VT Works

The power of the Space Fixator, as a device, is certainly not in its curb appeal. As Vision Therapy equipment goes, it is nowhere near as sexy as something that turns off and on, or lights up with a lot of bells and whistles, but what it does offer is a clear and definite opportunity to resolve the mismatch which exists between central and peripheral inputs. This is accomplished by asking the patient to interact and reorganize their space with an increased awareness of the full and overall visual world. No power switch needed.

Part Three – Alternating Hands

As mentioned in both Part One and Part Two, this is an activity that certainly builds on itself, and each level is to become a foundation for the next challenge. That statement would certainly seem to apply to many different activities, and perhaps Vision Therapy as a whole, but it is most definitely applicable here.

Our setup for this activity level of the Space Fixator remains the same: standing comfortably balance when possible with the center of the device at the same altitude as the tip of the patient’s nose.

The goal of this level is to continue with the “Look, Ready, Touch, Back” commands while asking the patient to alternate hands. Most times, by this level, the patient is also reciting the commands out loud as they perform the task. There are times the Vision Therapist may want to give the commands, but ultimately, the main goal seems to be having the patient completely independent by the end of this level.

In adding bilaterality and an element of cross patterning, we are now asking the patient for an addition level of coordination. Some patients may continue to perform well with this additional skill requirement, and some may begin to struggle. For those who struggle, discussing with the patient how they are doing and what they may want to change to improve their performance might be prudent.

To add a level of difficulty we can add the metronome to the activity, ask our patient’s to balance on a balance board, add in an element of jamming, or even a slower or faster pace – depending on the patient’s habitual performance and relative skill level. As before, the goal is for both increased speed and efficiency.

As in all previous levels, and again worth repeating, is the patient’s ability to maintain full awareness of all the dots in the circle. The patient should always be reminded to use their peripheral input to guide the hand movements. If the Vision Therapist notices the patient being “off” in their touching of the dots, there may be an important conversation to be had about peripheral awareness, steady fixation, and motor planning. Lastly, remember, in order to help the patient take their skills beyond the VT room and out in to the real world, we want to encourage them to be aware of the entire space around and behind the Space Fixator. But also, and perhaps most importantly, they should be encouraged to remain of the space that exists between their face and the surface of the Space Fixator, as an increase Z-axis awareness helps to build and maintain that “Where Is It?’ system.

Stay Tuned for Part Four!