Advisory Committee Chair
Elizabeth Barstow
Advisory Committee Members
Drew Davis
Dawn Decarlo
Robert Ostler
Brooks Wingo
Document Type
Dissertation
Date of Award
2023
Degree Name by School
Doctor of Philosophy (PhD) School of Health Professions
Abstract
Cerebral Visual impairment (CVI) has become the leading cause of vision impairment in children worldwide. Early identification of CVI has been shown to improve visual function outcomes and improve developmental outcomes and quality of life. However, children with CVI are difficult to identify and assess because the medical conditions that cause CVI can also cause impairment across domains of function. A scoping review was first conducted on interventions and outcome measures used for children with CVI. The sources identified (n=20) were grouped into five types of interventions. The review confirmed the need for quantitative, standardized methods for measuring visual function in children with CVI. The next aim was to develop and evaluate a new Video-based Visual Function Assessment (VFA) to quantify visual function in young and medically complex children with CVI. The VFA was also designed to be presented over a video-conference platform (Zoom) to allow for potential remote assessment. Participants comprised a convenience sample of young and medically complex children with CVI (n=22) who were assessed in the clinic via a mock remote Zoom session. Participants were rated from video recordings of the Zoom session by three clinicians of different backgrounds. Using interclass correlation coefficients (ICCs) we found strong agreement between raters for all total mean VFA scores. Clinical acuity iv was obtained when possible, and there was a strong correlation with mean total VFA scores. A phenomenological study was concurrently conducted to understand the experience and perspectives of the caregivers as facilitators during VFA assessment. Caregivers found the VFA to have good face validity and felt it was able to assess their child in a way that past clinical assessments have not been able. The remote capabilities of the VFA could also offer new methods for obtaining assessment of children with CVI during a window that the caregiver perceives their child to be using their vision the best. The VFA was able to reliably quantify basic visual function in a small group of young and medically complex children with CVI. In addition, most caregivers found the video-based assessment to be an ideal modality for assessing vision in their children.
Recommended Citation
Weden, Kathleen Mary, "Assessing Visual Function in Young and Medically Complex Children with Cerebral Visual Impairment" (2023). All ETDs from UAB. 374.
https://digitalcommons.library.uab.edu/etd-collection/374
