{"id":8944,"date":"2020-11-24T11:34:23","date_gmt":"2020-11-24T11:34:23","guid":{"rendered":"https:\/\/www.optometrists.org\/?page_id=8944"},"modified":"2021-07-20T04:29:03","modified_gmt":"2021-07-20T04:29:03","slug":"vision-therapy-and-evidence-based-medicine","status":"publish","type":"page","link":"https:\/\/www.optometrists.org\/vision-therapy\/guide-to-vision-therapy\/vision-therapy-evidence-based-published-research\/vision-therapy-and-evidence-based-medicine\/","title":{"rendered":"Vision Therapy: Additional Evidence-Based Research"},"content":{"rendered":"<h2><b>Evidence-based medicine integrates academic research with clinical trials \u2014 making it the gold standard of published research.\u00a0<\/b><\/h2>\n<p><i>The following articles provide just a sample of the many evidence-based research publications on vision therapy.<\/i><\/p>\n<ol>\n<li>\n<h3>Quaid, P., Simpson, T. <b>Association between reading speed, cycloplegic refractive error, and oculomotor function in reading disabled children versus controls. <\/b>Graefes Arch Clin Exp Ophthalmol 251,169\u2013187 (2013)<\/h3>\n<\/li>\n<\/ol>\n<p><b>Background<\/b><\/p>\n<p>An estimated one in ten students aged 6 to 16 in the Ontario (Canada) school system have an individual education plan (IEP) for various learning disabilities, many of which include reading difficulties.<\/p>\n<p><b>Method<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\">One hundred children aged 6 to 16 were examined in this study. Included in the participants were 50 students that held IEPs and 50 students that acted as the control group.<\/li>\n<li style=\"font-weight: 400;\">The following binocular vision related data was acquired: Cycloplegic refractive error vergence facility, vergence amplitudes, accommodative facility, accommodative amplitudes, near point of convergence, stereopsis, and a standardized symptom scoring scale.<\/li>\n<li style=\"font-weight: 400;\">Both the IEP and control groups were examined using the Visagraph III system, which allows recording of reading speed and the number of eye movements made per 100 words read.<\/li>\n<li style=\"font-weight: 400;\">Reading comprehension was evaluated using a questionnaire administered at the end of the reading task, with a requirement of 80% or greater comprehension.<\/li>\n<\/ul>\n<p><b>Results<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Cycloplegic examination<\/b>: The IEP group had significantly greater hyperopia.<\/li>\n<li style=\"font-weight: 400;\"><b>Vergence facility<\/b>: The IEP group showed significantly reduced vergence skills. There was also a significant correlation between this visual skill and reading speed, number of eye movements when reading, and a standardized symptom scoring system.<\/li>\n<li style=\"font-weight: 400;\"><b>Other binocular vision skills<\/b>: Significant differences were found within the IEP and control groups.<\/li>\n<\/ul>\n<p><b>Conclusion<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\">This research indicates significant correlations between reading speed, refractive error, and vergence facility.<\/li>\n<li style=\"font-weight: 400;\">Students being considered for reading IEPs should have a full eye examination with cycloplegia, as well as a comprehensive binocular vision evaluation.<\/li>\n<\/ul>\n<ol start=\"2\">\n<li>\n<h3>Borsting E, Mitchell GL, Kulp MT, et al. <b>Improvement in academic behaviors after successful treatment of convergence insufficiency.<\/b> Optom Vis Sci. 2012;89(1):12-18.<\/h3>\n<\/li>\n<\/ol>\n<p><b>Purpose<\/b><\/p>\n<p>To determine if treatment of symptomatic convergence insufficiency (CI) will affect Academic Behavior Survey (ABS) scores.<\/p>\n<p><b>Method<\/b><\/p>\n<p>The ABS is a survey developed by the Convergence Insufficiency Treatment Trial Group that enumerates the frequency of negative school behaviors and parental concern about school performance on a scale from 0 (never) to 4 (always) with total scores ranging from 0 to 24.<\/p>\n<ul>\n<li style=\"font-weight: 400;\">Participants included 218 children aged 9 to 17 with symptomatic CI and enrolled in the Convergence Insufficiency Treatment Trial.<\/li>\n<li style=\"font-weight: 400;\">The ABS was administered to the parents of the participants prior to treatment and after 12 weeks of treatment.<\/li>\n<li style=\"font-weight: 400;\">Three groups of children were randomized into different treatment groups:\n<ul>\n<li style=\"font-weight: 400;\">(1) Home-based computer vergence\/accommodative therapy with pencil push-ups<\/li>\n<li style=\"font-weight: 400;\">(3) Office-based vergence\/accommodative therapy with home reinforcement<\/li>\n<li style=\"font-weight: 400;\">(4) Office-based placebo therapy with home reinforcement<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Participants were classified as successful, improved, or non-responder after completing 12 weeks of treatment.