Assessment of visuo-attentional abilities in young children with or without visual disorder: Toward a systematic screening in the general population

• Published in: Research in developmental disabilities 2010-09, Vol.31 (5), p.1102-1108
• Main Authors: Cavézian, Céline, Vilayphonh, Marc, de Agostini, Maria, Vasseur, Vivien, Watier, Laurence, Kazandjian, Seta, Laloum, Laurent, Chokron, Sylvie
• Format: Article
• Language: English
• Subjects: Aptitude; Attention; Biological and medical sciences; Cancellation; Child, Preschool; Children; Diagnosis, Differential; Disabled children; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Female; Humans; Male; Medical sciences; Memory; Nervous system (semeiology, syndromes); Neurological Impairments; Neurology; Neuropsychological Tests; Neurovisual disorders; Ophthalmological disease; Perceptual Disorders - diagnosis; Perceptual Disorders - psychology; Psychology. Psychoanalysis. Psychiatry; Psychometrics. Diagnostic aid systems; Psychomotor Performance; Psychopathology. Psychiatry; Reading; Screening; Screening Tests; Sensitivity and Specificity; Techniques and methods; Undiagnosed; Vision Disorders - diagnosis; Vision Disorders - psychology; Vision Screening; Visual Impairments; Visual Perception; Young Children
• ISSN: 0891-4222; 1873-3379
• DOI: 10.1016/j.ridd.2010.03.006

In young children, visual attention, analysis or memory is only rarely evaluated. Moreover, tools to test for such higher-order visual capacities in children are limited. In an attempt to develop and refine such tools, we selected nine tests to assess visuo-attentional abilities before formal reading education (grade 1). The battery consisted of gaze fixation, visual field, visual extinction, binocular visual pursuit, visual memory, “A” cancellation, Teddy bears cancellation, embedded figures, and matching tasks. This battery was used in the general population ( n = 110) to calculate cut-off scores identifying the lower 5% of the general population to obtain a screening measure for neurovisual disabilities in children. To evaluate our battery's sensitivity and specificity to neurovisual disorders over ophthalmological diseases, a neurovisual group ( n = 9) and an ophthalmologic group ( n = 13) also completed the tests. Overall, all but three tests of the battery could be used to discriminate between neurovisual and ophthalmologic children. The ophthalmologic children failed the visual field extent examination and the cancellation tasks, consistent with deleterious effects of ophthalmologic disease on visual perception as well as higher-order vision. Using the cut-off scores, the battery identified only 2 out of 13 ophthalmologic patients, but 5 out of 9 neurovisual patients. In the general population, these cut-off scores identified seven children. These children were previously undiagnosed with any disability (i.e., no diagnosis of ophthalmological, neurological, or psychiatric disease) and thus did not receive any rehabilitation. This preliminary study highlights the necessity for a neurovisual disorder screening tool for young children.