{"id":4417,"date":"2015-07-29T08:17:00","date_gmt":"2015-07-29T06:17:00","guid":{"rendered":"https:\/\/www.acotv.org\/?p=4417"},"modified":"2022-04-29T10:27:25","modified_gmt":"2022-04-29T08:27:25","slug":"tractament-viso-cognitiu-pels-problemes-de-lectura","status":"publish","type":"post","link":"https:\/\/www.acotv.org\/ca\/tractament-viso-cognitiu-pels-problemes-de-lectura\/","title":{"rendered":"TRACTAMENT VISO-COGNITIU PELS PROBLEMES DE LECTURA"},"content":{"rendered":"\n

Punt de vista optom\u00e8tric<\/strong><\/p>\n\n\n\n

Els trastorns d\u2019aprenentatge s\u00f3n una s\u00e8rie de dificultats que afecten en l\u2019aprenentatge de la lectura, l\u2019escriptura i el c\u00e0lcul. El desenvolupament neuropsicol\u00f2gic no \u00e9s el mateix per a tots els nens, pel que s\u2019han d\u2019evitar comparacions entre ells ja qu\u00e8 poden haver regions cerebrals que s\u2019hagin desenvolupat de diferent manera (poden destacar en unes \u00e0rees i estancar-se en altres), per tant hem de tenir en compte el grau de maduresa cerebral o el desenvolupament de les \u00e0rees visuals, auditives i psicomotrius, imprescindibles per un bon aprenentatge escolar. Dins l\u2019estudi dels problemes de lectura el diagn\u00f2stic m\u00e9s conegut \u00e9s la disl\u00e8xia.<\/strong><\/p>\n\n\n\n

La disl\u00e8xia<\/strong> es defineix, segons la British Dyslexia Association<\/em>, com una dificultat en l\u2019aprenentatge que afecta principalment en les habilitats involucrades en la lectura efica\u00e7 de paraules i ortograf\u00eda1<\/sup>. L\u2019estudi de la disl\u00e8xia sempre s\u2019ha diferenciat per l\u2019origen de l\u2019afectaci\u00f3, sent les hip\u00f2tesis m\u00e9s famoses l\u2019origen fonol\u00f2gic o visual.<\/p>\n\n\n\n

Certament, dins les definicions de la disl\u00e8xia existeixen molts subgrups (adquirida, evolutiva, visual, fonol\u00f2gica, l\u00e8xica etc.), l\u2019objectiu d\u2019aquest escrit es proporcionar una s\u00e8rie de investigacions cient\u00edfiques que avalen el tractament optom\u00e8tric en els casos de problemes de lectura.<\/p>\n\n\n\n

En primer lloc, est\u00e0 documentat que els nens diagnosticats amb disl\u00e8xia<\/strong> tenen problemes amb el control oculomotor (sac\u00e0dics, seguiments, fixacions), afectant al rendiment lector2,3<\/sup>. A un nivell biol\u00f2gic aquests d\u00e8ficits estan atribu\u00efts a una disfunci\u00f3 de la via magnocel\u00b7lular, del que es sap que est\u00e0 involucrat en el processament de les freq\u00fc\u00e8ncies espacials baixes i el control oculomotor4<\/sup>.En efecte, la disl\u00e8xia<\/strong> s\u2019ha associat amb d\u00e8ficits a causa de la via magnocel\u00b7lular com ara baix processament temporal5<\/sup> i baixa atenci\u00f3 viso-espaial6<\/sup>. Per exemple, un estudi recent afirma trobar difer\u00e8ncies morfol\u00f2giques amb el cos geniculat lateral de pacients diagnosticats amb disl\u00e8xia, donant suport a la teoria de qu\u00e8 la disl\u00e8xia \u00e9s a causa d\u2019un problema visual7<\/sup>.<\/p>\n\n\n\n

D\u2019altra banda, \u00e9s habitual trobar pacients diagnosticats de disl\u00e8xia s\u00edmptomes com \u201cles lletres salten\u201d, \u201cles l\u00ednies ballen\u201d i \u201c veig borr\u00f3s el text\u201d8<\/sup>, per\u00f2 hem de tenir en compte que els mateixos s\u00edmptomes poden ser d\u2019origen purament visual i es poden solucionar mitjan\u00e7ant la ter\u00e0pia visual9,10,<\/sup> i probablement la millora dels moviments oculars augmentin el control postural11<\/sup>.<\/p>\n\n\n\n

