Seeing Is Believing: Part 4 – The Triad of Transfer

Most of the enlargement of the primate brain comes from a massive expansion of the cerebral cortex, especially the prefrontal cortex and the parts of the cortex involved in vision. The visual processing network of primates includes at least 30 distinguishable brain areas, with a complex web of interconnections. It has been estimated that visual processing areas occupy more than half of the total surface of the primate neocortex.  The prefrontal cortex carries out functions that include planning, working memory, motivation, attention, and executive control. It takes up a much larger proportion of the brain for primates than for other species, and an especially large fraction of the human brain. –  Wikipedia


It’s been argued that monkeys could perform many of the jobs currently held by humans, and to be fair, we are not immune to that assertion. Surely with a little training our primate cousins could swing a ball suspended from the ceiling, flip lenses, slide cards, and record a number or two.  If that were all Vision Therapy was about, we’d all be unemployed – tomorrow. Luckily there’s a bit more to it than that, and with our skills in higher level thinking, we are able to ensure the monkeys will not be taking over anytime soon 🙂

Vectograms have one specific goal; clear and single images.  As we walk our patients through the activity, sliding the cards into various positions, we’re working to build flexibility between vergence and accommodation, working to better integrate the “where am I”, “where is it” and the “what is it”, and hoping for some of that magical awareness of changes in space called SILO.

But then what? What happens when we put the cards away and the patient heads home? Do those new found skills stay with them?  Is it possible that we created conditions for change with our tools and those changes don’t stay with the patient when they leave the office?  It’s possible, but luckily our path doesn’t end there.

Working with our patients to ensure their new found skills transfer into their real world happens with three key components. Increased ability, localization, and feeling tone.

localizationAs the name would suggest, increased abilities are positive and measurable changes in the system – the clear/break/recovery metrics that most of us are accustomed to recording.

Feeling tone is purely subjective, and is the patient’s awareness of the quality of change within their body, specifically their visual system.  In Vectograms, we use this skill to our advantage to help the patients understand how their vision is changing, and with hopes of repeating each action in and out of instrument.

Localization is simply the ability to find or identify the location of something. Since the Vectograms create a virtual image, often times we ask patients to identify where the image “seems to be”. It is the also an important interaction between the “where am I” and the “where is it” that Dr. A.M. Skeffington modeled.

The interaction and interweaving of these skills is crucial to the patient’s transferring their new found skills into real world experiences.  We should always be working to increase their visual abilities, help them understand how things are changing kinesthetically by discussing reinforcing and repeating feeling tone, and associate those changes in feeling with the accurate identification of  the changes in their visual space. As an added bonus, processing this information with speed and efficiency will only make them stronger and stronger.

In the home stretch – conclusion coming soon!


Posted on January 9, 2014, in From My Perspective.... Bookmark the permalink. Leave a comment.

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