Cerebral visual impairment (CVI) is the most common cause of vision impairment affecting children in the economically developed world. Despite this, there are limited options for screening, resulting in many children going undiagnosed, especially those with normal visual acuity.

A recent study from researchers at Massey University in Auckland, New Zealand, led by Dr. Nicola McDowell and Dr. Philippa Butler, has introduced a promising screening tool for cerebral visual impairment (CVI) related visual issues. The tool, an iPad app named the Austin Assessment, has undergone rigorous validation to determine its effectiveness. The findings, published in PLOS ONE, could significantly enhance early detection and intervention for children affected by CVI.

Despite its prevalence, many children with CVI go undiagnosed, particularly those with normal visual acuity. The Austin Assessment aims to address this gap by providing a simple and efficient screening process. The app was designed to capture key indicators of higher visual function impairments through a card-matching activity, and its development involved creating a database of normative ranges, screening children, and conducting specific validation research.

In the initial phase of the research, normative ranges for children aged 5 to 18 were established across various variables of the Austin Assessment. The second phase involved screening many children, which identified a significant number with potential visual issues indicative of CVI. The final phase compared the Austin Assessment’s effectiveness against a validated visual search tool, further supporting the app’s diagnostic value. “Phase three found that the Austin Assessment has moderate diagnostic value for each age group, with good sensitivity and specificity,” Dr. Butler explained.

Significant results include the identification of children with clinical findings indicating CVI-related visual issues. Additionally, the Austin Assessment demonstrated moderate diagnostic value, accurately distinguishing between children with visual issues and those with typical vision. The study highlights the app’s potential as a valuable screening tool, noting that further research is necessary to confirm these initial findings.

The research underscores the importance of early detection and the need for reliable screening tools for CVI. Dr. McDowell emphasized the tool’s impact, stating, “The Austin Assessment can be facilitated by parents, teachers, therapists, and other professionals, making it accessible for widespread use.” By providing an easy-to-use app that does not require specific vision expertise, the Austin Assessment could revolutionize how CVI is detected and managed in children, ensuring timely intervention and support.

The findings from this study pave the way for broader application and further refinement of the Austin Assessment. As more children are screened using this tool, the true prevalence of CVI can be better understood, leading to improved outcomes for affected children. The researchers recommend ongoing validation and adaptation of the assessment to cater to diverse populations and settings.

How the app works:

The visual issues the app screens for:

The website of the Austin Assessment: http://www.austinassessment.org/

Journal Reference

McDowell, N., Butler, P. Validation of the Austin Assessment: A screening tool for cerebral visual impairment related visual issues. PLOS ONE (2023). DOI: https://doi.org/10.1371/journal.pone.0293904

About The Authors

Dr. Nicola McDowell is the founder and creator of the Austin Assessment, a screening app for cerebral visual impairment related visual issues, and a Senior Lecturer and researcher in the Institute of Education, Massey University, New Zealand. Nicola teaches into the Post Graduate Diploma and Masters in Specialist Teaching programmes, which focus on training educators to work in the learning support space in Aotearoa, New Zealand.

Her research interests include understanding and supporting children and young people who have cerebral visual impairment, empowerment of children and their parents/caregivers and equity in education. 

Nicola also regularly shares both her research and personal experience of cerebral visual impairment through presentations and blogs, with a focus on improving outcomes for others with the condition.

Philippa Butler is a Senior Lecturer in the Institute of Education, Massey University, New Zealand. Her teaching interests are in research methodology and the practice of research, and her research interests include ethnic group identifications and issues of equity in education. She is an expert in qualitative, quantitative and mixed methods research and is an experienced and accomplished writer. Philippa is a trustee of the Austin McDowell Foundation and provides research support for the development of the Austin Assessment.