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

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

Research output: Contribution to journalArticlepeer-review

2 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
JournalThe British journal of ophthalmology
Issue number4
Publication statusPublished or Issued - Apr 2017
Externally publishedYes


  • Adolescent
  • Child
  • China
  • Disability Evaluation
  • Humans
  • Prevalence
  • Reproducibility of Results
  • Sickness Impact Profile
  • Vision, Low
  • Visual Acuity
  • Visually Impaired Persons
  • Journal Article
  • Validation Studies

Cite this