Computer Assisted Visual Perception Training Program for Older Adults

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Computer Assisted Visual Perception Training
Program for Older Adults
Erin Cunningham Victoria Hatch Teresa Kreis
Leonard Trujillo, PhD, OTR/L East Carolina
University

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Introduction

• The purpose of this study was to evaluate the
  effectiveness of the Computer-Assisted Visual
  Perception Training (CAVPT) software as a means
  to improve visual perception skills in older
  adults
• Visual perception skills are important in the
  ability to engage in meaningful tasks, increase
  safety in activities such as driving, or decrease
  the risk of falls

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Visual Perception Skills

• Visual Discrimination
• Visual Figure Ground
• Spatial Relations
• Object Memory
• Object Closure

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Visual Discrimination

• The ability to recognize particular features of
  an object, essentially noticing similarities and
  differences between various objects

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Visual Figure Ground

• The ability to differentiate between foreground
  objects (figure) and background objects (ground)

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Spatial Relations

• Being able to recognize an objects orientation
  in the space, as well as its relation to the
  objects around it

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Object Memory

• The ability to retain visual information in short
  term memory, and then recall it as needed

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Object Closure

• The ability to identify or recognize an object
  that is partially covered or obstructed

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Current Research

• Declines in visual abilities are common in the
  aging population
• Older adults typically perform slower on spatial
  tasks than younger adults
• Figure-ground perception skills may start to
  decline as early as age 50
• Medications to treat common age-related
  conditions can cause declines in visual skills
  and memory
• Cognitive declines, including those that affect
  perception, may be due to changes in activity
  patterns
• Use it or lose it

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Current Research

• Neuroplasticity
• The brains ability to reorganize by generating
  new neural pathways in response to trauma or new
  experiences allows for the restoration of
  cognitive skills
• Research shows that numeric skills, spatial
  orientation, problem solving, memory, and
  inductive reasoning can all be improved through
  cognitive intervention at any stage of life,
  although the benefit seems to be specific to the
  skill taught

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Current Research

• Current Visual Perception intervention
• Simplistic line drawn paper presentations
• Typically used with children and not adult
  populations
• There is limited support for the effectiveness of
  clinical interventions for visual perception
  problems

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Current Research

• The future of treatment
• A growing amount of research recommends using
  computers as means to acquire skills
• Older adults can master technology-based learning
  and are more willing to use technology than it is
  sometimes presumed

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Research Questions

• Will repetitive practice enhance visual
  perception skills of older adults?
• Is there a significant difference detectable in
  the participants degree of improvement between
  the traditional paper-based and computer-based
  motor-free visual perceptional training program?

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Design

• Quasi-experimental pre-test post-test with
  control
• Participants randomly assigned to computer
  intervention, paper intervention, or control
• Interventions
• Computer Assisted Visual Perception Training
  (CAVPT) software
• Paper copies of the images from the CAVPT software

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Participants

• Inclusion Criteria
• Older adults, 55 years and older
• English-speaking
• No known visual deficits that cannot be
  compensated for by wearing corrective lenses
  (glasses, contacts, reading glasses)
• Individuals who can tolerate sitting and
  participating for 45 minutes to 1 hour
• No computer access or skills are necessary

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Participants

• Recruitment
• Convenience sampling with a snowballing effect
• Cypress Glen Retirement Community
• Written announcement in newsletter
• Verbal presentation at Tai Chi class led by
  fellow graduate students
• Phone solicitation of participants in CarFit
  research project led by fellow graduate students
• Word of mouth

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Participants

• Our original intent was to recruit 45
  participants in order to yield statistically
  significant results
• Due to time constraints, 23 participants were
  pre-tested, though only 20 participants completed
  the post-test

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Participant Demographics

• Computer
• Age 56-86
• 1 male and 8 females
• Dunn, Greenville, and Raleigh
• Paper
• Age 64-85
• 1 male and 3 females
• Goldsboro and Greenville

• Control
• Age 59-90
• 2 males and 5 females
• Greenville, Jamestown, Wilson, and Whiteville
• Dropout
• Age 77-88
• 2 males and 1 females
• Greenville

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Location of research participants
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Methods

• Instrumentation
• Motor-Free Visual Perception Test, Third Edition
  (MVPT-3)
• Used for pre-test and post-test
• Normed for ages 4-95
• It has an internal consistency of a 0.86 to
  0.90, with a median reliability coefficient for
  age 11 and older of 0.89, and a test-retest
  reliability of 0.92
• Content validity determined through item
  discrimination and item bias studies
• Criterion validity was .78 with the overall score
  of the DTVP-2
• Construct validity correlation with chronological
  age for individuals above age 40 is -.46

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MVPT-3
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Methods

• Instrumentation
• The Computer Assisted Motor-Free Visual
  Perceptual Training software
• Designed by the principle investigator
• Provides immediate feedback to the user
• Gives measurable percentage outputs of the
  participants progress
• Presents traditional perceptual environmental
  challenges using road signs that are relevant to
  everyday life

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CAVPT
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Methods

• Procedure
• Each participant received a pre-test and
  post-test utilizing the MVPT-3 within a two to
  three week time span
• Each participant assigned to an intervention
  group received a one-on-one training session
  prior to beginning the intervention to
  familiarize them with materials/intervention
  tools
• Participants in the intervention groups received
  approximately 8 hours of intervention and were
  instructed to record the times on a log sheet

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Results

• Each participants raw scores were compared to
  determine if there had been any improvement
  between their pretest and posttest
• t-Tests were performed to determine significance
  of improvement within each group

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Results
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Results
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Results
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Results

• The percent change of each participants pretest
  and posttest scores were compared between groups
• t-Tests were performed to determine significance
  of improvement between groups

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Results
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Results

• Visual perception skills mature around age 11 and
  remain relatively stable until about age 40 when
  age-related declines may begin.
• It is important to consider that even though
  these results do not appear to be significant,
  they have the potential to be.

true measure of change
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Challenges

• Timing and scheduling
• Time of day test administered
• Length of test
• Participants had difficulty understanding the
  instructions in MVPT-3
• Difficulty level of assessment and intervention
  did not match
• Researchers were not present during all
  intervention sessions, resulting in concerns
  regarding compliance
• All of the participants randomly assigned to the
  computer intervention group owned a computer,
  though their levels of computer experience
  differed

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Conclusion

• The computer intervention showed slightly greater
  magnitude of change in the scores than the paper
  intervention
• However, neither intervention group showed a
  significant improvement compared to the control
  group
• CAVPT is promising as an intervention (motivating
  and enjoyable), but needs to be revised to be
  more challenging according to feedback from
  participants

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Acknowledgements

• We would like to offer a special thank you to
• The residents and staff of Cypress Glen
• Masters Degree students
• Erin Cunningham
• Victoria Hatch
• Teresa Kreis

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