The development of a screener for Cerebral Visual Impairment.

[en] This study explored the secondary use of Luxembourg's school monitoring tool for a large-scale screening of Cerebral Visual Impairment (CVI)-related difficulties. 44 items, with and without time constraint, were developed, and pretested among 959 children. All children subsequently participated in an individual evaluation of higher-level visual processing (HLVP) measures related with CVI. A clinical outcome was attributed post hoc with 32 children being classified as having CVI-related difficulties. To explore the predictive power of the CVI items included in the monitoring, item responses were matched to the results of the individual HLVP assessment. Of all items, the untimed item targeting the combined functions of surface and rotation significantly distinguished group performances (<.05). To improve condition discrimination, different item combinations were tested. Sensitivity and specificity metrics were computed resulting in ranges of 37.5% - 81.3% and 27% - 88.8% respectively. The item combination with the highest sensitivity (81.3%) was retained considering a viable trade-off between sensitivity and specificity metrics. These results support the secondary use of an existing large-scale monitoring tool to screen for CVI-related difficulties in the beginning of elementary school, provided that additional sources of information are progressively implemented to strengthen the tool's predictive power.

Disciplines :

Neurosciences & behavior

Author, co-author :

MONTEIRO, Sara ; University of Luxembourg > Faculty of Humanities, Education and Social Sciences > LUCET > Team Sonja UGEN

ESCH, Pascale ; University of Luxembourg > Faculty of Humanities, Education and Social Sciences (FHSE) > LUCET

Hipp, Géraldine ; Centre pour le Développement des Compétences relatives à la Vue (CDV), Ministère de l'Éducation nationale, de l'Enfance et de la Jeunesse (MENJE), Luxembourg

UGEN, Sonja ; University of Luxembourg > Faculty of Humanities, Education and Social Sciences (FHSE) > LUCET

External co-authors :

Language :

English

Title :

The development of a screener for Cerebral Visual Impairment.

Publication date :

22 January 2025

Journal title :

Applied Neuropsychology: Child

ISSN :

2162-2965

eISSN :

2162-2973

Publisher :

Informa UK Limited, United States

Pages :

1 - 14

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://www.tandfonline.com/doi/pdf/10.1080/21622965.2025.2451986

Available on ORBilu :

since 23 February 2025

Statistics

Number of views

93 (8 by Unilu)

Number of downloads

28 (5 by Unilu)

