Institute of Education, Massey University, Auckland, New Zealand.
PLoS One. 2023 Nov 2;18(11):e0293904. doi: 10.1371/journal.pone.0293904. eCollection 2023.
Cerebral visual impairment is the most common cause of vision impairment affecting children in the economically developed world with a prevalence rate of approximately 3.4%. Currently there are limited options for screening for cerebral visual impairment, resulting in many children going undiagnosed, especially those that have normal visual acuity. The aim of this research was to validate an iPad App called the Austin Assessment, which was developed as a potential screening tool for cerebral visual impairment related visual issues. The research involved three separate phases: (1) creating a database of normative ranges for children aged 5-18 across the different variables of the Austin Assessment, (2) using the Austin Assessment to screen children aged 5-13 to assess the effectiveness of the Austin Assessment as a screening tool for CVI related visual issues, and (3) conducting specific validation research assessing children using the Austin Assessment and an already validated visual search tool. Each phase used different quantitative research methodologies to help show the effectiveness of the Austin Assessment as a screening tool for cerebral visual impairment related visual issues. From phase one of the research, thresholds were established for three variables of the Austin Assessment for the age groupings of 5-8, 9-12 and 13-18. If a child meets one of these thresholds this indicates further assessment is required to determine if they do in fact have cerebral visual impairment related visual issues. Phase two identified 17 children out of 270 who had clinical findings indicating visual issues; potentially indicative of CVI; investigation into the nature of these visual issues is ongoing. Phase three found that the Austin Assessment has moderate diagnostic value for each age group, with good sensitivity and specificity, making it effective at distinguishing those children who have visual issues from those who have typical vision. Further investigation is needed to confirm this initial validation.
脑性视觉障碍是影响经济发达国家儿童视力障碍的最常见原因，其患病率约为 3.4%。目前，脑性视觉障碍的筛查选择有限，导致许多儿童未被诊断出来，尤其是那些视力正常的儿童。本研究的目的是验证一款名为 Austin Assessment 的 iPad 应用程序，该程序是作为一种与脑性视觉障碍相关视觉问题的潜在筛查工具而开发的。研究分为三个阶段：（1）为 Austin Assessment 的不同变量创建 5-18 岁儿童的正常范围数据库；（2）使用 Austin Assessment 对 5-13 岁儿童进行筛查，以评估 Austin Assessment 作为筛查工具对与 CVI 相关的视觉问题的有效性；（3）进行特定的验证研究，使用 Austin Assessment 和已经验证的视觉搜索工具评估儿童。每个阶段都使用不同的定量研究方法来帮助展示 Austin Assessment 作为筛查工具对与脑性视觉障碍相关的视觉问题的有效性。从研究的第一阶段开始，为 Austin Assessment 的三个变量确定了三个年龄组（5-8 岁、9-12 岁和 13-18 岁）的阈值。如果孩子符合这些阈值之一，则表明需要进一步评估以确定他们是否确实存在与脑性视觉障碍相关的视觉问题。第二阶段从 270 名儿童中发现了 17 名有临床发现表明存在视觉问题的儿童；这些问题可能提示存在 CVI；对这些视觉问题的性质的调查正在进行中。第三阶段发现，Austin Assessment 对每个年龄组都具有中等的诊断价值，具有良好的敏感性和特异性，能够有效地区分有视觉问题的儿童和有正常视力的儿童。需要进一步的调查来确认这一初步验证。
