Can the functional impact of childhood visual impairment be assessed? A preliminary trial of VIS-Ability

Abstract

It is accepted that support for children with visual impairment should aim at mitigating for the functional impact experienced. Assessment for support should focus on this functional impact. However, it is now common practice that children in Australia are assessed in clinical environments that do not adequately reflect a child’s everyday functional performance. This article presents a preliminary trial that investigated VIS-Ability – a new approach aimed at identifying behaviours that indicate the functional impact of childhood visual impairment. VIS-Ability is a tool that derived from an e-Delphi study in which professionals experienced in the management of children with visual impairment identified four key areas related to functional impact. The behaviours believed to indicate this impact were also identified and included in VIS-Ability, as simple statements that questioned impact on use of vision in the immediate environment, on spontaneous and continuous use of vision, and on coordination of vision with other tasks. A total of 12 children with visual impairment and no additional disabilities consented to participate in the VIS-Ability preliminary trial. All participants completed VIS-Ability (based on behaviours), and an aggregated result was then compared to the child’s performance on a validated, self-reported (activity-based) questionnaire named the Functional Vision Questionnaire for Children and Young People, 36 items (FVQ_CYP 36). When participant results on VIS-Ability were compared to FVQ_CYP (36) scores, an association between the assessment of functional impact made by each instrument (VIS-Ability: FVQ_CYP 36) was evident. Support systems for children with visual impairment must be founded in assessment that reveals the child’s true needs. The preliminary trial presented a new approach to identifying functional impact named VIS-Ability, an approach that identifies impact through the presence of behaviours rather than clinical measurements. Further evaluation of VIS-Ability will reveal whether this approach assists with the development of better clinical and educational understanding of childhood visual impairment.