More statistics

Scopus citations^®

Scopus citations^®
without self-citations

OpenCitations

OpenAlex citations

Bibliography

Akobeng, A. K., (2007). Understanding diagnostic tests 1: Sensitivity, specificity and predictive values. Acta Paediatrica (Oslo, Norway: 1992), 96(3), 338–341. https://doi.org/10.1111/j.1651-2227.2006.00180.x
Bennett, C. R., Bex, P. J., Bauer, C. M., & Merabet, L. B., (2019). The assessment of visual function and functional vision. Seminars in Pediatric Neurology, 31, 30–40. https://doi.org/10.1016/j.spen.2019.05.006
Benton, A. L., Varney, N. R., & Hamsher, K. D., (1978). Visuospatial judgment: A clinical test. Archives of Neurology, 35(6), 364–367. https://doi.org/10.1001/archneur.1978.00500300038006
Boonstra, F. N., Bosch, D. G. M., Geldof, C. J. A., Stellingwerf, C., & Porro, G., (2022). The multidisciplinary guidelines for diagnosis and referral in cerebral visual impairment. Frontiers in Human Neuroscience, 16, 727565. https://doi.org/10.3389/fnhum.2022.727565
Cavézian, C., Vilayphonh, M., de Agostini, M., Vasseur, V., Watier, L., Kazandjian, S., Laloum, L., & Chokron, S., (2010). Assessment of visuo-attentional abilities in young children with or without visual disorder: Toward a systematic screening in the general population. Research in Developmental Disabilities, 31(5), 1102–1108. https://doi.org/10.1016/j.ridd.2010.03.006
Chandna, A., Ghahghaei, S., Foster, S., & Kumar, R., (2021). Higher visual function deficits in children with cerebral visual impairment and good visual acuity. Frontiers in Human Neuroscience, 15, 711873. https://doi.org/10.3389/fnhum.2021.711873
Chang, M. Y., & Borchert, M. S., (2020). Advances in the evaluation and management of cortical/cerebral visual impairment in children. Survey of Ophthalmology, 65(6), 708–724. https://doi.org/10.1016/j.survophthal.2020.03.001
Chokron, S., (2007). Troubles neurovisuels d’origine centrale chez l’enfant: vers un diagnostic et une prise en charge précoce. Ophtalmologies,1(5), 94–98.
Chokron, S., (2008). Diagnostiquer les troubles neurovisuels d’origine centrale chez l’enfant Pourquoi, quand, comment?Neurologies,15(105), 163–168.
Chokron, S., & Dutton, G. N., (2016). Impact of cerebral visual impairments on motor skills: Implications for developmental coordination disorders. Frontiers in Psychology, 7, 1471. https://doi.org/10.3389/fpsyg.2016.01471
Chokron, S., & Dutton, G. N., (2023). From vision to cognition: Potential contributions of cerebral visual impairment to neurodevelopmental disorders. Journal of Neural Transmission (Vienna, Austria: 1996), 130(3), 409–424. https://doi.org/10.1007/s00702-022-02572-8
Chokron, S., Kovarski, K., & Dutton, G. N., (2021). Cortical visual impairments and learning disabilities. Frontiers in Human Neuroscience, 15, 713316. https://doi.org/10.3389/fnhum.2021.713316
Corkum, V., Byrne, J. M., & Ellsworth, C., (1995). Clinical assessment of sustained attention in preschoolers. Child Neuropsychology, 1(1), 3–18. https://doi.org/10.1080/09297049508401338
Dutton, G. N., (2003). Cognitive vision, its disorders and differential diagnosis in adults and children: Knowing where and what things are. Eye (London, England), 17(3), 289–304. https://doi.org/10.1038/sj.eye.6700344
Dutton. (2015). The brain and vision. In Lueck & Dutton, (Eds.) Vision and the brain understanding cerebral vision impairment in children (pp. 411–434). AFB Press, American Foundation for the Blind.
Fazzi, E., Bova, S., Giovenzana, A., Signorini, S., Uggetti, C., & Bianchi, P., (2009). Cognitive visual dysfunctions in preterm children with periventricular leukomalacia. Developmental Medicine and Child Neurology, 51(12), 974–981. https://doi.org/10.1111/j.1469-8749.2009.03272.x
Fazzi, E., Molinaro, A., & Hartmann, E., (2015). The potential impact of Visual Impairment and CVI on Child Development. In Lueck & Dutton, (Eds.). Vision and the brain understanding cerebral vision impairment in children (pp. 83–104). AFB Press, American Foundation for the Blind.
Fazzi, E., Signorini, S. G., Bova, S. M., La Piana, R., Ondei, P., Bertone, C., Misefari, W., & Bianchi, P. E., (2007). Spectrum of visual disorders in children with cerebral visual impairment. Journal of Child Neurology, 22(3), 294–301. https://doi.org/10.1177/08830738070220030801
Fischbach, A., Ugen, S., & Martin, R., (2014). ÉpStan technical report. University of Luxembourg, ECCS research unit/LUCET.
Gauthier, L., Dehaut, F., & Joanette, Y., (1989). The bells test: A quantitative and qualitative test for visual neglect. International Journal of Clinical Neuropsychology,11, 49–54.
Gompel, M., Janssen, N. M., van Bon, W. H. J., & Schreuder, R., (2003). Visual input and orthographic knowledge in word reading of children with low vision. Journal of Visual Impairment & Blindness, 97(5), 273–284. https://doi.org/10.1177/0145482X0309700503
