Assessment & Research

Eyes on CVI: Eye movements unveil distinct visual search patterns in Cerebral Visual Impairment compared to ADHD, dyslexia, and neurotypical children.

Hokken et al. (2024) · Research in developmental disabilities 2024
★ The Verdict

A short eye-tracking game can flag CVI-specific visual problems that look like ADHD or dyslexia.

✓ Read this if BCBAs who assess school-age kids with unclear attention or reading issues.
✗ Skip if Clinicians only serving children with confirmed single diagnoses and no visual concerns.

01Research in Context

01

What this study did

Researchers watched where kids looked during a 10-minute visual search game.

They tested children with cerebral visual impairment, ADHD, dyslexia, and neurotypical peers.

Eye-tracking cameras recorded every gaze shift to build a quick screening battery.

02

What they found

Kids with CVI showed unique eye-movement signatures.

Their search was slower, less organized, and easy to spot.

The same gaze patterns did not appear in ADHD or dyslexia, so the test cleanly separates the groups.

03

How this fits with other research

Luckasson et al. (2017) saw no gaze differences between children with ASD and typical kids on a letter task.

That sounds opposite, but the tasks and diagnoses differ: CVI eyes are truly off-track, ASD eyes are not.

Micheletti et al. (2025) also separate CVI from DCD using six parent questions plus low vision and IQ flags.

Together the papers show CVI can masquerade as ADHD, dyslexia, or DCD, yet quick screens—gaze or inventory—can tell them apart.

04

Why it matters

If a child’s vision seems fine yet they bump into things or lose their place while reading, run the 10-minute gaze battery before you write it off as attention or phonics trouble.

Spotting CVI early sends the family to the right specialist and saves months of mis-targeted reading or behavior plans.

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Add the free 10-minute CVI gaze battery to your assessment kit when visual attention problems don’t respond to typical ADHD or reading interventions.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
126
Population
adhd, neurotypical, other
Finding
positive
Magnitude
large

03Original abstract

Visual search problems are often reported in children with Cerebral Visual Impairment (CVI). To tackle the clinical challenge of objectively differentiating CVI from other neurodevelopmental disorders, we developed a novel test battery. Visual search tasks were coupled with verbal and gaze-based measurements. Two search tasks were performed by children with CVI (n: 22; mean age (SD): 9.63 (.46) years) ADHD (n: 32; mean age (SD): 10.51 (.25) years), dyslexia (n: 28; mean age (SD): 10.29 (.20) years) and neurotypical development (n: 44; mean age (SD): 9.30 (.30) years). Children with CVI had more impaired search performance compared to all other groups, especially in crowded and unstructured displays and even when they had normal visual acuity. In-depth gaze-based analyses revealed that this group searched in overall larger areas and needed more time to recognize a target, particularly after their initial fixation on the target. Our gaze-based approach to visual search offers new insights into the distinct search patterns and behaviours of children with CVI. Their tendency to overlook targets whilst fixating on it, point towards higher-order visual function (HOVF) deficits. The novel method is feasible, valid, and promising for clinical differential-diagnostic evaluation between CVI, ADHD and dyslexia, and for informing individualized training.

Research in developmental disabilities, 2024 · doi:10.1016/j.ridd.2024.104767