To the Editor:—
The response to the question on the "E test" for visual acuity in preschool children, which appeared in The Journal (208: 1195, 1969) does not discuss some of the other possibilities which, in my opinion, should be mentioned. In a study of 5,000 children, 3 through 6 years old, Jackson and I (Vision Screening of 3- Through 5-Year-Old Children, Brookline, Mass; Health Department, 1967) found that for the 3- through 4-year-old child, the Allen picture cards were superior to the Snellen E, Sjogren hand, or the Titmus screener. We completely agree that the commonest cause of inaccurate results is due to inadequate communications between the tester and the child. We also found that when a small child failed to respond to one type of test, he often responded correctly to another. We therefore think that every child who fails or does not respond to a specific preschool