THE EYE PROBLEM IN THE SCHOOLS
A Paper read before the 1914 meeting of the North Dakota State Association of Opticians. It was printed in the May, 1914, issue of "The Optical Journal and Review," also in the same issue of "The Keystone"
I do not know how fully people appreciate the importance of the eye as an agent, or factor, of human cultivation. Judging from the amount of work it is being made to do in our schools and in nearly all our processes of education, we might perhaps be led to feel that its importance is fully appreciated, indeed, that it is being looked upon as the sole factor, or agent. But, on the other hand, this very excessive use, especially in the early school years, leading, as it does in such a large percentage of cases, to serious impairment of vision, almost tells us that its great value is not appreciated. If it were, should we be likely to abuse it as we do in these early years and thus render it incapable of performing its larger, fuller use later on? The attitude seems rather to be that its conservation is not thought to be necessary. That, however, springs from ignorance rather than from studied disregard.
But let us look for a moment at the processes of education and note where the eye comes in. If there is anything upon which leading educators are now practically agreed, or upon which they tend to agree, it is that education as a process is a matter of development rather than the learning of knowledge facts. Now, that development is analogous to the growth and development of the plant, that is, it is brought about thru nourishment. In the plant this nourishment is taken in thru the roots, becomes absorbed and assimilated and thus ministers to growth and development. In the child, looking at it from the physical point of view and having in mind psychical, not physical, nourishment, the sense organs serve this purpose. Did you ever stop to think that the sense organs form the only connecting link between the great outside world, which serves as raw material for the nourishment, and the inner life of the child, the development of which we are seeking? Did you ever stop to think that these sense organs, the eye, the ear, the nose, the tongue, and the surface of the body as the organ of touch, form the only possible avenue of approach to that inner life? Cut off, or close up, these avenues and no development of this inner life would be possible in the slightest degree. Thus considered, these same sense organs, simple as they seem to be, leap into importance that almost staggers one's thought. The most priceless possession of any child, I often say to my classes in education, is made up of their eyes, their ears, their noses, their tongues, and their finger tips—simply because thru them is poured the nourishment that sustains psychic life and ministers to the development of the same.
Of these five sense organs, the eye is, par excellence, the one of value. More psychic nourishment is poured into the laboratory of psychic life thru this one channel alone than thru all others combined. Indeed, one of our most eminent scientific psychologists after making most careful investigation of the matter, estimates that the eye's contribution is about 74% as against the other 26% that comes thru all the other sources. If this relative value of the eye be even approximately correct, how eminently important it is that it be studied with close scientific accuracy, that it be guarded with the utmost and intelligent jealousy, and that it be cared for with the most scrupulous fidelity!
But what is the situation? The Optician and the Oculist have made the most careful, scientific study of the eye. They know it thoroly, both its possibilities of service and its limitations. And they have told the rest of us all about it. But let us see how intelligent we are in the use of the knowledge they have given us. They tell us that the eye of the child is undeveloped and that in the undeveloped state it should not be much used on small or close work. In other words, the child's eye is far-sighted. But at the age of six years we place the child in the school room, put a book in its hands, and compel its use, eyes or no eyes, as long as the child remains in any institution of learning. Why, gentlemen, we have gone mad on this book proposition. We act as tho we think that it is only in the book that knowledge can be found. We act as tho we think that it is only thru the printed page that psychic nourishment can reach the inner life of the child, whereas, as a matter of fact, both the knowledge and the nourishment that are appropriate to the child in all its early years are better obtained thru direct contact with the great outside world itself and by direct communication from the lips of the teacher. If this fact were fully appreciated and acted upon, we should, in two very definite ways, conserve this very important organ; for we should use the eyes upon objects at a greater distance thus preventing unnecessary strain, and allow other organs of sense to share with the eye in the work of gathering information and of appropriating mental nourishment.
Please do not misunderstand me. I am not underestimating the place and value of books, nor decrying their use. They are the storehouse of knowledge and the source of inspiration, but not for children. Our young children in school and out of school read too much—are too much tied to the book. Thru this prolonged and close use of the eye upon small and nearby objects for which, in its undeveloped condition, it is not fitted, the organ is permanently weakened and rendered incapable of its legitimate use later in life when the book is a necessity. And again, this excessive use of the eye causes an atrophy of the other organs that is really serious.
