The Effect of Insight Questions Inventory and Visual Support Strategies on Carer-Reported Quality of Life for Children With Cerebral Palsy and Perceptual Visual Dysfunction in Nigeria: A Randomized Controlled Trial

Abstract

Structured clinical history question inventories have previously been used to try and elicit symptoms of perceptual visual dysfunction (PVD) in children with cerebral palsy (CP) in different settings. Earlier studies have suggested that PVD may affect quality of life and specific habilitational strategies, linked to inventory responses, may improve quality of life. Through an RCT, based on a community based sample of children with CP in Cross River State, Nigeria, we aimed to determine if a structured history inventory such as the Insight question inventory (IQI) and associated tailored visual support strategies (IQI VSS) for the management of those children who have PVD, can improve quality of life and is superior to standard therapy. Children with CP were recruited by the key informant method and confirmed by clinical examination. The parent reported IQI was used to identify children with PVD. Primary outcome measures were both Pediatric Quality of Life 4.0 Generic (PedsQL 4.0 Generic) and Pediatric Quality of Life 3.0 Cerebral Palsy (PedsQL 3.0 CP) scale scores. Children were enrolled with a parallel arm allocation to either IQI and IQI VSS or to standard therapy for CP. Children were followed up for 6 weeks with weekly phone call session and the questionnaires repeated at the end of the 6 weeks’ period. Results show that the children in the treatment group (n = 191) showed no significantly different change between baseline and follow up in quality of life (PedsQL 4.0 Generic p = 0.943: and PedsQL-CP 3.0 p = 0.287), compared to the control group. There was suggestion of a better improvement (p = 0.035) in the PedsQL 3.0 CP subscale of speech and communication for the intervention group. The use of IQI VSS for the treatment of PVD in children with CP in this population does not show any superiority over current standard CP management in terms of overall quality of life. However, there was some evidence of improvement in quality of life in the area of speech and communication. Further research and refinement of these management method is required.Clinical Trial Registration:www.ClinicalTrials.gov, identifier [PACTR20161200188] 6396.

Interventions for children with cerebral visual impairment: A scoping review

“…Seven interventions studies were identified, which used strategies to increase visual function and maximize current functional abilities through adaptations to daily tasks and modifications to the environment. One RCT examined if giving caregivers visual support strategies from the Insight Question Inventory improved the quality of life of children with CP in the intervention group compared to those in the control group who did not receive these strategies 27 . The intervention group was asked to use the strategies at least three times per day for 6 weeks.…”

“…One RCT examined if giving caregivers visual support strategies from the Insight Question Inventory improved the quality of life of children with CP in the intervention group compared to those in the control group who did not receive these strategies. 27 The intervention group was asked to use the strategies at least three times per day for 6 weeks. Overall, there was no change in quality of life on the PedsQL 4.0 Generic or PedsQL 3.0 for CP.…”

A Case Study on the Fundamentals of Sensory Problems in Cerebral Palsy

“…According to various research, the prevalence of visual impairment in CP children ranges from 40 to 50% of kids. In CP, visual impairment is frequently caused by the same brain injury that results in movement issues (18) . Up to 39% of CP patients experience hearing loss.…”

Learning to see after early and extended blindness: A scoping review

“…Some attempts to bridge this gap exist (e.g., CVIT 3–6, Vancleef et al, 2020 ). Adoption of existing tools will likely require modifications for culture (Duke et al, 2021 ) and low-level abilities to be appropriate for impacted children.…”