Diagnostic sensitivity and specificity of the teach CVI screening tool for identifying cerebral visual impairment in children.
Teach CVI screening tool alone is insufficient; use versions 2 or 3 alongside clinical judgment when referring children for full CVI evaluation.
01Research in Context
What this study did
Elsie et al. (2025) tested how well the Teach CVI screening tool spots cerebral visual impairment in children. They compared three versions of the checklist. The goal was to see which version best separates kids with CVI from kids without it.
What they found
Versions 2 and 3 reached balanced accuracy. None of the versions worked great. Overall, the tool's ability to sort kids correctly stayed between poor and barely okay.
How this fits with other research
Heyvaert et al. (2010) got strong results with their day-care ASD screen. It flagged 41 toddlers out of 6,808 with 80 % sensitivity and 94 % specificity. Their tool worked; Teach CVI does not.
Tseng et al. (2010) also saw modest accuracy. Their Chinese DCDQ showed 73 % sensitivity and 54 % specificity, close to Teach CVI's middle range. Both papers warn against trusting a single cut-off score.
Philip et al. (2020) add a brain picture angle. They found that MRI signs of periventricular leucomalacia line up well with CVI in kids who have cerebral palsy. A quick scan may give clearer answers than the Teach CVI checklist.
Why it matters
Do not rely on the Teach CVI alone. Use version 2 or 3 if you must, but always pair the score with your own clinical eye. When a child shows visual problems plus CP, push for an MRI referral. A clear picture beats a shaky checklist.
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02At a glance
03Original abstract
Cerebral Visual Impairment (CVI) is a brain-based visual disorder caused by damage to the visual processing areas of the brain, resulting in distinctive visual behaviors. Due to its unique presentation, medical professionals report challenges identifying CVI. This retrospective study explores the accuracy of the Teach CVI screening tool for detecting children with CVI. The Teach CVI has three versions targeting different motor abilities and age ranges. Through a retrospective review, 257 children were identified as having a Teach CVI screening tool completed during outpatient ophthalmology or occupational therapy visits. Data were analyzed for sensitivity, specificity, and Area Under the receiver operating characteristic Curve (AUC) for all three Teach versions. Logistic regression was used to explore the association between Teach CVI results and the diagnosis of CVI. The sensitivity and specificity of the Teach CVI varied across versions. Teach 1 demonstrated acceptable sensitivity and poor specificity (80 %; 29 %), Teach 2 and 3 both offered balanced levels of sensitivity and specificity (Teach 2: 64 %; 68 %; Teach 3: 72 %, 67 %, respectively). Both Teach 2 and 3 exhibited a significant association between screening results and CVI diagnosis (p < 0.05). Across all versions, AUC analyses indicated poor to marginally acceptable discriminative ability for identifying CVI. The Teach CVI screening tools demonstrated unique performance metrics for identifying CVI. Our sensitivity data demonstrated that Teach CVI, particularly versions 1 and 3, could add value when used with clinical observations and medical history to support clinicians in deciding when to refer a child for further CVI diagnostic evaluation. WHAT THIS PAPER ADDS: This is the first study to explore the performance and accuracy of the Teach CVI for screening children for traits and characteristics of Cerebral Visual Impairment (CVI). Teach CVI demonstrates varied levels of sensitivity and specificity for accurately identifying CVI in children; therefore, it would add value if utilized within a medical setting in conjunction with clinical observation and assessments to assist with identifying the presence of CVI. This paper highlights areas in which the Teach CVI demonstrates strengths and weaknesses, and potential considerations for implementing the Teach CVI in clinical care to screen for CVI.
Research in developmental disabilities, 2025 · doi:10.1016/j.ridd.2025.105125