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Mitchell Scheiman, Christopher Chase, G. Lynn Mitchell, Eric Borsting, Marjean T. Kulp, Susan A. Cotter, CITT-RS Study Group; The Effect of Successful Treatment of Symptomatic Convergence Insufficiency on Reading Performance in School-Aged Children. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6370.
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To evaluate the impact of successful treatment of symptomatic convergence insufficiency (CI) using office-based vergence/accommodative therapy (OBVAT) on reading performance in children.
Children (N=44) ages 9 to 17 years with symptomatic CI were administered the Gray Oral Reading Test (GORT-4), the Test of Silent Word Reading Fluency (TOSWRF), the Test of Word Reading Efficiency (TOWRE), and the Wechsler Individual Achievement Test II (WIAT-II) at baseline and 8 weeks after completion of a 16-week program of OBVAT for CI. Treatment outcome (successful, improved, non-responder) for CI was determined using a composite score of symptoms as measured by the CI Symptom Survey, the near point of convergence, and positive fusional convergence at near.
The subjects demonstrated a broad range of reading ability with baseline reading scores ranging from 1 to 99 percentile on most of the tests. The composite and subscale mean scores were not significantly different than the published norms except for the TOWRE sight word reading subscale (mean = 95.4, p = 0.009) and the TOWRE composite score (mean = 94.6, p = 0.003) which were significantly below published norms (mean=100, SD=15). After treatment for CI, significant improvements were found for reading comprehension (mean = 4.2, p = 0.009) and pseudo-word decoding (mean = 1.9, p = 0.043) standard scores as measured by the WIAT-II. These improvements were related to treatment outcome (p = 0.011) with the largest improvements occurring in those who were successfully treated for CI (mean = 8.2). No significant improvements were observed in the composite or subscale standard scores on the GORT, TOSWRF, and TOWRE tests.
Although children with symptomatic CI showed significant improvements in reading comprehension as measured by the WIAT II reading comprehension subtest, improvements in reading were not found using the GORT, TOSWRF, or TOWRE. Future studies should include a placebo control group and a longer period of follow-up should be considered.
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