The nurses in Dr. Rappo's Brockton, Mass., pediatric office struggled repeatedly to persuade preschoolers to undergo vision screening evaluations, often to no avail. They couldn't figure out if the children wouldn't complete the tests because they were ornery, fidgety, or just because they didn't understand them.

Everything came to light, however, when Peter Rappo, M.D., AAP Committee on Practice and Ambulatory Medicine (COPAM) chairperson, compared the number of patients with vision problems with those who were uncooperative. He concluded that patients who resisted screening or didn't seem to understand the tests were more likely to have vision problems.

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