Donna Fishman, MPH, is the Director for the National Center for Children’s Vision and Eye Health (NCCVEH) at Prevent Blindness. She facilitates and manages the Better Vision Together Community of Practice (in which the Minneapolis Public Schools participates) and manages the development of a family vision resource kit for Head Start and other early childhood education and care agencies to increase parent/caregiver education around children’s vision and eye health.

ED: How did you begin your career in early childhood?

While I had some exposure to early childhood before my current job, this is really my first opportunity to work in depth within the field.  In my master’s program in public health, I studied Maternal and Child Health and so learned about policies, systems and programs in the public health space related to young children; but not how health related to and impacted education. When I was Training Director for the Healthy Schools Campaign, I managed a school nurse leadership program where I learned about the intersection of health and learning as it relates to obesity and asthma. And now, as the Director of the National Center for Children’s Vision and Eye Health (NCCVEH) at Prevent Blindness, I work with early childhood education systems to bring awareness of the connection of vision health to childhood development and learning readiness. Early detection of vision disorders and connecting children to eye care has a dramatic impact on helping children reach developmental milestones and succeed both academically and socially in school and throughout their lives. In just the year since I’ve been working at Prevent Blindness, I’ve heard many stories from friends, colleagues and parents about their own or their children’s undiagnosed vision problems and the impact on their self-esteem and ability to learn to read, and then their transformation once they received vision correction.  I’m honored to work in this early childhood space and to be working in this important Center supported by the Health Resources and Services Administration (HRSA)’s Maternal and Child Health Bureau.

ED: What efforts have you been involved in to improve the quality of early childhood programs and services?

The NCCVEH works to educate and train early childhood programs about the importance of healthy vision to early learning and school success. When children are not developing as expected or meeting early learning standards, we encourage early childhood educators to think of uncorrected vision health conditions as a possible cause of classroom behavioral challenges, inability to focus and bond with teachers, parents and other students, and frustration with “academic” work. We present this information at state and local conferences, in webinars and by posting slides from presentations on our website. We offer a multitude of fact sheets and other resources on our website as well. We have created a children’s vision and eye health tool kit for the National Association of School Nurses and are currently developing a family vision resource tool kit for Head Start and other early childhood program to help educate staff, parents and caregivers about the importance of caring for their children’s and their own vision health. We also facilitate a Community of Practice, Better Vision Together, to incubate innovative approaches to the children’s vision and eye health system, and have developed the 12 components of a Strong Vision Health System of Care. We are available for technical assistance and have helped the National Head Start Association and Parents as Teachers to develop vision screening guidelines for children ages 5 years and younger.

We are getting ready to launch a work group of our Advisory Committee to look at how children with special health care needs are getting their vision addressed and to create new resources for early childhood education and care programs. We have guidelines in place for referring certain children for comprehensive eye exams (and bypassing vision screening), but I am eager to learn more about and offer resources for this population to improve the vision health of children with neurodevelopmental and other health conditions.

ED: What are some of the challenges you have experienced in your work and what strategies have you tried to overcome them?

One of our challenges is that approaches to children’s vision health in the United States have historically been challenged by a fragmented public health system that lacks performance indicators and health objectives, which mean there aren’t national goals and measures of accountability to ensure we are reaching the children in need. There is also not enough funding to address children’s vision health. Also, vision has traditionally been disconnected from the early childhood and education spheres and we tend to address health issues among young children in silos without focusing on the connection between the sensory systems (vision, hearing, and oral health) and learning.

I’d love to have more time to make more connections with early childhood programs, associations and government agencies. This is one of my goals for the next year.

ED: What suggestions do you have for others interested in improving early childhood services and programs?

First, educate yourself. We have resources for early childhood programs about the importance of vision to learning, how to help teachers identify potential eye conditions in children that require care, why vision screening is critical for young children and resources for becoming a certified vision screener.

In working with young children (infants and toddlers), check out our new resources — 18 Vision Development Milestones from Birth Through Baby’s First Birthday, a vision assessment tool available in English and Spanish, and our Guide to Vision Health for Your Newborn, Infant and Toddler for parents and caregivers.

Next, take a holistic view of health and education for young children and understand that healthy sight among children plays a role in reducing poverty, improving reading readiness, increased graduation rates, attainment of developmental milestones, and positive social relationships.

Finally, I’d like to thank all of you on the front line caring for and educating our young children and citizens of the future.