perceptual function in adult physical dysfunction

PERCEPTION

• refers to the integration of sensory

  information by the brain to make sense of

  the environment and the body.

• allows individuals to interpret visual,

  tactile, auditory, proprioceptive, and

  other sensory inputs in a meaningful way.

• critical in occupational therapy because

  they directly impact how clients interact

  with their environment and perform

  everyday tasks

Types of Perceptual Functions

• Visual Perception

• spatial awareness

• body schema perception

• motor perception

• tactile perception

Visual Perception

• Understanding and interpreting what we

  see.

Spatial Awareness

• Knowing the position of our body in space.

Body Schema Perception

• Awareness of body parts and movement.

Motor Perception

• Planning and coordinating purposeful movement.

Tactile Perception

• Identifying textures, temperatures, and object properties through touch.

Common Conditions Affecting Perception in Adults

• CVA - hemianopsia, unilateral neglect, impaired spatial awareness

• TBI - difficulty recognizing objects, impaired proprioception

• parkinson’s disease - visual-spatial deficits, difficulty with movement perception

• multiple sclerosis - sensory-perceptual changes, impaired depth perception

• dementia - agnosia (difficulty recognizing objects, sounds, or faces)

Sensory-Perceptual Awareness

perceptual functions

• proprioception

• kinesthesia

proprioception

• Awareness of

  body/joint position

  without visual input.

• Poor balance,

  clumsiness, and

  difficulty

  manipulating

  objects.

• Difficulty buttoning

  a shirt without

  looking at hands.

Kinesthesia

• Awareness of body

  movement.

• Trouble judging

  speed, force, or

  direction of

  movement.

• Overreaching or

  applying too much

  pressure when

  writing.

Body Perception and Awareness

• body image

• body scheme

body image

• Internal view of one’s body size, shape, and function.

• Distorted perception of self, often seen in body dysmorphia or post-amputation.

• A person with amputation still perceives the limb to be present (phantom limb).

body scheme

• Internal map of body parts and their relationships.

• Disorientation in movement and positioning.

• Child misplaces hands when trying to clap or self-feed.

spatial perception

• r/l discrimination

• unilateral neglect

• topographical disorientation

• figure-ground discrimination

• depth perception

• spatial relations

• position in space

Right/Left Discrimination

• Ability to distinguish right from left.

• Mistakes in following directional cues, especially in self-care or mobility.

• Wearing shoes on the wrong feet.

unilateral neglect

• Inattention to one side of the body/space, often after stroke.

• Increased safety risk, functional dependence.

• Ignoring food on one side of the plate.

topographical disorientation

• Inability to navigate familiar surroundings.

• Getting lost in known environments.

• Patient gets lost going back to hospital room.

figure-ground

• Distinguishing objects from background.

• Trouble identifying items in cluttered spaces.

• Unable to find white shirt in a white drawer.

depth perception

• Awareness of distance between objects and self.

• Falls, spillage, poor judgment of spatial relationships.

• Misjudging stair height or pouring water into a glass.

Spatial Relations

• Understanding object positions in relation to each other and self.

• Misplacement or misalignment of objects.

• Struggles to align toothbrush in cup holder.

Position in Space

• Understanding directionality (above, below, behind, etc.).

• Confusion during navigation or organizing objects.

• Puts items under instead of inside a drawer.

Visual-Cognitive and Recognition Deficits

• homynymous hemianopsia

• form perception

• agnosia

• apraxia

homonymous hemianopsia

• Visual loss on the same side in both eyes.

• Misses items on affected side; at risk of accidents.

• Bumps into door frames on the left side.

Form Perception

• Identifying objects by shape or structure.

• Difficulty with recognition and classification.

• Unable to differentiate between a fork and a spoon.

Agnosia

• Inability to recognize objects, people, or sounds.

• Misidentification leading to functional and safety issues.

• Mistakes a toothbrush for a comb.

apraxia

• Impaired motor planning despite intact motor system.

• Inability to execute learned tasks.

• Puts pants on arms or tries brushing hair with a spoon.

Occupational Therapy Interventions

• Restorative Approaches (Neuroplasticity-Based)

• Compensatory Strategies (Adaptive Techniques)

• Task-Specific Training (Functional Rehabilitation)

Restorative Approaches (Neuroplasticity-Based)

• These techniques are based on the principle of

  neuroplasticity—the brain’s ability to reorganize

  and form new connections through experience

  and repetition.

• Sensory Re-Education

  • Used for proprioception and kinesthetic deficits.

  • Includes weight-bearing exercises, joint compression, and sensory stimulation.

• Constraint-Induced Movement Therapy (CIMT)

  • Restricts the unaffected limb to encourage use of the affected limb

  • Helps improve body scheme awareness and motor planning.

• Visual Scanning Therapy

  • Trains patients to scan the entire visual field.

  • Used for neglect and hemianopsia.

  • Methods: Anchoring techniques (e.g., colored markers on the left side), verbal cues, structured reading tasks.

• mirror therapy

  • Uses a mirror to create visual feedback for a weakened limb.

  • Effective for proprioception, kinesthesia, and body image disorders.

• Graded Motor Imagery

  • Sequential training from imagined movements to real movement.

  • Used in apraxia and somatosensory impairments.

Compensatory Strategies (Adaptive Techniques)

• When full recovery is not possible, OTs use

  adaptive techniques to help clients perform

  tasks in new ways or with assistive devices.

Compensatory Strategies (Adaptive Techniques)

• Environmental Modifications

  • High-contrast markings for depth perception issues. Decluttering for figure-ground discrimination deficits. Clear signage for topographical disorientation.

• Visual and Auditory Cues

  • Verbal prompts for right-left discrimination issues. Tactile guides (e.g., raised dots on buttons) for spatial deficits.

• assistive devices

  • Prism glasses for hemianopsia. Large-print labels for visual perceptual deficits.

• One-Handed Strategies for Neglect

  • Placing objects on the unaffected side. using mirrors to enhance awareness

• errorless learning for apraxia

  • Breaking tasks into simple steps. Using physical guidance before verbal cues.

Task-Specific Training (Functional Rehabilitation)

• This approach focuses on practicing meaningful tasks in the real-world context, using motor learning principles.

• Dressing Training

  • Simplified dressing techniques (e.g., Velcro instead of buttons).

  • Color-coded shoes for right-left discrimination deficits.

• Gait and Balance Training

  • Step-by-step navigation training for topographical disorientation.

  • Obstacle courses to improve spatial awareness.

• Feeding and Eating Strategies

  • Contrasting plates for figure-ground discrimination deficits.

  • Using a finger to locate the edge of a glass before drinking.

• Handwriting and Fine Motor Training

  • Raised-line paper for spatial awareness.

  • Verbal cues for letter formation in apraxia.

• Community Reintegration

  • Route-finding exercises for navigation deficits.

  • Shopping and banking tasks with environmental cues.