Molts problemes lectors no s\u00f3n sin\u00f2nim de disl\u00e8xia, per exemple, els problemes de desenvolupament donen problemes acomodatius i oculomotors que afecten a la lectura i originen s\u00edmptomes similars a la disl\u00e8xia12<\/sup>. Problemes com ara inversions durant la lectura poden ser a causa d\u2019un baix desenvolupament en el cerebel13<\/sup>, on s\u2019est\u00e0 veient que el cerebel participa en els processos cognitius d\u2019alt nivell (habilitat viso-espaial, mem\u00f2ria, llenguatge)13<\/sup>. De fet, les \u00faltimes hip\u00f2tesis afirmen que la disl\u00e8xia pot ser una alteraci\u00f3 a nivell del cerebel14,15<\/sup>, sent l\u2019origen de l\u2019afectaci\u00f3 de la via magnocel\u00b7lular afectant a nivell visual, auditiu i control motor. No tots els problemes durant la lectura s\u00f3n sin\u00f2nims de disl\u00e8xia, per exemple habilitats com l\u2019atenci\u00f3 viso-espaial16<\/sup> o percepci\u00f3 visual17<\/sup>s\u2019han trobat en la majoria de disl\u00e8xies i contribueixen al baix rendiment lector (l\u2019origen del qual pot ser  una disfunci\u00f3 en la ruta magnocel\u00b7lular18<\/sup>).<\/p>\n\n\n\n

Per aquest motiu \u00e9s molt important desenvolupar e integrar amb la ter\u00e0pia visuals aspectes com el cerebel i c\u00f2rtex pre-frontal (reflexes primitius, sac\u00e0dics, seguiments); sistema vestibular (rotacions que involucrin girs de cap i coll); percepci\u00f3 i pensament visual (parquetry, geoboards); control psico-motor (cos call\u00f2s, integraci\u00f3 bilateral) i visual SPAN i RAN (taquitosc\u00f2pia, visi\u00f3 perif\u00e8rica, tic-tae-toe).<\/p>\n\n\n\n

Per tant, molts problemes de lectura estan sent diagnosticats de disl\u00e8xia quan realment poden ser un problema de poca integraci\u00f3 de les habilitats visuals, auditives o psicomotrius que donen els mateixos s\u00edmptomes i que mitjan\u00e7ant el treball i l\u2019estimulaci\u00f3 es pot millorar el rendiment lector.<\/p>\n\n\n\n

Un estudi recent19<\/sup><\/strong>, basant-se amb la teoria magnocel\u00b7lular, van utilitzar la estimulaci\u00f3 transmagn\u00e8ticacraneal (ETMC), un mecanisme no invasiu que facilita o inhibeix la activitat cortical, pel que fa possible l\u2019estudi de les relacions entre la activitat cerebral i el comportament. En aquest estudi mitjan\u00e7ant la ETMC van estimular i potenciar les regions visuals V5 i MT (importants per la detecci\u00f3 de moviment i reconeixement de paraules) en pacients disl\u00e8xics adults, on l\u2019estimulaci\u00f3 va millorar l\u2019efic\u00e0cia lectora tant en velocitat com flu\u00efdesa. Tot i que l\u2019estudi s\u2019ha de prendre amb precauci\u00f3, les rehabilitacions per estimular \u00e0rees cerebrals estan augmentant per millorar els problemes de lectura, poden ser una d\u2019elles la ter\u00e0pia viso-cognitiva.<\/p>\n\n\n\n

29_7_15Improved-reading-measures-in-adults-with-dyslexia-following-transcranial-direct-current-stimulation-treatment<\/a>Descarga<\/a><\/div>\n\n\n\n

