# Visual Acuity Assessment in Children With Autism Spectrum Disorder Using a Child-Friendly Minimum-Separable Chart: A Five-Case Report

## TL;DR

A new child-friendly chart was developed to test visual acuity in children with autism, improving cooperation during assessments.

## Contribution

The study introduces a novel, child-friendly minimum-separable chart for visual acuity testing in children with autism.

## Key findings

- All five children with ASD cooperated during testing with the CFMS chart, unlike the Landolt ring test.
- The CFMS chart's design increased understanding and interest in children with ASD.
- This is the first demonstration of the CFMS chart's potential for assessing visual acuity in this population.

## Abstract

Children with autism spectrum disorder (ASD) often have eye disorders, such as strabismus and amblyopia; thus, it is important to evaluate their visual function. However, achieving their cooperation for visual acuity testing is challenging. We developed a child-friendly minimum separable chart (CFMS chart) using meaningful pictures and two-choice answers. In this study, visual acuity tests were performed using both Landolt rings and CFMS charts in five children with ASD. For the Landolt ring test, only one patient was cooperative, whereas for the CFMS chart, all the patients were cooperative for evaluating the visual acuity of at least one eye. The meaningful visual targets and the two-choice format promoted understanding and interest among children with ASD, making it easier to obtain their cooperation for visual acuity testing. This is the first study to demonstrate the potential of the CFMS chart as a method for assessing visual acuity in children with ASD.