Purpose.Most color vision tests require a high level of cognitive ability and as such are problematic for preschool children and multiply challenged individuals. Our goal was to design a color vision test for these groups and evaluate the clinical utility for preschool children.Methods.The University of Waterloo Colored Dot Test (UWCDot) for Color Vision Testing requires the subject to distinguish a colored disc from seven gray discs. The target disc was a Munsell color along the deutan, protan, or tritan confusion line with gray. The first phase estimated the sensitivity and specificity of the test for adults. Thirty-one adults with normal color vision and 21 adults with congenital red-green defects participated. In the second phase, the utility of the UWCDot test for screening preschool children was determined. Subjects were 281 males and 269 females aged 2.5 to 5 years with normal vision. Their color vision was also assessed with the Standard Pseudoisochromatic Plates, Part 1 (SPP1).Results.The sensitivity and specificity of UWCDot for adults approached the values for the desaturated D-15 when subjective responses were scored. Monitoring fixational eye movements produced sensitivity and specificity values that were similar to the anomaloscope. After adjusting the scoring criterion for the preschool children by using the females as a control, 2.9% of the males were identified as red-green deficient, 1.8% were blue-yellow deficient, and 3.2% had an unclassified deficiency. By definition, 1% of the females failed the test. Counting fixational eye movements was not a useful scoring method in the preschool children. Comparisons with SPP1 indicated that the UWCDot uncovers approximately 35% of the individuals with definite red-green color vision defects.Conclusions.Our results indicate that the UWCDot is capable of detecting approximately 35% of the preschool children who have a congenital red-green color vision defect. These individuals are likely to have a more severe deficiency.