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Dodick D, Starling AJ, Wethe J, Pang Y, Messner LV, Smith C, Master CL, Halker-Singh RB, Vargas BB, Bogle JM, Mandrekar J, Talaber A, Leong D. The Effect of In-School Saccadic Training on Reading Fluency and Comprehension in First and Second Grade Students. J Child Neurol 2017; 32:104-111. [PMID: 28257277 DOI: 10.1177/0883073816668704] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Efficient eye movements provide a physical foundation for proficient reading skills. We investigated the effect of in-school saccadic training on reading performance. In this cross-over design, study participants (n = 327, 165 males; mean age [SD]: 7 y 6 mo [1y 1 mo]) were randomized into treatment and control groups, who then underwent eighteen 20-minute training sessions over 5 weeks using King-Devick Reading Acceleration Program Software. Pre- and posttreatment reading assessments included fluency, comprehension, and rapid number naming performance. The treatment group had significantly greater improvement than the control group in fluency (6.2% vs 3.6%, P = .0277) and comprehension (7.5% vs 1.5%, P = .0002). The high-needs student group significantly improved in fluency ( P < .001) and comprehension ( P < .001). We hypothesize these improvements to be attributed to the repetitive practice of reading-related eye movements, shifting visuospatial attention, and visual processing. Consideration should be given to teaching the physical act of reading within the early education curriculum.
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Affiliation(s)
- David Dodick
- 1 Department of Neurology, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Amaal J Starling
- 1 Department of Neurology, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Jennifer Wethe
- 1 Department of Neurology, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Yi Pang
- 2 Illinois Eye Institute, Chicago, IL, USA
| | | | - Craig Smith
- 3 Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - Christina L Master
- 4 Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Bert B Vargas
- 1 Department of Neurology, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Jamie M Bogle
- 1 Department of Neurology, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Jay Mandrekar
- 5 Division of Biomedical Statistics and Informatics, Mayo Clinic Rochester, Rochester, MN, USA
| | | | - Danielle Leong
- 2 Illinois Eye Institute, Chicago, IL, USA.,6 King-Devick Test, Inc, Oakbrook Terrace, IL, USA
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Weise KK, Swanson MW, Penix K, Hale MH, Ferguson D. King-Devick and Pre-season Visual Function in Adolescent Athletes. Optom Vis Sci 2017; 94:89-95. [PMID: 27464573 PMCID: PMC5182104 DOI: 10.1097/opx.0000000000000938] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The King-Devick test (KD) has been studied as a remove-from-play sideline test in college-age athletes and older; however, studies in younger athletes are limited. A cross-sectional study of the KD and other vision correlates was completed on school-aged athletes during pre-season physicals for a variety of sports to determine the repeatability of the KD. The study also evaluated how convergence, alignment, or pupil function contributed to a slower King-Devick baseline reading. METHODS Seven hundred eighty-five athletes underwent vision screenings in a hospital or school setting by trained/certified staff as part of pre-season physicals. Six hundred nineteen had KD testing completed per the manufacturer's suggested protocol and repeated. Other baseline vision testing included visual acuity, Modified Thorington testing for alignment, convergence testing, and pupil function using the NeurOptics (NPI-200) NPi. RESULTS The mean fastest, error-minimized KD time for all participants was 43.9 seconds(s) (SD ± 11.6, range 24-120). Median KD time got faster (+) with age (p < 0.0001). The inter-class correlation coefficient for all scores was 0.92. The absolute mean time difference for any two tests was 3.5 s (SD ± 2.5, range 0-23). There was no association between the best KD time and reduced NPC (p = 0.63), Modified Thorington measure of alignment (p = 0.55), or NPi pupil function (p = 0.79). The Bland Altman repeated measure limits of agreement was ±6.5 seconds for those in the 10th to12th grades, and ±10.2 seconds for those in the 6th to 9th grades. CONCLUSIONS King-Devick score in junior high and high school athletes is variable but gets faster and more repeatable with increasing age. The KD does not correlate significantly with reduced convergence, alignment, or pupil function. Based on grouped data, a slowing of 10 seconds for younger athletes and 6 seconds for older athletes on a second administration represents a true difference in testing speed. Within-player variability should be considered when removal-from-play decisions are influenced by KD results.
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Affiliation(s)
- Katherine K Weise
- *OD, MBA, FAAO †OD, MSPH, FAAO ‡OD, FAAO §MPH, MD ‖MEd. ATC/L The University of Alabama at Birmingham Sports Medicine Clinic at Children's of Alabama, Birmingham, Alabama (all authors)
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56
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Galetta KM, Liu M, Leong DF, Ventura RE, Galetta SL, Balcer LJ. The King-Devick test of rapid number naming for concussion detection: meta-analysis and systematic review of the literature. Concussion 2015; 1:CNC8. [PMID: 30202552 PMCID: PMC6114024 DOI: 10.2217/cnc.15.8] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 07/07/2015] [Indexed: 01/23/2023] Open
Abstract
Background: Vision encompasses a large component of the brain's pathways, yet is not represented in current sideline testing. Objectives: We performed a meta-analysis of published data for a vision-based test of rapid number naming (King-Devick [K-D] test). Studies & methods: Pooled and meta-analysis of 15 studies estimated preseason baseline K-D scores and sensitivity/specificity for identifying concussed versus nonconcussed control athletes. Result: Baseline K-D (n = 1419) showed a weighted estimate of 43.8 s (95% CI: 40.2, 47.5; I2 = 0.0%; p=0.85 – indicating very little heterogeneity). Sensitivity was 86% (96/112 concussed athletes had K-D worsening; 95% CI: 78%, 92%); specificity was 90% (181/202 controls had no worsening; 95% CI: 85%, 93%). Conclusion: Rapid number naming adds to sideline assessment and contributes a critical dimension of vision to sports-related concussion testing.
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Affiliation(s)
- Kristin M Galetta
- Department of Neurology, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA.,Department of Neurology, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Mengling Liu
- Department of Population Health, NYU School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA.,Department of Population Health, NYU School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | - Danielle F Leong
- Illinois College of Optometry, 3241 S Michigan Ave, Chicago, IL 60616, USA.,Illinois College of Optometry, 3241 S Michigan Ave, Chicago, IL 60616, USA
| | - Rachel E Ventura
- Department of Neurology, NYU School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA.,Department of Neurology, NYU School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | - Steven L Galetta
- Department of Neurology, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA.,Department of Neurology, NYU School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA.,Department of Ophthalmology, NYU School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA.,Department of Neurology, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA.,Department of Neurology, NYU School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA.,Department of Ophthalmology, NYU School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | - Laura J Balcer
- Department of Neurology, NYU School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA.,Department of Biostatistics & Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.,Department of Neurology, NYU School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA.,Department of Biostatistics & Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
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