< Terug naar vorige pagina
Visuoperceptual profiling and game-based rehabilitation in children with cerebral visual impairment
Boek - Dissertatie
Intact visual skills are essential for positive cognitive and social development, as well as independent movement in the environment. Cerebral visual impairment (CVI) is one of the most prominent causes of severe visual impairment in childhood. The most common cause of CVI is damage to the periventricular white matter, a characteristic lesion in prematurely born children. CVI involves visual dysfunction due to pathology affecting the retrochiasmatic visual pathways and projection areas, in the absence of any major ocular disease. The cause, location, and severity of brain lesions are different in each child, leading to the heterogeneous symptoms in visual orienting functions, as well as mid- and higher-order perception. There is evidence showing that visual rehabilitation for patients with neurological visual impairment can be effective. Unfortunately, few rehabilitative games exist to improve visuoperceptual abilities in CVI and they are usually uniform, uninteresting, not adaptive, and unsuitable for use with children. Moreover, existing rehabilitative tools are not specific enough in training visual impairments or need to be instructed and supervised by therapists. As the visuoperceptual problems and hence the complexity of the clinical picture of children with CVI are very heterogeneous, specific rehabilitation needs to be developed. The overall aim of this PhD project was to develop a novel game-based rehabilitation for children with CVI using an individualized visuoperceptual quantification and adaptivity. To attain this goal, we analysed children's impairments in daily life using a functional questionnaire and we developed a visuoperceptual profile quantification using children's visuoperceptual test results. The visuoperceptual profile developed consists of six dimensions namely, (1) visual discrimination and matching, (2) object or picture recognition, (3) visual spatial perception, (4) figure-ground perception, (5) motion perception, and (6) visual short-term memory. We then developed four visuoperceptual mini-games (MatchMaker, Hurricane Chaos, Maze Explorer 2D, and Maze Explorer 3D) aiming to train these functions. These games underwent rigorous formative testing and expert feedback in clinicians and researchers, and usability was observed and player experience was discussed during semi-structured interviews with neurotypical children and with children with CVI. The findings from these studies led to design guidelines. Finally, an eye tracking paradigm was used to investigate the relations between visual orienting functions and (1) daily life behaviour and (2) visuoperceptual abilities in children with CVI to further characterize the clinical picture of CVI.
Jaar van publicatie:2021