Nor is this all. The Optician and the Oculist have studied the matter so carefully and know the eye so thoroly in its various stages of development that they know exactly the size of type that children of various ages should use. And they know, too, the kind of paper that should be used in books for children. And they have told us all about it. But we systematically disregard all this information gained with such painstaking care, and instead of using the large clear type and the unglazed, soft tinted paper recommended, we persist in tolerating the unsatisfactory merely because it is a little cheaper. Penny wise and pound foolish we surely are. What we save now we shall have to pay later on with compound interest besides compelling our children to undergo physical pain and mental handicap.
And yet again. We are told by our scientific friends the relative amounts of window and floor space that the schoolroom should have in order to be adequately lighted! Not one in ten has as much window space as it should have, and a good portion of what has been provided is frequently covered up by shades thru the teacher's perverted notion of relative values—seeming to have greater appreciation for certain so-called artistic effects than for eye comfort and safety in work. And then again, these scientific friends of ours have told us that there should be in the schoolroom no cross lights; that the light should not shine upon the blackboards nor into the faces of the children, but that it should come only from the rear and the left and from above. They have found out, too, and told us, the proper shades of color for the walls—scientific knowledge, all of it, and therefore thoroly reliable. But how systematically do we disregard all this valuable information! In the construction of a new school building there is nothing that should receive more careful and scientific consideration than the matter of lighting, but too often the architect is either entirely ignorant of the entire matter, or else is selfishly interested in so-called architectural effects.
I do not mean that we all disregard all these things, that we have no school houses properly constructed, no school books properly printed, and no teachers intelligent and sensible in their handling of boys and girls. Not at all. During the last twenty years we have made long strides in advance along many of these lines in many places. But the bright spots are still the exception and not the rule. The friends of children and of the race need to keep vigilantly at work.
Now, let us look at the matter from another point of view. Let us ask what are the results of this persistent and widespread disregard of the normal conditions under which the eye should work and of the fundamental laws of eye development. What do we find? Why, we find just what you are prepared to expect after considering the above disregard. We find that, whereas at the beginning of school life the percentage of school children suffering from visual defects is relatively small, that percentage increases as we ascend the grades. In other words, the regular, systematic work of our schools is all the time weakening the eyes—all the time causing serious visual defects. Gulick and Ayers came to this conclusion as one of the results of their exhaustive investigation, made in 1908, which culminated in the well known work on "Medical Inspection of Schools," published at that time. This is all the more striking since they found that the prevalence of other physical defects steadily decreases as the years pass.
An investigation carried on in Jefferson City, Missouri, in 1907-1908, illustrates the point under discussion; 20% of all children in grades one to three inclusive were found to have defective vision, whereas in grades nine to twelve inclusive 40.5% were found thus handicapped. In some parts of Germany the increase in defective vision as children ascend the grades is seen to be much more marked than in our own country. In one particular study that comes to mind, a study of short-sightedness alone (published, however, some years ago) it was shown that the increase was from practically none at all to approximately 100%. In other words, the work of the schools had made practically every child near-sighted. And the general tendency seems to be in this direction. Indeed, I know of but one study in which a contrary tendency has been observed. And that was in a rural district—St. Louis County, Missouri—where a study was made about four years ago. Under the conditions observed there, the frequency of short-sightedness seemed to diminish with increasing age. And the reasons for this local tendency, being so directly contrary to the general tendency, men have been trying to understand. Various suggestions have been made such as the atmosphere of the rural as against the city districts being, in the main, more favorable from hygienic points of view; or the fewer pupils in the classes in school, thus enabling the teachers to give more personal attention so preventing undue eye-strain; and the shorter school year maintained in the country giving the children less prolonged periods of eye-strain. But whatever be the explanation of this interesting exception, it yet remains true that the regular work of the school, week in, week out, year after year, causes the eyes of our children to deteriorate, or at least the two go hand in hand with grounds for a very strong suspicion in the minds of those who have expert knowledge of the general situation that the one is the cause of the other.
With this point established, namely, that the work of the schools is but ill-adapted to the structure the nature of the child's eye, resulting in steady deterioration, let us try to see how widespread is such deterioration and how serious. This can best be done briefly thru the use of a few statistics taken from the results of investigations that have been made as to the physical conditions of our school children. From these results I disregard all figures save those that bear on the matter of visual defects since that is our one topic of discussion.
