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Manley CE, Walter K, Micheletti S, Tietjen M, Cantillon E, Fazzi EM, Bex PJ, Merabet LB. Object identification in cerebral visual impairment characterized by gaze behavior and image saliency analysis. Brain Dev 2023; 45:432-444. [PMID: 37188548 PMCID: PMC10524860 DOI: 10.1016/j.braindev.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 05/17/2023]
Abstract
Individuals with cerebral visual impairment (CVI) have difficulties identifying common objects, especially when presented as cartoons or abstract images. In this study, participants were shown a series of images of ten common objects, each from five possible categories ranging from abstract black & white line drawings to color photographs. Fifty individuals with CVI and 50 neurotypical controls verbally identified each object and success rates and reaction times were collected. Visual gaze behavior was recorded using an eye tracker to quantify the extent of visual search area explored and number of fixations. A receiver operating characteristic (ROC) analysis was also carried out to compare the degree of alignment between the distribution of individual eye gaze patterns and image saliency features computed by the graph-based visual saliency (GBVS) model. Compared to controls, CVI participants showed significantly lower success rates and longer reaction times when identifying objects. In the CVI group, success rate improved moving from abstract black & white images to color photographs, suggesting that object form (as defined by outlines and contours) and color are important cues for correct identification. Eye tracking data revealed that the CVI group showed significantly greater visual search areas and number of fixations per image, and the distribution of eye gaze patterns in the CVI group was less aligned with the high saliency features of the image compared to controls. These results have important implications in helping to understand the complex profile of visual perceptual difficulties associated with CVI.
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Affiliation(s)
- Claire E Manley
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Kerri Walter
- Translational Vision Lab. Department of Psychology, Northeastern University, Boston, MA, USA
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Matthew Tietjen
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Emily Cantillon
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Elisa M Fazzi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Peter J Bex
- Translational Vision Lab. Department of Psychology, Northeastern University, Boston, MA, USA
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA.
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Tsai LT, Wu WC, Hsieh CL, Wu TY, Lu YC, Hou CH. Development and validation of the Visual Function Battery for Children with Special Needs. Dev Med Child Neurol 2022; 65:632-639. [PMID: 36282724 DOI: 10.1111/dmcn.15441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 11/28/2022]
Abstract
AIM To develop and validate the Visual Function Battery for Children with Special Needs (VFB-CSN). METHOD This was a scale development and validation study with (1) construct and item generation and (2) evaluations of interrater reliability, acceptability, and content, ecological, and convergent validities. RESULTS Children with special needs were recruited for the reliability (n = 32) and validity (n = 95) investigations. The construct and items were generated based on literature review and an expert panel. We constructed eight categories, namely visual reflex, ocular muscle balance, visual acuity, oculomotor, visual field, contrast sensitivity, colour/form vision, and visual attention. Both functional assessment and standardized tests were adopted. The reliabilities were high for the whole VFB-CSN (intraclass correlation coefficient [ICC] = 0.90, 95% confidence interval [CI] = 0.80-0.90) and good for the oculomotor, contrast sensitivity, and colour/form vision (ICC = 0.80-0.86, 95% CI = 0.50-0.93). Correlations between the VFB-CSN and the Functional Vision Questionnaire were strong and acceptable for the contrast sensitivity, acuity, and colour/form vision (r = 0.79, r = 0.69, r = 0.69, r = 0.70 respectively). The correlation between the VFB-CSN and standardized visual acuity test was acceptable (r = -0.72). INTERPRETATION The VFB-CSN is a reliable and valid multifaceted battery for children with special needs. Acceptable psychometric properties were also found for the acuity and contrast sensitivity.
