Visual Function Classification System for children with cerebral palsy: development and validation

Abstract

AIM To develop and validate the Visual Function Classification System (VFCS), which was created to classify how children with cerebral palsy (CP) use visual abilities in daily life.METHOD The process of development and validation of the VFCS involved four phases: (1) drafting of the five levels from the analysis of literature and clinical experience; (2) validation of constructs and revision of the levels for concept meaningfulness, using nominal group process; (3) refinement by international Delphi survey; and (4) assessment of interrater reliability among professionals and with caregivers, and of test-retest reliability.RESULTS Five nominal groups involved 29 participants; 65 people completed the first round and 51 the second round of the Delphi survey. Construct validity was demonstrated within an expert group and external validation through several stakeholders, with the involvement of patients and families to ensure meaningfulness of the concept. Discussions continued until consensus was reached about the construct and content of the five levels. Participants in the reliability study included 29 professionals, 39 parents, and a total sample of 160 children with CP (mean age [SD] 6y 6mo [3y 4mo]; median 5y 7mo, range 1-19y). Absolute interrater agreement among professionals was 86% (weighted j=0.88; 95% confidence interval [CI] 0.83-0.93). Test-retest reliability was high (weighted j=0.97; 95% CI 0.95-0.99). Parent-professional interrater reliability on 39 children was moderate (weighted j=0.51; 95% CI 0.39-0.63).INTERPRETATION The VFCS has been appropriately constructed and provides a reliable system to classify visual abilities of children with CP both in clinical and in research settings.

Study protocol: functioning curves and trajectories for children and adolescents with cerebral palsy in Brazil – PartiCipa Brazil

“…Classification System (VFCS) [8,9]. It is important to highlight that functional classifications facilitate the exchange of consistent information among members of the interdisciplinary team and between the team and the family or the child/adolescent.…”

Sistemas de clasificación para niños, niñas y adolescentes con parálisis cerebral: su uso en la práctica clínica

“…Es así que, estudios han comprobado que no hay una correlación directa entre los niveles de las clasificaciones. Sin embargo, se estudió que las habilidades intelectuales sí serían un factor que está asociado a las habilidades funcionales de las personas, afectando el nivel que alcanzan en los sistemas de clasificación 36,43 .…”

“…La vista se evalúa mediante controles oftalmológicos, pero hasta el momento no se contaba con un sistema de clasificaciones para valorar el grado de afección de las funciones visuales. Así, se ha incorporado recientemente a la familia de los sistemas de clasificación la VFCS por sus siglas del inglés Visual Function Classification System, publicada en el año 2019 por Baranello y colaboradores36 . Al igual que las demás clasificaciones se compone de cinco niveles y pone su foco en las actividades que niños y jóvenes con PC sí pueden hacer (tabla 1 e).El 80% de las personas con PC presentan neuroimágenes anormales, dentro de las principales utilizadas se encuentra las resonancias magnéticas38,39 .…”

Corrigendum

“…In the article by Baranello et al, the affiliation of the author Francesca Tinelli was incorrectly published. The correct affiliation is ‘Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy’.…”