Working memory and processing speed in children with vision problems

Abstract

Purpose : Vision problems, such as convergence insufficiency, have been negatively associated with cognitive function in young adults [Daniel & Kapoula 2016;93(2):194-208]. We investigated working memory and processing speed in school-aged children referred for vision problems and compared them to age-matched children with normal or corrected-to-normal vision.

Methods : Children in 2^nd (7–8 yr, n=63), 5^th (10–11 yr, n=101) and 10^th (15–16 yr, n=135) grade participated in this cross-sectional study. Refractive error, ocular biometry, visual acuity, binocular vision, and medical history were examined as part of a Norwegian school vision program. The children were referred for a full eye examination if they failed any of the predetermined criteria for these measurements, indicating an uncorrected eye- or vision-problem. All children completed three working memory tasks, forward digit recall (FDR), backward digit recall (BDR) and the Corsi task, and one processing speed (PS) task on a tablet computer, using finger touch as input [Hill et al. 2022;6(53):16429.2]. Mean proportion correct (mPC) was calculated for each of the three working memory tasks. Mean reaction time measured in seconds was used for PS. Descriptive analysis and Wilcoxon rank sum tests were performed to compare the difference between referred and non-referred children in each age-group.

Results : Performance in all cognitive tasks improved with increasing age, and 10^th graders outperformed both 2^nd and 5^th graders (all p<0.001, ε2[H]=0.33–0.53). A total of 66 (22%) children were referred for full eye examination. The children referred in 2^nd grade (n=21) had significantly lower performance in the FDR task than non-referred 2^nd graders (n=42), [median (IQR) mPC: 0.54 (0.13) vs. 0.65 (0.09), p=0.003, r=0.37]. There were no differences between the referred and non-referred children in any of the age groups for the remaining three cognitive tasks [e.g., the Corsi task among referred (n=16) vs. non-referred (n=85) 5^th graders, median (IQR) mPC: 0.79 (0.13) vs. 0.76 (0.19), p=0.83, r=0.02].

Conclusions : Working memory and processing speed improved with increasing age. Younger children with vision problems had poorer working memory than peers with normal or corrected-to-normal vision. Consequently, uncorrected vision problems appear to interfere with cognitive function and potentially 7–8-year-old children’s ability to learn.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.