REFER\u00c8NCIES BIBLIOGR\u00c0FIQUES <\/strong> <\/p>\n\n\n\n

  1. http:\/\/www.bdadyslexia.org.uk\/dyslexic\/definitions<\/a>.(\u00daltima entrada el 28\/06\/2015)<\/em> <\/li>
  2. Bucci, M. P., Bremond-Gignac, D., &Kapoula, Z. (2008). Latency of saccades and vergenceeyemovements in dyslexicchildren. Experimental BrainResearch<\/em>, 188(1). <\/li>
  3. Kapoula, Z., Bucci, M. P., Ganem, R., Poncet, S., Daunys, G., &Bremond-Gignac, D. (2008). Freeexploration of paintinguncovers particular looseyoking of saccades in dyslexicreaders. Dyslexia<\/em>, 15(3), 243\u2013259. <\/li>
  4. Solomon, S.G., Peirce, J.W., Dhruv, N.T., Lennie, P.(2004). Profund contrast adaptationearly in the visual pathway. Neuron<\/em>42 (1), 155\u2013162. <\/li>
  5. Laycock, R., Crewther, S.G.(2008). Towardsanunderstanding of therole of the \u2018magnocellularadvantage\u2019 in fluent reading. NeuroscienceBiobehavioralReview<\/em>. 32 (8), 1494\u20131506. <\/li>
  6. Ruffino, M., Gori, S., Boccardi, D., Molteni, M., Facoetti, A. (2014). Spatial and temporal attention in developmentaldyslexia. Frontiers ofHumanNeuroscience<\/em>. 8, 331. <\/li>
  7. Giraldo-Chica M, Hegarty JP, Schneider KA(2015). Morphologicaldifferences in the lateral geniculatenucleusassociatedwithdyslexia. NeuroImageClinical<\/em>. 7 830-836 <\/li>
  8. Shovman, M. M., &Ahissar, M. (2006). Isolatingtheimpact of visual perception on dyslexicsreadingability. VisionResearch<\/em>, 46, 3514\u20133525.<\/li>
  9. Scheiman M<\/a>, Kulp MT<\/a>, Cotter S<\/a>, Mitchell GL<\/a>, Gallaway M<\/a>, Boas M<\/a>, Coulter R<\/a>, Hopkins K<\/a>, Tamkins S<\/a>.  (2010). Visiontherapy\/orthoptics for symptomatic convergenceinsufficiency in children: treatmentkinetics. Optometry&Vision Science<\/em>.<\/a>87(8):593-603.<\/li>
  10. Gaerter C, Bucci MP, Ajrezo L, Wiener-Vacher SW. (2013). Binocular coordination of saccadesduringreading in childrenwithclinicallyassesedpoorvergencecapabilities.VisionResearch<\/em>. 87 22-29.<\/li>
  11. Bucci MP, Ajrezo L, Wiener-Vacher. (2015). Oculomotor tasksaffectdifferently postural control in healthychildren.International Journal of DevelopmentalNeuroscience.<\/em>461-6.<\/li>
  12. Rafique SA, Northway N. (2015). Relationship of oculoraccommodation and motor skills performance in developmentalcoordinationdisorder. HumanMovementScience.<\/em> 42 1-14.<\/li>
  13. Kaltner S, Jansen P. (2014). Mental rotation and motor performance in childrenwithdevelopmentaldyslexia. Research in DevelopmentalDisabilities.<\/em> 35:741-754.<\/li>
  14. Ust\u00e1rroz JT, Luna-Lario P, Iglesias D, Heern\u00e1ndez P.(2011).Contribuci\u00f3n del cerebelo a los procesoscognitivos:avancesactuales. Revista de Neurologia.<\/em> 53:301-315.<\/li>
  15. Pernet CR, Poline JB, Demonet JF, Rousselet GA.(2009). Brainclassificationrevealstherightcerebellum as the best biomarker of dyslexia. BMC Neuroscience<\/em>. 25, 10:67<\/li>
  16. Facoetti A, Ruffino M, Peru A, Paganoni P, and Chelazzi L.(2008). Sluggishengagement and disengagement of non-spatialattention in dyslexicchildren. Cortex: A Journal Devoted to theStudy of theNervous System and Behavior<\/em>. 44(9): 1221e1233.<\/li>
  17. Boden C and Giaschi D.(2007). M-Streamdeficits and reading-related visual processes in developmentaldyslexia. PsychologicalBulletin<\/em>. 133(2): 346e366.<\/li>
  18. K\u00f6rne GS, Bruder J.(2010). Clinicalneurophysiology of visual and auditoryprocessing in dyslexia: a review. ClinicalNeurophysiology.<\/em> 121 1797-1809.<\/li>
  19. Het<\/strong>h I, Lavidor M. (2015). Improvedreadingmeasures in adults withdyslexiafollowingtranscranialdirectcurrentstimulationtreatment. Neuropsychologia<\/em>.70 107-113<\/li><\/ol>\n\n\n\n

    Article el\u00b7laborat per: Marc Argil\u00e9s Sans<\/strong>
    Diplomat en \u00d2ptica i Optometria
    M\u00e0ster en Optometria i Ci\u00e8ncies de la Visi\u00f3
    Membre de l’ACOTV<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

    Punt de vista optom\u00e8tric Els trastorns d\u2019aprenentatge s\u00f3n una s\u00e8rie de dificultats que afecten en l\u2019aprenentatge de la lectura, l\u2019escriptura […]<\/p>\n","protected":false},"author":2,"featured_media":4418,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ocean_front_end_style_editor":"no","ocean_post_layout":"","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"0","ocean_second_sidebar":"0","ocean_disable_margins":"enable","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"default","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"default","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"default","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","ocean_post_oembed":"","ocean_post_self_hosted_media":"","ocean_post_video_embed":"","ocean_link_format":"","ocean_link_format_target":"self","ocean_quote_format":"","ocean_quote_format_link":"post","ocean_gallery_link_images":"off","ocean_gallery_id":[],"footnotes":""},"categories":[24],"tags":[66,72,67],"class_list":["post-4417","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-bloc","tag-optometria-ca","tag-problemesdaprenentatge","tag-terapiavisual-ca","entry","has-media"],"yoast_head":"\nTRACTAMENT VISO-COGNITIU PELS PROBLEMES DE LECTURA - 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