In a third-floor classroom at P.S. 49, in the Mott Haven section of the Bronx, first grader Ashely Reyes leaned forward in her chair and read her letters slowly.
“L…P…E...”
But the focus was not on whether Ashely could recognize the letters — it was on whether she could see them at all.
She’s one of 150 kids at this elementary school — 20 percent of all students — who failed a vision screening this fall.
Normally, it would be up to each child’s family to find eye care but many would not follow through. One study done by the city's Department of Health found that 60 percent of students identified as needing glasses in kindergarten still needed their vision corrected a year later.
But this year, kids at P.S. 49 and two other pilot schools — P.S. X140 in the South Bronx and P.S. 36 in West Harlem — got all the follow up they needed at school.
Visiting optometrist Kimberly Stacel checked Ashely for astigmatisms. From her velvet-lined case she pulled different lenses.
"What happens when I change it to that one? Is that better or is that worse?” she asked. “Better,” Ashely said.
With a prescription in hand, a frame manufacturer could now come to school and fit the kids with two pairs of glasses, one for home and one for school. And teachers would know exactly who should be wearing them.
While educators often look to boost student achievement through efforts like curriculum changes or teacher training, the Children’s Health Fund in New York City is taking a different approach — a laser-like focus on a particular set of health issues that tend to affect poor children.
“We like would basically to revolutionize the way children are screened going to school,” says Irwin Redlener, president of the Children’s Health Fund. “Do they or don’t they have these particular health conditions that we know will have consequences in the classroom?”
The eight health issues are those that disproportionately affect poor children and that specifically impact learning, either by causing students to miss school or by affecting focus or cognitive functioning. In addition to vision, they include untreated asthma, hearing issues, elevated lead levels, anemia, hunger, dental pain, and behavior issues like attention deficit disorder.
Prof. Charles Basch of Teachers College, Columbia University developed much of the thinking behind the initiative.
“Even when the teachers may be really good teachers, and even when the curriculum may be good, and even when there’s assessments and standards and accountability measures in place, if the students aren’t in school because of health problems, or even if they’re there, but they can’t see well or they can’t pay attention, it really jeopardizes everything else that’s being done,” said Basch.
The pilot project, dubbed “Healthy and Ready to Learn,” assigns a health coordinator and a mental health expert to each school. The project is paid for with private money, including support from Jaguar Land Rover, at a cost of about $400,000 per school in this start-up year and a projected $300,000 in years to come, or about $500 per pupil. Basch said principals begged to participate.
Principal Frank Hernandez at P.S. 49 said he understood first-hand how it could help.
“I myself am a chronic asthmatic,” said Hernandez, who grew up in the Bronx. “I carry my asthma pump. My sister is also asthmatic. My sister as a matter of fact missed a lot of days of school as a result. If (these) services were provided to my sister and my mom, then I think that she would have missed less school.”
Absences are a big problem at high-poverty schools. Hernandez said he didn't have the personnel to follow up on health issues: there is one school nurse for 900 students.
But now, PS 49’s health coordinator calls parents, teaches kids to manage their asthma, even goes along on doctor visits. Fourth grade teacher Arielle Goldfine says the project is changing how she works.
“I feel that I’m more focused on the students’ needs,” says Goldfine. “And instead of maybe pushing a problem aside, I’ll focus on it more. I have backup to help me.”
The idea of addressing health issues at school is not new. Actual health clinics are located inside dozens of New York City public schools. Mayor Bill de Blasio has said he wants to open more than 100 additional community schools, with expanded partnerships and services, including health services.
But a number of studies have shown such health projects were not a panacea. Many have not improved test scores at all.
The Children’s Health Fund said it's tracking dozens of academic indicators for each child — from absences to reading scores — in addition to health information, in the hope the numbers show that going after a targeted set of health issues also improves learning.