Hammill, D. D., Pearson, N. A., & Voress, J. K., (1993). Developmental test of visual perception–2. Pro-Ed.
Hokken, M. J., Krabbendam, E., van der Zee, Y. J., & Kooiker, M. J. G., (2023). Visual selective attention and visual search performance in children with CVI, ADHD, and Dyslexia: A scoping review. Child Neuropsychology: A Journal on Normal and Abnormal Development in Childhood and Adolescence, 29(3), 357–390. https://doi.org/10.1080/09297049.2022.2057940
Hokken, M. J., Stein, N., Pereira, R. R., Rours, I. G. I. J. G., Frens, M. A., van der Steen, J., Pel, J. J. M., & Kooiker, M. J. G., (2024). Eyes on CVI: Eye movements unveil distinct visual search patterns in Cerebral Visual Impairment compared to ADHD, dyslexia, and neurotypical children. Research in Developmental Disabilities, 151, 104767. https://doi.org/10.1016/j.ridd.2024.104767
Humphreys, G. W., & Riddoch, M., (1987). Visual object processing: A cognitive neuropsychological approach. Lawrence Erlbaum Associates, Inc.
Hyvärinen, L., Näsänen, R., & Laurinen, P., (1980). New visual acuity test for pre-school children. Acta Ophthalmologica, 58(4), 507–511. https://doi.org/10.1111/j.1755-3768.1980.tb08291.x
Ishihara, S., (1917). Tests for color-blindness. Hongo Harukicho.
Lam, C., Lovett, F., & Dutton, G. N., (2010). Cerebral visual impairment in children: A longitudinal case study of functional outcomes beyond the visual acuities. Journal of Visual Impairment & Blindness, 104(10), 625–635. https://doi.org/10.1177/0145482X1010401008
Laurent-Vannier, A., Chevignard, M., Pradat-Diehl, P., Abada, G., & De Agostini, M., (2006). Assessment of unilateral spatial neglect in children using the Teddy Bear Cancellation Test. Developmental Medicine and Child Neurology, 48(2), 120–125. https://doi.org/10.1017/S0012162206000260
Lueck, A. H., & Dutton, G. N., (2015). Vision and the brain understanding cerebral vision impairment in children. AFB Press, American Foundation for the Blind.
Lueck, A. H., Dutton, G. N., & Chokron, S., (2023). Profiling children with cerebral visual impairment using multiple methods of assessment to aid in differential diagnosis. Seminars in Pediatric Neurology, 47, 101070. https://doi.org/10.1016/j.spen.2023.101070
Mallett, S., Halligan, S., Thompson, M., Collins, G. S., & Altman, D. G., (2012). Interpreting diagnostic accuracy studies for patient care. BMJ, 345(jul02 1), e3999–e3999. 10.1136/bmj.e3999
Mazzone, P., Carlton, J., & Griffiths, H., (2019). Summary vision screening data: Luxembourg. EUscreen Vision & Hearing. https://www.euscreen.org/wp-content/uploads/2019/02/Luxembourg-Country-Report-Vision_def.pdf
McConnell, E. L., Saunders, K. J., & Little, J., (2021). What assessments are currently used to investigate and diagnose cerebral visual impairment (CVI) in children? A systematic review. Ophthalmic and Physiological Optics, 41(2), 224–244. 10.1111/opo.12776
McDowell, N., & Butler, P., (2023). Validation of the Austin assessment: A screening tool for cerebral visual impairment related visual issues. PLoS One, 18(11), e0293904. https://doi.org/10.1371/journal.pone.0293904
Merabet, L. B., Manley, C. E., Pamir, Z., Bauer, C. M., Skerswetat, J., & Bex, P. J., (2023). Motion and form coherence processing in individuals with cerebral visual impairment. Developmental Medicine and Child Neurology, 65(10), 1379–1386. https://doi.org/10.1111/dmcn.15591
Molloy, C. S., Di Battista, A. M., Anderson, V. A., Burnett, A., Lee, K. J., Roberts, G., Cheong, J. L., Anderson, P. J., & Doyle, L. W., (2017). The contribution of visual processing to academic achievement in adolescents born extremely preterm or extremely low birth weight. Child Neuropsychology: A Journal on Normal and Abnormal Development in Childhood and Adolescence, 23(3), 361–379. https://doi.org/10.1080/09297049.2015.1118024
Monteiro, S., Esch, P., Hipp, G., & Ugen, S., (2023). The impact of cerebral visual impairment in school related competences in elementary school children. Journal of Vision, 23(9), 4889. https://doi.org/10.1167/jov.23.9.4889
Morelli, F., Aprile, G., Martolini, C., Ballante, E., Olivier, L., Ercolino, E., Perotto, E., & Signorini, S., (2022). Visual Function and Neuropsychological Profile in Children with Cerebral Visual Impairment. Children, 9(6), 92110.3390/children9060921
Navon, D., (1977). Forest before trees: The precedence of global features in visual perception. Cognitive Psychology, 9(3), 353–383. https://doi.org/10.1016/0010-0285(77)90012-3
Ortibus, E. L., De Cock, P. P., & Lagae, L. G., (2011). Visual perception in preterm children: What are we currently measuring?Pediatric Neurology, 45(1), 1–10. https://doi.org/10.1016/j.pediatrneurol.2011.02.008
