J Clin Neurol.  2021 Jul;17(3):354-362. 10.3988/jcn.2021.17.3.354.

Development of the Parental Questionnaire for Cerebral Visual Impairment in Children Younger than 72 Months

Affiliations
  • 1Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
  • 2Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
  • 3Department of Pediatrics, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwasung, Korea
  • 4Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
  • 5Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 6Department of Pediatrics, Keimyung University Dongsan Hospital, Daegu, Korea
  • 7Department of Pediatrics, Daegu Catholic University School of Medicine, Daegu, Korea
  • 8Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea
  • 9Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
  • 10Department of Pediatrics, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea
  • 11Department of Pediatrics, Seoul National University College of Medicine, SMC-SNU Boramae Medical Center, Seoul, Korea
  • 12Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Abstract

Background and Purpose
Cerebral visual impairment (CVI) is an underdiagnosed condition in children, and its assessment tools have focused on older children. We aimed to develop a parental questionnaire for cerebral visual impairment (PQCVI) for screening CVI in young children.
Methods
The PQCVI comprised 23 questions based on a modified version of Houliston and Dutton’s questionnaire for older children. The PQCVI with neurocognitive function tests was applied to 201 child–parent pairs with typically developing children younger than 72 months (age 32.4±20.1 months, mean±standard deviation). The children were classified into six age groups. The normative data, cutoff scores, and internal reliability were assessed and item analysis was performed. We referred to the total score for all questions as the cerebral visual function (CVF) score.
Results
The normative data showed that the CVF score and the scores corresponding to ventral-stream and dorsal-stream visual functions plausibly increased with age. The scores rapidly reached 90% of their maximum values up to the age of 36 months, after which they increased slowly. Cronbach’s alpha for all questions across all age groups was 0.97, showing excellent consistency. The item difficulty and item discrimination coefficients showed that the questions were generally adequate for this age stage.
Conclusions
The PQCVI items produced reliable responses in children younger than 72 months. The rapid increase in scores before the age of 3 years supports the importance of early identification of CVI. Following additional clinical verification, the PQCVI may be useful for CVI screening.

Keyword

vision disorders; development; neurodevelopmental disorders; preschool children; early diagnosis
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