Validation of an instrument to assess visual ability in children with visual impairment in China

Jinhai Huang, Jyoti Khadka, RongRong Gao, S Zhang, Wenpeng Dong, Fangjun Bao, Haisi Chen, Qinmei Wang, Hao Chen, Konrad Pesudovs

    Research output: Contribution to journalArticlepeer-review

    5 Citations (Scopus)


    Objective To validate a visual ability instrument for school-aged children with visual impairment in China by translating, culturally adopting and Rasch scaling the Cardiff Visual Ability Questionnaire for Children (CVAQC). Methods The 25-item CVAQC was translated into Mandarin using a standard protocol. The translated version (CVAQC-CN) was subjected to cognitive testing to ensure a proper cultural adaptation of its content. Then, the CVAQC-CN was interviewer-administered to 114 school-aged children and young people with visual impairment. Rasch analysis was carried out to assess its psychometric properties. The correlation between the CVAQC-CN visual ability scores and clinical measure of vision (visual acuity; VA and contrast sensitivity, CS) were assessed using Spearman's r. Results Based on cultural adaptation exercise, cognitive testing, missing data and Rasch metrics-based iterative item removal, three items were removed from the original 25. The 22-item CVAQC-CN demonstrated excellent measurement precision (person separation index, 3.08), content validity (item separation, 10.09) and item reliability (0.99). Moreover, the CVAQC-CN was unidimensional and had no item bias. The person-item map indicated good targeting of item difficulty to person ability. The CVAQC-CN had moderate correlations between CS (-0.53, p<0.00001) and VA (0.726, p<0.00001), respectively, indicating its validity. Conclusions The 22-item CVAQC-CN is a psychometrically robust and valid instrument to measure visual ability in children with visual impairment in China. The instrument can be used as a clinical and research outcome measure to assess the change in visual ability after low vision rehabilitation intervention.

    Original languageEnglish
    Pages (from-to)475-480
    Number of pages6
    JournalBritish Journal of Ophthalmology
    Issue number4
    Early online date2016
    Publication statusPublished - Apr 2017


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