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Infant vision screening predicts failures on motor and cognitive tests up to school age
Janette Atkinson1, Shirley Anker, Marko Nardini
1Visual Development Unit, Department of Psychology, University College London, London, UK. j.atkinson@ucl.ac.uk
Insights
Early significant hyperopia in infants is linked to lasting developmental delays in visual-cognitive and visual-motor skills. These effects persist until at least 5.5 years of age, impacting early childhood development.
Area of Science:
- Developmental Pediatrics
- Ophthalmology
- Child Psychology
Background:
- Infant vision screening identifies significant refractive errors.
- Longitudinal studies are crucial for understanding developmental trajectories.
- Early hyperopia may impact broader child development.
Purpose of the Study:
- To compare developmental outcomes in infants with significant hyperopia versus controls.
- To assess the relationship between early hyperopia and visual, cognitive, motor, and language development.
- To determine the persistence of these developmental differences up to age 5.5 years.
Main Methods:
- Longitudinal study of 5295 infants from a population-based screening program.
- Comparison of infants with significant hyperopia (identified at 9 months) and age-matched controls.
- Assessment using the Atkinson Battery of Child Development, Henderson Movement Assessment Battery, Griffiths Scales, MacArthur Communicative Development Inventory, and British Picture Vocabulary Scales up to 5.5 years.
Main Results:
- Hyperopic infants performed significantly worse on visual-cognitive and visual-motor assessments at 14 months, 3.5 years, and 5.5 years.
- No significant differences were observed in language development or overall cognitive/motor development as measured by other scales.
- Excluding infants who developed amblyopia or strabismus did not alter the observed differences.
Conclusions:
- Early significant hyperopia is associated with persistent visuocognitive and visuomotor deficits in children.
- These developmental impacts are specific to visual-motor and visual-cognitive domains, not language.
- Findings highlight the importance of early detection and management of refractive errors for overall child development.
Abstract:
In a population-based infant vision screening programme, 5295 infants were screened and those with significant refractive errors were followed up. To assess the relationship between the development of vision and other domains, we report a longitudinal study comparing infants with significant hyperopia, identified at age 9 months ('hyperopes') with infants with normal refractions ('controls'). Children are included who completed at each age a broad set of visual, cognitive, motor and language measures taken over a series of follow-up visits up to age 5.5 years. Hyperopes performed significantly worse than controls on the Atkinson Battery of Child Development for Examining Functional Vision at 14 months and 3.5 years and the Henderson Movement Assessment Battery for Children at 3.5 and 5.5 years. The Griffiths Child Development Scales, MacArthur Communicative Development Inventory and British Picture Vocabulary Scales showed no significant differences. Exclusion of those infants who became amblyopic and strabismic did not substantially alter these results, suggesting that the differences between groups were not a consequence of these disorders. These results indicate that early hyperopia is associated with a range of developmental deficits that persist at least to age 5.5 years. These effects are concentrated in visuocognitive and visuomotor domains rather than the linguistic domain.