In Cleveland, Ohio, in 1906-1907, a very exhaustive and illuminating investigation was made under the general supervision of Dr. Wallin, one of the most eminent authorities on the relationship of the physical and the mental in the work of our schools. Dr. Wallin called to his assistance many experts, both medical and physical, and his report was a very noteworthy one from many points of view. I touch only two or three points here and there. In one school, the Mayflower, located in a fine residence section of the city, 972 pupils were examined, and 20% of them found to be suffering from some rather serious form of eye defect. In an East End school, another of the so-called better class of schools, 668 children were examined and 32.4% found with defective vision. Even more startling than these were the results found in a school of about the same size in what was called a "congested" district of the city. Six hundred and sixteen were examined and 71.1% found defective.
Another very significant fact was brought to light by this investigation—the disregard paid to the whole matter by parents and teachers. Perhaps I should not include teachers in speaking of this disregard since they have, at best, but advisory power. In the East End school, out of the 668 children examined, 216, or 32.4% were found defective, but only 43, or 6.4%, were being relieved by the use of glasses. And in the "congested" district the disparity was even more striking since out of the 437, or 71.1% of the entire number who had visual defects, only 11, or 1.8%, were being relieved.
In one investigation made in New York City in 1908, 1,442 pupils were considered, and 42% found suffering from eye defects. In Jefferson City, Missouri, in 1908, the results of the examination of 1,000 white children showed 36.5% suffering from somewhat serious visual defects; and many others in lesser degrees. Of these 1,000 children, 410, or 41%, were found to need the assistance of glasses, but only 38, or 3.8%, were being thus assisted.
In Los Angeles, California, in 1909, 5,000 children were examined, and 61% found to be suffering from the same trouble. Again, in Philadelphia, in 1909, the well-known Dr. Risley found, in an examination of 2,422 children, that 44.7% were continual sufferers from some form of eye trouble. I could easily cite similar results from many more studies, but surely these are sufficient. These are startling facts, and very serious when we think merely of this one fact alone without considering it in its relationship to anything else. But when we stop to consider the fact that these sufferers are children, in the schools, and are thus handicapped in their work of education—in their efforts to fit themselves for the struggle of life—it assumes even larger proportions and becomes truly appalling.
What does it mean? Why, it means, in terms of the school man, retardation and elimination. To the layman those words may need interpretation. Retardation means the checking of a pupil in his educational progress thru the grades, necessitating the spending of a longer period than that which is considered normal. For example, a normal pupil is one who enters school at six years of age and is promoted each year regularly; or "a pupil whose age and grade correspond to this standard." Thus, the standard age for a second grade pupil, during the year, is 7 years; for a fourth grade, 9 years; and for an eighth grade, 13 years; or in every case, five more than the number of his grade. If one is older than the number of his grade plus five, he is retarded by the amount of the difference; thus a twelve-year-old child in the sixth grade is retarded one year since a sixth-grade child should be but eleven years old. Somehow he has lost a year. Thru failure to do satisfactory work such a child has had to repeat the work of some one of his grades. Elimination means the dropping out of a child from school altogether before the regular course is completed. We find relatively little elimination in the lower grades since the compulsory attendance laws require attendance. But just as soon as the upper limit of age is reached there is much of it.
I do not know how closely you have followed this matter of retardation in the schools and elimination from them, but I think sufficiently to render it unnecessary for me to discuss the matter at length. Let me refer to but one study which is typical as showing the seriousness of the situation. In 1907, Mr. S. L. Heeter, at that time Superintendent of Schools in St. Paul, Minnesota, working under instruction of his Board of School Inspectors, made a very careful investigation as to the matter of retardation in the schools of that city. You may be surprised to learn some of the results. He found more than one-half, exactly 56%, of all the children in the schools at least one year behind normal grade, and many of them much more than one year behind. To be exact: 12,672 children were below grade. Of these, 6,328 were one year behind; 3,650 were two years behind; 1,689 were three years behind; 651 were four years behind; 221 were five years behind, and 133 were six years behind. Now, what is the cause of such a serious situation? Mr. Heeter, in his report of his findings, speaks as follows:
"There are evidently many causes of this phenomenal retardation—yet it seems likely that one of the largest factors ... is physiological, and that more attention given in our schools to the bodily conditions of our children will throw new light on our educational problems, and even on the subject of backward children, and of delinquency itself." "It appears," he goes on to say, "that the schools have been too exclusively concerned about the minds of children and too little concerned about their bodies. Much time and energy and money have been wasted in trying to make all children equal in mental power, without regard to physical inequalities, until now waste products are clogging our educational machinery." And Mr. Heeter's conclusion is that of all who have studied the matter with any care.
