Eyes on vision – functional visual assessment in the child with a disability: a practical assessment approach for paediatricians

Vision plays a critical role in early developmental processes and current functioning. Descriptions of current developmental skills are often confidently made by paediatricians without making explicit the ways in which visual materials are used by the child in everyday activities. When we describe how the child functions in the performance of tasks that involve vision and which are meaningful to everyday activity and participation, it is the child's functional vision that is being described. Although responsibility for vision assessment is often assumed to lie with the eye clinic, multiple aspects of functional vision assessment fall strongly within the scope of paediatric practice and of other members of the multidisciplinary team. Paediatricians can develop their ability to help parents of disabled children understand what their child can visually detect and interpret and use existing developmental knowledge to contribute to advice on the most appropriate format and style of visual materials to support play and learning. Confidence in assessment of functional visual skills will support such advice giving. A practical approach to such assessment is set out here.