Psychometric Validation and Cultural Adaptation of the Functional Vision Questionnaire for Children (FVQ-Ar): A COSMIN-Compliant Study
This study successfully cross-culturally adapted and psychometrically validated the Arabic Functional Vision Questionnaire for Children (FVQ-Ar) in Jordan, demonstrating excellent reliability and validity to support evidence-based educational accommodations and inclusive education for visually impaired students in the Middle East.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Vision is the primary way children learn about the world, shaping how they play, read, and connect with others. When a child's sight is impaired, it does more than blur the edges of their vision; it can quietly reshape their entire daily life, from the simple act of walking down a hallway to the complex task of following a lesson in a classroom. For decades, doctors have relied on clinical tests to measure how well an eye sees, but these tests often miss the bigger picture of how a child actually functions in the real world. To truly understand the challenges a child faces, experts need a way to ask the right questions about their daily experiences. This is where patient-reported tools come in, designed to capture the lived reality of vision loss rather than just the numbers on an eye chart. However, for Arabic-speaking families in the Middle East, a reliable way to ask these questions has been missing, leaving a gap in care that this new research aims to fill.
A team of researchers in Jordan has stepped in to bridge this gap by adapting and testing a specific questionnaire called the Functional Vision Questionnaire for Children. This tool is designed to be filled out by adults who know the child well, such as teachers or parents, to describe how the child uses their remaining sight in everyday situations. The researchers took the original English version of this questionnaire and carefully translated it into Arabic, ensuring that every word made sense not just linguistically, but also culturally within the context of Jordanian schools and homes. They did not simply translate the words; they worked with a group of experts, including eye doctors, special education teachers, and language specialists, to make sure the questions felt natural and accurate for the people who would be answering them. They also tested the questions with families to ensure the language was clear and that the concepts were understood exactly as intended.
Once the Arabic version, known as the FVQ-Ar, was ready, the team put it to the test with 68 children between the ages of three and twelve who have diagnosed visual impairments. These children attended various schools and clinics in the cities of Amman and Irbid. The adults who knew these children best—mostly their teachers, with a few parents—filled out the questionnaire based on what they had observed over the previous two weeks. The researchers then analyzed the responses to see if the tool worked as well in Arabic as it does in English. They looked for consistency in the answers, checking if the questions measured the same thing every time, and they examined whether the scores matched up with other known facts about the children's vision.
The results showed that the new Arabic tool is highly reliable and effective. The answers given by the teachers and parents were consistent, meaning the questionnaire successfully captured a clear picture of each child's functional vision. When the researchers looked at the structure of the answers, they found that the questions all pointed toward a single, strong understanding of how well a child is using their vision, rather than measuring unrelated things. The tool also proved sensitive enough to detect real differences between children. For instance, the children who did not need glasses to see scored higher on the questionnaire than those who did, which makes sense because the children without glasses generally face fewer daily visual hurdles. The questionnaire also highlighted specific areas where children struggle, such as moving around a classroom or participating in visual activities, while showing that some tasks, like recognizing a face up close, were easier for many of them.
This study confirms that the FVQ-Ar is a solid, trustworthy instrument for assessing how children with visual impairments function in their daily lives across the Arabic-speaking world. By providing a way to measure these real-world challenges, the tool gives doctors and educators a new way to understand the specific needs of each child. It moves beyond simple clinical measurements to offer a deeper look at how vision loss affects a child's ability to learn and socialize. With this validated tool now available, clinicians in Jordan and the wider region can make better-informed decisions about rehabilitation and education, ensuring that support is tailored to the actual experiences of the children they serve. The work establishes a foundation for more equitable care, allowing professionals to see the full scope of a child's vision and the specific barriers they face every day.
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