DS completed the TVPS this week at the optometrists office. Next week is the vision therapy test (where they look at eye teaming, binocularity etc.)
He did very well on the TVPS. With the exception of one subtest (where he had to remember and image and then find it on the next page) he basically got everything right. Including other subtests that also tested visual memory. I remember from his neuropsych. he surprised us all by getting a perfect score on a figure-ground test. He did demonstrate alot of reversals when he had to write, or read letters however.
What I observed was also consistent with his neuropscyh exam: he had good focus, worked methodically, answered correctly but is SLOW. After 45 minutes he pooped out. She characterized him as a good thinker - but it seems like the thinking is fatiguing for him.
The Dr. didn’t give me the test scores yet, but told me did very well, and I could see her scoring sheet too. She said she thinks she’ll find deficits next week at the VT evaluation and that his issues are not perceptual.
I think I understand that the visual perceptual is a part of the overall visual processing system. but I’m not clear on if this is also a measure of visual /spatial? Could he could have visual/spatial deficits (which I believe he does have) that don’t show up on the TVPS?. This is a kid that bumps into things and always puts his glass on the edge of the table. It also seems clear to me that once again his issues are motor and processing speed .
Can someone clarify if I understand this correctly?
Re: TVPS results and my puzzling child
Is he ADHD or ADD? Those problems might be characterized as an “output” problem, rather than visual-perceptual input difficulties. Look at Russell Barkley’s writings on executive function problems…just a thought.
Re: TVPS results and my puzzling child
Well, *I* bump into things and *I* put my glass on the edge of the table. Yesterday I was fatigued and I spilled hot lasagna all over a light blue sofa and my green sweater. Facts of life for us with visual problems.
The following may be like your son, and may be some of the same thing going on:
My bumping into things is because of years of deliberately mistreated focus problems — my eyes do not focus at the same point due to astigmatism allied with farsightedness. Over the years this led to amblyopia and my left eye is nearly useless — it works fine physically, but the brain suppresses the images to reduce the confusion. Since the particular eye problems that I have are unusual in young children, and I pass the eye chart with flying colours (I am *far* sighted, darnit!) the “experts” of the time chose to blame it on some sort of Freudian thing. Your son may have some problem that is causing difficulty in focus and coordination of his eyes, which may not necessarily show up in certain tests. It’s worth getting second and third opinions, and different *kinds* of testing (see below).
As far as putting the glass on the edge of the table, this became a bone of contention with my ex-husband (there are reasons he’s an ex). I have improved my coordination to the point that I can pass as normal unless I’m very fatigued (as with the lasagna). My daughter has always been quite good for her age; I don’t like plastic and she used china dishes and real glass before age 2, and she breaks less than I do. Well, the ex, her step-dad starting at age 8, took to screaming at both of us for leaving glasses at the edge of the table, as well as for other things that didn’t suit his worldview. Now, we were *not* knocking the glasses off and breaking them; he just screamed because he decided that we *would* do so. He moved the glasses to where he thought was the correct place — and then we did start spilling them. Of course part of that was the stress of being screamed at every supper. But, I realized, the edge placement made sense for other reasons. Because my left eye doesn’t work, I don’t have any binocular vision. (funny note below) I have to use other coping skills and sources of info to get depth. I am a very very careful driver with a perfect record, because I *do* do this. If a glass is in the middle of the table, with the transparent glass and reflections and no other clues as to how for away it is, I have a very, very hard time judging where to reach for it, and I will knock it over as often as not. But if the glass is towards the edge off to my side, I have all sorts of distance clues from the table’s edge, shadows,. and so on. In fact I am far *less* likely to spill a glass that I have neatly placed near the edge than one in the middle of the table. Your son may be doing something of the same kind of thing.
Funny story: I have very minimal depth perception, using the 10% function that remains in my left eye, shadows, size, position, perspective, and all sorts of other clues. I usually fake my way to a minimum score on depth perception. Well, one day the eye doctor came up with a new test that tested specifically binocular vision without all the other environmental clues I use. The test was a card with the “fly’s eye” grooved lens, the kind of thing where if you move it you see two different views of an object. This one was divided into eight sections of increasing difficulty, and all you had to do was to look at the picture and tell which dog was farther away and which closer; the difference between your two eyes was supposed to give the illusion of distance. The first was supposed to be extremely obvious, a sort of control question to see if you understood the directions. Well, I couldn’t even do that one. The doctor was very shocked and worried.
I have no hope of ever doing those “magic eye” pictures either.
Your son may have something similar, a problem of coordinating the two eye’s images in his brain, so that one is suppressed. Keep working on finding out, and meanwhile, also help him learn coordination in other ways; skiing and art lessons helped me a lot.
Re: TVPS results and my puzzling child
Wow Karen,
That is so similar to Joe. He surprised us by scoring amazingly high on TVPS assessments given both by at OT and again by an optometrist. I know he sorts through stationary visual information quite well—but when a spatial element or movement is introduced, he falls apart. Unlike your son, however, he has a left lazy eye and the resultant problems including a lack of binocular function and minimal depth perception.
On his most recent assessment he scored poorly on delayed spatial recall, short term spatial recall and speed in visual scanning but did very well with matrices, recall of designs (visual memory) and pattern construction. I am not exactly sure how to tackle this particular problem and it has been on my mind a while.
I too think this is locked up somewhere with the speed and motor issues. I am sure there can be good visual processing with poor spatial processing. Many of the programs target visual processing skills rather than spatial skills…but I am still looking. I am certain we have to work on scanning. If I find anything in my travels, I will pass it on.
Ciao for now,
Margo
YES!
I’m not sure where to go with this, but I really related to your post. Its the introduction of movement, and speed. Reminds me of why ended up at the OT many years ago. He could copy movement A, or movement B, but couldn’t putit together. It was subtle.
I’ll share what ever I learn as we continue…
Good question.. one I keep asking...
He’s not ADHD. We have asked , and been asked, about ADDinattentive. He is so dreamy and inattentive sometimes. But our psychiatrist didn’t feel (after doing the conners with his teacher and us and based on his own observations) that he met the criteria.
He for sure has executive function issues. Your comments on output vs. input have me thinking…. thanks , again.
Re: YES!
My son has both types of problems so I don’t really understand how you separate them.
Visual spatial is definitely the biggest problem. He scored in the 1% even after a year of OT where this was addressed and I did see writing gains.
One interesting thing that some might find interesting. He is a whiz at vocabulary but could not grasp the words rotate and revolve. Not even with mom spinning on her axis trying to get it in his little brain.
My son’s optometrist thinks this problem will be solved.
I am curious about one other thing:
Do all the kids who have visual spatial problems also have bilateral motor and directionality problems? We are going to VT tonight. I will ask the therapist.
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