重度脳性麻痺児(者)における視機能評価方法  [in Japanese] Assessment of the Visual Function of People With Severe Cerebral Palsy  [in Japanese]

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Author(s)

    • 小町 祐子 KOMACHI Yuko
    • 国際医療福祉大学保健医療学部視機能療法学科 Department of Orthoptics and Visual Sciences, School of Health Sciences, International University of Health and Welfare
    • 新井田 孝裕 NIIDA Takahiro
    • 国際医療福祉大学保健医療学部視機能療法学科 Department of Orthoptics and Visual Sciences, School of Health Sciences, International University of Health and Welfare

Abstract

本研究は、評価の難しい重度脳性麻痺児(者)の視機能評価方法を検討することを目的とした。施設入所の24例を対象に9項目の簡便かつ汎用的な方法を用いて視反応の状態を3段階で評価し、クラスター分析を用いて結果を検討した。対象児(者)の視機能は、光覚反応と対光反射の有無による「G1. 視反応(-)群」および「G2. 光覚反応群」、片眼遮閉による視野の妨げに対して回避反応を示す「G3. 回避反応・注視・追視群」、周辺への注意の移動能力がみられる「G4. 瞥見視野反応群」、縞視標の弁別可能な「G5. 縞視標反応群」と、4つの評価項目により5群に分類できることが判明した。いずれの評価項目も特別な手技の習得や視覚専門職による評価を必要とせず、簡便に対象児(者)の視機能の状態を把握・分類することが可能であるため、療育支援介入における視覚の活用の可否や介入方法の選択に有効であると考えられた。

The purpose of the present study was to devise a method for assessing the visual function of people with severe cerebral palsy (CP). Participants in the study were 24 people with severe cerebral palsy who were residents of an institution for people with developmental disabilities. Their visual function was assessed on a 3-point ordinal scale using 9 different visual reaction tests. When the findings were classified with cluster analysis, the results reveals that the participants' visual function could be classified into 5 groups using 4 of the 9 tests. The groups were: (a) group 1: no visual reaction, (b) group 2: reaction to perceiving light, in which the stimulus was a light and the response measured was the pupillary light reflex, (c) group 3: avoidance reaction and gazing at or following a visual object with the eyes, in which the avoidance reaction recorded was the participant covering one eye, (d) group 4: an attentional shift toward the peripheral visual field, based on an orienting response, which made possible a behavioral visual-field screening test, and (e) group 5: reaction to grating acuity cards, measured by the participant's discrimination of the gratings on the cards. These 4 tests enabled classification of the participants' visual function without the need for a special technique or equipment or for assessment by an ophthalmic specialist. This suggests that classification using these 4 tests might be useful for evaluating the level of visual function in people with severe cerebral palsy and, from those results, for selecting an intervention.

Journal

  • The Japanese Journal of Special Education

    The Japanese Journal of Special Education 55(3), 123-132, 2017

    The Japanese Association of Special Education

Codes

  • NII Article ID (NAID)
    130007616459
  • NII NACSIS-CAT ID (NCID)
    AN00172513
  • Text Lang
    JPN
  • ISSN
    0387-3374
  • NDL Article ID
    028814878
  • NDL Call No.
    Z7-314
  • Data Source
    NDL  J-STAGE 
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