Quantitative characterisation of eye movements in typical and atypical children

Doctoral thesis English OPEN
Vinuela Navarro, Valldeflors
  • Subject: RE
    mesheuropmc: eye diseases | genetic structures | sense organs

Children with delayed reading skills and/or poor academic achievement are increasingly being referred to Eye Care Professionals with suspected eye movement/“tracking” difficulties. However, current clinical techniques are highly subjective, poorly controlled, and relatively imprecise. It is therefore reasonable to suggest that Eye Care Professionals face challenges in recognising and diagnosing genuine eye movement disorders, and consequently, fail to support and/or manage these children. The principal aim of the studies described in this thesis was to characterise eye movements in children with learning related difficulties who are frequently considered to be at risk of eye movement disorders.\ud \ud Using a novel child-friendly method, we have shown that, in general, eye movement characteristics in children with reading/learning related difficulties are not different from those in typically developing age-matched children when compared as a group. The findings also showed that when eye movement characteristics in children with reading/learning related difficulties were compared on an individual basis, some of these children had eye movement parameters outside their age-matched norms. Further, our results suggested that children whose eye movements were outside their age-matched norms, generally corresponded to those who had specific, more complex and global difficulties (e.g. dyspraxia, general developmental delay). \ud \ud In conclusion, the studies presented in this thesis suggest that there is an association between specific learning difficulties and eye movement disorders, but challenge the view that eye movement disorders can be found in isolation in children with delayed reading/academic performance. Finally, based on the sum of results obtained, simple actionable guidelines are proposed to improve the examination of eye movements in clinical practice in order to recognise genuine eye movement disorders.
  • References (10)

    Chapter 1 Introduction 1.1. Introduction...........................................................................................................1 1.3.1. Eye movements and reading ...................................................................31 1.3.2. Eye movements and learning difficulties ................................................35 1.4. The clinical examination of eye movements.......................................................38 1.4.1. Simple observational tests.......................................................................38 1.4.2. Observational tests with standardised rating systems .............................40 1.5. Eye movement recording methods......................................................................50 1.5.2. Electrooculography (EOG) .....................................................................51 1.6. Summary and thesis structure .............................................................................53

    Chapter 2 Scoping exercise: what are eye movement/

    “tracking” difficulties? 2.1. Introduction.........................................................................................................55

    Chapter 8 Discussion and future work 8.1. Introduction.......................................................................................................263 8.2. Eye movements in school age children using a novel child-friendly setup ......264 8.3. Eye movements in children with an IEP related to delayed reading skills .......266 8.4. Eye movements in children referred with suspected eye movement difficulties....

    ....................................................................................................................... 269 8.5. Limitations of this study ...................................................................................271 8.6. Suggested guidelines for the clinical assessment of eye movements in children

    referred with suspected eye movement/“tracking” difficulties.........................272

    8.6.1. Stimuli for the assessment of eye movements ......................................272

    8.6.2. Assessment of smooth pursuit, saccades and visual fixation................274 8.7. Future work .......................................................................................................279

    Appendices Appendix A: Scoping exercise interview sheets......................................................300 Appendix B: Repeatabilty and agreement studies ...................................................311 Appendix C: School of Optometry and Vision Sciences Research and Audit Ethics

    from non-NHS sites ..........................................................................................313 Figure 4.9. Final Excel file for 6º/s horizontal smooth pursuit ................................120 Figure 4.10. Eye movement traces for the saccadic task .........................................120 Figure 4.11. Duration vs amplitude main sequence for participant P01..................122 Figure 4.12. Duration vs amplitude main sequence and the corresponding linear regression participant P01. .......................................................................................123 Figure 4.13. Peak velocity vs amplitude main sequence for participant P01 ..........124 Figure 4.14. Peak velocity vs amplitude main sequence and the corresponding power fit for participant P01 ...............................................................................................124 Figure 4.15. Peak velocity x duration vs amplitude main sequence for participant P01 ...........................................................................................................................125 Figure 4.16. Peak velocity x duration vs amplitude main sequence and the corresponding linear regression through the origin for participant P01. .................126 Figure 4.17. Eye position relative to the centre of the screen during the fixation task obtained from participant (P01) ...............................................................................128

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