Abstract:Purpose The aim of this study was to assess visual perception at school age of children born preterm with known lesions to the posterior visual pathways or with ophthalmologic signs that might indicate such lesions. Methods The study group consisted of 91 patients born before the 37th gestational week. Visual perception was assessed using the TVPS-R (Test of Visual Perceptual SkillsRevised) and a structured interview. In addition, ophthalmologic and orthoptic examinations were performed. Results On the test of… Show more
“…Fifteen studies were finally included. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Table I summarizes the main characteristics, outcomes, and quality assessment of each study according to each neuropsychological test. Seven were conducted in Europe and nine had been published after 2000.…”
Aim
Visual perception is one of the cognitive functions often impaired in children with cerebral palsy (CP). The aim of this systematic literature review was to assess the frequency of visual–perceptual impairment (VPI) and its relationship with patient characteristics.
Method
Eligible studies were relevant papers assessing visual perception with five common standardized assessment instruments in children with CP published from January 1990 to August 2011.
Results
Of the 84 studies selected, 15 were retained. In children with CP, the proportion of VPI ranged from 40% to 50% and the mean visual perception quotient from 70 to 90. None of the studies reported a significant influence of CP subtype, IQ level, side of motor impairment, neuro‐ophthalmological outcomes, or seizures. The severity of neuroradiological lesions seemed associated with VPI. The influence of prematurity was controversial, but a lower gestational age was more often associated with lower visual motor skills than with decreased visual–perceptual abilities.
Interpretation
The impairment of visual perception in children with CP should be considered a core disorder within the CP syndrome. Further research, including a more systematic approach to neuropsychological testing, is needed to explore the specific impact of CP subgroups and of neuroradiological features on visual–perceptual development.
“…Fifteen studies were finally included. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Table I summarizes the main characteristics, outcomes, and quality assessment of each study according to each neuropsychological test. Seven were conducted in Europe and nine had been published after 2000.…”
Aim
Visual perception is one of the cognitive functions often impaired in children with cerebral palsy (CP). The aim of this systematic literature review was to assess the frequency of visual–perceptual impairment (VPI) and its relationship with patient characteristics.
Method
Eligible studies were relevant papers assessing visual perception with five common standardized assessment instruments in children with CP published from January 1990 to August 2011.
Results
Of the 84 studies selected, 15 were retained. In children with CP, the proportion of VPI ranged from 40% to 50% and the mean visual perception quotient from 70 to 90. None of the studies reported a significant influence of CP subtype, IQ level, side of motor impairment, neuro‐ophthalmological outcomes, or seizures. The severity of neuroradiological lesions seemed associated with VPI. The influence of prematurity was controversial, but a lower gestational age was more often associated with lower visual motor skills than with decreased visual–perceptual abilities.
Interpretation
The impairment of visual perception in children with CP should be considered a core disorder within the CP syndrome. Further research, including a more systematic approach to neuropsychological testing, is needed to explore the specific impact of CP subgroups and of neuroradiological features on visual–perceptual development.
“…52,53 Interpreting reported data to guide clinical management and assessment of visual function in preterm children is hampered by variability in methods and findings, as discussed previously. 19,46,[54][55][56][57] Furthermore, there is a paucity of research that has thoroughly examined visual perceptual outcomes in highrisk ELBW/EP children beyond school age, although difficulties have been noted in judgment of line orientation, 58 perceptual matching, 41 and biological motion processing. 59 The current study was a unique opportunity to report on a contemporary and representative cohort on long-term visual outcomes in preterm adolescents.…”
BACKGROUND AND OBJECTIVES
Ocular growth and development differs between preterm and term-born infants and may cause long-term negative consequences for visual function, but contemporary data on long-term visual outcomes in representative samples of the highest risk extremely low birth weight (ELBW, <1000 g birth weight) or extremely preterm (EP, <28 weeks’ gestation) survivors are lacking. Our objective was to compare visual functioning between ELBW/EP and normal birth weight (NBW, >2499 g birth weight) control adolescents.
METHODS:
Geographically determined cohort study of 228 consecutive ELBW/EP survivors born in the state of Victoria in 1991 and 1992, and 166 randomly selected NBW controls assessed between 14 and 20 years of age. Visual acuity, stereopsis, convergence, color perception, and visual perception were assessed and contrasted between groups.
RESULTS:
ELBW/EP subjects had significantly worse visual acuity with habitual correction in both the left and right eyes, and for the best eye (P < .001). The ELBW/EP adolescents also exhibited poorer stereopsis, odds ratio (OR) 3.22 (95% confidence interval [CI] 1.78 to 5.84), and convergence, OR 2.76 (CI 1.32 to 5.75) than controls, and more problems with visual perception, OR 3.09 (CI 1.67 to 5.71) after habitual correction.
CONCLUSIONS:
Despite advances in medical care improving the survival rate of high-risk ELBW/EP infants, visual morbidity is still relatively high compared with controls in late adolescence.
“…The most commonly reported visual–spatial processing difficulties amongst preterm children include problems with the perception of motion, depth, and simultaneous perception, as well as the ability to survey a complex scene . Problems with global and local processing are also common .…”
Aim
The aim of this study was to compare the approximate number system acuity in children born extremely preterm aged 6 years 6 months and typically developing, age‐matched peers.
Method
This population‐based follow‐up study included 65 children born before 27 gestational weeks (35 males, 30 females; mean gestational age 25.4wks [SD 1.1wk]; mean birthweight 789g [SD 158g]) and 47 typically developing children (24 females, 23 males) at the age of 6 years 6 months. A battery of cognitive tests was administered, including a computerized test for measuring approximate number system acuity and tests for general cognition, working memory, processing speed, and visual attention. Approximate number system outcome measures were means of Weber fraction (w) values and response time in milliseconds.
Results
The 43 extremely preterm children in whom usable data were obtained performed significantly worse than the typically developing children on the approximate number system task (w=0.30 [SD 0.23] vs. 0.17 [SD 0.13]; p=0.003) and were significantly slower (response time=2934ms [SD 1102ms] vs 2376ms [SD 310ms]; p=0.002). The differences remained when adjusting for differences in other cognitive functions (p=0.03).
Interpretation
Preterm birth has a negative impact on an individual's ability to rapidly approximate and compare numbers of visually presented items. This deficiency is thought to be a consequence of dorsal stream dysfunction. Future studies will investigate whether this deficiency is correlated with lower mathematical proficiency in this group of children.
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