Prevent Blindness is profoundly concerned about a proposed rule from the Trump Administration that would fundamentally change the Head Start Program. Head Start provides comprehensive, high-quality, individualized services to support school readiness and learning for children, from birth through 5 years old, who are from families that have lower incomes. For participating children and families, Head Start provides critical health services, including vision screenings, that help set them on the path to a well-rounded, healthy life with every opportunity to learn.
While Prevent Blindness is reviewing the proposed rule and is working to better understand how its changes could affect the program and its beneficiaries, we are alarmed at a proposal that seeks changes to the comprehensive health screenings provided to children. Currently, Head Start programs are required to conduct evidence-based vision screenings within 45 days of a child’s first day in the program and refer a child who needs follow-up vision care to the appropriate provider for additional treatment and family services.
While the underlying statute will continue to require Head Start programs to conduct vision screenings, the proposed rule relaxes standards for how screenings are completed, potentially resulting in programs not following evidence-based guidelines. The rule also directs Early Head Start programs to coordinate with state and local entities to provide these services, reflecting the Administration’s broader effort to shift Head Start toward a more state-based model.
Early detection and treatment are emphasized as important for supporting children’s readiness and success in school. Research has found that approximately one in five Head Start preschoolers (21.4%) has a vision disorder. If left untreated, these can negatively impact learning, academic performance, and overall development. According to the Office of Head Start, vision-related medical diagnoses among children in Head Start are second in frequency only to asthma.
“Prevent Blindness, a leader in children’s vision and eye health through our National Center for Children’s Vision and Eye Health (NCCVEH), recognizes that children’s vision and eye health systems are already highly fragmented and inconsistent across states,” says Donna Fishman, Executive Director, NCCVEH. “In addition to other fundamental changes to the Head Start program, loosening requirements around how and when vision screenings are conducted risks creating even greater inconsistency and could result in children receiving screenings that do not follow evidence-informed guidelines. Every child in Head Start should have access to timely, effective vision screening and appropriate follow-up so that vision problems can be identified and treated before they lead to permanent vision loss or deficits in early learning and school readiness.”
“Head Start represents one of the most fundamental promises that our country gives to its children: that no matter where they live, what their background is, or the economic circumstances in which they were born, the Head Start program provides a good start in life,” says Jeff Todd, President and CEO, Prevent Blindness. “We at Prevent Blindness and our National Center for Children’s Vision and Eye Health will continue working to strengthen that promise and ensure that every child – regardless of where they live or their family’s economic circumstances – has access to effective vision screening and follow-up care so they can reach their full potential in school and beyond.”
In addition to submitting comments on the proposed rule before the October 6 deadline, Prevent Blindness is urging Congress to pass the Early Detection of Vision Impairments for Children (EDVI) Act. This bipartisan legislation would provide federal grant support to help states and communities build and strengthen systems of care for children’s vision, supported by a national technical assistance center that promotes evidence-based practices. The EDVI Act was borne out of the reality that states and communities need more support, not less, when it comes to addressing the needs of their children and preparing them for their education and future.
