Background
Method
ICF-CY Codes (N)b
| Visual ability constructsg
N (%) | ||||||||
---|---|---|---|---|---|---|---|---|---|
Assessment tool | Ref | Type of contenta
| Items/Scales | Linking units (N) | BF/BSc
| ACT/PARTd
| ENVe
| Other/Not codedf
| |
ABCDEFV | [35] | Clinical | 22 Tests | 28 | 20 | 8 | 0 | 0 | 6 (21.4) |
Alimovic | [42] | Patient oriented | 2 Scales | 5 | 0 | 5 | 0 | 0 | 4 (80) |
CAS | [33] | Clinical | 33 Visual development items | 41 | 14 | 26 | 0 | 1 | 18 (43.9) |
CVI Q | [16] | Patient oriented | 46 Items | 56 | 11 | 41 | 0 | 6 | 28 (50) |
CVI R | [31] | Clinical & Patient oriented | 10 Characteristics | 12 | 3 | 11 | 0 | 0 | 8 (66.7) |
1 Scale | 1 | 0 | 1 | 0 | 0 | 1 (100) | |||
EDVA | [32] | Clinical | 7 Test Items | 7 | 3 | 4 | 0 | 0 | 4 (57.1) |
FVQ | [18] | Patient oriented | 26 Questions | 34 | 5 | 30 | 0 | 0 | 23 (67.6) |
Hoyt | [43] | Patient oriented | 1 Scale | 2 | 1 | 1 | 0 | 0 | 1 (50) |
HSCS-PS | [38] | Patient oriented | 1 Vision Sub-scale | 4 | 2 | 1 | 1 | 0 | 1 (25) |
HUI-III | [44] | Patient oriented | 1 Vision Sub-scale | 5 | 2 | 2 | 1 | 0 | 1 (20) |
IDP | [45] | Patient oriented | Visual competence 1 Scale | 7 | 5 | 2 | 0 | 0 | 1 (14.3) |
LVC | [30] | Clinical | 8 Tests | 10 | 2 | 8 | 0 | 0 | 4 (40) |
PreViAs | [24] | Patient oriented | 30 Questions | 41 | 13 | 27 | 0 | 1 | 12 (29.3) |
Short CVI Q | [34] | Patient oriented | 12 Questions | 15 | 5 | 10 | 0 | 0 | 4 (26.7) |
SoGS | [17] | Clinical | 22 Visual skill Items | 25 | 13 | 12 | 0 | 0 | 10 (40) |
VAP-CAP | [37] | Clinical | 19 Items | 34 | 22 | 12 | 0 | 0 | 10 (29.4) |
VSI | [36] | Patient oriented | 22 Items | 35 | 11 | 17 | 3 | 3 | 6 (17.1) |
Wong | [46] | Patient oriented | 1 Scale | 2 | 1 | 1 | 0 | 0 | 1 (50) |
15-D | [47] | Patient oriented | 1 Vision Sub-scale | 6 | 1 | 3 | 2 | 0 | 1 (16.7) |
Part I: process of linking visual ability assessments to the ICF-CY
-
d1 Learning and applying knowledge (first or chapter level)
-
d160 Focusing attention (second level)
-
d1600 Focusing attention on the human touch, face and voice (third level)
Identification of linking units | |
i. | Determine the type of information to be linked: patient-oriented measure (self-report, caregiver report, or health professional reported) or clinical assessment. |
ii. | Identify linking unit(s). The linking unit of a measure answers the question: What is the item about? The names of measures, the instructions, and subscale titles provide useful information to define the linking units. e.g., Item 17 from the CVI Questionnaire asks whether the child “Sits right in front of the television”. This item needs to be considered in the context of being an item in a measure screening for cerebral visual impairment. The item falls in the section of ‘Visual attitude’ and the subscale of ‘visual attention’. This item is not about ‘sitting’.
For Patient-oriented measures: • Refer to the item as it appears in the questionnaire • Identify response options of items that contain linking unit(s) For Clinical assessments: • Refer to the aim of the clinical assessment • Consider that the linking unit may change depending on the context in which the clinical assessment is used. |
iii. | Identify any relationship between concepts: when there are more than two linking units the relationship between the units is also provided. e.g., Item 21 in the Functional Visual Questionnaire asks whether the child “Looks at a toy or object while reaching/moving hand towards it”. This item is about looking ‘whilst’ reaching. The relationship should be recorded.
