When our clinic receives a new patient, they undergo a Developmental Vision Evaluation (DVE). A DVE combines a thorough eye exam, visual processing, and a visual tracking test called RightEye.
The doctor tests for visual motor integration with Beery VMI and Wold Sentence copy. The doctor uses a Test of Visual Perceptual Skills (TVPS) to test for visual discrimination, visual memory, visual-spatial, visual form constancy, visual sequential memory, visual figure-ground, and visual closure. Jordan is used for visual-spatial perception (letter reversals). She also does a Dyslexia Determination Test to screen for dyslexia. The doctor uses the Test of Information Processing Skills (TIPS) for memory, which looks at visual memory, auditory memory, delayed recall, and word fluency.
The doctor does visual processing testing when the patient first does their initial evaluation, halfway through the program, and at the end of the program. By the halfway point in their program, we can look at the visual processing and incorporate more of what they need into their therapy program as a therapist. The patient should be at a point where they are getting better tracking and binocular function to make it a more fluent transition into visual processing activities. The goal in our office is for the patient to be higher than the 63rd percentile in all of the testing by the end of the program.
There are a variety of enjoyable processing games that we use to practice the necessary skills. We use Parquetry blocks, which primarily work visual-spatial and form constancy. Parquetry blocks are differently shaped and have different colors, and the patient has to look at a key card and copy what is on it. There are different levels of parquetry blocks; the easiest level is where the key card just has the outlines of shapes in a pattern without the color. The next level key card has the shapes' outlines and the shapes' colors, so the patient has to match the color and shape. The last level key card has just the colors and no outline of each shape. The patient can either place the shapes over the key card to match it up, or they can copy it separately from the card.
Hidden pictures is an activity that we use to work on figure-ground. In the activity, the paper gives the patient a list of objects to find in the bigger picture. There are different difficulties in hidden pictures, where the objects are easier and harder to find based on the level of the patient's needs or how old the patient is.
An activity that we use for visual closure is Geoboard. This activity is where the patients put rubber band(s) on a pegboard in a pattern we give them. The patient must make the pattern using as few rubber bands as possible. This activity has different difficulties, which are based on the patterns. The more difficult ones are intricate and require more than one rubber band. You can also make it more intricate by having the patient copy the pattern in the color combination shown to them. This activity can also be made into a visual memory game by showing them the pattern for a few seconds and having them make it based on memory.
Visual President is an activity that works on visual and sequential memory. We have a paper with many silly pictures that correlate to all of the presidents. For example, the first president was George Washington, and the picture is of a lady washing a ton of clothes. When teaching this activity, we start with the patient looking at the images and telling us the presidents based on the pictures. The next level of this activity is telling us all the presidents based on memory by visualizing the paper. The final level is being able to say the president backward to me. At the end of this activity, the patient should know all of the presidents in ascending and descending order.
Slap tap works on laterality, directionality, and processing speed. This activity lists p,q,b, and d’s randomly. Each letter correlates to a part of a body. P would be right hand, q is left hand, b is right foot, and d is left foot. At first, we have the patient read the chart by saying the intended part of the body. Then, we have the patient put the body movement to the words they are saying by either stomping or tapping the hand that is instructed. Once the patient gets a little better, we can add a metronome to have them follow the beat to make it harder.
Improving visual perception encompasses a range of tests and activities tailored to address a patient's needs. Through diligent assessments and engaging exercises, we aim to enhance visual processing skills, ensuring our patients experience a significant improvement in their overall visual function. The vision therapy procedures are designed to be adaptable, allowing us to tailor treatment plans to the unique requirements of each patient. We closely monitor progress throughout the therapy journey, regularly assessing performance and adjusting interventions as necessary. Our ultimate goal is to give the patients the tools they need to achieve optimal visual perception and information processing skills.
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