Literacy abilities of veterans with visual impairment: impact of vision loss and rehabilitation
 
Gale R. Watson, William De l’Aune, Erica Watkins
 
Rehabilitation R&D Center of Excellence, Atlanta VA Medical Center
 
Objectives: The purpose of this two year project was to evaluate the literacy skills of older persons who have age-related visual impairment compared to normally sighted cohorts, and to understand the relationship of literacy ability to outcomes in vision rehabilitation.
 
Methods: Subjects were recruited from the community in Atlanta, the VA Medical Center in Atlanta and Salisbury, NC, and community low vision clinics in the Philadelphia area. All subjects were screened to assure cognition and physical health were within normal limits. Thirty-five visually impaired older subjects who were scheduled for low vision services were recruited. They were administered a battery of assessments of literacy abilities, a measure of quality of life and a measure of overall functional abilities via self-report immediately prior to receiving low vision services, immediately after low vision services and at a six week follow-up in their homes. They were also asked to name pre-vision loss reading materials and these materials were categorized as to grade level equivalent. Thirty-five normally sighted elderly persons were also evaluated. Repeated measures and correlations used to answer most study questions.
 
Results: As a group, visually impaired subjects were able to regain their pre-vision loss basic literacy abilities (grade level equivalent in comprehension) following vision rehabilitation services. There were statistically significant gains in all literacy measures from pre to post-rehabilitation, including accuracy, comprehension and rate of reading, writing ability, functional health literacy and duration of reading. Subjects’ increased literacy abilities were related to increases in quality of life and overall independent functioning. Reading comprehension ability was predictive for both amount of reading and overall literacy functioning in the home environment at follow-up. Subjects who were visually impaired showed lower overall literacy ability after rehabilitation than normally sighted peers, however.
 
Conclusions: Older persons who are visually impaired are able to regain basic literacy abilities that have been lost due to age-related visual impairment. Vision rehabilitation services can provide significant gains in literacy abilities for older visually impaired persons. Strategies should be developed to assure that visually impaired older persons enjoy similar literacy abilities as their normally sighted peers.
 
Funding acknowledgment: This project was funded via Department of Veterans Affairs Rehabilitation Research and Development Service grant # C1837-R