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Measuring recognition visual acuity in young children - testability with the Waterloo Differential Acuity Test
Susan J Leat1, Aashi Saraf1, Kalpana Rose1
1School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada.
Clinical & Experimental Optometry
|November 20, 2022
Summary
The Waterloo Differential Acuity Test (WatDAT) shows promise for assessing visual acuity in children as young as 18 months. This new recognition visual acuity test is more effective than traditional matching tests for young children.
Area of Science:
- Ophthalmology and Optometry
- Developmental Pediatrics
- Pediatric Vision Science
Background:
- Accurate visual acuity (VA) measurement is crucial for early detection and management of pediatric eye disorders.
- Recognition VA, measured by matching, is more sensitive than resolution VA for visual deficits in children aged 3+.
- The Waterloo Differential Acuity Test (WatDAT) is a novel recognition VA test designed to be cognitively simpler than matching tests, potentially enabling use in younger children.
Purpose of the Study:
- To evaluate the testability of the WatDAT paradigm in children aged 12-36 months.
- To identify the optimal format and number of distractors for the WatDAT in this age group.
Main Methods:
- Fifty-one typically developing children aged 12-36 months participated.
- The study assessed testability using Patti Pics (PP) and Face Targets (FT) with 3, 4, and 5 distractors presented on a touchscreen.
- Testability was defined as correctly identifying at least 4 out of 5 presentations; comparison was made with uncrowded PP symbols using matching.
Main Results:
- 87% of children aged 18-36 months could perform WatDAT with PP targets (3 distractors), versus 68% for FT targets.
- Testability for FT targets increased to 85% for children aged 22 months and older.
- Younger children (12-18 months) demonstrated significantly lower testability rates (9% for PP, 16% for FT with 3 distractors).
Conclusions:
- The WatDAT demonstrates higher testability compared to traditional matching visual acuity tests.
- The findings suggest the WatDAT has significant potential for measuring recognition visual acuity in children from 18 months of age.

