The online version of this article (doi:10.1186/s12874-017-0316-6) contains supplementary material, which is available to authorized users.
Vision influences functioning and disability of children with cerebral palsy, so there is a growing need for psychometrically robust tools to advance assessment of children’s vision abilities in clinical practice and research. Vision is a complex construct, and in the absence of clarity about this construct it is challenging to know whether valid, reliable measures exist. This study reports a method for conceptualising ‘visual ability’ as a measurable construct.
Using the items from 19 assessment tools previously identified in a systematic review, this study used a two-phase process: first, deductive content analysis linked items to the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY), and second, vision-specific ‘Activity’-level items were explored using inductive thematic analysis.
The linking and content analysis identified that existing assessment tools are measuring vision across the ICF-CY domains of Body Functions, Activities and Participation, and Environmental and Personal Factors. Items specifically coded to vision at the Activity level were defined as measuring ‘how vision is used’, and these items form the basis of the conceptualisation that ‘visual ability’ is measurable as a single construct.
The thematic analysis led to the identification of 3 categories containing 13 themes that reflect a child’s observable visual behaviours. Seven abilities reflect how a child uses vision: responds or reacts, initiates, maintains or sustains looking, changes or shifts looking, searches, locates or finds, and follows. Four interactions reflect the contexts in which a child uses their vision to purposefully interact: watches and visually interacts with people and faces, objects, over distance, and with hands. Finally, two themes reflect a child’s overall use of vision in daily activities: frequency of use, and efficiency of use.
This study demonstrates an approach to exploring and explaining a complex topic utilising World Health Organization language and building on existing research. Despite the complexity of vision, the concept of ‘how vision is used’ can be clearly defined as a measurable construct at the Activity level of the ICF-CY. This study has identified observable visual behaviours that may be developed into items assessing how vision is used in daily activities.
Additional file 1: Study-Specific Guidelines: ICF-CY Linking Rules and Challenges. This file contains a summary of the ICF Linking Rules annotated with study-specific examples and a summary of solutions to commonly occurring challenges from Part I – Linking visual ability assessments to the ICF-CY. (DOCX 20 kb)12874_2017_316_MOESM1_ESM.docx
Additional file 2: Results table for Body Function and Environmental factor codes. This file contains the tabulated results for assessment items linked to Body Function and Environmental factor codes. These results are not pertinent to Phase II in this study. (DOCX 21 kb)12874_2017_316_MOESM2_ESM.docx
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- Methods for conceptualising ‘visual ability’ as a measurable construct in children with cerebral palsy
Belinda Deramore Denver
- BioMed Central
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