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[诵读困难症的计算机化眼球运动训练:一项针对儿童群体的随机交叉临床试验]

[Computerized oculomotor training in dyslexia: A randomized, crossover clinical trial in pediatric population].

作者信息

Peyre H, Gérard C-L, Dupong Vanderhorst I, Larger S, Lemoussu C, Vesta J, Bui Quoc E, Gouleme N, Delorme R, Bucci M P

机构信息

Service de psychiatrie de l'enfant et de l'adolescent, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 48, boulevard Serrurier, 75019 Paris, France.

Service de psychiatrie de l'enfant et de l'adolescent, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 48, boulevard Serrurier, 75019 Paris, France.

出版信息

Encephale. 2018 Jun;44(3):247-255. doi: 10.1016/j.encep.2017.03.004. Epub 2017 Jun 1.

Abstract

OBJECTIVE

Several studies have reported abnormal oculomotor capacities leading to reading/writing difficulties among dyslexic children. However, no randomized clinical trial has been conducted to determine whether oculomotor training improves reading/writing skills of these children. The present study aims to evaluate the efficacy of computer-based oculomotor training among dyslexic children.

METHOD

Crossover randomized trial with enrollment from January 12, 2015 to July 24, 2015, and follow-up to February 4, 2016. Eleven children (aged 7 to 12 years old) with dyslexia were included in a French psychiatric unit. The computer-based oculomotor training consisted of exercises focused on control of saccadic movements (reflexes and voluntary saccades), vergences and visual attention and memory. At baseline, 3 and 6 months, participants were assessed on reading and writing skills as well as phonological skills, visuo-attentional skills and verbal memory using the French batterie analytique du langage écrit (BALE). Saccadic and antisaccadic ocular movements (latencies and gains) were recorded using a specific device. Several Anova models were performed to test whether oculomotor training improves reading, writing and phonological, verbal memory and visuo-attentional skills. Our analyses were considered exploratory (alpha at 5%).

RESULTS

No effect of oculomotor training was found on reading skills. However, oculomotor training was associated with a short-term effect (after 3 months of training) on several tests measuring phonological skills (syllabic suppression; P-value=0.022), visuo-attentional skills (search of anarchic verbal cues; P-value=0.035) and verbal memory (digit span backward; P-value=0.022) and with a long-term effect (3 months after the end of the 3 months of training) on a measure of writing skills (regular words; P-value=0.019). Finally, training was associated with an increase of saccadic latencies indicating an increase of visuo-attentional skills (P-value=0.026).

CONCLUSIONS

Our results suggested that computer-based oculomotor training might be effective on writing skills and several cognitive skills among dyslexic children, but future clinical trials are needed to confirm our results.

摘要

目的

多项研究报告称,诵读困难儿童存在导致阅读/书写困难的异常眼球运动能力。然而,尚未进行随机临床试验来确定眼球运动训练是否能提高这些儿童的阅读/书写技能。本研究旨在评估基于计算机的眼球运动训练对诵读困难儿童的疗效。

方法

采用交叉随机试验,招募时间为2015年1月12日至2015年7月24日,随访至2016年2月4日。11名患有诵读困难的儿童(年龄在7至12岁之间)被纳入法国一家精神病科。基于计算机的眼球运动训练包括专注于控制扫视运动(反射性和自主性扫视)、辐辏以及视觉注意力和记忆力的练习。在基线、3个月和6个月时,使用法国书面语言分析测试组(BALE)对参与者的阅读和书写技能以及语音技能、视觉注意力技能和言语记忆进行评估。使用特定设备记录扫视和反扫视眼球运动(潜伏期和增益)。进行了多个方差分析模型来测试眼球运动训练是否能提高阅读、书写以及语音、言语记忆和视觉注意力技能。我们的分析被视为探索性分析(α设定为5%)。

结果

未发现眼球运动训练对阅读技能有影响。然而,眼球运动训练与对多项测量语音技能(音节抑制;P值 = 0.022)、视觉注意力技能(无规律言语线索搜索;P值 = 0.035)和言语记忆(倒背数字广度;P值 = 0.022)的测试有短期影响(训练3个月后),以及与对一项书写技能测量(规则单词;P值 = 0.019)有长期影响(训练3个月结束后3个月)相关。最后,训练与扫视潜伏期增加相关,表明视觉注意力技能提高(P值 = 0.026)。

结论

我们的结果表明,基于计算机的眼球运动训练可能对诵读困难儿童的书写技能和多项认知技能有效,但需要未来的临床试验来证实我们的结果。

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