Why Visual Performance Matters: Foundations for Occupational Therapy Practice: facilitator notes

Presenter cues

• Teach the streams as two questions the brain asks, not as anatomy to memorize: "What is it?" and "Where is it, and where am I relative to it?"
• Use the handwriting before/after immediately after the stream teaching — it is the cleanest live demonstration that a "where" demand can be supplied by the page.
• Insist that participants never write stream language in a school document.

Answer key

Which stream does this description sound more consistent with, and what would you probe next to confirm it?

A dorsal / "where" pattern: word identification is intact, spatial localization and re-finding are not. Probes: (1) re-find a target line after a controlled look-away, counted over 10 trials; (2) locate a named object in a sparse array versus a cluttered array; (3) copy a simple spatial diagram versus copy a word list; (4) same reading passage on plain paper versus with a line guide. If performance jumps when spatial structure is supplied, you have your answer. Note out loud that this is patterning, not localization of a lesion.

How would you phrase this finding for a teacher without naming a "dorsal stream deficit"?

Model: "She reads the words accurately. What she loses is her place and her ability to find things on a busy surface. With a line guide and a decluttered desk she re-finds her line in about 2 seconds instead of 15, so those two supports should stay in place while we get an eye exam scheduled."

Examples to read aloud

• Reflection model answer (Module 2): "A ‘what’ problem looks like hesitating on visually similar letters even when the print is large. A ‘where’ problem looks like skipping a line every time she looks up at the board."
• Mini-exercise model answer: "During 10-minute board-copy tasks, the student re-finds her place an average of 15 seconds after each look-away and completes 40% of assigned lines; with a line guide she completes 80%."

Watch-outs

• Participants will try to assign a student to one stream. Say plainly that most real students show mixed patterns, and the value is in the probe, not the label.