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Validation of the Austin Assessment: A screening tool for cerebral visual impairment related visual issues
Nicola McDowell1, Philippa Butler1
1Institute of Education, Massey University, Auckland, New Zealand.
Insights
The Austin Assessment iPad app shows promise as a screening tool for cerebral visual impairment (CVI) in children. Initial validation suggests it can effectively identify children needing further visual assessment.
Area of Science:
- Ophthalmology
- Pediatrics
- Developmental Neuroscience
Background:
- Cerebral visual impairment (CVI) is a leading cause of childhood vision impairment in developed nations, affecting approximately 3.4% of children.
- Current screening methods for CVI are limited, leading to underdiagnosis, particularly in children with normal visual acuity.
- There is a critical need for accessible and effective screening tools to identify CVI-related visual issues early.
Purpose of the Study:
- To validate the Austin Assessment, an iPad application designed as a potential screening tool for CVI-related visual issues in children.
- To establish normative data and assess the diagnostic accuracy of the Austin Assessment across different age groups.
Main Methods:
- The study involved three phases: establishing normative ranges (Phase 1), screening children aged 5-13 (Phase 2), and validation against a known tool (Phase 3).
- Quantitative research methodologies were employed across all phases.
- Statistical analysis included establishing thresholds and assessing sensitivity and specificity.
Main Results:
- Normative thresholds for three Austin Assessment variables were established for age groups 5-8, 9-12, and 13-18.
- Phase 2 identified 17 out of 270 children with potential CVI-indicative visual issues.
- Phase 3 demonstrated moderate diagnostic value, with good sensitivity and specificity, indicating effectiveness in differentiating affected children.
Conclusions:
- The Austin Assessment shows potential as a valid screening tool for CVI-related visual issues in children.
- The app's ability to distinguish children with visual issues from those with typical vision supports its utility.
- Further research is recommended to confirm these initial validation findings.
Abstract:
Cerebral visual impairment is the most common cause of vision impairment affecting children in the economically developed world with a prevalence rate of approximately 3.4%. Currently there are limited options for screening for cerebral visual impairment, resulting in many children going undiagnosed, especially those that have normal visual acuity. The aim of this research was to validate an iPad App called the Austin Assessment, which was developed as a potential screening tool for cerebral visual impairment related visual issues. The research involved three separate phases: (1) creating a database of normative ranges for children aged 5-18 across the different variables of the Austin Assessment, (2) using the Austin Assessment to screen children aged 5-13 to assess the effectiveness of the Austin Assessment as a screening tool for CVI related visual issues, and (3) conducting specific validation research assessing children using the Austin Assessment and an already validated visual search tool. Each phase used different quantitative research methodologies to help show the effectiveness of the Austin Assessment as a screening tool for cerebral visual impairment related visual issues. From phase one of the research, thresholds were established for three variables of the Austin Assessment for the age groupings of 5-8, 9-12 and 13-18. If a child meets one of these thresholds this indicates further assessment is required to determine if they do in fact have cerebral visual impairment related visual issues. Phase two identified 17 children out of 270 who had clinical findings indicating visual issues; potentially indicative of CVI; investigation into the nature of these visual issues is ongoing. Phase three found that the Austin Assessment has moderate diagnostic value for each age group, with good sensitivity and specificity, making it effective at distinguishing those children who have visual issues from those who have typical vision. Further investigation is needed to confirm this initial validation.
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