What question did this study set out to answer?

The study aims to validate the Tumbling-Hand test for measuring visual acuity in neurodivergent populations.

February 28, 2026Revista Brasileira de Oftalmologia0 citationsOpen Access

Tumbling-hand optotype: a novel gesture-based tool for visual acuity assessment in neurodivergent populations

JCJ. Costa DPDaniela Leite Pinto MOMariana Thayna Oliveira

Key Points

The study aims to validate the Tumbling-Hand test for measuring visual acuity in neurodivergent populations.
Compared visual acuity (VA) thresholds of the Tumbling-Hand test to the printed Tumbling E test in neurotypical participants.
Assessed repeatability using intraclass correlation coefficients and Bland-Altman analysis.
Evaluated feasibility and success rates of the Tumbling-Hand test in neurodivergent participants against the Tumbling E and Landolt C tests.
Conducted statistical analyses such as McNamar's test.
The Tumbling-Hand test demonstrated good psychometric properties in neurotypical participants.
Feasibility and success rates were found to be promising in neurodivergent participants.
Statistical analyses confirmed strong agreement between the Tumbling-Hand and established visual acuity tests.

Abstract

Objective: This study aimed to validate the psychometric properties, feasibility, and clinical utility of the Tumbling-Hand test. Methods: The validation process involved two phases. In neurotypical participants, VA thresholds of the Tumbling-Hand test were compared with the printed Tumbling E test, with repeatability assessed using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. In neurodivergent participants, the feasibility and success rates of the Tumbling-Hand test were evaluated against the Tumbling E and Landolt C tests. Statistical analyses, including McNamar’s and ...

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