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Efficacy of a vision-screening tool for birth to 3 years early intervention programs
Roger D Struble1, Ryan R House1, Joyce Trower2
1University of Kansas School of Medicine, Kansas City, Kansas.
Insights
This study validated a vision screening tool for preschool children with developmental disabilities. The tool demonstrated high sensitivity and negative predictive value, making it effective for detecting visual pathway issues in this population.
Area of Science:
- Ophthalmology
- Developmental Pediatrics
- Public Health
Background:
- Early detection of visual pathway pathology is crucial for children with developmental disabilities.
- Preschool children under 3 with developmental disabilities require specialized screening tools.
- The Kansas Department of Health and Environment (KDHE) provides guidelines for vision screening.
Purpose of the Study:
- To validate a screening tool for detecting unsuspected visual pathway pathology in preschool children (under 3 years) with developmental disabilities.
- To assess the effectiveness of the KDHE-guided screening tool within an early intervention program.
Main Methods:
- Retrospective review of 300 children's records from a birth to 3 early intervention program (2011-2014).
- Inclusion criteria: documented KDHE vision screening by trained personnel and full ophthalmic evaluation.
- Ophthalmologist masked to screening results; pathology determined by comprehensive examination.
Main Results:
- 216 children met inclusion criteria; 137 were referred.
- Sensitivity: 95.3% (95% CI, 90.8-99.8).
- Negative predictive value: 94.9% (95% CI, 86.8-98.4).
- Specificity: 57.25% (95% CI, 48.3-65.7).
- Positive predictive value: 59.1% (95% CI, 50.4-67.3).
Conclusions:
- The screening examination, combined with risk factors, showed good sensitivity and negative predictive value in this population.
- The screening tool is effective for identifying visual pathway issues in young children with developmental disabilities.
- The inexpensive screening approach is valuable for early intervention programs.
Purpose:
To validate a screening tool used to detect unsuspected visual pathway pathology in preschool children under 3 years of age with developmental disabilities enrolled in an early intervention program using guidelines from the Kansas Department of Health and Environment (KDHE).
Methods:
The records of 300 consecutive children screened at a birth to 3 early intervention program from 2011 to 2014 were reviewed retrospectively. Inclusion criteria were documented KDHE vision screening examinations performed by trained early interventionist and full ophthalmic evaluations by a general ophthalmologist. The evaluation was only considered a pass if it was recorded on the chart and the child did not have any known risk factors. The visual pathway pathology status was determined after comprehensive ophthalmic examination, with the ophthalmologist masked to the vision screening results.
Results:
A total of 216 children met inclusion criteria, of whom 137 were referred. The sensitivity was 95.3% (95% CI, 90.8-99.8); specificity, 57.25% (95% CI, 48.3-65.7); positive predictive value, 59.1% (95% CI, 50.4-67.3); negative predictive value, 94.9% (95% CI, 86.8-98.4); and negative likelihood ratio, 0.082 (95% CI, 0.031-0.22). A Pearson χ2 test for fit yielded an approximate P value of <0.0001.
Conclusions:
In this study population, good sensitivity and negative predictive value were demonstrated by the inexpensive screening examination coupled with associated risk factors for the 0-3 population of children with developmental disabilities.
