Visual disorder and sensory integration in 3- to 6-year-old children with cerebral visual impairment and cerebral palsy.

Abstract

Background: Sensory and behavioral difficulties are frequently observed in children with cerebral palsy (CP), and these challenges may intensify when cerebral visual impairment (CVI) co-occurs. However, the extent and nature of these combined effects remain underexplored.

Objective: The aim of this study is to compare sensory processing skills and behavior of children with CP and CVI, CP without CVI, and typically development (TD) and to examine the relationship between sensory processing skills and behavior in children in these groups.

Design: Prospective, cross-sectional study with control group.

Setting: Special education and rehabilitation center.

Participants: A total of 120 children aged 3-6 years, consisting of three groups, were included in the study: 40 children with CP and CVI, 40 children with CP without CVI, and 40 children with TD.

Main outcomes measures: The Sensory Profile (SP) was used to assess sensory skills and the Child Behavior Rating Scale (CBRS) was used to assess behavior.

Results: There were significant differences in all pairwise comparisons between the three groups and between SP subdomains and CBRS scores (p < .05). Children with CP and CVI had the lowest median scores (SP: 7-78.5; CBRS: 26), followed by those with CP without CVI (SP: 9-95; CBRS: 33), whereas TD children had the highest scores (SP: 12-129; CBRS: 49). These findings suggest a trend toward worsening sensory and behavioral outcomes in the presence of CVI in addition to CP and in CP alone. Furthermore, moderate to strong positive correlations were observed between SP and CBRS scores in all groups (rho = 0.468-0.872; p < .001), suggesting that behavioral problems increase with decreased sensory processing skills.

Conclusions: This study reveals that children with CP have more problems in sensory processing and behavioral functioning compared to their peers with TD and that these problems are exacerbated in the presence of CVI accompanying CP. In addition, the significant relationship observed between the decrease in sensory processing skills and the increase in behavioral problems emphasizes the importance of evaluating these two areas together and adopting a holistic approach in intervention planning.