The effect of online visual games on visual perception, oculomotor, and balance skills of children with developmental dyslexia during the COVID-19 pandemic.

Abstract

To evaluate the effect of online visual games on the balance, visual perception, and oculomotor skills of children with developmental dyslexia during the COVID-19 pandemic. In this single-blind randomized clinical trial, 50 children with developmental dyslexia, aged 7 to 11years, were recruited from rehabilitation centers in Tehran, Iran, using a convenience sampling strategy. Participants were randomly divided into two groups: intervention (25) and control (25), with close matching based on sex, age, IQ, and type of disease. The interventions consisted of web-based online computer games focusing on visual perception and oculomotor skills. Outcome measures included the Test of Visual Perception Skills-Revised, the Pediatric Balance Scale, and videonystagmography. The Wechsler Intelligence Scale for Children-IV and the Reading and Dyslexia Test were used to evaluate IQ and reading skills, respectively. The intervention group exhibited significant post-intervention improvements in the Test of Visual Perception Skills-Revised, tracking gain, saccade latency, and saccade velocity scores (all P < 0.001). In contrast, the control group showed no significant differences in these tests in pre- and post-intervention (all P > 0.05). Notably, post-intervention comparisons between the groups revealed significant differences in smooth pursuit eye movements (P < 0.001), saccade latency (P = 0.027), and saccade velocity (P < 0.001). The Pediatric Balance Scale scores remained unchanged in both groups post-intervention (intervention: P = 0.317; control: P = 0.999). Game face validity was affirmed with impact scores above 1.5 for all items, suggesting that the games were straightforward, clear, and relevant. Online visual games enhanced oculomotor and visual perception skills in children with dyslexia but did not influence balance skills.