Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.
The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
Eur J Neurosci. 2023 Jun;57(12):1998-2016. doi: 10.1111/ejn.15841. Epub 2022 Nov 16.
Vision is a primary and motivating sense. Early visual experience derived from the external world is known to have an important impact on the development of central visual pathways, and not surprisingly, visual impairment constitutes a risk factor for overall development. In light of the role of vision in early brain development, infants and young children with visual impairment should be thus entitled to early and effective visual intervention programmes. In this review, we discuss early visual interventions in infants and young children with visual impairment, focusing on their contents and outcomes. We defined a PICO format to critically review different models with a particular focus on parent-mediated and therapist-mediated approaches. We consider protocols that involved direct manipulation or improvement of the infants' visual inputs or were based on behavioural strategies and communication towards infants with visual impairment. We also provide an overview of the effectiveness of these protocols. A total of nine intervention protocols were selected for the purposes of this review. Substantial agreement regarding the importance of promoting the enrichment of infant environments, and more specifically in the context of active play that engages the whole family, has been reported in most of the studies. However, there is no clear agreement on methodological aspects, including clinical population characteristics, outcome measures, length of treatment and follow-up programmes. Further high-quality, carefully designed and adequately reported studies are needed in order to improve the clinical efficacy of these approaches to treating infants with visual impairment.
视觉是一种主要的感觉，也是一种激励感官的感觉。早期来自外部世界的视觉体验，被认为对中央视觉通路的发育有重要影响，毫不奇怪，视力障碍是整体发育的一个风险因素。鉴于视觉在大脑早期发育中的作用，视力受损的婴儿和幼儿应该有资格获得早期和有效的视觉干预计划。在这篇综述中，我们讨论了视力受损的婴儿和幼儿的早期视觉干预，重点关注其内容和结果。我们定义了一个 PICO 格式，以批判性地回顾不同的模型，特别关注家长介导和治疗师介导的方法。我们考虑了涉及直接操纵或改善婴儿视觉输入的方案，或者是基于针对视力受损婴儿的行为策略和沟通的方案。我们还概述了这些方案的有效性。为了进行本次综述，共选择了 9 项干预方案。大多数研究都报告了大量关于促进婴儿环境丰富的重要性的共识，特别是在涉及全家参与的积极游戏的情况下。然而，在方法学方面，包括临床人群特征、结果测量、治疗和随访方案的长度，尚未达成明确共识。需要进一步开展高质量、精心设计和充分报告的研究，以提高这些治疗视力受损婴儿的方法的临床疗效。
