Parent-reported problems in children with Cerebral Visual Impairment: Improving the discriminative ability from ADHD
Marinke J Hokken1,2, Ymie J van der Zee2, Jos N van der Geest1
1Erasmus MC, Department of Neuroscience, Rotterdam, the Netherlands.
Insights
Daily visual problems in children with Cerebral Visual Impairment (CVI) are often missed. This study highlights parent-reported visual issues to better differentiate CVI from ADHD and dyslexia.
Area of Science:
- Pediatric ophthalmology
- Developmental neuroscience
- Clinical psychology
Background:
- Children with Cerebral Visual Impairment (CVI) often exhibit daily problems misinterpreted as behavioral or learning disabilities.
- Higher-order visual function (HOVF) deficits in CVI can be challenging to distinguish from other pediatric clinical groups based on observable behaviors.
Purpose of the Study:
- To compare parent-reported visual and behavioral problems in children with CVI, ADHD, dyslexia, and neurotypical children.
- To assess the utility of existing inventories (V-CVI-I, HVFQI, AVL) in differentiating these groups.
- To propose a refined screening approach for identifying potential CVI.
Main Methods:
- Utilized two CVI inventories (V-CVI-I, HVFQI) and an ADHD questionnaire (AVL).
- Compared parent-reported data for children aged 6-15 with Verbal Intelligence > 70 across CVI, ADHD, dyslexia, and neurotypical groups.
- Analyzed visual acuity levels and their impact on reported visual problems.
Main Results:
- Children with CVI reported significantly more visual problems than all other groups, irrespective of visual acuity.
- Children with ADHD and dyslexia also showed increased parent-reported visual problems in HOVF categories compared to neurotypical children.
- Children with ADHD had more behavioral problems, but CVI also showed more reported behavioral issues than neurotypical controls.
Conclusions:
- Existing inventories may complicate initial screening and referral for children with potential CVI.
- Parent-reported visual problems in daily life are crucial for differentiating CVI from ADHD and dyslexia.
- A shortened screening list focusing on visual problems is proposed to improve diagnostic differentiation.
Abstract:
Daily problems of children with Cerebral Visual Impairment (CVI) are often misinterpreted as symptoms of behavioural disorders or learning disabilities instead of higher order visual function (HOVF) deficits. It is difficult to differentiate between various paediatric clinical groups based on daily manifestations. We used two CVI inventories (V-CVI-I, HVFQI) and an ADHD questionnaire (AVL) to compare parent-reported visual and behavioural problems of children with CVI, ADHD, dyslexia and neurotypical children (Age 6-15, Verbal Intelligence > 70). Our results show a higher percentage of parent-reported visual problems in children with CVI compared to all other groups, which was not affected by their visual acuity levels. On most HOVF categories, a higher percentage of parent-reported visual problems was also found in children with ADHD or dyslexia compared to neurotypical children. Children with ADHD had significantly more parent-reported behavioural problems, but more behavioural problems were reported by the parents of children with CVI compared to neurotypical children as well. Our findings complicate using the existing inventories for initial screening and referral of children with potential CVI. We propose a shortened screening list to improve the potential differentiation between CVI and ADHD or dyslexia based on parent-reported visual problems in everyday life.
Related Concept Videos
01:25Learning Disabilities
Dyslexia
Dyslexia is a...
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....