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

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.