Seeing More Than Motor Challenges: Bringing Early CVI Screening into Cerebral Palsy Care

At the Cerebral Palsy Centre of University Hospitals Leuven (UZ Leuven), clinicians have always known that many children with cerebral palsy are at increased risk of cerebral visual impairment (CVI). Yet recognizing CVI during a busy outpatient consultation has never been straightforward. The signs are often subtle, easily attributed to motor or cognitive challenges, and can remain hidden for years. Although parents routinely completed questionnaires about a child's visual functioning, the team wanted a way to actively involve the child in the screening process and assess visual processing directly during the consultation.

Under the supervision of Professor Dr. Els Ortibus, the Cerebral Palsy Centre introduced the Austin Assessment App into routine consultations since January 2026. Children with cerebral palsy aged 5 to 18 years are now screened as part of their regular clinical care, making early identification of possible CVI a routine element of the consultation.

A practical solution during routine consultations

Rather than requiring an additional appointment, the Austin Assessment is completed during the consultation itself. In under ten minutes, clinicians obtain an objective, age-adjusted overview of a child's visual processing abilities. For a population in which CVI is a common comorbidity, this creates new opportunities to identify children who may otherwise have remained undetected.

"We knew many of our patients were at increased risk of CVI, but we wanted a structured way to identify those children earlier. The Austin Assessment allows us to screen efficiently within the consultation itself."

The assessment has proven particularly well suited for children with cerebral palsy. Its game-like interface keeps children engaged, while the minimal language demands mean it can be used with children who have speech, language or hearing difficulties. Response methods can be adapted to each child's abilities, whether through pointing or verbal responses, making the assessment accessible across a wide range of motor abilities seen in cerebral palsy. Most importantly, it provides screening results without adding a significant burden to families or clinicians.

Another reason the Austin Assessment works so well in our clinic is that it was developed using a normative sample of diverse group of children, including those with cerebral palsy, a history of prematurity and genetic conditions. As a result, it reflects the variety of children seen in everyday paediatric neurodevelopmental practice.

Turning screening into action

The Austin Assessment is designed as a screening tool, identifying children who may benefit from further investigation rather than providing a diagnosis. When the screening suggests a possible presence of CVI, the results are discussed within the multidisciplinary team alongside possible concerns raised by parents and/or information from the school.

"The screening result is one piece of the puzzle. Combined with clinical expertise and information from families and schools, it helps us decide which children should be referred for a comprehensive neurovisual assessment."

When indicated, children are referred to the Centre for Developmental Disabilities at UZ Leuven for a detailed assessment of cerebral visual impairment.

Earlier recognition, better support

For the team, introducing the Austin Assessment has not simply added another screening tool. It has changed the conversation. Children who previously may have been recognised only after prolonged difficulties at home or at school can now be identified earlier, allowing families to receive answers sooner.

The experience at UZ Leuven shows how a brief, accessible screening tool can fit seamlessly into routine cerebral palsy care. Sometimes, seeing a child more clearly begins by looking through a different lens.