Mendeley  

Zotero  

Ghasemi Fard F. Functional Vision Assessment for Iranian Children With Visual Impairment: A Policy Brief. Arch Rehabil 2026; 27 (3) :564-577
URL: http://rehabilitationj.uswr.ac.ir/article-1-3774-en.html

Background and Objective: The lack of a standardized, performance-based, and contextually appropriate tool for assessing functional vision in Iranian children with visual impairment limits the accurate identification of educational and rehabilitation needs and the development of targeted interventions. This policy brief aimed to provide evidence to support a systematic approach to functional vision assessment among Iranian children aged 3–10 years with visual impairment within educational and rehabilitation systems.
Methods: This policy brief was based on findings from an exploratory sequential mixed-methods study conducted to develop and validate a functional vision assessment instrument, in which 122 children with mild to severe visual impairment recruited from special schools and related centers in Tehran Province, Iran, were included. The performance-based functional vision assessment tool (FVT-PB) was developed based on the occupation domain of the fourth edition of the occupational therapy practice framework (OTPF-4). The instrument had 32 items and five domains: activities of daily living, instrumental activities of daily living, education, play/leisure, and social participation, with two age-specific versions for children aged 3–7 and 7–10 years. Face and content validity, criterion-related validity, construct validity, and intra- and inter-rater reliability were evaluated.
Results: The FVT-PB demonstrated satisfactory validity and reliability. The mean content validity index was 0.89, while intra- and inter-rater reliability coefficients exceeded 0.97 across both age groups. The instrument differentiated between age groups and different levels of visual impairment. The receiver operating characteristic (ROC)-derived cutoff scores were 91 and 104 for the 3–7 and 7–10-year age groups, respectively. Sensitivity and specificity were 96.88% and 78.95% for children aged 3–7 years and 97.06% and 86.18% for children aged 7–10 years, respectively. These findings support the instrument's potential applicability in Iranian educational, clinical, and rehabilitation settings.
Policy Implications: The available evidence supports the phased implementation of the FVT-PB in Iran. A multicenter pilot implementation across several provinces is recommended, accompanied by standardized training for occupational therapists, optometrists, and special-education teachers, development of implementation protocols, and establishment of a data-protection framework. After evaluating feasibility, acceptability, and implementation outcomes, the instrument can be considered for national standardization and broader implementation through a shared database. National normative studies across different provinces and the development of a shorter version for first-level screening are also recommended. This approach may strengthen data-informed decision-making, enable more targeted interventions, and advance educational and rehabilitation equity for children with visual impairment.