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視知覺介入對發展遲緩或障礙兒童成效之系統性文獻回顧
The Effectiveness of Visual Perceptual Interventions in Children With Developmental Delays or Disabilities: A Systematic Review
摘要
目的：本文收集近十年對發展遲緩或障礙兒童使用視知覺（visual perception）介入的研究，分析其證據等級、研究品質、成效差異與影響因素。方法：透過PubMed、Embase等電子資料庫搜尋文獻，納入條件包含（1）以中或英文發表、（2）研究對象為年齡3到12歲的發展遲緩或障礙（developmental delays or disabilities）診斷兒童、（3）以視覺認知（visual cognition）功能訓練為主要療法、和（4）經過同儕審查制度。結果：共收錄10篇研究，其中5篇為高證據等級之隨機分派試驗（randomized control trial, RCT）。5篇傳統視知覺介入研究結果雖大都呈現正面成效，但因多來自單組前後測比較之結果，無法排除其他治療和成熟之影響，故成效有待確定。而電腦視知覺介入，各類實證等級研究皆一致顯示其能有效提升兒童視知覺功能，且效果優於傳統型介入，但在其他發展和生活活動和參與功能的實證仍顯不足。另外，團體介入模式和結合居家訓練可能會影響介入成效。結論：對於發展遲緩與障礙兒童的視知覺功能提升，電腦化介入可能是較有效的方式。未來仍需更多高證據等級和品質研究以釐清團體模式或結合居家訓練是否更能提升臨床介入之成效，並且也需提供在生活活動和參與功能之實證證據。
並列摘要
Purpose: The purpose of this paper was to synthesize the studies over the past decade, which investigated the effects of visual perception (VP) interventions on children with developmental delays or disabilities (DD). We examined research quality, compared the effectiveness of interventions, and identified relevant influencing factors. Methods: We searched and identified the related studies from the databases such as PubMed and Embase. Subsequently, a comprehensive literature review was conducted. The studies meeting the specified criteria were chosen based on the following conditions: (1) publication in either Chinese or English, (2) inclusion of participants diagnosed with DD aged between 3 and 12 years, (3) primary utilization of visual cognition interventions, and (4) publication following a peer-reviewing process. Results: Ten studies were included, with 5 employing a high-evidence-level randomized controlled trial (RCT) design. Our results revealed that the effectiveness of the traditional VP interventions remains inconclusive due to the absence of high-evidence-level studies so far. The computerized VP training shows significant effectiveness on children's VP, surpassing that of traditional interventions. However, in addition to VP, few studies with high quality have investigated other outcomes. In addition, the group design and home-based training may contribute to the effectiveness of VP interventions. Conclusion: This review suggests that computerized VP interventions may be more effective in enhancing the VP function of children with DD compared to traditional interventions. High-evidence-level and high-quality research is needed to validate the impact of group-type or combined home-based training on clinical VP interventions, as well as the effectiveness of VP interventions on children's daily function and participation.