目的:确定旨在提高视觉信息处理(VIP)技能的典型视觉治疗(VT)计划是否能有效提高这些技能和/或学习成绩。
方法:我们使用双盲,比较VIPVT和安慰剂训练的随机临床试验。参与学校参考了579名被确定为识字率较低的小学生的样本。从引用的样本中,我们确定了247名有资格参与的儿童(通过视力和听觉处理筛查,和VIP性能<第34百分位数),其中94人参与。匹配IQ,通过对这些值进行分层排序,然后交替分配给室性心动过速组或安慰剂组,来获得学校年级和性别.这两个项目都运行了10周,包括33小时在家工作和4小时在办公室工作。VT计划表明了澳大利亚儿科验光实践中采用的方法,安慰剂计划包含类似的活动,除了针对儿童能力范围内的技能,并删除了特定的VIP开发活动。主要结果指标是三项标准化教育测试的分数变化(阅读理解,拼写和数学)和六个VIP测试,干预后立即(PI)和6个月后。
结果:69名儿童完成了项目。与对照组相比,VT计划在三项教育测试或六项VIP测试中的五项中没有显着改善。与对照组相比,VT程序将视觉顺序记忆(VSM)提高了适度(Cohen'sd=0.57和0.52,立即PI和6个月时,分别为:p<0.03和p<0.02)。
结论:VT计划的VIP和学业成绩收益与对照计划的收益基本相同,立即和6个月的PI。安慰剂效应和一般效应,如执行功能的改善和/或回归均值,可能被误认为是特定的方案有效性。
OBJECTIVE: To determine whether a typical vision therapy (VT) programme designed to improve visual information processing (VIP) skills is effective in improving these skills and/or academic performance.
METHODS: We used a double-blind, randomised clinical trial to compare VIP VT to placebo training. Participating schools referred a sample of 579 early primary school children identified as being within the lower third of their class for literacy. From the referred sample, we identified 247 children eligible to participate (passed visions and auditory processing screening, and VIP performance <34th percentile), 94 of whom participated. Matching IQ, school grade and sex was achieved by sorting hierarchically on these values and then alternately allocating to VT or placebo groups. Both programmes ran for 10 weeks and consisted of 33 h working at home and 4 h working in office. The VT programme was indicative of that employed in Australian paediatric optometry practices, with the placebo programme containing similar activities, except targeting skills within a child\'s competencies and with specific VIP development activities removed. The main outcome measures were score change on three standardised educational tests (reading comprehension, spelling and mathematics) and six VIP tests, both immediately post-intervention (PI) and 6 months later.
RESULTS: Sixty-nine children completed the programmes. The VT programme produced no significant improvement in the three educational tests or in five of the six VIP tests compared to the control. The VT programme improved visual sequential memory (VSM) by a moderate amount compared to the control (Cohen\'s d = 0.57 and 0.52, immediately PI and at 6 months, respectively: p < 0.03 and p < 0.02).
CONCLUSIONS: The VIP and academic performance benefits from a VT programme were largely identical to those from a control programme, both immediately and 6-month PI. Placebo effects and general effects such as improvements in executive function and/or regression-to-the-mean could be mistaken for specific programme effectiveness.