how psychological profiles differ in ss with varying eye...

1

Keynote Address:

How Psychological Profiles Differ

in Ss with Varying Eye Diagnoses

European Conference on Psychology and

Visual Impairment

Heidelberg, Germany

March 29-30, 2012

2

“Fashions” in Psychology

The era of tabula rasa (nurture lovers)

The eugenics movement (nature lovers)

The rise of psychoanalytic approaches (lovers)

Behaviorism and Skinner effects (reward lovers)

The influence of Spock (Star Trek lovers?)

Brain studies (head & science lovers)

Interactive effects (fickle lovers…)

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A Bit of History

Diagnosis and etiology as possible determinants of

learning style in Ss with visual impairment

The “RLF” Wave: Technology, incubators & research

Retinoblastoma: Observations &findings

Cataracts, lenses and vision: Changes over years

Albinism: Culture and achievement

Neurobiology: Brain development, visual, tactile &

auditory acquisition of information

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‡ See reference

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Research Questions

Are there differences in the way people with visual

impairment learn, develop, behave?

Are these factors affected by eye diagnosis, etiology,

age of onset or learning modes?

What approaches promote best outcomes in people

with these diagnoses or impairments?

How can professionals who render assistance to people

with visual loss apply this knowledge?

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Dimensions

Cognitive quotients and profiles

Measures of „intelligence‟ & limitations

Verbal and Performance subtest analyses

Academic

Reading, „riting & 'rithmetic scores (3R‟s)

Body and environmental imagery

Figures drawn, described, modeled in clay

Social/Adaptive

Data entry/analysis in process

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Sampling Issues

Low incidence

“Smallest” major group of disabled students

Blind Ss comprise <15% of vi students

High variability in samples

Behavioral styles around vision

Finding participants: non-random samples

Those who are referred or willing

Risk of stereotyping

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Quantitative View of Dataset

2, 401 participant assessments*

1,366 unique individuals

- 141 sighted controls

- 110 sleep study participants

*Differing measures by study and source

**N’s vary for dimensions & measures

up to 1,115 VI/NV Ss** included to date

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Cognitive Measures

Early: Binet-based, M.A. approach

Hayes and Perkins adaptations for VI/NV

Then: Wechsler Scales, Verbal & Performance

Ss with vision, modifications & allowances

Ss without vision, reliance on verbal items

Tactile Assessment of Performance

Now: Profile analysis via an array of methods

Few specifically adapted for VI/NV groups

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VIQ Contrasts, VI vs. NV/LP

70

75

80

85

90

95

100

Sighted

Norms

VI NV/LP

n = 348 n = 476

Mean SD

Sighted 100 15

VI 84.36 27.15

NV/LP 93.19 29.33

Significantly different

p < .001

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Subtest Contrasts VI vs. NV/LP Wechsler Verbal Scale

0

2

4

6

8

10

12

14

VI

NV/LP

* p < .05

** p < .001 Scale

d S

co

re

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Factors

Diagnosis

Original roster of diagnoses (107 entries)

Problems of grouping

Analyses of development by eye conditions

Etiology

Heredity and family history are relevant

Retina as brain extension (neurology)

Infection, accident, other causes

Congenital or Acquired

Age of onset has impact for latter group

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Diagnostic Group 1

Retrolental Fibroplasia/Retinopathy of Prematurity

Retinoblastoma

Leber‟s Congenital Amaurosis

Other Retinal Disorders

Optic Atrophy

Optic Nerve Hypoplasia

‡ See reference

16

90

117

102

97

7782

60

70

80

90

100

110

120

Rlf/Rop Rb Leber's Retinal Opt Atr Opt Hypn = 294 n = 70 n = 20 n = 67 n = 81 n = 18

