Development and face validity of a cerebral visual impairment motor questionnaire for children with cerebral palsy
M Salavati1,2, A Waninge1,2, E A A Rameckers3,4,5
1Centres of expertise for blind and visually impaired people, Royal Dutch Visio, The Netherlands.
Insights
This study developed two Cerebral Visual Impairment Motor Questionnaires (CVI-MQs) for children with cerebral palsy (CP). These validated tools effectively identify children with CP at risk for CVI, aiding early detection and intervention.
Area of Science:
- Pediatrics
- Neurology
- Ophthalmology
Background:
- Cerebral Visual Impairment (CVI) is a common visual deficit in children with cerebral palsy (CP).
- Accurate identification of CVI in children with CP is crucial for targeted interventions.
- Existing assessment tools may not adequately capture the motoric aspects of CVI in this population.
Purpose of the Study:
- To develop and validate two Cerebral Visual Impairment Motor Questionnaires (CVI-MQs) tailored for children with CP.
- To assess the face validity and usability of the CVI-MQs.
- To determine the sensitivity and specificity of the CVI-MQs for identifying CVI in children with CP.
Main Methods:
- Development of two CVI-MQ versions based on literature, stratified by Gross Motor Function Classification System (GMFCS) levels I-III and IV-V.
- Utilized the Delphi method with expert consensus to refine face validity and usability.
- Assessed sensitivity and specificity in 82 children with CP using receiver operating curve analysis to establish cut-off scores.
Main Results:
- Both CVI-MQ versions demonstrated excellent face validity (>96% agreement) and good usability (95% agreement).
- The CVI-MQ for GMFCS I-III achieved 1.00 sensitivity and 0.96 specificity (cut-off ≥12).
- The CVI-MQ for GMFCS IV-V showed 0.97 sensitivity and 0.98 specificity (cut-off ≥8).
Conclusions:
- The developed CVI-MQs are valid and usable tools for assessing motor aspects related to CVI in children with CP.
- These questionnaires can effectively identify children with CP who are at higher risk of having CVI.
- The CVI-MQs provide a valuable screening instrument to guide further diagnostic evaluations for CVI in pediatric CP populations.
Aim:
The objectives of this study were (i) to develop two cerebral visual impairment motor questionnaires (CVI-MQ's) for children with cerebral palsy (CP): one for children with Gross Motor Function Classification System (GMFCS) levels I, II and III and one for children with GMFCS levels IV and V; (ii) to describe their face validity and usability; and (iii) to determine their sensitivity and specificity.
Backgrounds:
The initial versions of the two CVI-MQ's were developed based on literature. Subsequently, the Delphi method was used in two groups of experts, one familiar with CVI and one not familiar with CVI, in order to gain consensus about face validity and usability. The sensitivity and specificity of the CVI-MQ's were subsequently assessed in 82 children with CP with (n = 39) and without CVI (n = 43). With the receiver operating curve the cut-off scores were determined to detect possible presence or absence of CVI in children with CP.
Results:
Both questionnaires showed very good face validity (percentage agreement above 96%) and good usability (percentage agreement 95%) for practical use. The CVI-MQ version for GMFCS levels I, II and III had a sensitivity of 1.00 and specificity of 0.96, with a cut-off score of 12 points or higher, and the version for GMFCS levels IV and V had a sensitivity of 0.97 and a specificity of 0.98, with a cut-off score of eight points or higher.
Conclusion:
The CVI-MQ is able to identify at-risk children with CP for the probability of having CVI.
