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Visual-perceptual impairment in a random sample of children with cerebral palsy
Peter Stiers1, Ria Vanderkelen, Griet Vanneste
1Laboratorium voor Neuropsychologie, KU Leuven Medical School, Belgium. peter.stiers@med.kuleuven.ac.be
Insights
Visual-perceptual impairment is common in children with cerebral palsy (CP), affecting over a third of participants. This study clarifies impairment by assessing non-verbal intelligence alongside visual skills in children with physical disabilities.
Area of Science:
- Neuroscience
- Developmental Psychology
- Ophthalmology
Background:
- Previous studies on visual-perceptual impairment in children with cerebral palsy (CP) often overlooked non-verbal intelligence deficits.
- This oversight led to confounding visual-perceptual and non-verbal intelligence impairments, potentially over or underestimating visual issues.
Purpose of the Study:
- To accurately determine the prevalence of visual-perceptual impairment in children with CP.
- To differentiate visual-perceptual deficits from non-verbal intelligence impairments by evaluating both concurrently.
Main Methods:
- Ninety-six children with physical disabilities (CP) and a non-verbal mental age of 3-7 years were assessed.
- Participants underwent grating acuity testing and the L94 visual-perceptual battery, including object recognition and visuoconstruction tasks.
- Performance was analyzed relative to non-verbal intelligence subtest scores.
Main Results:
- 37.5% of children showed impairment on at least one visual-perceptual task, and 18.7% on two or more.
- Visual-perceptual impairment was most prevalent in children with brain malformations (67%), followed by spastic CP (40%).
- No significant impairment was found in visuoconstruction tasks, and results were not attributable to visual acuity deficits.
Conclusions:
- Visual-perceptual impairment is frequent in children with physical disabilities, including those with CP.
- The findings are not limited to CP of hypoxic-ischaemic origin, highlighting broader implications for this population.
Abstract:
Several studies have tried to establish the prevalence of visual-perceptual impairment in children with physical disabilities, particularly in those with cerebral palsy (CP), but failed to take into account the selective impairment of non-verbal intelligence that is frequent in these children. This has resulted in the confounding of visual-perceptual and non-verbal intelligence impairment. In the present study we aimed to determine how widespread visual-perceptual impairment is in children with CP by evaluating perceptual ability together with the performance level on non-verbal intelligence subtests. All children (n=96; 44 females, 52 males) who attended an institute for children with physical disabilities were included (age ranged from 4 years 11 months to 21 years 5 months) who had a non-verbal mental age between 3 and 7 years; Total IQ was <85 in 91% of participants. They were given a grating acuity task and the visual-perceptual battery L94, comprising six visual object recognition and two visuoconstruction tasks. Relative to their performance level on non-verbal intelligence subtests, 37.5% of the children were impaired on at least one task, and 18.7% on two or more tasks. No child was impaired on the visuoconstruction tasks. Visual-perceptual impairment was highest among six children with brain malformation (67%), followed by spastic CP (40%), and brain damage acquired after the first year of life (38%). There was no difference in visual-perceptual impairment between the subtypes of spastic CP. Results are not secondary to visual acuity deficits, as only one L94 task was significantly correlated with acuity impairment. We conclude that visual-perceptual impairment is frequent in children with physical disabilities, and not restricted to children with CP of hypoxic-ischaemic origin.