Current practice used by therapists to screen and assess cerebral visual impairment in children with cerebral palsy in the South African setting

Abstract

Background and purpose: Cerebral visual impairment (CVI) is a common comorbidity in children with cerebral palsy and
has a significant impact on their functional capabilities. The lack of obvious deficits related to the eyes means awareness
of CVI is poor. However, early diagnosis of CVI in children with cerebral palsy supports intervention which may improve
the child's functioning in everyday activities. Occupational therapists and physiotherapists are able to identify children at
risk for CVI, but there is a lack of research on the screening procedures they use to identify this deficit. This study therefore
aimed at determining the current awareness of and clinical screening procedures used by occupational therapists and
physiotherapists to detect CVI in children with cerebral palsy in South Africa.
Method: A quantitative descriptive survey was distributed nationally to occupational therapists and physiotherapists
treating children with cerebral palsy.
Results: The majority (81%) of the participants could define and explain CVI but a formal diagnosis of CVI is not commonly
seen in practice (15.3%). The difficulty in getting a formal diagnosis of CVI was reported as being due to a lack of testing
for functional vision by medical professionals. Less than half of the participants (45.7%) reported that they would always
screen for a CVI in children with cerebral palsy and 42.9% of participants reported that they used informal screening
procedures. Most of the participants reported that they would alter their intervention if they were aware that a child
with cerebral palsy presented with CVI.
Conclusion: This study shows that although therapists are aware of CVI, there is limited screening for this deficit and
little or no formal screening of CVI in children with cerebral palsy in the South African context.