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Evidence of cognitive visual problems in children with hydrocephalus: a structured clinical history-taking strategy
M J Houliston1, A H Taguri, G N Dutton
1Department of Ophthalmology, Royal Hospital for Sick Children, Yorkhill, Glasgow, Scotland.
Insights
Children with occipital cortex damage can experience visual cognitive disorders. While some visual skills improve with age, specific challenges like orientation and simultaneous perception persist, particularly in children with shunted hydrocephalus.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Ophthalmology
Background:
- Damage to the occipital cortex in children can lead to complex cognitive visual function disorders.
- Cortical visual impairment (CVI) presents unique challenges in childhood development.
Purpose of the Study:
- To investigate the prevalence and nature of cognitive visual problems in children.
- To assess the impact of age on visual cognitive function in children without cerebral pathology.
- To identify visual disabilities in children with shunted hydrocephalus.
Main Methods:
- A cohort of 200 children (aged 5-12 years) without cerebral pathology had parents complete a series of clinical questions.
- Parental responses were analyzed for age-related trends in cognitive visual function.
- The same questions were administered to parents of 52 children (aged 5-17 years) with shunted hydrocephalus.
Main Results:
- A progressive improvement in cognitive visual performance was observed with increasing age.
- Most 11- and 12-year-olds showed few problems, except for 8% with orientation difficulties and 2% with simultaneous perception issues.
- Cognitive visual problems were identified in 27 of 52 children with shunted hydrocephalus, with 16 exhibiting multiple difficulties.
Conclusions:
- Age is a significant factor in the recovery and manifestation of cognitive visual disorders.
- Children with shunted hydrocephalus are at higher risk for developing multiple cognitive visual impairments.
- The study identified specific deficits including shape and object recognition, simultaneous perception, movement and color perception, orientation, and face recognition.
Abstract:
Damage to the occipital cortex in children can result in many complex disorders of cognitive visual function. A series of clinical questions, developed from the specific problems of a cohort of children with cortical visual impairment, was asked of the parents of 200 children with no history of cerebral pathology, aged 5 to 12 years. One hundred and ninety-two parents gave reliable consistent responses. The results show a progressive improvement in performance with age, culminating in few 11- and 12-year olds having frequent problems, apart from 8% having frequent difficulty with orientation in new surroundings and 2% having problems with simultaneous perception tasks. The parents of 52 children (aged 5 to 17 years) with shunted hydrocephalus were then asked the same set of questions. Evidence of cognitive visual problems was identified in 27 of these children of whom 16 manifested multiple difficulties. The disabilities identified by our study comprised problems with: shape recognition, simultaneous perception, perception of movement, colour perception, orientation, object recognition, and face recognition. The range, nature, and combinations of these disorders are presented in this paper.