Diagnostic Group 1

Me

an

VIQ

Cognitive Findings: Group 1

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Diagnostic Group 2

Albinism

Glaucoma

Micro/Anophthalmos

Cortical/Visualmotor/Perceptual

Exotropia/Esotropia/Strabismus

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93 94

87

81

73

60

70

80

90

100

110

120

Albinism

n = 26

Glaucoma

n = 39

Micro/Ano

n = 29

Cort Bl

n = 42

Exo/Eso/Strab

n = 10

Diagnostic Group 2

Mean

VIQ


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Diagnostic Group 3

Congenital/Acquired Cataracts

The Myopias

Cornea/Iris/Choroid/Uvea

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7478

91

60

70

80

90

100

110

120

Cataract Myopia C.I.C.Un = 72 n = 25 n = 16

Mean

VIQ

Diagnostic Group 3


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Comparing Ability

Significant variability in VIQ by diagnosis

ANOVA: F (17, 806) = 9.09, p < .001

Significant variability in AQ* by etiology

ANOVA: F (17, 691) = 9.73, p < .001

*AQ = Ability Quotient from several sources

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Etiology Groups

n %

Prematurity 374 38.8

Other/Unknown 212 22.0

Heredity 200 20.7

Pre- & Peri- natal 103 10.7

Neurological 53 5.5

Accident 22 2.3

Total 964 100

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AQ by Etiology

92

81

109

89

78

93

60

70

80

90

100

110

120

AQ

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Performance Findings

Visual/Tactile Contrasts

Pictorial display: those with vision

Figures, graphs, other visual methods

Tactile graphic display: NV/LP & Low Vision

Meaningful ways of accessing information

Application for assessment/research

Block Design as example

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PIQ by Acuity, VI Group

6975

84

92

84

40

50

60

70

80

90

100

110

120

PIQ

20/1000

– 20/501 20/500

– 20/351

20/350

– 20/201

20/200

– 20/101

20/100

– 20/40

n = 9 n = 9 n = 18 n = 32 n = 23

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Block Design Subtests

Visual Tactile

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Visual vs. Tactile Block Design by Age

0

5

10

15

20

25

30

35

Raw

Sco

re

Vis

BD

Tact

BD

1 17 13

2 24 17

3 20 36

4 11 61

5 8 66

6 4 37

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Male student @

residential school

Dx: ROP

C.A.: 20-2

O.S.: no vision

O.D.: 20/240 distance

Reads J10 at 3” near

Couldn‟t see graphics

(black & white) for PA

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WPPSI

Female

C.A.: 5-10

Dx: Albinism

O.U.: 20/200

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Environmental & Body Image

Measures

Goodenough-Harris Drawing Test

Verbal Draw-A-Person (VDAP)

Expansion to person, house, car

Clay Models: Person, house, car

Analyses

No significant variability by age

Clinical inquiry: Provides developmental insight

Insufficient data for comparisons by diagnosis

‡ See reference

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Goodenough – Harris Drawings

Female

8 years old

Achromatopsia

Acuity: 20/200

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Clay Models, Rb

Rb Male

Age 17 ½

Rb Female

Age 15½ Rb Female

Age 11½

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Clay Models ROP

ROP Male Age 15

ROP Female

Age 15½

ROP Female

Age 12¾ ROP Male

Age 12

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Rb, Male Age: 11½

Car House Person

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Congenital Buphthalmos, Female Age: 12½

(decreasing vision from 3 to 6 years)

Car

House

Person

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Cortical Blindness, Male Age: 12¼

Car

Person

House

38

ROP, Female 12 Years Old

House

#1

House

#2

Car

#1

Car

#2

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Summary

Data in process, trends are evident

Social scale & other findings to be added

Sampling difficulties & challenges

Hereditary vs. non genetic disorders

Brain & neurological involvement

Impact of amount & use of vision

Perceptual features of NV/LP & VI groups

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Meaning for Practitioners

There are no “rules” in development;

differences occur in patterns

Know the diagnosis, etiology and possible

implications as guides in planning

If vision is retained, consider practicing with

lenses that estimate acuity and field

Organize interventions around general

expectations for each group, but be adaptable

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Meaning for Researchers & Clinicians

Collect standardized data where possible,

-visual and diagnostic observations can be

cited when interpreting or reporting results

-Ss may describe their own perceptions &

understanding of the environment

-where possible, find tangible ways of

evaluating their verbal reports.

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