Agnosia

Evaluation - Prosopagnosia

Functional Evaluation - have client identify pictures of faces or real people when possible.

Environmental Agnosia

These clients get lost in familiar places, however, are able to read maps, plans, etc. - Another type of agnosia

Evaluation Guidelines - Agnosia

1. Assess for language deficits 2. Assess whether client can describe crucial features for identification of the object 3. Assess if client can categorize the object 4. Does the client focus on one aspect of the object and miss critical features of the object? 5. Assess if the client can describe the functional use of the object 6. Does seeing the object in the natural environment aide in object identification? 7. Determine if presenting the object from different perspectives assist in object identification 8. Is the client able to identify the real object versus pictures of the object?

Visual-Spatial Agnosia

A deficit in perceiving spatial relationships between objects or between objects and self. Depth perception is part of visual-spatial agnosia. - Another type of agnosia

Definition of Agnosia

A general term to describe the client's lack recognition of familiar objects perceived by the senses. Recognition includes behaviors such as attention, pattern and form perception, temporal resolution, and memory. - Successful object recognition is not only dependent upon vision, but kinesthetic, and tactile input as well. May result in a disturbance of any one of the sensory modes including visual, tactile, proprioceptive, and auditory.

Prosopagnosia

A neurological deficit characterized by the inability to identify a known individual by his or her face. - Clients may be able to discriminate features of the face; however may not recognize the face as a whole. - This severity can range from not being able to recognize others to not being able to recognize one's own face. - Theorists believe it is caused by either a perceptual problem or memory deficit. Prosopagnosia can have an impact on one's occupational roles and performance. Why?

Treatment - Prosopagnosia

Adaptive Approach: 1. Provide pictures with names 2. Assist the client with identifying characteristics of people other than just their face 3. Teach client to make a list with identifiable features of people 4. Use a personal data assistant to assist in identification

Tactile Agnosia

Also caused astereognosis, is the inability to recognize common objects through tactile, thermal, and proprioceptive input. - Requires the integration of information related to the temperature, texture, weight, and contour of an object. - It involves both the cutaneous and proprioceptive sensory systems.

Apractognosia

Consists of both apraxia and agnostic syndromes - all centering around a lack of perspective. May include one or all of the following: body-scheme problems, apraxia for dressing, constructional apraxia for lack of perspective, and unilateral spatial agnosia - Another type of agnosia

Topographagnosia

Impairment in interpretation of maps, house plans, etc. These clients do better in natural environment, but cannot identify with a map. - Another type of agnosia

Simultagnosia

Inability to recognize a complex visual assortment Clients are able to perceive only one thing at a time. They also require increased time to distinguish between two perceptual acts. Clients will only be able to look at segments of a picture, not the picture in its entirety. This is also true of letters and words.

Visual Object Agnosia

Inability to recognize objects presented visually, although primary visual skills (acuity) is intact. - Results in a defect in not only recognizing a specific object, but also the general semantic class to which it belongs. - May be limited to a category specific deficit.

Visual Agnosia

Inability to recognize visual stimuli despite normal acuity, visual fields, and oculomotor function. - Common objects may be recognized more easily than unfamiliar objects. - Recognition may range from being able to recall actual objects versus pictures. Visual agnosia has been described in two different ways: 1. Apperceptive agnosia 2. Associative agnosia.

Evaluation - Visual Object Agnosia

Object Recognition - common objects are presented to the client - toothbrush, key, etc. Client is then asked to pick up the object being named or demonstrate its functional use. LOCTA - Visual Identification of Objects - client is shown 8 cards and asked to name each object. If client has problems of expression, client is asked "where is....." questions. If the client has trouble with both receptive and expressive aphasia, see if the client can match objects.

Tactile Agnosia - Treatment

Restorative - Provide sensory retraining: master input of stimulus before moving to next stimulus. Adaptive • Present the objects within the normal context • Provide the client with compensatory skills - use of other senses, increase awareness of the problem

Treatment - Visual Object Agnosia

Restorative Approach - General Considerations 1. Common real objects should be used 2. Move from simple to complex 3. Progress from objects to pictures 4. Teach strategies learned in daily life 5. Provide nonverbal, tactile-kinesthetic guiding throughout the activity Adaptive Approach - General Considerations 1. Teach the client to think critically 2. Utilize all intact sensory modalities 3. Show object in natural environment when possible 4. Categorize objects 5. Label objects when appropriate

Tactile Agnosia - Evaluation

Stereognosis - put object in client's hand with vision occluded - have the client tell you what he or she is feeling - nonstandardized. Ayres' Manual Form Perception - uses shapes instead of objects - standardized Morphognosis - uses shapes cut out of stiff paper Ahylognosis - uses materials (cotton, silk, sandpaper, etc.)

Auditory Agnosia

The inability to discriminate variances in sounds - typically addressed by a speech therapist - Another type of agnosia

Color Agnosia

The inability to recognize colors, including picking out a color or naming the color on command. - Another type of agnosia

Metamorphopsia

The distortion of objects visually - seeing something either bigger or smaller than it actually is. - Another type of agnosia

Associative Agnosia

Type of visual agnosia Client is able to describe the features and shape of an object, but are unable to recognize it. • These clients are unable to attribute meaning to perceived stimulus. • The ability to copy figures, match, copy written material and name objects from definitions is still present. • These clients typically do well on the majority of visual tests.

Apperceptive Agnosia

Type of visual agnosia These clients are unable to match, recognize, copy, or discriminate simple visual stimuli. • Even simple shapes (circle, triangle) are not recognized. • It is believed this is caused by perception disturbance because primary visual functions are present.