Sex and rural-urban differences in the prevalence of childhood visual impairment in Taiwan: A nationwide population-based study.
Taiwan’s national data show boys and rural children carry the heaviest visual-impairment load, so BCBAs in those areas should screen and adapt materials accordingly.
01Research in Context
What this study did
Lai et al. (2020) counted every child with visual impairment in Taiwan. They used the national disability registry. The team looked at boys versus girls and rural versus urban kids.
The study ran from 2004 to 2014. No kids were treated; the paper only maps who has visual impairment.
What they found
Boys showed higher visual-impairment rates every single year. Rural children also had higher rates than city children. Over time the rural-city gap slowly closed, but the boy-girl gap stayed steady.
How this fits with other research
The same registry already showed the same boy-rural pattern for developmental delays (Der-Chung et al. 2011). The visual-impairment numbers now prove the pattern repeats across diagnoses.
Autism data from the same registry look opposite: city kids have more autism than rural kids (Der-Chung et al. 2012). The studies seem to clash, but they measure different things. Visual impairment is tied to birth injury and limited prenatal care, which are more common in rural areas. Autism identification depends on specialist access, which is easier in cities.
Together the papers show rural kids lose on both counts: higher true sensory-impairment risk and lower developmental-diagnosis pickup.
Why it matters
If you serve rural Taiwan clients, expect more children with visual issues. Screen vision early, especially in boys. Pair your ABA lessons with large-print or tactile materials. When a child’s progress is slow, check vision before you increase intervention intensity.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a quick vision-check question to your caregiver intake form and enlarge your teaching cards to 18-point font.
02At a glance
03Original abstract
BACKGROUND: Visual impairment (VI) is a major developmental disability in children, but data at the national level are limited. AIMS: We conducted a nationwide study in Taiwan to assess the sex and rural-urban differences in VI. METHODS AND PROCEDURES: Using data from the national disability registry, we calculated prevalence rates by age, sex, and geographic area and assessed changes from 2004 to 2010. We excluded cases under 3 years old because the government discourages certification at this age. OUTCOMES AND RESULTS: Between 2004 and 2010, the overall prevalence rate fluctuated between 3.48/10,000 and 3.66/10,000. Boys had higher prevalence rates in all years, and the boy-to-girl prevalence rate ratios ranged from 1.24 to 1.30 (p < 0.05 in all years), without an apparent time trend. The rates generally decreased over time in rural areas (p=0.008), but increased in urban areas (p=0.029); this resulted in a decreasing time trend (p = 0.001) in the rural-to-urban prevalence rate ratios (1.32 to 1.09; p < 0.05 except for 2010). CONCLUSIONS AND IMPLICATIONS: Boys are more likely to experience VI in Taiwan. Rural areas had higher prevalence rates than urban areas, but the difference has been decreasing over time. Identifying factors underlying this reduction may help the prevention of VI.
Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2020.103679