Assessment tool for visual perception deficits in cerebral visual impairment: reliability and validity

Aim To evaluate the reliability and validity of the Children's Visual Impairment Test for 3- to 6-year-olds (CVIT 3-6). Method Reliability was assessed via test-retest correlation and intraclass correlation coefficient (ICC) in typically developing children, children with cerebral visual impairment (CVI), intellectual impairment, and simulated impaired vision (validation groups n=59, mean developmental age=4y 10mo, 27 females, 32 males). Internal validity was evaluated with a confirmatory factor analysis on the normative sample (n=301, median age=4y 8mo, SD=9.7mo, 148 females, 153 males). External validity was assessed by correlating performance on CVIT 3-6 with L94, the Beery-Buktenica Developmental Test of Visuo-Motor Integration (Beery-VMI), the Freiburg Vision Test, the revised Snijders-Oomen Nonverbal Intelligence Test for children between 2 years 6 months and 7-years-old (SON-R 2.5-7), and the Social Responsiveness Scale (SRS) questionnaire and by comparing performance between validation groups. Results We observed very good test-retest reliability (r=0.82, p<0.001, ICC=0.80) and confirmed the hypothesized factor structure (comparative fit index=1; Tucker-Lewis index=1.045). We found high correlations with tests with a strong visual perception component (L94: r=0.74, pr=0.37, p=0.01) and low correlations with other tests (Beery-VMI: r=0.25, p=0.09; SRS: r=0-0.26, p=0.09). Lowest scores were observed for children with CVI compared to the other validation groups (F[3,44]=5.1, p=0.003). Interpretation CVIT 3-6 is grounded in knowledge of visual perception. The tool specifically measures CVI-related visual perception deficits and is not mediated by intellectual abilities or low visual acuity. What the paper adds Evidence for good test-retest reliability of the Children's Visual Impairment Test for 3- to 6-year-olds (CVIT 3-6). Factor structure of normative data reflects CVIT 3-6's foundations in vision science. CVIT 3-6 specifically measures visual perception impairments. CVIT 3-6 performance is not influenced by intelligence or low visual acuity.