The Austin Assessment is a validated tool that can be used for vision screening and as a research tool. On this page we share our ongoing research programme, other research projects that are using the Austin Assessment and the validation research that was undertaken prior to launching the app in January 2024.

Austin Assessment ongoing research programme

We have identified a number of different research avenues that will help with the ongoing development of the Austin Assessment. Our current focus is to develop a normative range database for adults aged 18 – 65 and children aged 3 and 4. This will help extend the normative range database created in 2021-22 for children aged 5-18.

If you are interested in partnering with us to expand the use of the Austin Assessment, please contact Dr Nicola McDowell at

Research projects that are using the Austin Assessment

The Austin Assessment is being used by researchers from around the world in a number of different projects. Current projects include:

Vision for learning: integrating eye care throughout childhood in New Zealand. This research is looking at the prevalence of visual issues in 12-year-olds with the aim of improving equity to eye care for children living in high deprivation areas. The Austin Assessment will be used along with other vision screening tools to screen for both ocular and brain based visual issues.

Prevalence of refractive errors and access to eye care for New Zealand children. This research is looking at the prevalence of visual issues in children aged 7 years. Uncorrected vision conditions in childhood have been linked to poorer early literacy, reduced self-esteem, increased rates of being bullied, and disengagement with education. Therefore, early detection and correction of vision problems is imperative to ensure children can thrive. Refractive error (need for glasses) is the leading cause of visual impairment in children. Cerebral visual impairment is the leading cause of irreversible visual impairment in children in the economically developed world.  With educational support, children with cerebral visual impairment can improve their visual and overall functioning.  Assessing the prevalence of cerebral visual impairment using the Austin assessment alongside the prevalence of other visual conditions will enable the development of health and educational systems that can ideally support children with these conditions to ensure they meet their academic potential.

If you would like to use the Austin Assessment in are search project, please contact Dr Nicola McDowell at, as you may be eligible for a discount when purchasing a screening pack.

Research on the Austin Assessment

2018 Initial pilot study

This was the first research project testing the idea or hypothesis behind the Austin Assessment. The research involved 11 children with neurodevelopmental conditions known to have visual search issues (ADHD, autism, dyslexia, dyspraxia and auditory processing disorder) with 11 age and gender matched control children. The study involved matching playing cards, this video explains how our founder, Dr Nicola McDowell came up with the hypothesis. Each child was assessed three times on three separate visits. The first and third assessment was conducted in a quiet room with no distraction. The second assessment was conducted in the child’s classroom, while the rest of the class completed their usual classroom activities. The main finding from this project was that a fun game of matching cards was effective at distinguishing children with potential CVI related visual issues (or visual perceptual difficulties) from those with typical vision. From the success of this project, an iPad digital version of the matching cards game was developed for further research and called the Austin Assessment.

Research publication:

McDowell, N. (2020). A pilot study of the Austin Playing Card Assessment: A tool to detect and find the degree of visual perceptual difficulties related to clutter. British Journal of Visual Impairment, 38(2), 118-136.

2021-2022 Research to validate the Austin Assessment

Extensive research was conducted to validate the Austin Assessment as an effective screening tool for CVI related visual issues over a two-year period. This included three separate research phases and the assessment of over 900 children with the Austin Assessment. The first phase was the creation of a normative range database for children aged 5-18. See our page How the Austin Assessment App Works for the different tests, measurements and age groups. For this, 724 children from four different schools in New Zealand were assessed using the Austin Assessment App on an iPad. The data from these assessments were analysed to determine the optimal age groupings. Further analysis led to the calculation of the thresholds for each age group in the three different variables, to identify potential visual search issue.

The second phase was assessing the effectiveness of the Austin Assessment as a screening tool for CVI related visual issues. For this, 271 children aged from 5-13 were screened using the Austin Assessment App. Any child that met at least one threshold in their screening assessment were further assessed by an ophthalmologist, an orthoptist and a vision education/rehabilitation specialist. From this, 17 children were identified as having a verifiable reason or clinical finding confirming that a result outside of the thresholds of the normative range in the Austin Assessment gives a reliable true positive.

The third phase was specific validation research which compared 149 children’s performance on the Austin Assessment with an already validated age-appropriate cancellation test. Of the 149,129 had a range of conditions, including CVI, neurodevelopmental conditions (autism, ADHD, dyslexia, auditory processing disorder), cerebral palsy and children who were born preterm. A further 30 children had typical vision. The findings from phase three were that the Austin Assessment has moderate diagnostic value for each age group, with good sensitivity and specificity. It also confirmed that the Austin Assessment is effective as accurately distinguishing between children with visual issues and those with typical vision.

Research publication:

McDowell, N., & Butler, P. (2023). Validation of the Austin Assessment: A screening tool for cerebral visual impairment related visual issues. PLoS One, 18(11), e0293904.

2022 Supporting children with CVI related visual issues in mainstream classrooms

The parents and classroom teachers of the children from one school identified in the validation research as having CVI related visual issues were invited to participate in further research to explore the awareness and understanding of CVI in the school community and assess the effectiveness of a range of strategies to support the children in the classroom environment.This research was recently reviewed on the CVI Scotland website – CVI in mainstream schools.

Research publication:

McDowell, N. (2023). Children with cerebral visual impairment related visual issues in the classroom. Kairaranga, 24(2),15-29.

Science Feature summary of validation research

The Austin Assessment validation research was recently featured on, a not-for-profit organisation dedicated to illuminating the wonders of science.  

The feature, EARLY SCREENING FOR CHILDREN’S VISUAL IMPAIRMENT WITH INNOVATIVE APP, provides a short summary of the extensive validation research and the key findings from this research.  

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