CEREBRAL VISUAL IMPAIRMENT IN CHILDREN WITH CEREBRAL...
1
INTRODUCTION Cerebral visual impairment (CVI) is the most common bilateral visual disorder in children in the western world, expressing damage or malfunctioning of retrochiasmatic visual pathways. The incidence in children with cerebral palsy (CP) is approximately 60‐70%. Many of these children often present visual agnosia and and visual‐spatial disorders. Such difficulties could express maturation and integration abnormalities of the two primary visual systems. Conventional tools are often inappropriate for rehabilitation treatment and neuropsychological evaluation as they require adequate processing of visual information. If the quality or quantity of visual input are impeded during the critical period of infancy the impact on future visual development may in some cases be irreversible. RESULTS CONCLUSIONS This complex disorder can affect social, cognitive, communicative and motor development and requires knowledge of the range of potential intervention approaches. For infants and very young children, the goals are to maximize the use of the child’s existing vision, and when possible, to encourage further development of visual skills and behaviors. The data show the effectiveness of this intervention to promote visual skills and their use in all cases. The visual recognition skills related to ventral stream processing and the visuospatial skills related to dorsal stream procession were increased. The results suggest to us the need to continue the research project to verify the effectiveness of early specific cognitive‐visual training on a large sample of children affected by CP and CVI. Training: increasing the cognitive visual functions CEREBRAL VISUAL IMPAIRMENT IN CHILDREN WITH CEREBRAL PALSY: AN EARLY INNOVATION INTERVENTION Lijoi I a , Cappelli FR a , De Meis I b , Morocutti A a , Martini A a , Lettori D a & Castelli E a a Department of Neurosciences and Neurorehabilitation, IRCCS Children's Hospital Bambino Gesù, Santa Marinella, Rome, Italy. b CARIS, University Commission of the University of Rome Tor Vergata for the inclusion of Students with disabilities and Specific Learning Disorder, Rome, Italy e-mail: [email protected] PATIENTS AND METHODS % Spacial exploration tasks Shape matching of moving tridimensional objects Real objects and pictures matching, recognition and naming Visual graphic and visual constructive The software “Tridimensional moving objects” (designed and implemented by Italian Pediatric Neuro‐ rehabilitation Unit of Hospital “Bambino Gesù” in collaboration with Anahita Mobarhan, who teaches 3D animation at the Academy of Art in Chicago) includes 30 3D moving objects, sorted by their typical shape of reference (10 referable to sphere, 10 to parallelepiped and 10 to cylinder). It was taken into account that within the reference age group, children with typical development acquire the ability to categorize by prototypical shape. This ability represents the base for teaching in preprimary schools. References ATKINSON, J. [2000], The developing visual brain. Oxford: OUP (Oxford Psychology Series 32). BOVA, S. M., FAZZI, E., GIOVENZANA, A. [2007], The development of visual object recognition in school‐age children. Developmental Neuropsychology, 31 (1), 79‐102. DE MEIS, I., LIJOI, I., RAZZANO, C. & CAPPELLI, F. R., Visual disorder of central origin in developing age: evaluation protocol. (2010, Master Thesis in Speech Therapy, Tor Vergata University –RM, Italy–) DUTTON, G., BAX M. [2010], editors, Visual Impairment in Children Due to Damage to the Brain. London: Mac Keith Press. DUTTON, G. N [2015], The Brain and Vision. In A. Lueck & G. Dutton (Eds), Vision and the brain: Understanding cerebral visual impairment in children. New York: AFB Press. FAZZI, E.,et al. [2007], Spectrum of Visual disorders in Children with Cerebral Impairment. J Child Neurol, 22, 294. FAZZI, E. et al [2009], Cognitive visual dysfunctions in preterm children with periventricular leukomalacia. Developmental Medicine and Child Neurology, 51, 12. GUZZETTA, A., MERCURI, E., & CIONI, G. [2001], Visual disorders in children with brain lesions: 2. Visual impairment associated with cerebral palsy. European Journal of Paedriatic Neurology, 5 (3), 115‐119 HUMPHHREYS, G.W., & RIDDOCH, M. J al [2006], Features, objects, action: The cognitive neuropsychology of visual object, action: The cognitive neuropsychology, 23 (1), 156‐183. LIJOI, I., DE MEIS, I., RAZZANO, C. & CAPPELLI, F. R., Visual disorder of central origin in developing age: visual‐cognitive training. (2010, Master Thesis in Speech Therapy, Tor Vergata University –RM, Italy. PAGLIANO, E., et al. [2007], Cognitive profiles and visuoperceptual abilities in preterm and term spastic diplegic children with periventricular leukomalacia. Journal of Child Neurology, 22(3), 282–288. ROMAN‐LANTZY C. al [2007], Cortical Visual Impairment: An Approach to Assessment and Intervention. New York, NY: AFB Press. 