|
Linking of linking units to the ICF-CY | |
a. | Select the appropriate code(s) to describe the linking unit: Is the linking unit an element of Body Functions, Body Structures, Activities and Participation, or Environmental factors? Which chapter within the selected domain is the most appropriate? Which category within the selected chapter is the most precise? |
b. | If the content of an item is not explicitly named in the corresponding ICF-CY category, then the “other specified” is linked. This code allows for coding of functioning that is not included within any of the other specific categories. When an “other specified” code is used, the specification has to be annotated. |
c. | If the content of an item is insufficient to permit assignment of a more specific category, the “unspecified” is linked. The code has the same meaning as the second- or third-level term immediately above (b), without any additional information. i.e., Use d199 Learning and applying knowledge, unspecified rather than d1 Learning and applying knowledge |
d. | If the linking unit is an element of ‘Health condition’ the code HC is used. |
e. | If the linking unit is an element of ‘Personal factors’ it would be considered to have a positive or negative influence on disability and functioning. To determine if a linking unit is a Personal factor ask: Can the linking unit be impaired, restricted or limited? If no, it is a personal factor. |
f. | If the content of an item is unclear or too general to permit assignment of any category or component, the “nondefinable” (nd) is used. The perspective is documented as General Health (nd-gh), Quality of life (nd-qol), Physical health (nd-ph), Mental health (nd-mh), or Life satisfaction (nd-s). |
g. | If the linking unit is not a Health condition, Body function/body structure, Activity, Participation, Environmental factor or Personal factor, it is “Not covered” (nc). |
Part II: process of establishing ‘visual ability’ themes
Part I | Part II | ||||||
---|---|---|---|---|---|---|---|
Descriptive theme | Analytical theme | ||||||
Measure | Item | Linking unita
| ICF-CY codeb
| Descriptive word for visual ability | Indicator of visual ability | Theme: Observable visual behaviour | Category of visual ability behaviour |
CVI Q [16] | Manipulates an object rather than look at it
(Item 40, Other senses domain)
| Use of other senses | d110 Watching d1201 Touchingc
| Look | Look at object Manipulate rather than look (other senses) | Watches and/or visually interacts with objects Frequency of use of vision in activities | Interactions Use of vision |
FVQ [18] | Tracks an object/toy (Item 2)
| Tracking | d110 Watching | Tracking | Tracks an object/toy | Follows | Abilities |
Watches and/or visually interacts with objects | Interactions | ||||||
PreViAs [24] | Is he/she able to look towards a sound source? (Item 3)
| Looking toward a sound sourced
| d110 Watching b2302 Localisation of a sound source | Look | Looks toward sound source | Searches | Abilities |
VSI [36] | Does your child reach for a large, bright, silent object? (Item 17)
| Reaching | d4452 Reaching | n/a |
Results
Part I: constructs measured by vision assessments
Assessment tools with visual ability itemsa
| ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ICF-CY Activities and Participation Chapters and Two-level classificationb
| ABCDEFV | Alimovic | CAS | CVI Q | CVI R | EDVA | FVQ | Hoyt | HSCS-PS | HUI-III | IDP | LVC | PreViAs | ShCVI Q | SoGS | VAP-CAP | VSI | Wong | 15-D | N |
d1 LEARNING AND APPLYING KNOWLEDGE | ||||||||||||||||||||
d110 Watching and/or d160 Focusing attentionc, d
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
19
|
d120 Other purposeful sensinge
| X | X | X | X | 4 | |||||||||||||||
d130 Copyingf
| X | X | 2 | |||||||||||||||||
d131 Learning through actions with objectsg
| X | X | X | 3 | ||||||||||||||||
d161 Directing attentionh
|
X
|
X
|
X
|
3
| ||||||||||||||||
d166 Readingi
| X | X | X | X | 4 | |||||||||||||||
d170 Writingj
| X | 1 | ||||||||||||||||||
d2 GENERAL TASKS AND DEMANDS | ||||||||||||||||||||
d3 COMMUNICATION | ||||||||||||||||||||
d315 Communicating with – receiving – non-verbal messagesk
| X | X | X | X | 4 | |||||||||||||||
d335 Producing nonverbal messagesl
| X | X | X | 3 | ||||||||||||||||
d350 Conversationm
| X | 1 | ||||||||||||||||||
d4 MOBILITY | ||||||||||||||||||||
d440 Fine hand usen
| X | X | X | X | X | X | X | X | 8 | |||||||||||
d445 Hand and arm useo
| X | X | X | X | X | X | X | 7 | ||||||||||||
d450 Walkingp
| X | X | X | 3 | ||||||||||||||||
d460 Moving around in different locationsq
| X | X | 2 | |||||||||||||||||
d499 Mobility, unspecifiedr
| X | X | 2 | |||||||||||||||||
d5 SELF-CARE | ||||||||||||||||||||
d6 DOMESTIC LIFE | ||||||||||||||||||||
d7 INTERPERSONAL INTERACTIONS AND RELATIONSHIPS | ||||||||||||||||||||
d710 Basic interpersonal interactionss
| X | X | X | X | X | X | 6 | |||||||||||||
d8 MAJOR LIFE AREAS | ||||||||||||||||||||
d880 Engagement in playt
| X | X | 2 | |||||||||||||||||
d9 COMMUNITY, SOCIAL AND CIVIC LIFE | ||||||||||||||||||||
d920 Recreation and Leisureu
| X | 1 |
Part II: analysis of ‘visual ability’ items
I. Abilities | II. Interactions | III. Use of vision |
---|---|---|
1. Responds or reacts 2. Initiates 3. Maintains or sustains looking 4. Changes or shifts looking 5. Searches 6. Locates or finds 7. Follows | 8. Watches and interacts visually with people/faces 9. Watches and interacts visually with objects 10. Watches and interacts visually over distances 11. Watches and interacts visually with hands | 12. Frequency of use of vision in activities 13. Efficiency of use of vision in activities |
Category I: abilities
Responds/reacts
…the light perception test is deemed positive if the patient shows some reaction to light, even high-intensity light…by moving his or her head, winking, or making a defensive or stopping movement (extract from LVC, Test 1 guidelines) [30].