<\/p>\n<p><b>Results<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\">At baseline, the average ABS score for the entire group was 12.85 (SD = 6.3).<\/li>\n<li style=\"font-weight: 400;\">The average ABS score improved in children categorized as successful, improved, and non-responder by 4.0, 2.9, and 1.3 points, respectively.<\/li>\n<\/ul>\n<p><b>Conclusion<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\">Improvement after CI treatment was associated with reduced frequency of negative academic behaviors both in reading and overall school performance, and parental concern.<\/li>\n<\/ul>\n<p><strong>If you feel you or your child could benefit from Vision Therapy, <a href=\"https:\/\/www.optometrists.org\/practice-search\/\">schedule an appointment with a vision therapy eye docto<\/a>r and they will answer all your questions<\/strong>.<\/p>\n<p><strong>SEE RELATED: <a href=\"https:\/\/www.optometrists.org\/vision-therapy\/\">Guide to Vision Therapy<\/a><\/strong><\/p>\n\n\t<div class=\"practice-search-widget\">\n\t\t<h3>Find a Vision Therapy Eye Doctor Near You<\/h3>\n\t\t\n\t<form class=\"practice-search-form practice-search-form-widget\" action=\"https:\/\/www.optometrists.org\/practice-search\/results\/\" method=\"get\">\n\n\t\t<input type=\"hidden\" name=\"distance\" value=\"100\" class=\"practice-search-distance\">\n\t\t<input type=\"hidden\" name=\"page\" class=\"practice-search-page\">\n\t\t<input type=\"hidden\" name=\"address_latitude\"><input type=\"hidden\" name=\"address_longitude\">\n\n\t\t<input type=\"text\" name=\"address\" class=\"practice-search-address\" placeholder=\"City, Surburb or Address\" value=\"\">\n\n\t\t\n\t\t\t<input type=\"hidden\" name=\"distance\" value=\"100\" class=\"practice-search-distance\">\n\n\t\t\n\n\t\t<button type=\"submit\" class=\"practice-search-button\">\n\t\t\t\t\t\t\t\t\t<svg width=\"19\" height=\"19\" viewBox=\"0 0 19 19\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M10.6796 0.130005C9.15708 0.130059 7.66615 0.5646 6.38198 1.38258C5.09781 2.20057 4.07373 3.36803 3.43004 4.74783C2.78634 6.12763 2.54976 7.66246 2.74808 9.17205C2.9464 10.6816 3.57139 12.1033 4.54964 13.27L0.729639 17.08C0.6364 17.1732 0.562439 17.2839 0.511979 17.4058C0.461519 17.5276 0.435547 17.6581 0.435547 17.79C0.435547 17.9219 0.461519 18.0524 0.511979 18.1743C0.562439 18.2961 0.6364 18.4068 0.729639 18.5C0.917942 18.6883 1.17334 18.7941 1.43964 18.7941C1.5715 18.7941 1.70207 18.7681 1.82389 18.7177C1.94571 18.6672 2.0564 18.5932 2.14964 18.5L5.99964 14.62C7.35406 15.6038 8.98566 16.1324 10.6596 16.13C12.7814 16.13 14.8162 15.2871 16.3165 13.7869C17.8168 12.2866 18.6596 10.2517 18.6596 8.13C18.6596 6.00827 17.8168 3.97344 16.3165 2.47315C14.8162 0.97286 12.7814 0.130005 10.6596 0.130005H10.6796ZM10.6796 14.13C9.49295 14.13 8.33291 13.7781 7.34622 13.1188C6.35952 12.4595 5.59049 11.5225 5.13636 10.4261C4.68224 9.32975 4.56342 8.12335 4.79493 6.95946C5.02644 5.79558 5.59788 4.72648 6.437 3.88736C7.27611 3.04825 8.34521 2.4768 9.5091 2.24529C10.673 2.01378 11.8794 2.1326 12.9757 2.58673C14.0721 3.04085 15.0092 3.80989 15.6685 4.79658C16.3277 5.78328 16.6796 6.94332 16.6796 8.13C16.6796 9.7213 16.0475 11.2474 14.9223 12.3726C13.7971 13.4979 12.2709 14.13 10.6796 14.13Z\" fill=\"#fff\"\/><\/svg>\n\t\t\t\t\t<\/button>\n\n\t\t<button type=\"button\" class=\"practice-search-use-my-location\">\n\t\t\tSearch near me\n\t\t<\/button>\n\n\n\t<\/form>\n\n\n\n\t\t<\/div>\n\n\t\n<ol start=\"3\">\n<li>\n<h3>Leong, D. F., Master, C. L., Messner, L. V., Pang, Y., Smith, C., &amp; Starling, A. J. (2014). <b>The Effect of Saccadic Training on Early Reading Fluency. <\/b><i>Clinical Pediatrics<\/i>, <i>53<\/i>(9), 858\u2013864. <a href=\"https:\/\/doi.org\/10.1177\/0009922814532520\">https:\/\/doi.org\/10.1177\/0009922814532520<\/a><\/h3>\n<\/li>\n<\/ol>\n<p><b>Background<\/b><\/p>\n<p>Eye movements, necessary for reading, have been shown to relate to underlying cognitive and visual attentional processes during reading activities.<\/p>\n<p><b>Purpose\u00a0<\/b><\/p>\n<p>To determine the effect of saccadic training on reading fluency using the King-Devick remediation software.<\/p>\n<p><b>Method\u00a0<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\">Elementary students received standardized reading fluency tests at baseline and post treatment.