Development and initial validation of a screening tool for visual ability/performance of people with polyhandicap

Area of Science:

• Ophthalmology and Neuroscience
• Rehabilitation Medicine
• Disability Studies

Background:

• Visual impairments are prevalent but underassessed in individuals with polyhandicap.
• Accurate visual assessment is crucial for effective management of impairments in this population.

Purpose of the Study:

• To develop and validate an accessible visual-behavioral scale for assessing visual abilities in people with polyhandicap.
• To create a reliable tool for clinical and research settings.

Main Methods:

• The Visual Assessment for People with Polyhandicap (VA-PLH) scale was developed in two stages: construction and field validation.
• Criteria included age >3 years, early cerebral lesion onset, severe motor and intellectual impairments, and functional dependence.
• Validation involved comparing the scale against expert ophthalmological and orthoptic assessments.

Main Results:

• The study included 232 participants; 83% had ocular abnormalities, and 60% had insufficient visual ability.
• The final VA-PLH scale, with 3 visual reaction items, demonstrated strong diagnostic accuracy (AUC = 0.83).
• The scale achieved satisfactory reliability, sensitivity of 83%, and specificity of 73% for identifying at-risk individuals.

Conclusions:

• The VA-PLH scale is a user-friendly, reliable, and valid instrument for assessing visual status in people with polyhandicap.
• It is suitable for both clinical practice and research, improving the identification of visual challenges.
• The study highlights the high prevalence of visual impairments within this population.