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Measurement of visual ability in children with cerebral palsy: a systematic review
Belinda Deramore Denver1,2, Elspeth Froude3, Peter Rosenbaum1,4
1Faculty of Health Sciences, School of Allied Health, Australian Catholic University, Fitzroy, Vic., Australia.
Insights
This study found few valid measures for assessing visual abilities in children with cerebral palsy (CP) within the International Classification of Functioning, Disability and Health (ICF) framework, highlighting a critical gap in clinical practice and research.
Area of Science:
- Pediatric ophthalmology
- Rehabilitation medicine
- Disability studies
Background:
- Vision impairment is a significant factor affecting the daily functioning of children with cerebral palsy (CP).
- Current assessments often focus on basic visual functions (e.g., visual acuity) rather than how vision impacts activities and participation.
- There is a need to understand how children with CP engage in vision-related activities.
Purpose of the Study:
- To systematically identify and evaluate existing measures of visual ability in children with CP.
- To assess the psychometric properties of these measures using the COSMIN Checklist.
- To determine if measures align with the Activities and Participation domains of the ICF.
Main Methods:
- A comprehensive literature search was conducted across eight databases.
- Measures were selected based on their use with children with CP and focus on ICF's Activities and Participation domains.
- Psychometric properties were evaluated using the Consensus-based Standards for the Selection of Measurement Instruments (COSMIN) Checklist.
Main Results:
- Out of 6763 retrieved papers, 25 were relevant, identifying 19 visual ability measures.
- Only 10 measures demonstrated evidence of validity or reliability.
- No discriminative measures comparable to existing CP functional classifications or valid outcome measures for visual abilities were found.
Conclusions:
- A significant gap exists in psychometrically sound measures for assessing visual abilities in children with CP, particularly concerning their functional performance in daily activities.
- Current measurement practices often overlook the crucial 'Activities and Participation' aspects of vision.
- Developing and validating robust measures is essential for improving clinical care and research for children with CP.
Aim:
To identify and evaluate measures of visual ability used with children with cerebral palsy (CP).
Method:
Eight databases were searched for measures of visual ability. Key selection criteria for measures were: use with children with CP; focus of visual ability measurement at the Activities and Participation domain of the International Classification of Functioning, Disability and Health (ICF). The Consensus-based Standards for the Selection of Measurement Instruments (COSMIN) Checklist was used to assess psychometric properties.
Results:
From 6763 papers retrieved, 25 were relevant and 19 measures of visual ability were identified. Only 10 measures were supported with evidence of validity or reliability. No discriminative measure analogous to existing CP functional classification systems was found. No outcome measure valid for evaluation of visual abilities of children with CP was found.
Interpretation:
Vision impairment is recognized as relevant to the functioning of children with CP; however, measurement of vision is most often focused at 'Body Function' levels, for example visual acuity. Measuring visual abilities in the Activities and Participation domain is important in considering how a child with CP functions in vision-related activities. The lack of psychometrically strong measures for visual ability is a gap in current clinical practices and research.
