CVI questionnaires for preschool children: Towards early screening of visual difficulties in daily life.

Abstract

Cerebral Visual Impairment (CVI) is associated with a wide range of visual deficits that can be difficult to identify in young children. Parental observations are essential for the early screening and diagnostic assessment of CVI. However, most existing CVI (screening) questionnaires are designed for children aged 6 years and older. This study aimed to (1) explore how CVI manifests in the daily lives of preschool children and (2) develop a preschool CVI screening list. In total, 118 parents of children aged 2-5 years with CVI (n = 30), at risk of CVI (n = 22), and neurotypical children (n = 66) completed two questionnaires: the Parental Questionnaire for Cerebral Visual Impairment (PQCVI) and a new Preschool version of the Visio-CVI-Inventory (V-CVI-I). Parent-reported difficulties were compared across groups at questionnaire, category, and item level. Items were evaluated on three criteria: (1) Discriminability (A' ≥ .75, CVI vs. neurotypical), (2) Relevance (≥ 25% of the CVI-group showing difficulties), (3) Exclusivity (≤10% the neurotypical group showing difficulties). Parents of children with CVI reported significantly more daily visual difficulties, particularly in global and local visual selective attention and visuomotor processing. The Preschool V-CVI-I showed excellent internal consistency (a = .91) and stronger discriminative ability than the PQCVI. Our results indicate that daily visual deficits are already observable in preschool children with CVI and resemble the difficulties previously reported in older children with CVI. A new 10-item Preschool CVI Screening List is proposed to support early recognition and referral for further diagnostics.