Pilling Rachel F, Outhwaite Louise, Bruce Alison
Department of Ophthalmology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
Bradford Institute for Health Research, Bradford, UK Department of Health Sciences, Seebohm Rowntree Building, University of York, York, UK.
Br J Ophthalmol. 2016 Aug;100(8):1118-21. doi: 10.1136/bjophthalmol-2015-307558. Epub 2015 Dec 1.
Assessment of children with complex and severe learning disabilities is challenging and the children may not respond to the monochrome stimuli of traditional tests. The International Association of Scientific Studies on Intellectual Disability recommends that visual function assessment in poorly or non-cooperative children should be undertaken in an objective manner. We have developed a functional visual assessment tool to assess vision in children with complex and multiple disabilities.
The Bradford visual function box (BVFB) comprises a selection of items (small toys) of different size and colour, which are presented to the child and the response observed. The aim of this study is to establish its intertester validity in children with severe learning disability. The visual function of 22 children with severe learning disability was assessed using the BVFB. The children were assessed by experienced practitioners on two separate occasions. The assessors were unaware of each other's findings.
In 15/22 of the children, no difference was found in the results of the two assessors. The test was shown to have a good intertester agreement, weighted κ=0.768.
The results of this clinical study show that the BVFB is a reliable tool for assessing the visual function in children with severe learning disability in whom other tests fail to elicit a response. The need for a tool which is quick to administer and portable has previously been highlighted. The BVFB offers an option for children for whom other formal tests are unsuccessful in eliciting a response.
对患有复杂和严重学习障碍的儿童进行评估具有挑战性，而且这些儿童可能对传统测试的单色刺激没有反应。国际智力残疾科学研究协会建议，对于不合作或合作性差的儿童，应采用客观的方式进行视觉功能评估。我们开发了一种功能性视觉评估工具，用于评估患有复杂和多重残疾儿童的视力。
布拉德福德视觉功能盒（BVFB）包含一系列不同尺寸和颜色的物品（小玩具），将其呈现给儿童并观察其反应。本研究的目的是确定其在患有严重学习障碍儿童中的测试者间效度。使用BVFB对22名患有严重学习障碍的儿童进行视觉功能评估。这些儿童由经验丰富的从业者在两个不同的时间进行评估。评估者彼此不知道对方的评估结果。
在22名儿童中的15名中，两位评估者的结果没有差异。该测试显示出良好的测试者间一致性，加权κ=0.768。
这项临床研究的结果表明，对于其他测试无法得到反应的患有严重学习障碍的儿童，BVFB是一种可靠的视觉功能评估工具。此前曾强调需要一种快速实施且便于携带的工具。对于其他正式测试无法得到反应的儿童，BVFB提供了一种选择。
