1. Visual Spatial & CAPD 謝中君

2. Visual Spatial Abilities Case report: the following problems may be resulted from vestibular and proprioceptive sensations & and reflects poor visual processing. 1. Motor clumsiness 2. Walk through his classroom with bumping into desks or tripping over objects 3. Misjudged the movement of the swings 4. Find his way around the school

3. 5. Do not know how to use landmarks as a guide 6. Gym class is a disasters: can ’ t catch a ball until it his him in the chest 7. When printing letters, can ’ t keep his letters with the lines, the size and space of letters varied tremendously 8. Need help in dressing 9. Can ’ t tie his shoelaces

4. Visual system: –1. Object vision (what) — recognize objects the perception of form, color, texture, and size. –2. Spatial vision (where) — unconscious level visual location of objects in space; the locations and positions of objects; relative both to ourselves and to other objects.

5. Vision and the body schema Body schema: the proprioceptive-motor- spatial structure of our bodies defined by our orientation to gravity and the position of our head and limbs. Body schema is dependent on information about both ongoing and intended patterns of movements that come from tactile, proprioceptive, and vestibular inputs

6. Our actions in space are accurate because the visual-spatial coordinates and the body reference coordinates are integrated. Vision can direct body in space with the information in the body schema The foundation to Visual perception is the vestibular 、 proprioception and other senses

7. Visual-motor skills All movements through space and all interactions with objects –Ex. Interactions in the environment including kicking a ball & avoiding obstacles

8. The use of vision in reach and grasp Reach: need information about the distance and direction and location of object Preparation to Grasp: – a complex interplay of the motor system with the visual registration of the object ; –need information about the object ’ s size, shape and orientation; –eg. Differences of reaching for a horizontal & vertical rod; vision registers the differences in the orientation of the objects and without conscious awareness Touch the object: tactile input adjusts the hand pressure to qualities such as hardness and texture.

9. Vision & Balance –The influence of vision on balance is secondary to the integration of the vestibular, proprioceptive, and tactile signals –Postural control & vision are influenced with each other –Closed or open eyes have different impacts on balancing activities. –Optic flow ： eg. P. 129

10. Locomotion –Vision, vestibular, proprioceptive systems are critical for posture and balance –Vision is the important sensory system for walking –Moving through a room without bumping into objects requires accurate perception of the location of the objects and a central image of the boundaries of our bodies

11. Dealing with moving objects –Figure 12-21 (picture) –Some children have difficulties with this, Eg. can ’ t accurate in judging the speed and distance of oncoming cars and unable to cross a street alone. Eg. Catching a moving ball

12. Visual-spatial abilities and cognition Features within an object or design To understand the relationship between lines, angles, and curves in geometry or architecture or in visualizing potential chess moves Use spatial cognition to find our way around a new place or to move through familiar surroundings without getting lost

13. Two types of Visual-Spatial skills 1. Topographical orientation –An individual ’ s relationship to his environment –The basic component is the knowledge of the location of places with respect to oneself/ use the landmarks in the environment –The highest level:A spatial schema of the spatial relationship between multiple locations is to make spatial references and allows the use of shortcut, perspective thinking, and making of maps –Children with way finding problems can be taught with compensatory strategies eg. Verbal or visual cues.

14. 2. Object-focused spatial abilities –Spatial relations of objects themselves –Mostly assessed by tests due to the unclear functional implications of poor performance –Confounding factors: Attention, memory, or verbal facility Spatial dysfunction may not be evaluated by test

15. –Introduce two different types of object- focused spatial abilities 1. Spatial analysis The ability to analyze the position and relationship of objects Simple tasks: finding two lines that are in the same orientation Complex tasks: Chess; paper folding Space visualization test: part of it is for spatial analysis

16. 2. Constructional abilities A perceptual activity with a motor response that includes drawing and assembling (use of objects to construct a design) Construction: two-dimensional or three dimensional design Abilities: including spatial abilities, form perception, & cognitive abilities (attention, concentration, verbal facility)

17. Drawing & coping 1. For example: Imitation of drawing strokes, copying model with sticks; draw the model presented; drawing/copying the model from memory(model removed). 2. From simple lines to complex combination of forms. 3. Form discrimination to form reproduction are separate developmental skills

18. Handwriting 1. writing numbers and letters,check the space between words, horizontal alignment 2. Letter formation 3. Writing a page: attention to the edge of the paper, from top to down, or left to write.

19. Construction with objects 1. Manipulation of objects that must be assembled to match a model 2. Tasks: cube design

20. Central Auditory Processing Disorder (CAPD) Functional description: –A condition in which one has problems processing or interpreting auditory information when it is presented in a less than optimal listening environment Individual with CAPD have normal hearing on traditional pure tone and speech tests but unable to perform well on a CAP test

21. People with CAPD can hear even the faintest speech signals, but when listening to speech input in a dynamic auditory environment, they have difficulty understanding the speech message. It is probably distortion of the signal or an overloaded auditory system

22. Professionals do not recognize CAPD due to –Knowledge of the CANS(central auditory processing system) is limited –Traditional hearing tests are not designed to evaluate the complexity of the CANS –CAPD is viewed too simplistically –Terminology describing CAPD is often non specific and misleading –Audition stimuli are very transient in nature and cannot be held in time

23. Behaviors commonly seen in children with CAPD CAPD often co-existed with learning disability, ADD, ADHD, or SLI –Difficulties following directions –Distractible –Easily flustered and confused –Had short attention spans – were sensitive to loud sounds –Inconsistenly aware of sound: not always alerted by new auditory information in the same way as other children; poor listener –Delayed responses to verbal stimuli

24. Classroom behaviors –Daydreaming –Forgetfulness –Problems sitting still –Difficulty with time concepts –Problems completing assignements –Dislike of school –Excessive talking in the classroom –Parents classify children as underachivers

25. Social-emotional behaviors –Increased anxiety and tension –Low self-confidence –Increased frustration –Attention seeking –Temper tantrums –Being easily upset in new stiuations –Parents report that children prefer to play with younger children

26. Disinhabition behaviors(seen in ADD or ADHD too) –Irritability –Hyperactivity –Impulsivity –Disobedience –Rowdiness –Oppositional behaviors

27. Incidence & maturation Referral rates were three times higher for boys Incidence is not available Do know when or which children will develop a mature CANS Use age-normed tests to identify children with CAPD Its better to identify them under 9 y.o.