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Saeideh Ghahghaei, Spencer Harris, Devanish Singh, Arvind Chandna; The spectrum of reading difficulties in children with Cerebral Visual Impairment (CVI): a qualitative study. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3565.
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Reading difficulties are increasingly reported in children with CVI even in the presence of good visual acuity. CVI is now the commonest cause of childhood visual impairment in the western hemisphere and consequent lack of proficiency in reading is likely to have negative consequences for development, academic success and the well-being of the child and society. Oculomotor dysfunction, crowding and delayed comprehension have been suspected but not systematically investigated. We set out to address this gap by documenting the spectrum of reading difficulties.
We conducted remote, in-depth 40 to 60 minute, semi-structured interviews of parents of children with CVI (and recorded, if permitted). An open statement ‘Please tell me about your child’s journey in reading’ commenced the interview. If needed, interview guides were provided to ensure consistency between participants. Notes were taken, problems were documented Specific questions were reserved for end of interview if not covered by parent’s description.
Data from 7 parents (target N = 10) were analyzed by first transcribing then coding interviews . A spectrum of reading difficulties were identified which indicated a range from lower to higher level visual processing. The frequency of reporting each difficulty across participants was calculated. For example, of the 7 parents, 4 reported the need for large fonts (frequently reported in literature) and 2 reported that ‘sometimes nothing works’ (rarely reported in literature). These documented difficulties indicated the following neurophysiological correlates; in isolation or in combination: (1) acuity and accommodation (2) crowding (3) oculomotor problem (4) restricted visual field (5) spatial attention (6) or central attention.
In-depth interviews with parents reveal multiple reading difficulties in children with CVI presenting in different ways frequently and rarely reported by clinicians. The six areas identified from our study provide a framework for further focused interviews and quantitative research designed specifically to investigate these areas with a potential for targeted (re)habilitation techniques to be assist the child to overcome these difficulties.
This is a 2021 ARVO Annual Meeting abstract.
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