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Affiliation(s)
- Li-Ting Tsai
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Ophthalmology, Chang Gung Memorial Hospital, and Department of Medicine, School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, and Department of Medicine, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Tien-Yun Wu
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Chieh Lu
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chiun-Ho Hou
- Department of Ophthalmology, Chang Gung Memorial Hospital, and Department of Medicine, School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.,Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Juneja M, Gupta A, Sairam S, Jain R, Sharma M, Thadani A, Srinivasan R, Lingappa L, Ahmed S, Multani KS, Buch P, Chatterjee N, Dalwai S, Kabra M, Kapoor S, Patel PK, Girisha KM, Kulkarni M, Kunju PAM, Malhi P, Meenai Z, Mishra D, Mundkur N, Nair MKC, Oommen SP, Prasad C, Singh A, Srivastava L, Suman P, Thakur R. Diagnosis and Management of Global Development Delay: Consensus Guidelines of Growth, Development and Behavioral Pediatrics Chapter, Neurology Chapter and Neurodevelopment Pediatrics Chapter of the Indian Academy of Pediatrics. Indian Pediatr 2022. [DOI: 10.1007/s13312-022-2522-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ben Itzhak N, Kooiker MJG, van der Steen J, Pel JJM, Wagemans J, Ortibus E. The relation between visual orienting functions, daily visual behaviour and visuoperceptual performance in children with (suspected) cerebral visual impairment. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 119:104092. [PMID: 34619456 DOI: 10.1016/j.ridd.2021.104092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 09/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Children with cerebral visual impairment (CVI) present heterogeneous visual orienting functions (VOF) and higher-order perception. Multiple assessment methods evaluate CVI, but the relations between them remain unclear. AIM To investigate the relations between VOF and (1) daily life behaviour and (2) visuoperceptual tests in children with (suspected) CVI. METHODS AND PROCEDURES VOF were tested with a validated eye tracking-based paradigm. Visual perception was assessed using the children's visual impairment test for 3- to 6-year olds (CVIT 3-6) and (retrospective) visuoperceptual dimension results. Caregivers completed the Flemish cerebral visual impairment questionnaire (FCVIQ) and an expert panel scored relations between VOF and the other methods. We compared experts' survey responses with data-based results (linear mixed models and correlations). OUTCOMES AND RESULTS Fourty-four children (23 boys, 21 girls; median age = 7y11mo, SD = 2y7mo) participated. Twenty-one experts completed the survey. Slower VOF was significantly associated with (1) object and face processing impairments, (2) visual (dis)interest, (3) worse visual spatial perception (to local motion and form stimuli), and (4) worse CVIT 3-6 object and scene recognition (to cartoon stimuli). CONCLUSIONS AND IMPLICATIONS Integration of VOF with existing visual assessments provides a better clinical picture of CVI and can prevent misdiagnosing children as inattentive, incapable, or unmotivated.
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Affiliation(s)
- N Ben Itzhak
- Department of Development and Regeneration, University of Leuven (KU Leuven), O&N IV Herestraat 49, Box 805, 3000 Leuven, Belgium.
| | - M J G Kooiker
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Royal Dutch Visio, Amsterdam, the Netherlands
| | - J van der Steen
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - J J M Pel
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - J Wagemans
- Department of Brain & Cognition, University of Leuven (KU Leuven), Leuven, Belgium; Leuven Brain Institute (LBI), Leuven, Belgium
| | - E Ortibus
- Department of Development and Regeneration, University of Leuven (KU Leuven), O&N IV Herestraat 49, Box 805, 3000 Leuven, Belgium; Child Youth Institute (L-C&Y), Leuven, Belgium
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Lueders KS. Rethinking the Reading Stand to Maximize Visual Efficiency. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2021. [DOI: 10.1177/0145482x211047629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Jackel B, Wilson M, Hartmann E. A Survey of Parents of Children with Cortical or Cerebral Visual Impairment. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x1010401007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article summarizes the results of a survey of 80 parents of children with cortical or cerebral visual impairment (CVI) regarding how a CVI diagnosis is received and supports that are provided after the diagnosis, the educational supports received by children with CVI, and the parents’ perceptions of the supports that they and their children receive.
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Affiliation(s)
- Bernadette Jackel
- FOVI (Focus on Visual Impairments), monitor of the NAPVI/AFB FamilyConnect CVI page, a focus group coordinator for NAPVI/AFB, cofounder of presenter at the 2009 NE AER, and board member of the Pilot House, a special needs foundation; mailing address: 985 Powder Horn Lane, Fairfield, CT 06824
| | - Michelle Wilson
- FOVI, monitor of the NAPVI/AFB FamilyConnect CVI page, focus group coordinator for NAPVI/AFB, cofounder of and a presenter at the CVI Summit; mailing address: P.O. Box 28, Hamilton, OH 45012
| | - Elizabeth Hartmann
- Boston College and CAST; mailing address: 40 Harvard Mills Square, Suite 3, Wakefield, MA 01880
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Salavati M, Rameckers E, Waninge A, Krijnen W, van der Schans C, Steenbergen B. Evaluating the outcome of an individual functional therapy program focused on children with cerebral palsy and cerebral visual impairment: a multiple case study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2017.1374455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Masoud Salavati
- Royal Dutch Visio, Center of Expertise for Blind and Visually Impaired People, Haren, The Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Eugene Rameckers
- Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Adelante Center of Expertise in Rehabilitation and Audiology, Valkenburg and Hoensbroek, The Netherlands
- AVANSplus, University for Professionals for Paediatric Physical Therapy, Breda, The Netherlands
| | - Aly Waninge
- Royal Dutch Visio, Center of Expertise for Blind and Visually Impaired People, Haren, The Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Wim Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Cees van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bert Steenbergen
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
- School of Psychology, Australian Catholic University, Melbourne, Australia
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Chorna OD, Guzzetta A, Maitre NL. Vision Assessments and Interventions for Infants 0-2 Years at High Risk for Cerebral Palsy: A Systematic Review. Pediatr Neurol 2017; 76:3-13. [PMID: 28918222 PMCID: PMC5677526 DOI: 10.1016/j.pediatrneurol.2017.07.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/14/2017] [Accepted: 07/15/2017] [Indexed: 10/19/2022]
Abstract
We performed a systematic review and evaluated the level of evidence of vision interventions and assessments for infants at high risk for or with a diagnosis of cerebral palsy from zero to two years of age. Articles were evaluated based on the level of methodologic quality, evidence, and clinical utilization. Thirty publications with vision assessments and five with vision interventions met criteria for inclusion. Assessments included standard care neuroimaging, electrophysiology, and neuro-ophthalmologic examination techniques that are utilized clinically with any preverbal or nonverbal pediatric patient. The overall level of evidence of interventions was strong for neuroprotective interventions such as caffeine and hypothermia but weak for surgery, visual training, or developmental programs. There are few evidence-based interventions and assessments that address cerebral/cortical visual impairment-related needs of infants and toddlers at high risk for or with cerebral palsy. Recommendation guidelines include the use of three types of standard care methodologies and two types of protective interventions.
