The impact of involving young children in improving the understanding of a new eye test

Background Although considered important, the involvement of young children in research is rare and its impact has never been measured. We aim to provide a good practice example of involvement of young children in the development of a tablet-based 3D eye test or stereotest, ASTEROID. We focus on improving understanding of test instructions. Methods After a pre-measure of understanding was taken, we explored issues with the test instructions in patient and public involvement (PPI) sessions. Feedback was collected via observations, rating scales and children’s comments. An interdisciplinary panel reviewed the feedback and decided on the implementation. Subsequently, a post-measure was collected. In Study 1, 650 children (2-11.8 years old) took part in the pre-measure, 111 children (1-12 years old) in the PPI sessions, and 52 children (4-6 years old) in the post-measure which also served as a pre-measure for Study 2. PPI sessions for Study 2 attracted 122 children (1-12 years old) and adults. 53 people (2-39 years old) participated in the post-measure of Study 2. Results Following feedback in Study 1, we added a frame cue and included a shuffle animation. This increased the percentage of correct practice trials from 76% to 97% (t(231)=14.29, p<.001). After adding a cardboard demo in Study 2, the percentage of correct trials remained stable but the number of additional instructions given decreased (t(103)=3.72, p<.001). Conclusions Our study demonstrates impact of involvement of very young children in research through accessible activities. It can encourage researchers to involve young children and contribute to developing guidelines.