Quantifying Grating Acuity in Children With Developmental Delays Using Newborn Acuity Cards

Introduction: The Newborn Acuity Cards (NAC) have been used on neonates and were noted to be simple, fast, and reliable. The distinguishing features of NAC include central placement of the gratings and wide range of grating acuity that can be measured. In the current study, NAC were used with children who had developmental delays to determine the clinical utility of the cards for this group. Methods: Binocular grating acuity was measured using NAC in children with developmental delays. Grating acuity was measured on one group using descending method of limits and on a separate group using random presentation. The acuity findings were obtained from the medical records. Retest was carried out on eight children after 1.2 ± 1.0 months using NAC. Results: A total of 47 children participated (M_age: 23.1 ± 15.6 months, male: 59.5%). Testability rates were 100% and 93.6% using descending method of limits and random presentation, respectively. In the data obtained from the medical records, only functional assessment was documented in 30 children (63.8%). However, among them, 27 children (90%) could be tested successfully using NAC. Grating acuity measured using NAC ranged from −1.21 to 0.35 logCPD (≈2.68–1.13 logMAR). The coefficient of repeatability for NAC was 0.85 octaves (<2 cards difference). Discussion: This is the first study to establish the clinical utility of NAC in children with developmental delays and to demonstrate the feasibility of using the cards when quantification using other conventional tests may be difficult. The study findings also indicate good repeatability indices using NAC, albeit with a small sample. Implications for Practitioners: NAC can be useful to test grating acuity of children with developmental delays. Wide range of acuity, grating placement, and better testability rates are potential reasons to adapt NAC for this group when quantification of acuity with conventional tests is not possible.