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Affiliation(s)
- Olena D Chorna
- Center for Perinatal Research and Department of Pediatrics at Nationwide Children's Hospital, Columbus, OH
| | - Andrea Guzzetta
- Stella Maris Infant Laboratory for Early Intervention, Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy,Department of Clinical and Experimental Medicine, University of Pisa, Italy,Address Correspondence to: Dr. Nathalie L. Maitre, Department of Pediatrics, 700 Children's Drive, WB6225, Columbus, Ohio 43215 [] 614-722-4559
- FX: 614-722-4541
| | - Nathalie L Maitre
- Center for Perinatal Research and Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio; Department of Hearing and Speech Sciences, Vanderbilt Kennedy Center, Nashville, Tennessee.
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Salavati M, Waninge A, Rameckers EAA, van der Steen J, Krijnen WP, van der Schans CP, Steenbergen B. Development and face validity of a cerebral visual impairment motor questionnaire for children with cerebral palsy. Child Care Health Dev 2017; 43:37-47. [PMID: 27481724 DOI: 10.1111/cch.12377] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/24/2016] [Accepted: 06/11/2016] [Indexed: 11/27/2022]
Abstract
AIM The objectives of this study were (i) to develop two cerebral visual impairment motor questionnaires (CVI-MQ's) for children with cerebral palsy (CP): one for children with Gross Motor Function Classification System (GMFCS) levels I, II and III and one for children with GMFCS levels IV and V; (ii) to describe their face validity and usability; and (iii) to determine their sensitivity and specificity. BACKGROUNDS The initial versions of the two CVI-MQ's were developed based on literature. Subsequently, the Delphi method was used in two groups of experts, one familiar with CVI and one not familiar with CVI, in order to gain consensus about face validity and usability. The sensitivity and specificity of the CVI-MQ's were subsequently assessed in 82 children with CP with (n = 39) and without CVI (n = 43). With the receiver operating curve the cut-off scores were determined to detect possible presence or absence of CVI in children with CP. RESULTS Both questionnaires showed very good face validity (percentage agreement above 96%) and good usability (percentage agreement 95%) for practical use. The CVI-MQ version for GMFCS levels I, II and III had a sensitivity of 1.00 and specificity of 0.96, with a cut-off score of 12 points or higher, and the version for GMFCS levels IV and V had a sensitivity of 0.97 and a specificity of 0.98, with a cut-off score of eight points or higher. CONCLUSION The CVI-MQ is able to identify at-risk children with CP for the probability of having CVI.
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Affiliation(s)
- M Salavati
- Centres of expertise for blind and visually impaired people, Royal Dutch Visio, The Netherlands.,Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - A Waninge
- Centres of expertise for blind and visually impaired people, Royal Dutch Visio, The Netherlands.,Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - E A A Rameckers
- Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Adelante Center of Expertise in Rehabilitation and Audiology, Valkenburg and Hoensbroek, The Netherlands.,Advanced Training for Professionals Working with Children with Movement Disabilities, AVANSplus, Breda, The Netherlands
| | - J van der Steen
- Centres of expertise for blind and visually impaired people, Royal Dutch Visio, The Netherlands.,Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
| | - W P Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - C P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Rehabilitation Medicine; Groningen, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - B Steenbergen
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.,School of Psychology, Australian Catholic University, Melbourne, Australia
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