汉语阅读障碍儿童的发育性眼动评估

Developmental eye movement assessment in Chinese children with developmental dyslexia

目的分析汉语发展性阅读障碍儿童发育性眼动(DEM)测试结果及其与识字量的关系。方法采用横断面研究设计,纳入2019年9-12月天津10所小学的5年级学生1243人,其中男664人,女579人;平均年龄(10.68+0.53)岁。对所有受检者进行中文识字量和智力测验,将识字量在平均值以下的85名阅读障碍儿童作为试验组,选取同期54名阅读能力正常的儿童作为对照组。2个组儿童进行DEM测试,分别测试纵向时间、横向校对时间、横纵时间比和错误总数。比较不同性别检出率、2个组组内不同性别儿童及2个组间DEM测试各检测指标的差异,分析2个组儿童的识字量与纵向时间、横向校对时间、横纵时间比和错误总数的相关性。结果阅读障碍儿童的总检出率为6.83%(85/1243),其中男生检出率为9.33%(62/664),高于女生的3.97%(23/579),差异有统计学意义(χ^(2)=13.974,P<0.001)。对照组不同性别儿童年龄、识字量、纵向时间、横向校对时间和横纵时间比的比较差异均无统计学意义(均P>0.05)。试验组女生识字量多于男生,差异有统计学意义(t=-2.259,P=0.027),不同性别间年龄、纵向时间、横向校对时间和横纵时间比的比较差异均无统计学意义(均P>0.05)。试验组纵向时间和横向校对时间均长于对照组,差异均有统计学意义(t=-4.848、-4.297,均P<0.001)。2个组横纵时间比的比较差异无统计学意义(t=0.126,P=0.900)。试验组错误总数为0(0,1)个,多于对照组的0(0,0)个,差异有统计学意义(H=1.979,P=0.001)。2个组儿童的识字量与纵向时间、横向校对时间和错误总数均呈负相关(r=-0.397,P<0.001;r=-0.355,P<0.001;r_(s)=-0.180,P=0.034),与横纵时间比无明显相关性(r=0.038,P=0.656)。结论汉语发展性阅读障碍儿童较正常儿童的DEM测试得分偏高,不同性别间各DEM测试值无明显差异。识字量得分与DEM测试值存在相关性。

Objective To analyze the relationship between the developmental eye movement(DEM)test results and the vocabulary size in Chinese children with developmental dyslexia.Methods A cross-sectional study was conducted.A total of 1243 fifth grade students from 10 primary schools were enrolled from September to December 2019 in Tianjin,among which there were 664 males and 579 females,with the average age of(10.68+0.53)years old.The Chinese vocabulary test and intelligence test were carried out.Eighty-five dyslexic children with subaverage vocabulary size were selected as the experimental group and 54 normal children were selected as the control group.The DEM test was conducted in the two groups,and the vertical time,the horizontal adjustment time,the ratio of horizontal to vertical time and the total number of errors were recorded and analyzed.The differences in positive rate of dyslexia,various DEM test indicators between different genders and different groups were analyzed.The correlations between vocabulary size and vertical time,horizontal adjustment time,the ratio of horizontal to vertical time and the total number of errors were analyzed.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of School of Optometry,Tianjin Vocational Institute(No.ysgxyll001).Written informed consent was obtained from the guardian of each subject.Results The total positive rate of dyslexia was 6.83%(85/1243),and the positive rate of 9.33%(62/664)in boys was higher than 3.97%(23/579)in girls,with a significant difference between them(χ^(2)=13.974,P<0.001).There were no statistically significant differences in age,vocabulary size,vertical time,horizontal adjustment time,and the ratio of horizontal to vertical time between different genders in the control group(all at P>0.05).The vocabulary size of girls in the experimental group was larger than that of boys,showing a statistically significant difference(t=-2.259,P=0.027).There was no significant difference in age,vertical time,horizontal adjustment time,and the ratio of horizontal to vertical time(all at P>0.05).The vertical time and horizontal adjustment time of the experimental group were longer than those of the control group,and the differences were statistically significant(t=-4.848,-4.297;both at P<0.001).There was no statistically significant difference in the ratio of horizontal to vertical time between the two groups(t=0.126,P=0.900).The total number of errors was 0(0,1)in the experimental group,which was higher than the control group 0(0,0),with a significant difference between them(H=1.979,P=0.001).The vocabulary size of students in the two groups was negatively correlated with the vertical time,horizontal adjustment time and the total number of errors(r=-0.397,P<0.001;r=-0.355,P<0.001;r s=-0.180,P=0.034),and was not obviously correlated with the ratio of horizontal to vertical time(r=0.038,P=0.656).Conclusions The DEM test scores of Chinese children with developmental dyslexia are higher than those of normal children,and there is no difference between different genders.The lower the scores of vocabulary size test,the higher the scores of DEM test.