advising them to discuss the report and the difficulties the child is experiencing direct with the classroom teacher.

Each State has a different education system.

New South Wales

The Department of School Education is divided into ten regions. Each region has one person, a Principal Education Officer for Special Education, who is responsible for the co-ordination of all support services. To seek advice from this Officer, consult the NSW State Government Section of the telephone book under "School Education, Department of" and locate the regional office for the appropriate area.

Victoria

The Directorate of School Education has advised that most students with learning difficulties are catered for by the class room teacher who has the responsibility for the planning and implementation of the educational program of each student in the class. If further support or advice is required, however, advanced skills teachers may assist, or district school support staff (guidance officers, speech pathologists, visiting teachers and social workers) may provide programs concerning behaviour management, cooperative learning in the classroom and the development of attention, literacy and numeracy skills.

If, despite these efforts the child is still experiencing problems, the school Principal may request the parent's permission to refer that student to a Directorate guidance officer, or through District Liaison Principals to other student services staff. In some instances the services of other government agencies may be required, such as the Royal Childrens' Hospital or Western Hospital, Footscray, for a medical or neurological assessment in order to determine the appropriate support.

Queensland

Children with learning difficulties have often been assessed by a guidance officer at school. It is generally agreed that a multi-disciplinary effort by appropriate medical, allied health professional and psychological personnel offers the most comprehensive service to children with learning difficulties. Access to special services can be gained via referral from the GP or local hospital doctor.

Referral then takes place to a paediatrician, a paediatric outpatient at a major regional hospital, child health services or a specialised child development and learning difficulty clinic at a major teaching hospital. More isolated regions have visiting paediatric services e.g. Charleville and Longreach which are able to offer appropriate services. It is appropriate to write to the school indicating whether or not the child has any significant ophthalmic pathology. Where there has been a normal ophthalmic examination it is appropriate to point out in the letter that glasses and eye exercises etc do not have a role in the management of a particular child's learning difficulty/disability.

South Australia

The Education Department recommends a one to one tuition ration to establish a good student/teacher relationship, after an assessment by SPELD, for children with learning difficulties.

An ophthalmologist of first contact can either deal with the situation himself; refer the child to the Childrens' Hospital; refer the child to a paediatric ophthalmologist; or refer the child to SPELD. In either case, the parents should be advised to communicate directly with the school about the difficulties the child is experiencing.

Western Australia

Avoid was created when the Department withdrew from this responsibility and left it to the individual Schools. The Operations Branch of the Department is presently in the process of writing their policies following the recommendations from the Ministerial Task Force Report (Shean Report) which was released in June 1993. It is anticipated that the policies will be ready towards the end of the year.

Tasmania

There are three regional subdivisions to its Family and Child Health Service, each of which provides the School Health Sisters to carry out visual screening procedures on children in their respective regions of Hobart, Launceston, or Devonport, It is best that the Tasmanian ophthalmologists write directly to the appropriate regional head office stating the child's name and school of attendance so that they can be traced. If there is no ocular abnormality but the child requires remedial teaching, then it should be stated in correspondence to the regional head office.