其他摘要 | Visual function screening of infants and young children is very important. At present, there are various methods of visual function testing for infants and young children, but the comparability between different test results is poor. A standardized screening system is urgently needed to comprehensively and systematically evaluate the developmental status and developmental trajectory of infant visual function. This study aims to develop a standardized visual function test set suitable for infants and young children, study the development characteristics of visual functions among Chinese infants and young children, and evaluate its potential in screening abnormal development (e.g. autism and low gestational age).
This research is divided into three parts. Study 1 investigated the applicability of common visual function testing tools in Chinese infants and young children, we conducted a comprehensive visual function test on 563 infants, aged 0-36 months and without any ophthalmological and cognitive abnormalities. Through analysis of variance and stratified chi-square test (Cochran-Mantel-Haenszel test), we analyzed the feasibility of different testing tools and the age effects of different testing, found that different testing items within the same function are relatively consistent, and extremely low coordination in LEA visual chart, Titmus stereo test, graphic matching. On the whole, the testing time of common testing tools is too long for infants, and is greatly affected by the cooperation between participates and experimenter. Subsequently, we developed a standardized visual function test set covering 13 functional measures (revised), based on the same materials, paradigms and procedures.
Study 2 validated the reliability and validity of the test set developed in study 1, and explore the developmental characteristics of 394 infants’ visual function from the aspects of continuity/stages, synchrony/asynchrony, correlation and dynamic pattern. The results indicated: (1) Light perception, vernier acuity, first-order contrast sensitivity, blue-yellow perception, constancy and hand-eye coordination developed continuously, and leveled off within 36 months. Some functions developed in stages, and the developmental rate is first fast and then slow; (2) There is obvious asynchrony between different functions, with light perception, visual acuity and contrast developing earlier, and red-green and blue-yellow perception developing the fastest, depth and motion perception, object cognition and joint attention developing more in the second stage; (3) Factor analysis, structural equation model and other analyses found that the tested functions can be divided into four latent variables, namely spatial vision (grating and Vernier acuity, first-order and second-order contrast sensitivity), color perception, depth and motion perception, and visual cognition and interaction (object cognition and constancy, joint attention and hand-eye coordination), and spatial vision can explain visual cognition and interaction under the mediating effect of motion and depth perception; (4) piecewise linear model and other analyses showed that there may be three developmental stages of visual functions: 0~11 months, 12~24 months, and 24~36 months, and the relationship between latent variables was different in different stages; (5) During the dynamic development of visual function, the separation between latent variables, e.g. spatial vision and color perception, as well as visual cognition and interaction and depth and motion perception, always exists, suggesting the possibility of different developmental pathways.
In Study 3, the development status of visual function in autism (44.166±11.626 months) and low gestational age (21.179±10.048 months) infants and young children were systematically evaluated using the infants’ visual function test set, the number of participates was 50 and 41 respectively. The results showed that all visual functions were significantly delayed and the correlation between functions was significantly weaker in autism and low gestational age infants and young children, as opposed to its normal counterparts, and the developmental delay of children with autism was more serious. Classification based on visual functions have shown that autism and low gestational age infants can be divided into three categories, but the performance of children with low gestational age is more similar to that of normal children.
This study comprehensively and in-depth revealed the development characteristics and developmental patterns of visual functions in normal infants and young children from multiple dimensions. The relevant results also provide insights for the early identification and classification of abnormal development. |
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