Enhancing Development Through Teleoccupational Therapy in Children With Cortical Visual Impairment: A Quasiexperimental Study.
Eight children with cortical visual impairment improved in cognitive, fine motor, and gross motor scores after 8 weeks of online occupational therapy.
Play skills improved in some areas but not others. No control group means the gains cannot be separated from maturation or parent attention.
Key findings
1On the Ankara Developmental Screening Inventory, cognitive scores rose from a median of 26.50 to 33.50 (p = 0.018), fine motor from 11.00 to 13.00 (p = 0.017), and gross motor from 11.00 to 13.00 (p = 0.008). The social domain did not reach significance (p = 0.102).
2On the Knox Preschool Play Scale, material management (p = 0.011), manipulation (p = 0.014), construction (p = 0.046), and attention (p = 0.005) improved significantly. Space management, participation, symbolic play, imitation, and several other play domains did not reach significance.
3The Discussion and Conclusion state that symbolic play and participation improved significantly, but the data table shows symbolic play at p = 0.102 and participation at p = 1.000, neither of which meets the study's own threshold of p < 0.05.
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What it does not show
Only 8 children, so the results are too small to generalise beyond this specific group. No control group. The children were 4 to 6 years old and received 8 weeks of structured, parent-supported activity. Gains could reflect normal development, increased parent attention, or the novelty of a new routine rather than the specific therapy content. The three intervention components (environmental changes, play activities, parent training) were delivered together, so the contribution of any single component cannot be separated. No follow-up beyond the 8-week intervention. It is unknown whether the gains were maintained. Parent-reported compliance with home practice was the only measure of between-session engagement, which may overestimate how much the child actually practised. The criterion of 'no severe cognitive impairment' was based on clinical records and parent reports rather than standardised neuropsychological testing. The Discussion and Conclusion state that symbolic play and participation improved significantly, but the data table shows neither reached the study's own significance threshold.
Declared interests
No funding was received. The authors declare no conflicts of interest.
The easy way to misread this
Do not read the significant p-values as proof that tele-OT improves development in children with CVI. The study had 8 children and no control group, so the gains could reflect 8 weeks of extra parent attention and structured activity rather than the specific therapy. The Discussion also states that symbolic play and participation improved significantly, but the data table shows neither reached significance (p = 0.102 and p = 1.000 respectively). And because three components were delivered together, the effect cannot be attributed to any one of them.
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