assessment of visual functioning with special reference to infants lea hyvärinen, md, phd, faap...
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Assessment of visual functioning with special reference to infants
Lea Hyvärinen, MD, PhD, FAAP
Professor h.c., Rehabilitation Sciences, University of Dortmund
Senior Lecturer, Developmental Neuropsychology, Univ. of Helsinki
www.lea-test.fiTampa USF October 2011
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Visual communication
Eye contact, copying of expressionsAt 6 weeks, 8 weeks at the latest
Social smile, active interaction at the age of 12 weeks.
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Communication – at 8 weeks
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Eye contact and social smile
Normal eye contact at 6 weeks, social smile at 12 weeks.
Insufficient accommodationMirror neuron system
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Eye contact and social smile
Insufficient accommodation
Near correction
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Recommended assessments
• Following functions should be assessed in all infants:
• eye contact and social smile (accommodation )• grating acuity as detection acuity• contrast sensitivity for communication
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Grating Acuity & Heidi Face as detection acuity & communcation distance
Detection tests
Preferential looking
2.5%
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Hiding Heidilow contrast pictures for assessment of communication distance
Nordic faces and shadows of facial expressions are at low contrast.
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Recommended assessments
• Following functions should be assessed in all infants:
• eye contact and social smile• grating acuity as detection acuity • contrast sensitivity for communication• refractive errors, confrontation visual fields• ocular motor functions, including accommodation • observation of hand functions and copying them
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Infant artists’
Mirror neuron functions
Photo: Päivi Setälä
At the Art MuseumPori, Finland
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Recommended assessments
• Following functions should be assessed in all infants : • eye contact and social smile• grating acuity as detection acuity • contrast sensitivity for communication• refractive errors, confrontation visual fields• ocular motor functions, including accommodation • observation of hand functions and copying them
• face recognition of family members
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Infants at risk
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Accommodation inHypotonic infants
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Compensating accommodation
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Watching simple picturestwo years later
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Infants at risk Delayed motor development in premaurely born infants
15Combined effect of visual and motor disorder delays the development of an infant in all functional areas.
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Constricted visual field
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Large illuminated ball used by child’s own therapist.
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Fixation
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Brief fixation on the middlesize picture of face
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Accommodationdifficult to measure when the infant does not look at
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Mother’s face and voiceused as the target.
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Eye contactwhen reading lenses give a clear image on the retina
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Reaction during assessment of her brothernoises and body language show disapproval
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Visually activeten weeks later: improved visual and motor functions
21RE: GrA less than in LE > trainingas a part of physiotherapy
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Infants at risk
• Infants with delays/difficulties in communcation• All hypotonic infants: brain damage, Down• All infants with Down syndrome, refraction• Infants with strabismus• All deaf and hard of hearing infants• All infants with syndrome based risk of VI
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Early Intervention
should start EARLY
It should start during the assessment.
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Assessment of visual functioning with special reference to infants
Lea Hyvärinen, MD, PhD, FAAP
Professor h.c., Rehabilitation Sciences, University of Dortmund
Senior Lecturer, Developmental Neuropsychology, Univ. of Helsinki
www.lea-test.fiTampa USF October 2011
![Page 25: Assessment of visual functioning with special reference to infants Lea Hyvärinen, MD, PhD, FAAP Professor h.c., Rehabilitation Sciences, University of](https://reader036.vdocuments.site/reader036/viewer/2022081518/551bb994550346af588b45bc/html5/thumbnails/25.jpg)
Accommodationeye contact and social smile
Weak accommodation can be compensated with ”reading glasses.”