Case Study

Ava's teacher, Liam, has been concerned about her vision. He noticed that she quickly loses interest during story time. Often, she will leave her place in the circle and move closer to see pictures in the books he is holding up$.$ Liam has also noted that Ava typically lowers her head close to puzzles, matching manipulatives, or an art project on which she is working.

Liam met with Ava's family to discuss his concerns. Her parents were not surprised by what they were told and shared that they, too, had observed similar changes in Ava's behavior at home. However, they were reluctant to do anything because Ava's father had recently been laid off and they no longer had health insurance. Liam encouraged Ava's parents to have her vision tested at the local public health department. The results of two screening tests indicated that Ava's vision was not within normal limits$.$ The nurse discussed the findings with Ava's parents and helped them to arrange a follow up examination with an eye specialist at a nearby wellness clinic.

What behaviors caused Ava's teacher to have concerns about her vision?