Detecting Visual Learning Disabilities Early with Christine Nearchou, BS

At the 2025 American Optometric Association Conference in Minneapolis, MN, Christine Nearchou, BS, senior lecturer in the department of optometry at the University of Melbourne, presented her study testing the effectiveness of the Novel Dot Pattern ‘A’ (NDPA) in screening for children with specific learning disabilities (SLD).1

Prior trials have indicated the efficacy of the NDPA in screening for visual cognition deficits in children. Nearchou and colleagues in 2022 published their findings from an investigation of 274 children, which acted as proof of concept for the tool based on a comparison against existing programs, such as the Wold Visuo-motor Test (WVMT) and the Rosner Test for Visual Analysis Skills (TVAS).2

"The research looked at children with a diagnosis of dyslexia or specific learning disability, and we tested those children using a novel dot pattern tool to test how well they could process visual information," Nearchou told HCPLive.

As Nearchou describes, the NDPA is a connect-the-dots puzzle that can be completed in around 3-4 minutes, designed to determine the presence of visual deficits in children. This early identification allows for similarly early mitigation.

This pilot study examined a learning center’s vision screening program in India. The NDPA was compared against the WVMT and the TVAS in identifying SLD. Nearchou and colleagues enrolled 45 children in the study; 15 children with SLD, with a mean (standard deviation [SD]) age 9.3 +/- 2 years, and 30 controls.1

The 3 tests analyzed the distance vision, near vision, and spherical equivalent for each child’s left and right eye individually. The NDPA indicated a median of 2 in the SLD cohort and 5 in the control cohort (P <.001). The TVAS found a 6.4 median in the SLD cohort and a 10.8 in the control cohort (P <.001). The first stage of the WVMT test found a median of 59 in the SLD group and 42 in control (P = .002). The second stage found a median of 82 in SLD and 55 in control (P = .001), and the third stage found a median of 30 in SLD and 22 in control (P = .002).1

“And we analyzed that data further to see how sensitive and specific that tool could be, and whether it could be used as a diagnostic test or perhaps a predictor for young children who might be at risk of developing a specific learning difficulty as they grow older,” Nearchou said. “And we found that that was very promising.”

Comparing these 3 tests via ROC analysis, investigators found that the NDPA presented an 86.7% sensitivity and 86.7% specificity. Additionally, a significant difference was noted between both the WVMT completion times and the NDPA and TVAS scores. Investigators concluded based on these data that the NDPA is a promising screening tool for SLD, which highlights potential for early identification methods in children at risk of SLD.1

Nearchou also spoke on her and colleagues’ future research stemming from these data. The team is working on a digital version of the test, gamifying it to encourage children to use the tool.

“We’ve worked with a team of software developers, and we’ve actually already piloted that application in multiple schools and a variety of school cohorts,” Nearchou said. “And it’s been very promising in its usability and ability to capture lots of children in a very short period of time without requiring a specialist to administer the tool.”

Nearchou discussed future research that she hopes to see from this field, especially regarding the next step after identification.

“Once we’ve identified these children, what’s going to be the gold standard of care in terms of early intervention?” Nearchou said. “How do we include optometry, occupational therapy, education, and other healthcare providers in helping that child be the best that they can be and get the best learning opportunity on a level playing field? So there’s a lot of work to be done in that space.”

Nearchou reports no disclosures.

References

1. 1: Nearchou C, Ravi A, Irom A, Hussaindeen R. Evaluating a Novel Dot Pattern Task for Screening Visual Cognition Deficits and Predicting Risk of Specific Learning Disabilities in Children. Abstract presented at the 2025 American Optometric Association Conference in Minneapolis, MN, June 25-28, 2025.

2. 2: Ravi A, Hussaindeen J, Nearchou C. A novel test for visual cognition in school children. Vision Development & Rehabilitation. Published online December 2022:248-255. doi:10.31707/vdr2022.8.4.p248