24.3 Survey

OMB #: 0925-0593

OMB Expiration Date: 08/31/2014

NIH Toolbox Visual Acuity Test, Phase 2g

NIH Toolbox - Visual Acuity Test

Event Category:	Time-Based
Event:	36M, 60M
Administration:	N/A
Instrument Target:	Child
Instrument Respondent:	Child
Domain:	Physical Measures
Document Category:	Physical Measure
Mode (for this instrument*):	In-Person, CAI;
OMB Approved Modes:	In-Person, CAI; Web-Based, CAI
Method:	Data Collector Administered
Estimated Administration Time:	3 minutes
Multiple Child/Sibling Consideration:	Per Child
Special Considerations:	N/A
Version:	1.0
MDES Release:	4.0
Publisher:	NIH Toolbox
NCS Contact:	Westat - 301-251-1500

*This instrument is OMB-approved for multi-mode administration but this version of the instrument is designed for administration in this/these mode(s) only.

Physical Measures Visual Acuity Test

This test directly measures participants’ visual acuity, or distance vision. The participant is seated 12.5 feet away from a computer monitor at eye level, and letters (called “optotypes”) are displayed one at a time on the screen for the participant to identify, using both eyes at the same time.

As the participant successfully identifies optotypes of a given size, smaller ones appear on the screen, until the computer program ascertains the smallest-size optotype the participant can successfully see. Conversely, the program displays larger optotypes if the participant cannot see the letter size that is first displayed, until a size that he/she can accurately see is found.

For participants ages 3-7, only the letters H, O, T, and V are used, and children may point to a laminated card showing the letters if they cannot verbalize or cannot recall the letter names.

This test takes approximately three minutes to administer and is recommended for ages 3-85.

Public reporting burden for this collection of information is estimated to average 3 minutes (total) per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0593*). Do not return the completed form to this address.