A pilot study of the Austin Playing Card Assessment: A tool to detect and find the degree of visual perceptual difficulties related to clutter

Abstract

The Austin Playing Card Assessment was developed to help identify visual perceptual difficulties related to clutter and to determine the nature of each child’s difficulties. The aim of this pilot study was to find out whether a task of progressively increasing difficulty, for pairing playing cards, is effective in identifying these kinds of visual difficulties. Parents of 11 research and 11 control subjects completed an inventory to ascertain whether their child’s visual behaviours were suggestive of visual perceptual difficulties. All participants completed the Austin Playing Card Assessment in two separate locations, with an ABA experimental design. The time taken to complete each level of the test was recorded. Structured observations were made of the participants’ visual behaviours when completing the assessment. Inventory scores from the research subjects indicated a higher likelihood of visual perceptual difficulties, whereas the control subjects’ scores did not. Research subjects were also slower at completing the Austin Playing Card Assessment. Independent T-tests comparing the time taken across all levels of difficulty ranged between p = .011 to p < .001. Cohen’s d calculations demonstrated a large effect size. Overall, research subjects demonstrated more indicators of visual perceptual difficulties. The Austin Playing Card Assessment has the potential to be effective for detecting and identifying visual perceptual difficulties in children. Information gathered through the assessment process could also be used to inform intervention. As this was a pilot study, further research is needed to support these findings.

Assessing Higher-Order Visual Processing in Cerebral Visual Impairment Using Naturalistic Virtual-Reality-Based Visual Search Tasks

“…Preliminary analysis of results from the free viewing behavior of naturalistic images revealed that children with CVI showed a longer latency initiating saccades while searching for a target in the visual scene [ 58 ] (see also [ 59 ] using eye tracking to assess visual acuity). Finally, the Austin Playing Card Assessment developed by McDowell (2020) represents a novel screening method to help identify visual perceptual difficulties in CVI [ 20 ]. Using standard playing cards, a participant is instructed to pick up pairs of cards, while task demand is increased by varying the number of cards in the search array.…”

“…Furthermore (and consistent with the observations reported in our toybox task), performance worsened with increasing task demand. Future studies are looking to digitize the Austin Playing Card Assessment testing platform and incorporate eye-tracking metrics [ 20 ].…”

“…In other words, it is important to characterize how an individual uses their vision in real-world situations [ 16 , 17 ]. Failing to do so can lead to an underestimation of visual difficulties or worse, a dismissal of reported complaints and even misdiagnosis [ 18 , 19 , 20 , 21 ]. Furthermore, developing novel and adaptive assessments are particularly relevant in the case of individuals with CVI who may not be able to verbalize the nature of their visual difficulties, have challenges undergoing formal ophthalmic testing, or have perceptual deficits despite having visual functions within normal or near normal range.…”

“…Finally, while standardized neurophysiological testing can provide important information regarding developmental progress, it nonetheless remains difficult to disentangle the nature of observed perceptual impairments and, ultimately, how testing results translate to real-world tasks and situations. Thus, there remains a pressing need to develop objective assessment tools that can characterize higher-order visual perceptual functional vision abilities in the context of common and everyday activities and capture the complex and heterogeneous profile of individuals with CVI [ 2 , 20 , 23 ].…”

Validation of the Austin Assessment: A screening tool for cerebral visual impairment related visual issues

“…With this in mind, a screening tool to detect CVI related visual issues, specifically, limitations in the higher visual functions of catering for visual crowding and shape analysis was developed, called the Austin Assessment [ 28 ]. The Austin Assessment is a simple iPad activity of matching cards with different shapes over 5 levels, with the numbers of cards increasing from 4 cards and 1 pair at level one, to 12 cards and 5 pairs at level five [ 28 ]. The activity is completed via an app on an iPad and requires the child to use their finger to move a card on top of another card when they believe they are a pair.…”