0 10 20 30 40 50 60 70 80 90 PRE-TRAINING POST-TRAINING Training: 40 rehabilitation sessions Cycle I: 20 sessions Cycle II : 20 sessions Interval between 2 cycles: 5 months This preliminary study reports the data from seven cases whose participants underwent this specific intervention aiming at increasing cognitive visual functions. The rehabilitation program, aimed at children aged 48‐78 months, was administered after comprehensive neuropsychological testing and a formal assessment of cognitive visual functions. The criteria used for selecting participants were: diagnosis of CP, spoken language acquisition, ability to use at least one upper limb in pointing, reaching, and grasping activities, visual acuity greater than 3/10, and an IQ greater than 50. The intervention involved visual recognition skills related to ventral stream processing and visuospatial skills related to dorsal stream procession. Specific tasks included space exploration, shape matching of moving tridimensional objects using a software program, the matching of objects and pictures, recognition and naming, and visual graphic and visual constructive training. The tools (objects, pictures, and software) were used by a sample group of 55 Italian children with typical development who were aged 39 to 78 months. Sample: 7 children with CVI and CP 4 and 3 Mean age: 4 years and 9 months Mean gestational age at birth was 30 weeks The results of the evaluation before and after treatment show the effectiveness of this intervention in all cases. In particular the improvement of matching, recognition and naming tasks was clinically significant in each child. The data show a meaningful and parallel increase of visual spatial skills, fluent reasoning and black‐ and‐ white pictures naming. This intervention may allow the implementation of prevention strategies and improve outcome. Children that have reached school age have had access to the learning of reading‐writing. Legend: VMI: Developmental Test of Visual-Motor Integration, K.E. Beery, 2007 SVP: supplemental Visual Perception test (Vmi, K.E. Beery, 2007) SMC: supplemental Motor Coordination test (Vmi, K.E. Beery, 2007) TVPS-R: Test of Visual-Perceptual Skills (n-m) Revised, Gardner,1987) Leiter-R: Leiter International Performance Scale-Revides, Roid e Miller,2002 ABCDEFV: A Battery of Child Development for Examining Functional vision, Atkinson,2002. PPVT: Peabody Picture Vocabulary Test, Stella, 2000. BOSTON: Boston naming test, Riva, 1998. TPL: Test del primo linguaggio, Axia, 1995. VISUAL RECOGNITION SKILLS % data VISUO SPATIAL SKILLS centile data
Transcript of CEREBRAL VISUAL IMPAIRMENT IN CHILDREN WITH CEREBRAL...
![Page 1: CEREBRAL VISUAL IMPAIRMENT IN CHILDREN WITH CEREBRAL …edu.eacd.org/sites/default/files/Meeting_Archive/... · [2007], Spectrum of Visual disorders in Children with Cerebral Impairment.](https://reader034.fdocuments.in/reader034/viewer/2022043021/5f3ca914f08b952ec358fc9c/html5/thumbnails/1.jpg)
INTRODUCTIONCerebral visual impairment (CVI) is the most common bilateral visual disorder inchildren in the western world, expressing damage or malfunctioning ofretrochiasmatic visual pathways. The incidence in children with cerebral palsy (CP)is approximately 60‐70%. Many of these children often present visual agnosia andand visual‐spatial disorders. Such difficulties could express maturation andintegration abnormalities of the two primary visual systems. Conventional tools areoften inappropriate for rehabilitation treatment and neuropsychological evaluationas they require adequate processing of visual information. If the quality or quantityof visual input are impeded during the critical period of infancy the impact onfuture visual development may in some cases be irreversible.
RESULTS
CONCLUSIONS
This complex disorder can affect social, cognitive, communicative and motor development and requires knowledge of the range of potential interventionapproaches. For infants and very young children, the goals are to maximize the use of the child’s existing vision, and when possible, to encourage furtherdevelopment of visual skills and behaviors. The data show the effectiveness of this intervention to promote visual skills and their use in all cases. The visualrecognition skills related to ventral stream processing and the visuospatial skills related to dorsal stream procession were increased. The results suggest to us theneed to continue the research project to verify the effectiveness of early specific cognitive‐visual training on a large sample of children affected by CP and CVI.
Training: increasing the cognitive
visual functions
CEREBRAL VISUAL IMPAIRMENT IN CHILDREN WITH CEREBRAL PALSY: AN EARLY INNOVATION INTERVENTION
Lijoi I a, Cappelli FR a, De Meis I b, Morocutti A a , Martini A a , Lettori D a & Castelli E aa Department of Neurosciences and Neurorehabilitation, IRCCS Children's Hospital Bambino Gesù, Santa Marinella, Rome, Italy.
bCARIS, University Commission of the University of Rome Tor Vergata for the inclusion of Students with disabilities and Specific Learning Disorder, Rome, Italy
e-mail: [email protected]
PATIENTS AND METHODS
%
Spacial exploration tasks
Shape matching of moving tridimensional objects
Real objects and pictures matching, recognition and naming
Visual graphic and visual constructive
The software “Tridimensional moving objects” (designed and implemented by Italian Pediatric Neuro‐rehabilitation Unit of Hospital “Bambino Gesù” in collaboration with Anahita Mobarhan, who teaches3D animation at the Academy of Art in Chicago) includes 30 3D moving objects, sorted by their typicalshape of reference (10 referable to sphere, 10 to parallelepiped and 10 to cylinder). It was taken intoaccount that within the reference age group, children with typical development acquire the ability tocategorize by prototypical shape. This ability represents the base for teaching in preprimary schools.
