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Improvement in Academic Behaviors After Successful Treatment of Convergence Insufficiency

Borsting, Eric*; Mitchell, G. Lynn†; Kulp, Marjean Taylor*; Scheiman, Mitchell‡; Amster, Deborah M.‡; Cotter, Susan*; Coulter, Rachael A.‡; Fecho, Gregory§; Gallaway, Michael F.‡; Granet, David∥; Hertle, Richard∥; Rodena, Jacqueline§; Yamada, Tomohiko‡; the CITT Study Group

doi: 10.1097/OPX.0b013e318238ffc3
Original Article
Press Release

Purpose. To determine whether treatment of symptomatic convergence insufficiency (CI) has an effect on Academic Behavior Survey (ABS) scores.

Methods. The ABS is a six-item survey developed by the Convergence Insufficiency Treatment Trial Group that quantifies the frequency of adverse school behaviors and parental concern about school performance on an ordinal scale from 0 (never) to 4 (always) with total scores ranging from 0 to 24. The ABS was administered at baseline and after 12 weeks of treatment to the parents of 218 children aged 9 to 17 years with symptomatic CI, who were enrolled in the Convergence Insufficiency Treatment Trial and randomized into (1) home-based pencil push-ups; (2) home-based computer vergence/accommodative therapy and pencil push-ups; (3) office-based vergence/accommodative therapy with home reinforcement; and (4) office-based placebo therapy with home reinforcement. Participants were classified as successful (n = 42), improved (n = 60), or non-responder (n = 116) at the completion of 12 weeks of treatment using a composite measure of the symptom score, nearpoint of convergence, and positive fusional vergence. Analysis of covariance methods were used to compare the mean change in ABS between response to treatment groups while controlling for the ABS score at baseline.

Results. The mean ABS score for the entire group at baseline was 12.85 (SD = 6.3). The mean ABS score decreased (improved) in those categorized as successful, improved, and non-responder by 4.0, 2.9, and 1.3 points, respectively. The improvement in the ABS score was significantly related to treatment outcome (p < 0.0001), with the ABS score being significantly lower (better) for children who were successful or improved after treatment as compared to children who were non-responders (p = 0.002 and 0.043, respectively).

Conclusions. A successful or improved outcome after CI treatment was associated with a reduction in the frequency of adverse academic behaviors and parental concern associated with reading and school work as reported by parents.

*OD, MS, FAAO

MAS, FAAO

OD, FAAO

§OD

MD

Southern California College of Optometry, Fullerton, California (EB, SC), The Ohio State University College of Optometry, Columbus, Ohio (GLM, MTK), Pennsylvania College of Optometry at Salus University, Philadelphia, Pennsylvania (MS, MFG), College of Optometry, NOVA Southeastern University, Ft. Lauderdale, Florida (DMA, RAC, GF, JR), Abraham Ratner Children's Eye Center, University of California, San Diego, San Diego, California (DG), Northeastern Ohio Universities College of Medicine and Pharmacy, Rootstown, Ohio (RH), and Mayo Clinic (TY).

Received February 4, 2011; accepted August 29, 2011.

© 2012 American Academy of Optometry