3. Visual information processing
____ in _____ pure perceptual disorders _____ in ______ with mixed disorder
1 in 5 for pure perceptual disorders 1 in 5 with mixed disorder so 2 in 5 learing disorders have vision factors! (not the majority but a good amount!)
How common are learning disorders
1 in every 5 people in US over 6 million children recieve special education in school for learning disorder in the US *over half do not receive the special education they need
4 criteria for DSM-5 definition of SLD
1. Key characteristics of LD, which are at least 1 of 6 symptoms of LD that have persisted for at least 6 mo despite intervention 2. measurement of these characterstics which are below expected for age causing impairment in academic, occupational, everyday life 3. age of onset during school years 4. specifies which disorders or adverse conditions must be ruled out before dx of SLD can be confirmed
TVPS: visual memory
2 sample items, 15 test items, 0 or 1, stop after 3 consequtive errors raw score to scaled to percentile 1 if right, 0 if wrong look at image then match what was seen in other page
Beery VMI test
24 design 27 points total, 3 points added strict scoring criteria developmental milestones for each design use rulers and protractors to evaluate stop after 3 consecutive errors raw score- standard score- percentile
Border's group (dysphonetic, Dyseidetic, Mixed) patients with visual processing deficit?
31%
Clinical visual processing testing
5 tests that can be done individually or as a group in primary care setting standarized testing: sample child's performance, uniform testing, protocols specified for duplication
Ayres right left discrimination
9 items 20 possible points score 0, 1, 2
average IQ
90-109
Developmental norms
Age equivalent- raw score that is characteristic of particular age in normative sample grade equivalent- compares individual performance with average students in particular grade developmental stage norms: ID order in whcih a child should reach successive stages of development for specific behavior or skill
Types of learners examples
Auditory visual
Two subtypes of dyslexia
Auditory- Linguistic: trouble hearing word Low verbal compared to performance Visual-spatial: trouble recognizing word again Low performance compared to verbal right left disorientation
Areas within visual processing that can affect learning and reading?
Auomaticity and processing speed Simultaneous- sequential processing Magnocellular vision deficit Rapid automatized naming Integrative Factors Visual perception
Two major changes in DSM-5 cateogry of Specific Learning Disorder
Characterize the specific manifestation of LD into the domains of reading, writing, and math Elimination of IQ achievement discrepancy and its replacement with 4 criteria! which must all be met
Optometrist _____ teach reading, dx, evaluate learning disablity, treat dyslexia
DO NOT
Types of learning disabilities
Dyslexia- reading disorder, most common Dysgraphia- writing disorder, difficulty transferring language into written output Dyscalculia- math disorder, difficulty understanding numbers and number concepts
Visual information processing
ID, discrimination, spatial awareness, integration Ability to analyze, interpret, act upon incoming visual information
Optometrists role
ID, evaluate, treat Visual acuity Visual efficiency Visual processing
Visual spatial skill tests
Laterality: Ayres Southern California Right/ Left Directionality: Gardner Test of reversal frequency, recognition subtest
Most common childhood disorder
Learning disability (5-15% of school children) usually due to differences in how their brain works and process information, no cure, life long learning challenges, classifies children, but doesnt say how to teach them
DSM definition of "specific learning disability"
Neurodevelomental disorder impedes the ability to learn or use specific academic skills (reading, writing, arithmetic) which are foundations for learning learning difficulties are unexpected *cross culutural and chronic, perist in adulthood
types of scores and meaning: Raw score Scaled score Standard score T-score
Raw score: number correct or number of errors Scaled score: mean of 10 and standard deviation of 3 Standard score: mean of 100 and standard deviation of 15 T score: mean of 50 and standard deviation of 10
Magnocellular Vision Deficit: Two processing system
Transient- mangocellular, motion sensitive, low resolution, processes overall stimulus organization (Where) sustained- parvocellualr, pattern sensitive, high resolution, obj ID and stimulus configuration (What) *retinal images smapled twice by visual system *alteration in order and timing or processing speed can result in visual processing deficit
Visual memory/ visualization
Visual memory: recall visual information, greater in older kids, develop strategies (visual imagery or verbal reinforcement) visualization: recall and manipulate, better in older kids ie what would it look like if it was flipped at different angle
Wechsler Scales
WISC IV/V 6-16 years WPPSI 2 years 6 mo to 7 years 2 mo WAIS 16-89 years tests admin by clinical or school pscychologist (NOT anyone else!)
