Visual Information Processing

Transcription

1 Developmental Optometrist Speaker Author Centennial, CO Lynn F. Hellerstein, O.D., FCOVD, FAAO Evaluating Beyond 20/ You Will Learn to: Identify information () difficulties. Use a specific battery of tests to evaluate skills. Interpret and communicate the relevance of testing results. Develop a vision treatment plan for patients with difficulties. Learn what types of other treatment options may be considered. Emphasize the importance of comanagement strategies in working with patients with complex issues. Psychologist Physician Educator Reprinted with permission from Dr. Lynn Hellerstein 2010 Educator Know the Signs LynnHellerstein.com Reprinted with permission from Dr. Lynn Hellerstein

2 Physician Psychologist Disparity- higher verbal/lower performance speed Psychologist Coding & search symbols low Meet psychologist WISC IV Optometric evaluation Developmental History DEVELOPMENTAL/SENSORY HISTORY FORM Patient s Name: DOB: Date: CHILD S BIRTH, INFANCY, TODDLER YEARS: Yes No Brief Explanation 1) Premature 2) Full term 3) Required forceps 4) Had any birth injuries 5) Any major birth complications 6) Had insufficient oxygen 7) Any other after birth 8) Did your child crawl Age: 9) What age did child walk Age: 10) What age was child toilet trained Age: 11) When did your child begin putting clothes on Age: 12) When did your child begin buttoning clothes Age: 13) When did child begin tying shoes Age: GENERAL INFORMATION: Which hand does your child prefer to use? Was handedness ever changed: If so explain What are your child s special interests? Give a brief thumbnail sketch of your child s personality: Has your child had a neurological, psychological or educational evaluation performed? If so by whom and the results: School Name: Grade: 2

3 Lynn Fishman Hellerstein, O.D. FCOVD, FAAO 7180 E. Orchard Road, Suite 103 Tricia Brenner, O.D. Englewood, CO Joe Borden, O.D. (303) AUXILLARY TESTING EVALUATION Note: Testing areas left blank are not appropriate for diagnosed problem. NAME: DOB: DATE: SCHOOL: GRADE: COMPLAINTS: OD OS WORN NOT WORN BEERY-VMI: INT SEC FNL R L SCORE % SCORE % SCORE % Observations: TVPS: (Test of vis. per.) Age % Age % Age % VISUAL DISCRIMINATION VISUAL MEMORY VISUAL SPATIAL RELATIONS VISUAL FORM CONSTANCY VISUAL SEQUENTIAL MEMORY VISUAL FIGURE GROUND VISUAL CLOSURE OBSERVATIONS: GETMAN: GRADE GRADE GRADE OBSERVATIONS: HANDWRITING: GRADE GRADE GRADE TIME: OBSERVATIONS: 11/9/2013 Symptoms Symptoms Avoids/ difficulty puzzles Auditory Spells phonetics Poor reading comprehension Memorizing/ historian Does well in practice, not performance Vision Ocular health VA Refractive Binocular Oculomotor Accommodative 11 Points Overview Hellerstein & Brenner Vision Center, P.C. Doctors of Optometry Beery Motor Integration (VMI) Test of Perceptual Non-motor 1 2 3

4 2 Test of Perceptual Non-motor discrimination Memory spatial relation form constancy sequential memory figure-ground closure 3 Getman Recall Wold Sentence Copy Eye Movement Test (DEM) 4 Speed Accuracy Quality 5 Eye Movement Test Visagraph/Readalyzer Test of Dyslexia Screener 5 6 4

5 Test of Auditory Analysis Auditory/ Integration 7 8 Referral Criteria Sequencing Developmental readiness Directionality/laterality VO Star/cheiroscope 9 10 Sensory Motor screening 11 Reflexes Bilateral integration Sensory Jumping Hopping Skipping Tactile Vestibular Proprioception Postural security Body Scheme Now What? 5

6 Now What? Relevance of scores Prioritize treatments Relate to patient concern Review testing from others Now What? Develop a plan Vision therapy Referrals Lenses/ prisms Case Presentation Referrals Now What? Develop a plan Medical Education Therapist Allergist Neuro Ped/intern Tutor Psycheducation Speech/ lang. OT/PT Counselor Case Presentation Pearls Case #1- VMI difficulties relate it to writing, sports Discuss Brain it s the buzz word! RELATE findings to parent s concerns NO SELLING OF VT! People buy what they WANT Not what they NEED 6

7 History Referred by GDC Disparities in psychoeducational testing IQ: V112/P111; Difficulty fine & gross motor skills Doing ok in school Avoids writing tasks Ocular Health WNL RE D OU Ocular motorfull/smooth Binocular 2PD exo near NPC 1/3 inches Accommodation- pass +/- 2.00D Fusion ranges - WNL TVPS: 25%-91% scatter VMI: 47% Getman V. Recall: Kdg TDS: 1st grade words L/R confusion TAAS: kdg. DEM: Lost Poor bilateral integration - Hopping sequencing Jumping jacks. Diagnosis?. Diagnosis Refractive Oculomotor Motor Binoc/ accom Auditory Oculomotor Bilateral integration VMI 7

8 . Treatment Referral Audiologist (later) Lenses- None VT 32 sessions POST VT TVPS: 63%-99% (37%- 91) VMI: 58% (47%) Getman: (kdg) TDS: 3 rd grade words (1 st ) POST VT Piaget l/r awareness: pass TAAS: words DEM 65% (lost) Bilateral integration: improved IQ V 119(112)/ P 127 (111) Full 125(112) POST VT SMARTER? POST VT Coordination much improved Happy with sports Voracious reader! School wants to skip a grade Still auditory problem You Will Learn Identify information () difficulties. Use a specific battery of tests to evaluate skills. Interpret and communicate the relevance of testing results. Develop a vision treatment plan for patients with difficulties. Learn what types of other treatment options may be considered. Emphasize the importance of comanagement strategies in working with patients with complex issues. 8