Perception

Perception

the integration or use of sensory information into meaningful information having implications for decisions or movement

True or false: perception does not equal sensation***

true!

Does cognition equal perception?

per Andy, cognition is a broader term of how we think, while perception is the integration of sensory information into those decisions

What are the two most common causes of perceptual impairments that affect ADL's, IADL's, jobs, and relationships?

TBI and CVA

Where does perception live at?

associated with the parietal association cortex. think of this as the junction of where the temporal, parietal, and occipital lobes meet

What would we typically see with body scheme and body image impairments?

- unilateral spatial neglect

- anosognosia

- asomatognosia

- R/L discrimination

- finger agnosia

Unilateral spatial neglect

inability to register or integrate stimuli and perceptions from one side of the body or environment; think that 1/2 of the world doesn't exist to an individual

Where is the lesion located when someone has unilateral spatial neglect?

right parietal lobe --> stroke on the right side means that there will be left sided neglect

What are some examples of unilateral sensory neglect?

- drawing all of the numbers on a clock on only one side

- not drawing one side of the house to finish it

- only eating one part of a plate of food

- if you ask someone to turn their head to the left, they will only turn their head a little bit because that is where they think the world stops

Anosognosia

denial/lack of awareness of one's impairments; often can be challenging to work with and have to develop ways for them to participate in therapy

What is an example of anosognosia?

a patient who has right sided LE weakness but doesn't think that they do. they will lean to the right when they stand, demonstrating that they have a strength impairment, but they don't believe that they truly do

Asomatoagnosia

lack of awareness of the body structure and the relationship of body parts; doesn't know how one distal body part relates to a more proximal part

What is an example of asomatoagnosia?

- experience difficulty with lifting up their foot and straighten their knee

- if you asked them to draw a body, they would not know where to put certain body parts and they would be displayed all over the paper rather than in their correct place

R/L discrimination

inability to identify right versus left sides; this is very profound and they cannot remember which is the right direction

What are some examples of R/L discrimination?

- performing an exercise and not sure which is right versus left

- driving

- getting dressed

What are some things that we would see with spatial relations disorders?

- figure ground discrimination

- form discrimination

- spatial relations

- position in space

- topographic disorientation

- depth and distance perception

- vertical disorientation

Figure ground discrimination

inability to visually distinguish a figure from the background in which it is embedded; can't make out an image that has a similar color/pattern as the background

What is an example of figure ground discrimination?

- driving at night in Grand Rapids and trying to see the stoplights with all of the other lights around

- the picture of the horses that have a white and brown pattern that are against a white and brown pattern

Form discrimination

inability to perceive or attend to subtle differences in form/shape or objects placed in an unusual position

What are some examples of form discrimination?

- not being able to tell that a tree is a tree because it is upside down

- can't tell that a razor is a razor because the sharp side is facing upwards rather than facing down

Spatial relations

inability to perceive the relationship of one object in space to another object

What are some examples of spatial relations?

- standing at the sink and having a difficult time reaching for toothbrush

- sitting at dinner table and having difficult time reaching for cup

- having a hard time bringing fork to mouth to eat

Position in space

inability to perceive or interpret spatial concepts such as up, down, in, out, behind, and under

What are some examples of position in space?

- not being able to understand the relationship of putting the yellow swissball above the ankle weights

- not being able to understand a picture that has a pencil above a rock

Topographic disorientation

difficulty in understanding and remembering the relationship between one location to another; hard time finding way in different places; difficult time looking at map and determining the relationship to where they are and where they need to go

What are some examples of topographic disorientation?

- taking someone to the front desk in the clinic and having them walk back to their table and having a difficult time doing so

Depth and distance perception

inaccurate judgement of direction, depth, and distance

What is an example of depth and distance perception?

- throwing a swiss ball at someone and they have a difficult time catching it

- going down stairs (think of how this is difficult when we are under the influence of alcohol)

Vertical disorientation

distorted perception of what is vertical; we usually think of vertical as straight up and down, but certain individuals may see it as titled a little bit and then they have to recorrect this by laterally flexing their neck a little bit

Why is vertical disorientation a big deal?

the potential for contractures due to specific body parts being kept in a position for long periods of time

Visual agnosia

inability to recognize familiar objects despite normal function of the eyes; the hardware is intact (cranial nerve II, but the ability to perceive this information is not working properly)

What is an example of visual agnosia?

- looking at a pencil but being unable to identify what it is and need help via context clues

Prosopagnosia

the inability to recognize familiar faces, including one's own; face blindness; can see faces, but when looking at someone that is familiar to us, it doesn't register that we know them

What is an example of prosopagnosia?

a patient you have seen before does not register that it is you they are looking at, and have to rely on other cues in order to determine who it is

Auditory agnosia

inability to recognize non-speech sounds or discriminate between them; hearing structures are intact and can hear speech, but unable to distinguish between non-speech sounds

What are some examples of auditory agnosia?

- at a stop sign and not knowing that the sound you are hearing is an ambulance

- in school and not knowing that they sound you hear is a fire alarm

Tactile agnosia

inability to recognize forms by handling them through tactile means, while temperature and proprioceptive input is intact; unable to identify something by touch and difficulty determining it until we can see it

What is an example of tactile agnosia?

holding a paper clip in your hand and being unable to distinguish what it is until you open your eyes

Ideomotor apraxia

breakdown between concept and performance; we have the idea to move, but the execution of that particular movement does not occur

- remember, NOT a coordination issue as then this would be a cerebellar issue

- difficulty with EXECUTION of a task

What are some examples of ideomotor apraxia?

- being told to wave goodbye and moving the hand up and down rather than side to side

- asking to blow a kiss but just puffing out air rather than bringing your hand to mouth to make the motion

Ideational apraxia

failure in the conceptualization of a task; using a specific object for the wrong task; can't conceptualize a plan to use an object for what you are supposed to use it for

What are some examples of ideational apraxia?

- standing at the sink and using toothbrush to try and shave

- using a fork to try and brush hair

- using razor to try and brush teeth