Cognitive Rehabilitation Improves Functional Vision Skills in Children with Cerebral Visual Impairment

<b>Background/Objectives</b>: Cerebral visual impairment (CVI) is the leading cause of visual disability in children, resulting from damage to the brain’s visual processing pathways. Although ocular structures may be intact, functional vision, the use of vision in daily tasks, is often s...

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Main Authors: Zeynep Celik Turan, Esra Aki
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/6/590
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author Zeynep Celik Turan
Esra Aki
author_facet Zeynep Celik Turan
Esra Aki
author_sort Zeynep Celik Turan
collection DOAJ
description <b>Background/Objectives</b>: Cerebral visual impairment (CVI) is the leading cause of visual disability in children, resulting from damage to the brain’s visual processing pathways. Although ocular structures may be intact, functional vision, the use of vision in daily tasks, is often significantly affected. Cognitive Rehabilitation Therapy (CRT) has shown potential to enhance cognitive functions through neuroplasticity, yet its influence on functional vision remains underexplored. This exploratory pilot study aimed to examine whether CRT could improve functional vision in children with CVI by targeting underlying cognitive deficits. <b>Methods</b>: A single-arm pre–post intervention study was conducted with nine children aged 7–11 years diagnosed with CVI. Participants received 20 individualized CRT sessions over ten weeks, integrating principles from the Model of Visual Functioning. Functional vision was evaluated using the Gazi Functional Vision Assessment Instrument (GFVAI), while cognitive improvements were measured with the Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch) and the Motor-Free Visual Perception Test-4 (MVPT-4). Data were analyzed using Wilcoxon signed-rank tests. <b>Results</b>: Statistically significant improvements were observed in GFVAI domains such as light sensitivity, distant visual field, focusing, maintaining focus, and obstacle avoidance (<i>p</i> < 0.05 to <i>p</i> < 0.01). Qualitative analysis also indicated a shift from low/moderate to good/very good performance in most functional vision categories. Cognitive domains, including visual-motor organization, thinking operations, and spatial perception, showed significant gains. <b>Conclusions</b>: CRT may support improvements in functional vision by enhancing cognitive processes in children with CVI. This therapist-led approach is feasible, adaptable, and holds promise for widespread application in pediatric rehabilitation.
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spelling doaj-art-6df18ddb5a4f421f8cc0e8f83035b3982025-08-20T03:26:25ZengMDPI AGBrain Sciences2076-34252025-05-0115659010.3390/brainsci15060590Cognitive Rehabilitation Improves Functional Vision Skills in Children with Cerebral Visual ImpairmentZeynep Celik Turan0Esra Aki1Occupational Therapy Division, Brunel University of London, Uxbridge UB8 3PH, UKOccupational Therapy Department, Faculty of Health Sciences, Hacettepe University, Ankara 06100, Türkiye<b>Background/Objectives</b>: Cerebral visual impairment (CVI) is the leading cause of visual disability in children, resulting from damage to the brain’s visual processing pathways. Although ocular structures may be intact, functional vision, the use of vision in daily tasks, is often significantly affected. Cognitive Rehabilitation Therapy (CRT) has shown potential to enhance cognitive functions through neuroplasticity, yet its influence on functional vision remains underexplored. This exploratory pilot study aimed to examine whether CRT could improve functional vision in children with CVI by targeting underlying cognitive deficits. <b>Methods</b>: A single-arm pre–post intervention study was conducted with nine children aged 7–11 years diagnosed with CVI. Participants received 20 individualized CRT sessions over ten weeks, integrating principles from the Model of Visual Functioning. Functional vision was evaluated using the Gazi Functional Vision Assessment Instrument (GFVAI), while cognitive improvements were measured with the Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch) and the Motor-Free Visual Perception Test-4 (MVPT-4). Data were analyzed using Wilcoxon signed-rank tests. <b>Results</b>: Statistically significant improvements were observed in GFVAI domains such as light sensitivity, distant visual field, focusing, maintaining focus, and obstacle avoidance (<i>p</i> < 0.05 to <i>p</i> < 0.01). Qualitative analysis also indicated a shift from low/moderate to good/very good performance in most functional vision categories. Cognitive domains, including visual-motor organization, thinking operations, and spatial perception, showed significant gains. <b>Conclusions</b>: CRT may support improvements in functional vision by enhancing cognitive processes in children with CVI. This therapist-led approach is feasible, adaptable, and holds promise for widespread application in pediatric rehabilitation.https://www.mdpi.com/2076-3425/15/6/590vision disorderstherapyactivities of daily livingparticipationcognition
spellingShingle Zeynep Celik Turan
Esra Aki
Cognitive Rehabilitation Improves Functional Vision Skills in Children with Cerebral Visual Impairment
Brain Sciences
vision disorders
therapy
activities of daily living
participation
cognition
title Cognitive Rehabilitation Improves Functional Vision Skills in Children with Cerebral Visual Impairment
title_full Cognitive Rehabilitation Improves Functional Vision Skills in Children with Cerebral Visual Impairment
title_fullStr Cognitive Rehabilitation Improves Functional Vision Skills in Children with Cerebral Visual Impairment
title_full_unstemmed Cognitive Rehabilitation Improves Functional Vision Skills in Children with Cerebral Visual Impairment
title_short Cognitive Rehabilitation Improves Functional Vision Skills in Children with Cerebral Visual Impairment
title_sort cognitive rehabilitation improves functional vision skills in children with cerebral visual impairment
topic vision disorders
therapy
activities of daily living
participation
cognition
url https://www.mdpi.com/2076-3425/15/6/590
work_keys_str_mv AT zeynepcelikturan cognitiverehabilitationimprovesfunctionalvisionskillsinchildrenwithcerebralvisualimpairment
AT esraaki cognitiverehabilitationimprovesfunctionalvisionskillsinchildrenwithcerebralvisualimpairment