Preverbal visual assessment for screening cerebral visual impairment: Diagnostic accuracy and clinical utility

Aim To evaluate the relationship between Preverbal Visual Assessment (PreViAs) results and cerebral visual impairment (CVI) diagnosis. Method This single‐center retrospective chart review included children who completed a CVI interdisciplinary clinic or occupational therapy vision evaluation between May 2018 and May 2023 and had a completed PreViAs. Data were extracted from the electronic medical record. Data analysis included sensitivity, specificity, area under the curve, and Fisher's exact test. Results Of the 205 charts screened, 98 met study criteria (81 with CVI, 17 without); ages ranged from 3 to 50 months. The mean age of children with CVI was 15.41 months (SD = 8.93) and without was 13.24 months (SD = 5.98). Among the PreViAs domains, visual processing showed the highest frequency of concern (CVI = 94%; non‐CVI = 76%), while visual attention had the lowest (CVI = 72%; non‐CVI = 41%). Visual processing demonstrated the highest sensitivity (93.8%), whereas visual attention showed the best balance of sensitivity (71.6%) and specificity (58.8%). Area under the curve ranged from 0.59 to 0.66. All domains demonstrated significant differences between children with and without CVI (Fisher's exact test, p < 0.05). Interpretation Effective screening tools are critical for detection of CVI. The PreViAs is a sensitive screening tool in children at high risk for CVI. Children with concerns on the PreViAs should be referred for an interdisciplinary CVI evaluation.