The Convergence Insufficiency Treatment Trial - Attention and Reading Trial

描述（由申请人提供）：本提案是为阿克伦儿童医院作为会聚功能不全治疗试验-注意力和阅读试验（CITT-ART）的临床中心，这是一项多中心随机、安慰剂对照的临床试验，旨在评估治疗症状性会聚功能不全（Cl）对儿童阅读表现和注意力的影响。在这项试验中，324名患有症状性Cl的9至14岁儿童将被随机分配到16周：1)以办公室为基础的融合/调节治疗与家庭强化或2)以办公室为基础的安慰剂治疗。治疗16周后，主要结局指标为阅读理解（韦氏个人成就测试[WIAT-III]阅读理解子测试得分）和注意力（ADHD症状与正常行为量表[SWAN]），由治疗组的考官进行评估。Gates macginti -4测试采用的形式与课堂上基于课程的评估类似，它将为阅读理解提供第二种衡量标准。阅读流畅性、另一项注意力测试、01症状调查和01的临床测量（即近收敛点和近正融合收敛点）是其他次要结果测量；还包括对影响阅读理解的关键阅读和认知成分的评估，包括伪单词解码、单词阅读和听力理解。治疗后1年评估对阅读成绩和注意力的长期影响。这份申请证明了我们的研究中心至少有能力招募36名受试者，并在治疗完成后保留他们1年。根据OITT-ART程序手册（MOP），提供文件证明我们的现场有适当的人员、设备和设施来进行研究。研究基本原理、设计和方法的完整细节包含在程序手册中（与研究主席和数据协调中心[DOO]申请一起提交）。除了我们的中心，还有其他8个验光或眼科中心，Salus大学宾夕法尼亚验光学院的研究主席，以及俄亥俄州立大学验光协调中心的DOO。症状性Cl是一种常见的儿童视力障碍，通常与阅读时出现的症状有关（例如：迷失位置、注意力不集中、频繁重复阅读、阅读速度慢、难以记住所读内容）。然而，氯离子治疗对阅读和注意力的影响尚不清楚。这项研究的结果将有助于更好地理解这些关系，并对那些关心有阅读和注意力问题的儿童的教育家、心理学家和医生具有重要意义。这一发现将指导未来对视力障碍儿童进行科学研究的假设发展。

DESCRIPTION (provided by applicant): This proposal is for the Akron Children's Hospital to serve as a clinical center for the Convergence Insufficiency Treatment Trial - Attention and Reading Trial (CITT-ART), a multicenter randomized, placebo controlled, clinical trial designed to evaluate the effects of treatment for symptomatic convergence insufficiency (Cl) on measures of reading performance and attention in children. In this trial, 324 children aged 9 to <14 years with symptomatic Cl will be randomly assigned to 16 weeks of: 1) office-based vergence/ accommodative therapy with home-reinforcement or 2) office-based placebo therapy. After 16 weeks of treatment, the primary outcome measures of reading comprehension (Wechsler Individual Achievement test [WIAT-III] reading comprehension subtest score) and attention (Strengths and Weaknesses of ADHD Symptoms & Normal Behavior Scale [SWAN]) will be assessed by examiners masked to treatment group. The Gates MacGinitie-4 test, which uses a format similar to curriculum-based evaluation done in classrooms, will provide a secondary measure of reading comprehension. Reading fluency, another test of attention, the 01 Symptom Survey, and clinical measures of 01 (i.e., the near point of convergence, and positive fusional vergence at near) are other secondary outcome measures; also included are assessments of key reading and cognitive components that impact reading comprehension including pseudo word decoding, word reading, and listening comprehension. Long-term effects on reading achievement and attention are assessed 1-year post treatment. This application documents our site's ability to recruit at least 36 subjects and to retain them for 1 year after completion of treatment. Documentation is provided that our site has the appropriate personnel, equipment, and facilities to conduct the study in accordance with the OITT-ART Manual of Procedures (MOP). Complete details of the study rationale, design, and methods are contained in the Manual of Procedures (submitted with the Study Chair and Data Coordinating Center [DOO] applications). In addition to our center, there are 8 other optometric or ophthalmologic centers, the Study Chair at the Pennsylvania College of Optometry at Salus University, and the DOO at The Ohio State University Optometry Coordinating Center. Symptomatic Cl is a common vision disorder in children that is commonly associated with symptoms while reading (e.g.; loss of place, loss of concentration, frequent re-reading, reading slowly, and trouble remembering what was read). However, the effect of Cl treatment on reading and attention is unknown. The results of the proposed study will lead to a better understanding of these relationships and-have important implications for educators, psychologists, and physicians who care for children with reading and attention problems. The findings will guide hypothesis development for future scientific investigations in children with vision disorders.