Notebooks, writing tools and laptops are standard supplies on a parent's back-to-school shopping list. But one important appointment that can easily be overlooked in the back-to-school frenzy is a child's eye exam.

It's estimated that one in four school-age children faces difficulty with reading and learning because of undiagnosed eyesight disorders. Some schools may offer onsite testing, but optometrist Dr. Jennifer Wademan said a comprehensive exam at a doctor's office can pinpoint overall eye health and how the eyes are working and "teaming" together.

Wademan said a child's inability to see correctly can mean low performance in the classroom.

"Eighty percent of learning is visual," she said. "The concern that comes into play as kids approach back-to-school time and they're in the classroom is if our children aren't seeing clearly in the classroom, or their eyes are not working well together, we worry about the impact on their academic performance."

Riley Hospital for Children in Indianapolis said amblyopia, or "lazy eye," is the leading cause of vision loss in children. If left untreated, the condition can continue into adulthood.

Wademan said squinting is often an indication of vision challenges. Other signs are if a child is overly tired or has frequent headaches. She noted these are all symptoms parents often miss or don't associate with vision problems.

"Other signs may be that your child's avoiding certain activities, like reading. Perhaps they're excessively rubbing their eyes," she said. "Watch your child. Are they tilting their head or turning their head in a manner in order to see something?"

She added the good news is that most vision problems are treatable. Although children get additional screen time after school for socializing on their favorite apps, adults should also protect their eyes against dryness, irritation and redness. Wademan recommends the 20/20 rule: For every 20 minutes of screen time, take 20 seconds and look at least 20 feet away.

Notebooks, writing tools and laptops are standard supplies on a parent's back-to-school shopping list. But one important appointment that can easily be overlooked in the back-to-school frenzy is a child's eye exam.

The Illinois Department of Public Health mandates vision screening annually for preschoolers, starting at age 3, in any public or private educational program or licensed child care facility.

Optometrist Dr. Jennifer Wademan said a child's inability to see correctly can mean low performance in the classroom.

"Eighty percent of learning is visual," she said. "The concern comes into play as kids approach back-to-school time and they're in the classroom is if our children aren't seeing clearly in the classroom, or their eyes are not working well together, we worry about the impact on their academic performance."

While schools may offer onsite testing, Wademan recommended a more comprehensive exam be done at a doctor's office to examine how well children see, their overall eye health, and how their eyes are working and "teaming" together.

Wademan said squinting is often an indication of vision challenges. Other signs are if a child is overly tired or has frequent headaches. She noted these are all symptoms parents often miss or don't associate with vision problems.

"Other signs may be that your child's avoiding certain activities, like reading. Perhaps they're excessively rubbing their eyes," she said. "Watch your child. Are they tilting their head or turning their head in a manner in order to see something?"

She added that the good news is that most vision problems are treatable. Although children get additional screen time after school for socializing on their favorite apps, adults should also protect their eyes against dryness, irritation and redness. Wademan recommended the 20/20 rule: For every 20 minutes of screen time, take 20 seconds and look at least 20 feet away.

Thousands of Alabama students headed back to the classroom will get free breakfast and lunch at school.

Six school districts will be opting into the federal Community Eligibility Program for the first time, allowing every student to eat free. Schools once needed to have at least 25% of their students qualify for free school meals. But the U.S. Department of Agriculture loosened the participation threshold to 40%, helping more schools qualify.

LaTrell Clifford Wood, a hunger policy advocate with Alabama Arise, said this will account for the needs of all students so they can thrive in the classroom.

"In our rural communities, as well as more urban counties," she said, "there can be fluctuating degrees to which childhood food insecurity is experienced in those counties and municipalities. "

In Alabama, there is about $44 million of school meal debt, according to the Education Data Initiative.

Last school year, 118 out of 150 Alabama school districts and charter schools participated in the CEP program, up from just 51 districts in 2022-23, according to the state. Despite this increase, Clifford Wood said there is still a focus on making sure all students have access to meals. However, not all schools in Alabama can offer universal meals.

She said finances are a factor that play a role in the program's expansion.

"The federal reimbursement for that program leaves a lot of districts and counties in the red when it comes to school meal debt," she said. "So the rate that schools or districts are reimbursed at is not matching inflation."

In the future, Wood said, she hopes to see the state step in to support universal school meals. She said the importance of universal school meals extends far beyond addressing hunger benefiting students' overall health.

"What universal school breakfast does is, particularly, it has been seen to address chronic absenteeism, prove adolescent mental health," she said, "but beyond that, improve long-term learning outcomes and alleviate the school-to-prison pipeline."

Children in households that receive benefits such as SNAP and Medicaid, those in foster care, and houseless children also qualify for free or reduced meals.


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Many folks are familiar with the Annie E. Casey Foundation's Kids Count Data Book, a look at child well-being in every state. In Missouri, the research is being used to delve into issues at an even more local level.

Kids Count data spans the areas of economic well-being, education, health, and family and community. The national comparisons may be helpful, but the Missouri Kids Count data offers a more detailed and actionable picture of children's outcomes.

Tracy Greever-Rice, director of Missouri Kids Count, said they examine topics like poverty, food security, low birth-weight infants and preventable hospitalizations. She explains numbers like kids' asthma emergency-room visits reflect larger systemic issues.

"If asthma ER visits are on the rise, that's an indicator that preventative steps -- access to health care, how to manage asthma -- may not be happening the way that we want," Greever-Rice explained. "If we can keep kids out of the ER for a chronic disease, they're probably doing well on other health needs, also."

She noted the approach not only helps in immediate health care improvements but also provides policy directions so the state can address issues more effectively.

Education is another critical area which presents unique challenges in measurement. Greever-Rice pointed out policy decisions about content, distribution of resources and other factors vary widely, making comparative analysis more difficult.

"Education in the United States, and this is particularly true in the state of Missouri, happens at such a very local level," Greever-Rice noted.

The state rankings in the Kids Count Data Book get a lot of attention, but Greever-Rice said they should be viewed cautiously, as they reflect not just Missouri's performance but how other states are faring. She added a decline in Missouri's ranking might indicate improvement elsewhere, rather than a direct decline in Missouri itself.