<\/li>\n<li style=\"font-weight: 400;\">Treatment involved in-school training 20 minutes per day, 3 days per week for 6 weeks.<\/li>\n<\/ul>\n<p><b>Results\u00a0<\/b><\/p>\n<p>Post treatment, the treatment group had significantly higher reading fluency scores when compared to the control group.<\/p>\n<p><b>Conclusion<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\">Saccadic training involves rigorous practice of eye movements and shifting of visuospatial attention\u2014 both essential skills for reading fluency<\/li>\n<li style=\"font-weight: 400;\">With saccadic training, reading fluency can be improved significantly.<\/li>\n<\/ul>\n<ol start=\"4\">\n<li>\n<h3>Raghuram A, Gowrisankaran S, Swanson E, Zurakowski D, Hunter DG, Waber DP. <b>Frequency of Visual Deficits in Children With Developmental Dyslexia.<\/b> <i>JAMA Ophthalmol.<\/i> 2018;136(10):1089\u20131095.<\/h3>\n<\/li>\n<\/ol>\n<p><b>Purpose<\/b><\/p>\n<p>To assess the frequency of visual problems in children with Developmental Dyslexia (DD) and compare this frequency to typically developing (TD) readers. The visual skills assessed included: vergence, accommodation, and ocular motor tracking.<\/p>\n<p><b>Method<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\">An observational study was conducted in an outpatient ophthalmology ambulatory clinic including 29 children with DD and 33 TD children.<\/li>\n<li style=\"font-weight: 400;\">The following deficits were assessed: vergence (amplitude, fusional ranges, and facility), accommodation (amplitude, facility, and accuracy), and ocular motor tracking (Developmental Eye Movement test and Visagraph eye tracker).<\/li>\n<\/ul>\n<p><b>Results<\/b><b>\u00a0\u00a0<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\">Accommodation deficits were more frequent in the DD group (55%) than the TD group\u00a0 (9%).<\/li>\n<li style=\"font-weight: 400;\">Ocular motor tracking deficits were more frequent in the DD group (62%) than the TD group (15%).<\/li>\n<li style=\"font-weight: 400;\">Vergence deficits were more frequent in the DD group (34%) than the TD group (15%).<\/li>\n<li style=\"font-weight: 400;\">In total, 79% of children in the DD group had visual deficits in 1 or more domains of visual function compared to the 33% of the TD group.<\/li>\n<\/ul>\n<p><b>Conclusion<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\">Deficits in visual function are significantly more prevalent in school-aged children with DD than in TD children.<\/li>\n<li style=\"font-weight: 400;\">Further research is necessary to determine if treating these visual deficits can improve visual symptoms and\/or reading skills.<\/li>\n<\/ul>\n<h2><strong><a href=\"https:\/\/www.optometrists.org\/vision-therapy\/what-is-vision-therapy\/\">What is Vision Therapy?<\/a><\/strong><\/h2>\n<p><strong><a href=\"https:\/\/www.optometrists.org\/vision-therapy\/what-is-vision-therapy\/\">Vision therapy<\/a> is a research-based program that can improve the visual skills necessary for reading and learning.\u00a0<\/strong><\/p>\n<p>To read more about vision therapy and evidence based research, <a href=\"https:\/\/www.optometrists.org\/vision-therapy\/vision-therapy-evidence-based-published-research\/\">click here<\/a>.<\/p>\n<p>To learn more about how vision therapy can help your child, search through the many<a href=\"https:\/\/www.optometrists.org\/vision-therapy-for-children\/vision-therapy-for-reading-improvement-success-stories\/\"> Success Stories<\/a> written by parents of children who benefited from a program of vision therapy.<\/p>\n<p><strong>LEARN MORE: <a href=\"https:\/\/www.optometrists.org\/vision-therapy\/\">Guide to Vision Therapy<\/a><\/strong><\/p>\n<p><strong>If you have any questions or concerns regarding your child\u2019s vision and academic success, <a href=\"https:\/\/www.optometrists.org\/practice-search\/\">schedule an appointment<\/a> with a developmental optometrist near you.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Evidence-based medicine integrates academic research with clinical trials \u2014 making it the gold standard of published research.\u00a0 The following articles provide just a sample of<\/p>\n","protected":false},"author":4,"featured_media":8946,"parent":1001,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-article.php","meta":{"footnotes":""},"categories":[],"tags":[444,445,83],"class_list":["post-8944","page","type-page","status-publish","has-post-thumbnail","hentry","tag-evidence-based-medicine","tag-evidence-based-research","tag-vision-therapy"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.9 - 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