Quantifying visuoperceptual profiles of children with cerebral visual impairment

ABSTRACT

The aim was to develop a visuoperceptual profile schema reflecting visuoperceptual strengths and weaknesses, using neuropsychological tests. Secondly, this schema was used to quantify individual visuoperceptual profiles of children with and without cerebral visual impairment (CVI), and to identify differences in their profiles. Clinical records (2001–2018) of 630 children (386 males, 244 females; median age 77 months; interquartile range 63–98 months) suspected for CVI were reviewed. Neurological history, visuoperceptual results, ophthalmological, and neuroimaging data were retrieved. To develop the visuoperceptual schema, exploratory factor analyses (EFAs) were performed, followed by a Delphi study. In individual interviews, six experts were asked to “name the different visuoperceptual dimensions” and “what visuoperceptual dimensions are targeted by each of the 24 visuoperceptual subtests.” To reach consensus, two questionnaire rounds (44 statements and 20 statements, respectively, five experts) followed. EFAs showed clinically uninterpretable results. The Delphi study revealed seven visuoperceptual dimensions; (1) visual discrimination and matching, (2) object or picture recognition, (3) visual spatial perception, (4) figure-ground perception, (5) motion perception, (6) visual short-term memory, and (7) scene perception. The most discriminating dimensions between CVI and no CVI were object/picture recognition (r = 0.56), visual spatial perception (r = 0.52), visual discrimination and matching (r = 0.47), and figure-ground perception (r = 0.39). Motion perception and visual short-term memory (both r = 0.22) were less discriminating. Two case studies illustrate how to apply the visuoperceptual schema to characterize dysfunction and intact functions. Visuoperceptual profiling can serve as a basis for individualized therapies in heterogeneous disorders.

KEYWORDS:

• Visuoperceptual profiling
• cerebral visual impairment
• individualized therapy
• clinical assessment

Acknowledgments

This work was supported by the Fund Scientific Research Flanders (FWO-project) under grant number T003817N. Author JW was supported by the Flemish Government under grant number METH/14/02. The authors report no conflict of interest. The authors would like to thank the clinicians and physiotherapists from the CVI clinic and the Center for Developmental Disabilities at the University Hospitals of Leuven for their willingness to contribute to and advance our understanding of CVI. We would like to thank Sophie Decavele for her help in the Delphi study. Moreover, discussions with Professor Peter Stiers from Maastricht University in relation to visuoperceptual testing was beneficial for this project.

Disclosure statement

The views expressed in the submitted article are our own and not an official position of the institution or funder.

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/09297049.2021.1915265.

Additional information

Funding

This work was supported by the Fund Scientific Research Flanders (FWO-project) [grant number T003817N]. Author JW was supported by the Flemish Government [grant number METH/14/02].