Journal of Taiwan Occupational Therapy Research and Practice
背景與目的:兒童發展需仰賴大量視覺經驗，缺乏視覺刺激會嚴重影響全面發展。然而目前職能治療於低視能兒童之介入以代償為主，較少訓練視覺功能，遑論重度視障兒童之視覺訓練。故本研究以探討矯治型視覺訓練於提升重度低視能兒童之雙眼視覺功能與增加功能性視覺為主要目的。方法:本次採團體治療，對象為兩名 9 歲及 12 歲的低視能兒童，視力小於 0.05，診斷分別為腦性視覺損傷和骨質石化症。介入為期八週、每週一次、每次 60 分鐘的貼眼視能復健訓練，包括使用眼動儀和眼動訓練軟體、球類活動及繪畫活動提升個案視力、有效視野範圍與眼球動作控制;同時輔以每天進行兩個居家活動作為課後練習。介入前後使用「特殊需求兒童視覺功能量表」評估視覺功能，使用「功能性視覺問卷」評估功能性視覺，同時以半結構性質性訪談蒐集兒童其他功能性視覺之資料。結果:經過八週視覺訓練後，兩名兒童的視覺功能均獲改善，其中一名極低視力兒童之功能性視覺也獲提升。結論:結果顯示使用矯治型視覺訓練可提升低視能兒童之視覺功能、促進其日常生活參與;年齡較大的視障兒童也仍有機會透過訓練提升視覺功能。整體而言，本研究展現視能復健於低視能兒童之介入方案具有進一步研究驗證發展的潛力。
Background and purpose: Children rely on visual information to complete the development process. The lack of visual stimulation will seriously affect their overall development. At present, compensatory strategies have been widely adopted in occupational therapy for children with low vision, whereas remedial approaches of visual rehabilitation have not been the mainstream, let alone the training for severely visually impaired children. Therefore, this study aimed to examine the effect of visual remedial strategies on decreasing the degree of suppression of amblyopia eye, binocular visual functions and functional vision. Methods: Two children with severe low vision aged 9 and 12 years old were recruited in the group therapy, with diagnosis of cerebral visual impairment (CVI) and osteopetrosis respectively. The visual rehabilitation group lasted for eight weeks, with a 60-minute and once a week training program. Patching, eye tracking system with eye movement training software, ball activities and painting activities were adopted to improve the cases’ visual acuity, functional visual field, and oculomotor control. Furthermore, two everyday home program activities were also provided each time. The Visual Function Battery for Children with Special Needs (VFB- CSN) and Functional Vision Questionnaire (FVQ) were used to measure visual function and functional vision. Semi-structured qualitative interview was simultaneously conducted to collect other functional vision information. Results: After 8 weeks of visual training, the improvement was shown in the visual function of both children and in the functional vision of the child with the lower visual acuity. Conclusion: The preliminary results show that visual remediation approaches for children with low vision are positive for improving their visual function and promote their daily participation. In addition, even older children could also benefit from visual rehabilitation. Overall, the study demonstrated the promising effect of remedial visual approaches for children with low vision. Further studies are warranted.