References
ATKINSON, J. [2000], The developing visual brain. Oxford: OUP (Oxford Psychology Series 32).
BOVA, S. M., FAZZI, E., GIOVENZANA, A. [2007], The development of visual object recognition in school‐age children. Developmental Neuropsychology, 31 (1), 79‐102.
DE MEIS, I., LIJOI, I., RAZZANO, C. & CAPPELLI, F. R., Visual disorder of central origin in developing age: evaluation protocol. (2010, Master Thesis in Speech Therapy, Tor Vergata University –RM, Italy–)
DUTTON, G., BAX M. [2010], editors, Visual Impairment in Children Due to Damage to the Brain. London: Mac Keith Press.
DUTTON, G. N [2015], The Brain and Vision. In A. Lueck & G. Dutton (Eds), Vision and the brain: Understanding cerebral visual impairment in children. New York: AFB Press.
FAZZI, E.,et al. [2007], Spectrum of Visual disorders in Children with Cerebral Impairment. J Child Neurol, 22, 294.
FAZZI, E. et al [2009], Cognitive visual dysfunctions in preterm children with periventricular leukomalacia. Developmental Medicine and Child Neurology, 51, 12.
GUZZETTA, A., MERCURI, E., & CIONI, G. [2001], Visual disorders in children with brain lesions: 2. Visual impairment associated with cerebral palsy. European Journal of Paedriatic Neurology, 5 (3), 115‐119
HUMPHHREYS, G.W., & RIDDOCH, M. J al [2006], Features, objects, action: The cognitive neuropsychology of visual object, action: The cognitive neuropsychology, 23 (1), 156‐183.
LIJOI, I., DE MEIS, I., RAZZANO, C. & CAPPELLI, F. R., Visual disorder of central origin in developing age: visual‐cognitive training. (2010, Master Thesis in Speech Therapy, Tor Vergata University –RM, Italy.
PAGLIANO, E., et al. [2007], Cognitive profiles and visuoperceptual abilities in preterm and term spastic diplegic children with periventricular leukomalacia. Journal of Child Neurology, 22(3), 282–288.
ROMAN‐LANTZY C. al [2007], Cortical Visual Impairment: An Approach to Assessment and Intervention. New York, NY: AFB Press.
0102030405060708090
PRE-TRAININGPOST-TRAINING
Training: 40 rehabilitation sessions Cycle I: 20 sessionsCycle II : 20 sessionsInterval between 2 cycles: 5 months
This preliminary study reports the data from seven cases whose participantsunderwent this specific intervention aiming at increasing cognitive visual functions.The rehabilitation program, aimed at children aged 48‐78 months, wasadministered after comprehensive neuropsychological testing and a formalassessment of cognitive visual functions.The criteria used for selecting participants were: diagnosis of CP, spoken languageacquisition, ability to use at least one upper limb in pointing, reaching, and graspingactivities, visual acuity greater than 3/10, and an IQ greater than 50.The intervention involved visual recognition skills related to ventral streamprocessing and visuospatial skills related to dorsal stream procession.Specific tasks included space exploration, shape matching of moving tridimensionalobjects using a software program, the matching of objects and pictures, recognitionand naming, and visual graphic and visual constructive training.The tools (objects, pictures, and software) were used by a sample group of 55Italian children with typical development who were aged 39 to 78 months.
Sample: 7 children with CVI and CP 4 and 3Mean age: 4 years and 9 monthsMean gestational age at birth was 30 weeks
The results of the evaluation before and aftertreatment show the effectiveness of thisintervention in all cases. In particular theimprovement of matching, recognition andnaming tasks was clinically significant in eachchild.
The data show a meaningful and parallel increaseof visual spatial skills, fluent reasoning and black‐and‐ white pictures naming.
This intervention may allow the implementationof prevention strategies and improve outcome.Children that have reached school age have hadaccess to the learning of reading‐writing.
Legend:
VMI: Developmental Test of Visual-Motor Integration, K.E. Beery, 2007SVP: supplemental Visual Perception test (Vmi, K.E. Beery, 2007)SMC: supplemental Motor Coordination test (Vmi, K.E. Beery, 2007)TVPS-R: Test of Visual-Perceptual Skills (n-m) Revised, Gardner,1987)Leiter-R: Leiter International Performance Scale-Revides, Roid e Miller,2002
ABCDEFV: A Battery of Child Development for Examining Functional vision, Atkinson,2002.PPVT: Peabody Picture Vocabulary Test, Stella, 2000.BOSTON: Boston naming test, Riva, 1998.TPL: Test del primo linguaggio, Axia, 1995.
VISUAL RECOGNITION SKILLS % data VISUO SPATIAL SKILLS centile data