Learning disability definition in IDEA
a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, math, including conditions as perceptual disabilities, brain injury, min brain dysfunciton, dyslexia, dev aphasia
block design
ability to analyze, synthesize abstract information apply reaosning to abstract visual relationships *problem solving
Laterality
ability to be aware of left and right on oneself
Integrative factors
ability to integrate information from various sensory modalities intramodal: visual- visual pattern matching intermodal: audiotory- visual pattern matching
Directionality
ability to interpret right and left directions in interal sapce
Random automatized naming (RAN)
ability to name visual stimuli quickly highly predictive of dyslexia involves many visual, cognitive and linguistic processes responsive to VT
Visual spatial skills
ability to understand directional concepts important for: navigating understanding directions recognizing orinentation manipulating visual information
OD refer to psychologist when
academic or behavioral problems home or school may be multifactorial
Visual Efficiency
accommodation Binocularity Ocular motility *clear, comfortable, efficient
Perception
active process locate extract information sense organs (tools): learning something, make inferences Perceptions go on to guide our actions
ADHD dx
analysis of hx behavioral inventories (teacher and parent)- Child Behavior check list conner's Clinical observation
Information
aquisition, retention, recall of verbally encoded, factual information
neuropsychological assets
auditory perception, attention, memory simple motor sklls rote verbal memory language form and output
Full scale IQ tells us if child achieves at
average rate faster rate slower rate than children of the same age, scores can range from 40 to 160
New classification of SLD means
away from subtypes of LD braoder approach or one overall category better continuum for parents and children as additional learning difficulties emerge depending on age
Mixed
both dysphonetic (language processing) and Dyseidetic (visual processing) more severe reading problems standard remediation is poor
Automaticity and Processing Speed
children with LD need more task time Factors: automaticity (makes learning fast and effortless), Processing speed (part of IQ testing)
visual acuity
clear picture only visual pathway integrity: ocular health VA refractive status
Memory deficits
component: attention, concentration storage retrieval active working memory
Learning disability: relation ship to vision
contributes to Impact will vary
Visual motor integration
coordinate visual with motor skills copying and writing: fine motor/ manipulative skills, speed, accuracy
Gardner test
count total numebr of errors diff norms for males and females raw scores --> percentiles
Dyseidetic
deficiency in ability to perceive letters and whole words as configurations or visual gestalts spells by ear, not by sight, words look like seeing it for the first time
Dysphonetic
deficit in symbol, sound integration trouble with phonetic word analysis- synthesis spell right by sight NOT by ear! difficulty learning what the letters sound like
Other mental health dx
depression anxiety disorders (school phobia, OCD, separation anxiety disorder) developmental disorders
AOA statement for LD and vision
determining vision and learning is more than eye health and VA expected outcome of OD treatment is improvement in visual function intervention by Lenses, Prisms, VT *VT is multidiscplinary approach to LD, but not directly treating LD *emphasizes importance in OD working with professions to involve more than VA and eye health for LD
Major premise of learning disability
discrepancy in child's potential and actual level of academic or language skills *each state may differ!
Cancellation
draw a line through a specific category (ie animal) random vs structured processing
Visual perception
eyes more than receptors of form relay info to brain: direction, size, distance, color Learned dynamic process ie snellen you must not only see, but also recognize info
picture completion
figure out what is missing in the picture
TVPS: Form constancy
form perception, feature analysis, comparison, memory 2 sample items 16 test items score 0 or 1 stop after 3 consecutive errors might be bigger, darker, turned, on side
word reasoning
general reasoning ability two levels
Learning disability risk factors
genetics psychosocial and biological factors maternal nutrition premature birth low birth weight (<2,500 grams) *social economic status, lower the birth weight the lower the IQ Low birthweight, the lower the social economic status, the lower the IQ also: neonatal seizures, CNS trauma, TBI, birth experience, intraventricular bleeds, abuse
Word reasoning
hardest (ceiling item)
what will psychologist due
history cognitive functioning- IQ academic achievement- grades in school emotional functioning
ADHD three components
hyperactivity impulsivity inattention *started before age 7
learning best facilitated through?
intermodal learning match picture (visual to visual) spell or say word (auditory to visual) write the word (visual motor) *reinforces and internalizes knowledge!
