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IntroductionA comprehensive assessment of visual functioning at an early age is important not only for identifying and defining visual impairment but also for planning personalized rehabilitation programs based on the visual diagnosis. Since existing tools to evaluate visual functioning present some important limitations (e.g., they are based on qualitative reports, they do not take into account environmental adaptations of visual testing or they have not been formally validated as clinical instruments), the present work has the main aim to propose a new clinical tool (Visual Function Score, VFS) to detect and define visual disorders at an early age.MethodsThe Visual Function Score was administered to one hundred visually impaired children (age range 4 months to 17.75 years old) in the form of a professional-reported protocol for a total of 51 items, each of which is assigned a score from 1 to 9 (or from 0 to 9 in some specific cases). The VFS produces three sub-scores and a global score (from 0 to 100), resulting in a quantitative evaluation of visual functioning.ResultsThe VFS can detect the well-known differences between different types of visual impairment (cerebral, oculomotor, and peripheral or grouped as central and peripheral) and takes into account different environments in the definition of a quantitative score of visual functioning.DiscussionOverall, the use of a quantitative tool to evaluate visual functions and functional vision such as the VFS would be fundamental to monitor the progresses of patients over time in response to rehabilitation interventions.

The aim of the study was to assess early neuromotor development in 20 congenitally blind or severely visually impaired children, nine without (B) and 11 with associated handicaps (B + H), in order to develop a strategy for early intervention in these subjects. The mean age at first observation was 11.4 months (range: 4-30 months). The mean follow-up duration was 16.9 months (range: 3-36 months). Assessment included developmental history, neurological examination, video-recording of spontaneous activity and administration of the Reynell-Zinkin Scales and neuroradiological and neurophysiological investigations. All B children walked independently (mean age 19.8 months) and 55.5% crawled (mean age 15 months); the B + H subjects displayed absence of almost all neuromotor functions, except one who walked at 20 months. All the B and just one (9%) of the B + H children developed satisfactory fine motor abilities. 'Reach on sound' at distance was achieved by all the B children by the age of 14.2 months while in the B + H group it was achieved by only two subjects at a median age of 19.5 months. We conclude that it is possible to describe the profile of neuromotor development in B and B + H children; strategies to help postural-motor development and 'reach on sound' appear to be fundamental in early intervention in these subjects.