Make it easier: 3-word strategies to help children with cerebral visual impairment use their vision more effectively

INTRODUCTION: Cerebral Visual Impairment (CVI) is the most common cause of visual impairment in children in the United Kingdom. Management relies on identifying strategies and adaptations which enable the child to use their vision effectively and efficiently. Many published strategies involve lengthy inventories used in specialist settings, and parent groups highlight the need for immediate advice at diagnosis. The aim was to use the Delphi technique to construct a set of three-word phrases to succinctly describe strategies for common visual dysfunctions in children with CVI. METHOD: A panel of twelve experts across health, education and those with lived experience was recruited. Four rounds of questionnaires were used to reach consensus on symptoms and suggested 3-word phrases. Consensus was defined as 70% agreement. RESULTS: Response rates were 92%, 67%, 92% and 91% across rounds. The 3-word phrases reaching consensus were: Big Bold Bright; Keep it Still; Eyes or Ears; Show it High; Better on Left/Right; Clear the Clutter; Keep It Short; Give Me Time; My Vision Varies; Just One Thing. CONCLUSION: The phrases are intended as a starter set at the point of diagnosis and are appropriate for children of any developmental or visual ability. Real-life validation of these expert-consensus phrases will require further studies to evaluate their mapping to interventions and impact on visual development.

Rachel F. Pilling