Developmental trajectories of visual orienting functions in children born very or extremely preterm
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Updated: Jun 3, 2025
A Method to Quantify Visual Information Processing in Children Using Eye Tracking
Published on: July 9, 2016
Maud M van Gils1, Alja Bijlsma2, Marijn J Vermeulen2
1Vestibular and Oculomotor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands.
Insights
Eye tracking identified visual processing delays in 40% of very preterm children by age 5. Routine screening with salient stimuli can detect these delays early, enabling timely intervention for children at risk of neurodevelopmental impairments.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Ophthalmology
Background:
- Preterm birth (<32 weeks gestational age) elevates the risk of neurodevelopmental impairments, including Cerebral Visual Impairment (CVI), which impacts visual processing.
- Traditional methods for assessing visual functions in young children are often limited by reliance on verbal or motor responses.
- Eye tracking offers a promising, objective method for evaluating visual functions in infants and young children.
Purpose of the Study:
- To investigate the developmental trajectories of Visual Orienting Functions (VOF) in children born very preterm.
- To assess VOF development between 2 and 5 years corrected age (CA) using eye tracking.
- To compare VOF in preterm children with term-born peers.
Main Methods:
- Eye tracking was used to assess VOF in 263 preterm children at 2, 3, and 5 years CA.
- A subgroup of 49 children completed all three eye-tracking assessments.
- Brain imaging (MRI) was performed postnatally to evaluate brain damage, with results correlated to VOF outcomes.
Main Results:
- Approximately 40% of very preterm children exhibited normal VOF development to both high and intermediate salient visual stimuli.
- A significant subset (40%) of preterm children demonstrated delayed visual processing to high-salient stimuli by 5 years CA.
- No significant correlation was observed between early-life brain damage (MRI) and abnormal VOF at 5 years CA.
Conclusions:
- Routine visual screening utilizing high-salient stimuli can identify VOF delays in preterm children from 2 years CA.
- Early detection of visual processing deficits is crucial for initiating timely interventions and specialized care.
- This approach supports early identification of visual processing challenges in at-risk preschool populations.
Background And Aims:
Preterm birth increases the risk of neurodevelopmental impairments, such as Cerebral Visual Impairment (CVI), which affects visual processing. Assessing visual functions in young children is challenging with traditional methods that often rely on verbal/motor responses. The aim of the study was to investigate the developmental trajectories of Visual Orienting Functions (VOF) in children born very preterm (<32 weeks gestational age) between 2 and 5 years corrected age (CA) using eye tracking.
Methods:
263 children born preterm underwent eye tracking at 2, 3 and 5 years CA. A subgroup of 49 children underwent all three measurements. Magnetic resonance imaging (MRI) was performed shortly after birth and evaluated for brain damage using a modified Kidokoro scoring protocol. The VOF results to high (cartoon and contrast) and intermediate (form and motion detection) salient visual stimuli of the preterm group were compared to those of term-born age-matched peers.
Results:
Approximately 40 % of children born preterm showed normal VOF development to high and intermediate salient stimuli. However, in another 40 % of children born preterm, an increase in delayed visual processing to high-salient stimuli was found at 5 years CA. No significant correlation was found between brain damage on MRI shortly after birth and abnormal VOF at 5 years CA.
Conclusion:
The data suggest that routine visual screening using high-salient stimuli can identify VOF delays from 2 years CA onwards in children at risk of brain damage. Early detection of visual processing deficits can enable timely interventions and specialized care for pre-schoolers.
