1. Karen Hookstadt, OTR Spalding Rehabilitation Hospital

2.  Discuss the use of technology and how it can improve an individual’s visual and motor skills  Define the role of our visual system and how deficits affect performance in daily activities  Identify commonly used terminology in relation to visual skills

3.  Originally designed as a device to improve visual motor skills of athletes  Then adapted to provide the same benefits to individuals with visual motor deficits resulting from an injury or disease  Mary Warren PhD, OTR/L, SCLV, FAOTA (highly respected in OT and vision) recognized the device and the training programs as being useful within the rehabilitation field

4.  Large, height adjustable board (4 x 4 feet)  64 contoured LED switches  Five concentric rings/Four quadrants  Choice of Red or Green LED lights  Central Focal LCD screen  Audible feedback with correct responses  Game-like presentation, challenging levels  Computer Netbook: Patient database (history storage)

6.  Stroke  TBI (acquired or non-traumatic)  MS  Vestibular and Balance Disorders  Presentation of the following deficits: unilateral inattention, neglect, visual field loss, hemianopsia, or suppression.  Additional uses: sustained attention, divided attention, eye-hand coordination, reaction time, balance, endurance, UE AROM Contraindicated for clients with photo sensitive seizure disorders.

7.  Fixation: ability to direct and maintain steady eye gaze on a target  Scanning: visual search that requires attention and combines smooth and quick movements of the eyes to locate objects or targets in the surrounding environment  Smooth pursuits: eye movements that maintain continued fixation on moving targets

8.  Saccades: quick, discontinuous but simultaneous movements of both eyes in the same direction (visual search and then fixate onto an target)  Accommodation: ability to adjust visual focus at varying distances (convergence/divergence)

9.  Exhibit difficulty localizing or orienting visual stimuli or objects  Orientation of their body in space (ability to orient to midline)  Significant eye gaze or preference to uninvolved side OR reluctant to move their head past midline  Frequently bump into objects  Have difficulty initiating or coordinating movements

10.  Difficulty with self care, mobility and transfers  Depth perception (judging distances between objects, curb height, etc)  Anxiety moving in busy environments  Display limited functional cognitive skills (attention, memory, processing, multi- tasking)  Complain of disorientation (especially when moving, such as riding in a car)

12.  Primary method of gathering and processing environmental information  Postural alignment and control (vision leads our movement patterns)  Social interaction: visual system allows us to interpret body language, maintain eye contact

13.  Vision assists in our ability to engage in any cognitive activity and allows us to make decisions upon what we are interpreting (reading, writing, safety awareness, navigating in the environment, driving, etc)  When our vision is compromised our overall ability to process information slows significantly

14.  Mode A: self pacing program (light only turns off when the client touches it); facilitate visual scanning  Mode B: automatic presentation of stimulus (machine timed stimulus); facilitates reaction time  Mode B with Flash Option: challenging higher functioning individuals, incorporates divided attention (visual, physical and cognitive component)  Reaction time: able to assess visual and physical reaction times  Endurance Test: sustained attention- program continues for 4 minutes

15.  Lets see it in action

16.  Because of the relatively recent introduction of the Dynavision into rehabilitation centers, the published literature surrounding the use of this device in rehabilitation is limited  Over 600 rehabilitation centers are currently utilizing the Dynavision in treatment Websites:  Dynavisiond2.com  visABILITIES.com