Let me now show the relationship existing between the two, that is, between retardation and physical defects. I can do it briefly by referring to the work of Dr. Cronin in New York City. This is but one instance, but it is typical of conditions. A few years ago, as chief Medical Inspector of the schools of New York City, Dr. Cronin read a paper before the School Hygiene Association of America in which he made the statement that an examination of all children reported as backward by various teachers revealed 95% of them as physically defective.
Thus, in a hasty way, but I think correctly, I have thrown the chief burden of backwardness in school, or retardation, upon physical defects. But our special topic is eye trouble. How much of this burden must be referred to this specific source? It is difficult to say exactly. But knowing as we do the great prevalence of eye defects among school children, from 20% to 71%, you remember, depending somewhat upon locality and environment; and knowing, too, the close relationship existing between the eyes of our children and the work of the schools (this school work, you know, is nearly all done with the eyes. It should not be, but it is); knowing all this, it is not beside the mark to say that a very large percentage of the retardation must be laid at its doors.
And what are we going to do about it? What should be done? The reform is easily seen to be a many-sided one. It is educational—our teachers should come to know that the book is only one, and not the chief one, of the many sources of knowledge open to the child; it is physiological—we should all know the eye better than we do, its normal use and its limitations; the reform is architectural—our architects and boards of education should realize that the seating and the lighting of school houses should receive most careful consideration; the reform is economic—we should come to appreciate the unwisdom of being "penny wise and pound foolish," and recall the old saw, "a stitch in time saves nine"; the reform is medical—we should get our people to see that thoro and regular medical inspection of all our school children is the only sensible method of procedure. And so I might go on naming phase after phase of the problem. It is so many-sided that we can not hope for its immediate and perfectly satisfactory solution. But there are certain quite specific ends in view that should at once and all the time be kept before us. Touching the matter of medical inspection, our state law, instead of being merely permissive should be mandatory, and should be made to apply to every school community in the state. Of course, the cry of expense would be at once raised, but it could easily be shown, were there time at my disposal, that it would be an economic mesure rather than one increasing the cost of our schools. Because every time that a child repeats a grade in school, that year's school work in the life of the child has cost the city or school community twice as much as it should. Whenever, as in the case of St. Paul, already cited, a child is two, three, or six years behind normal grade, there is an extra heavy burden of taxation placed on the city. Medical inspection, wherever it has been made effective, has resulted in lowering, very materially, the amount of retardation. And it is looked upon as saving the community very much more than it has cost, saying nothing at all about the added effectiveness of the child for the work of the school nor of his greater happiness. This statement could easily be substantiated were there time. But that is not necessary. It is so apparent that he who runs may read.
But the time when we can expect such a law to be put in force is, I am afraid, considerably removed from the present. Large bodies move slowly; we must have patience. We must keep steadily at it preaching the good gospel of reform. But in the meantime can we not hasten the glad day of full and complete medical inspection, and at the same time bring relief to a very large number of little sufferers, by throwing emphasis, whenever the opportunity offers, upon the phase of the subject that is before us this morning? The eye trouble is the chiefest of all those of a physical nature. It has far more to do in causing retardation of our boys and girls than any of the other physical defects, and therefore should receive its own prompt and vigorous attention irrespective of everything else. Upon this one point let us have immediate relief and keep it up as rapidly as possible. Let us adopt some program of action which will bring relief as quickly as possible to children suffering from visual defects. For I have no sympathy with the position taken by that foolish mother (perhaps I should be charitable and merely say "ignorant" mother. I think she was both ignorant and foolish), who said to me when I was urging her to have glasses fitted for her little girl, "Why, Mr. Ladd, I can't bear to think of Mary wearing glasses. I am going to keep them away from her just as long as she can possibly get along without them." I replied, "My good woman, if you have any regard for the comfort and well-being of your little girl, or if you care for her progress in school, instead of keeping glasses away from her as long as possible, you should see to it that she has the best that can be procured just as soon as they can be of the slightest assistance." I went on to tell her that it was entirely possible that the use of the glasses at that time for a year or two might enable her to do without them permanently later on. But she did not get them; of course not. They would not have added to the attractiveness of the little face. How hard it is for the unreflecting to deny themselves a present pleasure, whether in money or pride, for a future good!