cognitive functioning
langauage memory auditory and visual perceptual skills visual motor abilities attention and concentration cognitive style
Learning disabilities do NOT include
learning problems due to visual, hearing, motor disabilities, of mental retardation, of emotional disturbance, of environmental, cultural, or economic disadvantage
Transient system: reading
major function in reading fixation (sustained), Saccades (transient) integration of eye movments Transient- diminishes effect of sustained channels, ERASES pattern information from previous fixation
Learning disorder issues
math, reading, listening and reasoning, written and oral language *wide range of learning issues
4 index scores and FSIQ
mean = 100 SD = 15 index scores help OD determine: verbal vs nonverbal abilities 1 SD = 15 pt difference is significant helps determine whether VT effective
Arithmetic
metnally solve series orally presented mmath problems without paper in 30 seconds
Changes with WISC- V
more user friendly, digital available, new art dropped some subtest from IV added new subtest (visual puzles, figure weights, picture concepts, picture span) change some of retained subtests gives partial scores
Dyslexia
most common childhood lerning disorder difficulty with accurate and fluent word recognition and poor spelling and decoding abilities from deficit in phonological component of language secondary- problem with reading comprehension and reduced reading experience that can impede grwoth of vocabulary and background knowledge
Non verbal learning disorder charactersitics
motor mouth talk excessively to comprehend cannot create mental picture of what they see cocktail party speech talk a lot but says very little miss majority of communication that is nonverbal lack of social cues - monopolize conversations makes inappropriate commets lose hidden meaning or intentions behind a person's word
auditory processing deficit
no detectable hearing problem not visual poor listener frequently misunderstands speech difficulty following oral directions often problem on verbal comprehension scale of IQ tests
Clinical psychologists refer to OD when
perceptual reasoning IQ low or significantly less than verbal IQ poor performance on Bender Gestalt (picture) Observation of visual problems during testing
PRI: perceptual reasoning index
perceputal and fluid reasoning spatial processing visual motor integration non verbal admin and response related to vision and visual perception block design, matrix reasoning, picture concepts, picture completion
transient system deficit
preceding pattern is not erased and you get overlap, aka masking makes confusing and inefficent
Milestones for Visual spatial skils
preschool 3-4 yo: front vs back, up vs down 5 years- frequent letter/word reversals 6 years- left vs right on self 8 years- min letter/ word reversals 7-12 years- left vs right for objects in space
Letter-number sequencing
properally give the correct order of number and letters lowest to highest
ADHD treatments
psychostimulants Non-stimulants *has other sx as well
Standard error of measurement (SEM)
reasonable estimate of range of fluctuation expected in child's score the more reliable the test the smaller the SEM SEM provides a confidence interval in which a true score is likely to be found (calculated with std dev, relaiablity measure, in test manual)
Visual analysis skills
recognize recall manipulate visual information * recognize whole without seeing al parts, ignore extraneous details, visual imagery for color and orientation early childhood- toys, faces, enviornment later- numbers, letters, words, math concepts
Digit span
repeat increasing strings of numbers both forward and backward *auditory with visual component
nonverbal learning disorders
significant primary deficits (tactile perception, visual perception, complex psychomotor, novel circumstance) secondary deficit (tactile attention, visual attention, limits in exploratory behavior) tertiary deficit (tactile memory, visual memory, concept formation, problem solving, hypothesis testing, difficulties in content and function of language) we note: visual perception and visual attention and Visual memory
Simultaneous/ Successive processing
simultaneous Successive/ sequential both are factors for kids with LD
comprehension
social knowledge and awareness, ability to evaluate and use past experiences uses general knowledge
AHDHD behavioral intervention
structured activities, goal cards, point system, reward for paying attention, self monitoring devices
Symbol search
timed children determiens wheter target symbol matches a specific group of symbols
coding
timed paper and pencil child copies symbols paired with geometric shapes and numbers based on speed and accuracy
Mile stone for visual analysis skills
under 5 search pattern: incomplete, unsystematic Older children: compare choices, systematic
Matrix reasoning
understanding visual relationshiops and patterns attentiveness to detail visual analogies!
WISC-IV 4 indices
verbal comprehension Perceptual reasoning Working memory Processing speed 4 index scores = full scale IQ
Verbal comprehensive index
verbal concept information verbal reasoning knowledge acquired from one's enviornment oral administration and response can be used to evaluate receptive and expressive language processes vocab, similarities, comprehension, information, word reasoning
similarities
verbal concepts and reasoning
VMI beery test requires
visual form perception fine motor coordination integration of visual and motor
Visual analysis skills: TVPS test
visual memory Visual form constancy *there are others but we focus on these two
Visual Analysis skill test
visual memory- TVPS visual memory visual form constancy- Visual form constancy
fine motor manipulative test
visual motor integration- Beery
PSI: processing speed index
visual perception and organization visual scanning ability to use hands/ eyes together in efficient manner attention is a factor- effort must be sustained for 2 min coding, symbol search, cancellation
picture concepts
why do two things go together?
vocabulary
word knowledge and retreval
WMI: Working memory index
working memory processes applied to manipulation of orally presented verbal sequences digit span (forward and backward), letter number sequencing, arithmetic