Ortibus, E., Fazzi, E., & Dale, N., (2019). Cerebral visual impairment and clinical assessment: The European perspective. Seminars in Pediatric Neurology, 31, 15–24. https://doi.org/10.1016/j.spen.2019.05.004
Parikh, R., Mathai, A., Parikh, S., Sekhar, G. C., & Thomas, R., (2008). Understanding and using sensitivity, specificity and predictive values. Indian Journal of Ophthalmology, 56(1), 45–50. https://doi.org/10.4103/0301-4738.37595
Philip, S. S., & Dutton, G. N., (2014). Identifying and characterising cerebral visual impairment in children: a review. Clinical and Experimental Optometry, 97(3), 196–208. 10.1111/cxo.12155
Pilling, R. F., Allen, L., Bowman, R., Ravenscroft, J., Saunders, K. J., & Williams, C., (2023). Clinical assessment, investigation, diagnosis and initial management of cerebral visual impairment: A consensus practice guide. Eye, 37(10), 1958–1965. https://doi.org/10.1038/s41433-022-02261-6
Sakki, H. E. A., Dale, N. J., Sargent, J., Perez-Roche, T., & Bowman, R., (2018). Is there consensus in defining childhood cerebral visual impairment? A systematic review of terminology and definitions. The British Journal of Ophthalmology, 102(4), 424–432. https://doi.org/10.1136/bjophthalmol-2017-310694
Schmetz, E., Rousselle, L., Ballaz, C., Detraux, J., & Barisnikov, K., (2018). The BEVPS: A new test battery to assess visual perceptual and spatial processing abilities in 5-14 year-old children. Applied Neuropsychology. Child, 7(4), 317–333. https://doi.org/10.1080/21622965.2017.1336710
Schmidgall, J. E., Getman, E. P., & Zu, J., (2017). Screener tests need validation too: Weighing an argument for test use against practical concerns. Language Testing,35(4), 1–25. https://doi.org/10.1177/0265532217718600
Trevethan, R., (2017). Sensitivity, specificity, and predictive values: Foundations, pliabilities, and pitfalls in research and practice. Frontiers in Public Health, 5, 307. https://doi.org/10.3389/fpubh.2017.00307
Uttl, B., (2005). Measurement of individual differences: Lessons from memory assessment in research and clinical practice. Psychological Science, 16(6), 460–467. https://doi.org/10.1111/j.0956-7976.2005.01557.x
Vancleef, K., Janssens, E., Petré, Y., Wagemans, J., & Ortibus, E., (2020a). Assessment tool for visual perception deficits in cerebral visual impairment: Development and normative data of typically developing children. Developmental Medicine and Child Neurology, 62(1), 111–117. https://doi.org/10.1111/dmcn.14303
Vancleef, K., Janssens, E., Petr, Y., Wagemans, J., & Ortibus, E., (2020b). Assessment tool for visual perception deficits in cerebral visual impairment: Reliability and validity. Developmental Medicine and Child Neurology, 62(1), 118–124. https://doi.org/10.1111/dmcn.14304
Wang, T.-Y., Huang, H.-C., & Huang, H.-S., (2006). Design and implementation of cancellation tasks for visual search strategies and visual attention in school children. Computers & Education, 47(1), 1–16. https://doi.org/10.1016/j.compedu.2004.08.012
Warrington, E. K., & James, M., (1991). Visual object and space perception battery. Thames Valley Test Company.
Weintraub, S., & Mesulam, M. M., (1985). Mental state assessment of young and elderly adults is behavioral neurology. In M. M., Mesulam (Ed.), Principles of behavioral neurology (pp. 71–123). Davis Company.
Weintraub, S., & Mesulam, M. M., (1988). Visual hemispatial inattention: Stimulus parameters and exploratory strategies. Journal of Neurology, Neurosurgery, and Psychiatry, 51(12), 1481–1488. https://doi.org/10.1136/jnnp.51.12.1481
Williams, C., Northstone, K., Sabates, R., Feinstein, L., Emond, A., & Dutton, G. N., (2011). Visual perceptual difficulties and under-achievement at school in a large community-based sample of children. PLoS One, 6(3), e14772. https://doi.org/10.1371/journal.pone.0014772
Williams, C., Pease, A., Warnes, P., Harrison, S., Pilon, F., Hyvarinen, L., West, S., Self, J., Ferris, J., Goodenough, T., Watanabe, R., Clark, R., Evans, M., Osborne, D., Edwards, E., Billington, C., Hunn, R., & Matharu, G, CVI Prevalence Study Group. (2021). Cerebral visual impairment-related vision problems in primary school children: A cross-sectional survey. Developmental Medicine and Child Neurology,63(6), 683–689. https://doi.org/10.1111/dmcn.14819
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/
Zuidhoek, S., Hyvärinen, L., Jacob, N., & Henriksen, A., (2015). Assessment of functional vision: Assessment of visual processing in children with CVI. In Lueck & Dutton, (Eds.), Vision and the brain understanding cerebral vision impairment in children (pp. 343–384). AFB Press, American Foundation for the Blind.