Initiates
Maintains/sustains looking
…keep looking at objects or persons (extract from CVI Q, Item 9) [16].
… brief fixations on movement and reflective materials; Movement continues to be an important factor to initiate visual attention; Movement not required for attention at near…(extract from CVI Characteristic - Need for movement, CVI R) [31].
Changes/shifts looking
…able to move the eyes quickly between two persons or two objects (extract from Question 4, PreViAs) [24].Shifts gaze between targets in near and middle space accurately (extract from 5-month Pattern Component, Gaze Shift - Visual Release, EDVA) [32].
Searches
Visually seeks missing object or person (Item 9b, CAS) [33].Looks around when entering a room (Question 25, FVQ) [18].
Locates/finds
Looks in correct place for fallen toy (Item 78, SoGS) [17].
…find his teddy bear (or equal) amongst other cuddly animals (extract from Item 33, CVI Q) [16].…Finding parents or friends in a crowd (extract from Question 3, Short CVI Q) [34].
…find his/her way to the classroom, in his house [familiar environments] (extract from Item 26, CVI Q) [16].
Follows
…Either saccadic (jerky) tracking or smooth pursuit can be accepted but it should be noted which type of eye movement the child makes … For infants over 3 months, tracking should be easily elicited on the first trial in either direction, provided the child is reasonably attentive at the start of each trial (extract from procedure, Item 3, ABCDEFV) [35].
Category II: interactions
Watches and interacts visually with people & faces
…Generally no regard of the human face…Regards familiar faces when voice does not compete… Smiles at/regards familiar and new faces… Typical visual/social responses (extract from CVI Characteristic – Visual Complexity, CVI R) [31].Focuses on a face when seated opposite him/her (Question 13, FVQ) [18].
Watches and interacts visually with objects
…reach for a drink bottle when you hold it in front of him/her…become excited but does not reach for the drink bottle (extract from Item 11, VSI) [36].Looks at/focuses on pictures in a book or on a communication board (Item 19, FVQ) [18].
Requires an additional sensory modality (e.g. sound, touch, etc.) to focus on or respond to an object/toy (Question 7, FVQ) [18].…Objects viewed are generally a single colour…(extract from CVI Characteristic – Color Preference, CVI R) [31].
Watches and interacts visually over distances
Visually attends in near space only … Visual attention extends beyond near space, up to 4 to 6 feet (extract from CVI Characteristic: Difficulty with distance viewing. CVI R) [31].Watches movements of people at distances or out of window with interest (Item 79, SoGS) [17].
Watches and visually interacts – with hands
…observe his/her own hands (extract from Question 6, PreViAs) [24].Visually explores the toy whilst you turn it over: The child looks interested in the toy but either because of physical disability or tactile defensiveness can’t or won’t take the toy, but visually examines the toy as the adult turns it over (extract from response option, Item 5, Low Vision Assessment, VAP-CAP) [37].Looks at a toy or object while reaching/moving hand towards it (Item 21, FVQ) [18].
Category III: use of vision
Uses vision in activities – Frequency of use
…Student functions with more consistent visual response…(extract from scoring, Rating I, Across CVI Characteristics, CVI R) [31].Attention is fluctuating from moment to moment and from day to day (Item 10, CVI Q) [16].
Manipulates an object rather than look at it (Item 40, CVI Q) [16].
Uses vision in activities – Efficiency of use
…able to see well enough to recognise small objects and familiar people at a distance…Sees objects close to oneself - e.g. at arm’s length, but has visual limitations at distance, even with glasses (extract from Vision (ability to see) subscale, HSCS-PS) [38].