RESUMO
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.
Assuntos
Dislexia/terapia , Músculos Oculomotores , Atenção , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Estudos Cross-Over , Dislexia/complicações , Dislexia/psicologia , Feminino , Humanos , Masculino , Memória , Destreza Motora , Educação Física e Treinamento , Leitura , Movimentos Sacádicos , Resultado do Tratamento , RedaçãoRESUMO
OBJECTIVES: The present study aimed to analyse the impact of vestibulo-ocular reflex (VOR) gain deficit on postural control (PC) in children with sensorineural hearing loss. METHODS: A retrospective study included 55 children with sensorineural hearing loss between 4 and 17 years of age. The Video Head Impulse Test (vHIT®) was used to assess semicircular canal function. PC was assessed on the Balance Quest® posturographic platform testing sensory organisation. RESULTS: Spatial and temporal postural parameters (area and mean speed of centre of pressure oscillation, spectral power index) in the OKN-U condition (optokinetic with unstable platform) were significantly better in children with than without VOR deficit. CONCLUSION: Posturographic exploration in the OKN-U condition can screen for semicircular canal deficit in hearing-impaired children. VOR deficit also seems to predict PC deficit.