A Howard County middle schooler who refused to do school work until he was granted accommodations for his visual impairment has become the poster child for a campaign to require more extensive vision screening in Maryland schools.
Atticus Carter, a 12-year-old student at Glenwood Middle School, was in Annapolis Wednesday to advocate for legislation that's being dubbed the "Atticus Act."
Sponsored by Sen. Gail Bates and Del. Trent Kittleman, Republicans from western Howard County, the measure would mandate school districts across the state to administer a computerized vision test that checks for more than a dozen conditions to all students in the first and eighth or ninth grades, and annually for any student with a special education plan.
The bill would also require teachers to take a training course designed to help them recognize the symptoms of vision disorders.
"There's a really old adage that an ounce of prevention is worth a pound of cure, and I think that what this particular bill does is it allows us to diagnose and treat early, and have savings in the long run," said Bates. "It's much easier to address (a vision problem) when the child is young and begin to work with it."
Ophthalmologists and teachers' groups, meanwhile, are opposed to the change, which they say is not backed by scientific research and could divert resources from other students with visual impairments.
"As far as the opthalmologic community and medical community are concerned, there is no computerized machine that can do all the things that the bill mandates," said Mary Louise Collins, a pediatric opthalmologist at the Greater Baltimore Medical Center in Towson. "I'm not sure how it makes sense to promote a machine that really doesn't have any science behind it."
Wednesday, Atticus and his mother, Catherine Carter, shared the story of how a vision screening at Costco changed the middle schooler's life for the better.
Atticus has 20/20 vision, which is why his family didn't at first suspect his eyes when reading and writing at school began to make him feel nauseous.
A doctor diagnosed Atticus with ADHD, but his issues didn't begin to improve until Carter took him to the big box chain for an eye exam. The optometrist there discovered Atticus has binocular vision disorder, or strabismus, a condition in which a person's eyes are misaligned. Drifting eyes gave Atticus double vision, headaches, dizziness and vertigo — and made completing schoolwork much more difficult, he recalled.
Once Carter learned the root of her son's problems might be vision, she took him to see a behavioral optometrist for therapy, which yielded improvements.
Now, "I can do homework in minutes instead of hours," Atticus said. After his schoolwork strike, he was given a laptop that allows him to dictate his assignments rather than writing them down.
Carter also discovered that three of her other children have visual impairments.
"I think it's just so important to understand that vision is more than how far you see, but how your eyes can process," she said.
By law, school systems already test students' visual acuity, but the Atticus Act would expand the conditions screened to more than a dozen.
Carter, Bates and Kittleman argue the extra screening could ultimately save the state money. An informational sheet that Kittleman distributed estimates the savings could be around $16 million if schools find that 1 percent of students with individualized education plans have vision problems that have been hampering their work, rather than learning disabilities.
And, they add, catching vision problems early might help keep children from getting so frustrated with school that they act out and end up in juvenile detention centers. Reducing the number of juvenile offenders by a quarter would save the state another $11.5 million, according to Kittleman.
Severna Park resident Lindsey Pence is advocating for the bill, too. The 34-year-old has struggled with vision problems for much of her life, and she's hoping her three-year-old daughter, McCall, won't have to do the same.
Pence hopes to see insurance policies expand to include vision therapy as a covered option. An original version of the bill proposed adding the therapy to Medicaid, but Bates and Kittleman decided to strike that recommendation after a state analysis said it would be costly. They plan on working to assemble a pilot program in a couple Maryland counties to study the cost and effects.
Opthalmologists, teachers skeptical
Opthalmologists caution against an assumption that many students with learning disabilities actually have undiagnosed visual impairments.
While strabismus makes reading and writing difficult, Collins said it is a rare condition that she would not classify as a learning disability. She noted that reading and vision use two different parts of the brain.
"There are no good scientifically based studies that show that treating children with vision therapy helps a reading or learning disability," she said.
Collins also worries that spending more money on vision screening would mean less money spent on children with impaired vision. A fiscal note on the bill estimates expanded screenings would cost the state $1.2 million in fiscal 2018.
"We would love to have an answer for parents of children with reading disabilities that is straightforward and simple," she said. "Scarce resources should be directed to scientifically proven treatments for disabilities, and not allocated based on anecdotal stories of improvement with one treatment. You want to make sure you're putting the resources in the area where there's science behind it."
Some teachers' groups have come out in opposition to the bill, as well. They argue the training requirements would place an "undue burden" upon teachers.
"It goes without saying that educators want our students to be healthy and ready to learn," the Maryland State Education Association, the state's largest teachers union, wrote in a letter. "We want to ensure that our students' medical and developmental needs are met so as to ensure they are ready to learn and succeed in our classrooms. However, this bill is not well suited to bring this about. And the burden upon our educators, particularly those who work with this very specialized group of students, makes the approach in this legislation ill advised."
The legislation had a hearing in the House Ways and Means committee Tuesday, where it will need a favorable vote in order to move to the House floor. Its sponsors in the House include legislators from both sides of the political aisle.
Carter is also lobbying Congress to require vision screenings for schools across the country.
"I want parents to know about this," she said. "It saves lives."