First off, what is CPS? It stands for Chicago Public Schools, and for ICO students, it is one of our third year specialty sites. Our CPS rotation is at a school on Princeton Ave, a few blocks south of the White Sox stadium. Each week, we can have walk-in patients, or we have a bus that brings a group of kids from different schools in the area. CPS sees patients up until the age of 18.
CPS is definitely different from regular clinic at the Illinois Eye Institute. At the IEI, we tend to see only 1-2 patients during a shift- usually an adult or older child. At CPS, we usually see 3-5 patients, ranging between 5-12 years old. As my quarter at CPS comes to an end, I have learned a few quite things about working with children.
First, you need to be flexible with what tests you will be doing on kids and when you will be doing them. When you have a three year old, you won’t be able to do refraction like you usually do. You will need to use different tools in order to do retinoscopy. This is one opportunity to become really comfortable with skiascopy bars while at ICO. You need to have more faith in your retinoscopy skills because you may end up prescribing your exact findings when you can’t do a reliable manifest. Also, there’s always a chance that you can’t do a lot of tests due to uncooperative behavior. That is ok! Breathe and move on.
Unlike adult patients, children don’t care what you found while doing BIO. Simplify it and just tell them if they need glasses and when they need to wear them. The most important part about working with kids is making them feel comfortable. We need to be able to talk their language and not be “scary” doctors.
I find talking to kids easier than talking to adults, but maybe it is because I have three siblings under the age of 14. Talk about what sports they play, what TV shows they like (kids still like Spongebob!), or what music groups they listen to. Ask if they have any siblings and what they do for fun. I have even resorted to asking what their favorite cereal is! Talking to kids should be easy. If they like you better, they will cooperate better.
Be efficient! You can see 4+ students while at CPS, so you need to learn to be fast. If something isn’t working, move on. If you know you won’t be prescribing glasses due to a small prescription, do near testing without your near Rx. Be quick, because kids won’t be able to sit still for too long. They want to go to the cafeteria so they can eat and watch movies with their friends.
I learned so much from CPS. I learned a lot more about when to give glasses and when to hold off. It helped me understand and remember that kids should be more hyperopic, and therefore a small hyperopic prescription can actually be normal. I also measured my first constant trope, and referred a patient to vision therapy. There are a lot of things you learn when working with children.
Make a difference:
Working with kids really puts in perspective what a difference optometrists can make. If it wasn’t for this program, some kids who really needed glasses may have never had the opportunity to receive them. I think it is really important that we realize how much of a difference we are making, and how we are helping these kids succeed in school.