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Visual perceptual deficit screening in stroke survivors: evaluation of current practice in the United Kingdom and Republic of Ireland

Colwell, Michael J.; Demeyere, Nele; Vancleef, Kathleen

Visual perceptual deficit screening in stroke survivors: evaluation of current practice in the United Kingdom and Republic of Ireland Thumbnail


Authors

Michael J. Colwell

Nele Demeyere



Abstract

Purpose
Visual perceptual deficits are frequently underdiagnosed in stroke survivors compared to sensory vision deficits or visual neglect. To better understand this imparity, we evaluated current practice for screening post-stroke visual perceptual deficits.

Methods
We conducted a survey targeted at professionals working with stroke survivors involved in screening visual perceptual deficits across the United Kingdom and the Republic of Ireland.

Results
Forty orthoptists and 174 occupational therapists responded to the survey. Visual perceptual deficit screening was primarily conducted by occupational therapists (94%), with 75∼100% of stroke survivors screened per month. Respondents lacked consensus on whether several common post-stroke visual deficits were perceptual or not. During the screening, respondents primarily relied on self-reports and observation (94%), while assessment batteries (58%) and screening tools were underutilised (56%) and selected inappropriately (66%). Respondents reported lack of training in visual perception screening (20%) and physical/cognitive condition of stroke survivors (19%) as extremely challenging during screening.

Conclusions
Visual perceptual deficits are screened post-stroke at a similar rate to sensory vision or visual neglect. Underdiagnosis of visual perceptual deficits may stem from both reliance on subjective and non-standardised screening approaches, and conflicting definitions of visual perception held among clinicians. We recommend increased training provision and use of brief performance-based screening tools.

Implications for Rehabilitation
Lack of agreement among clinicians on what constitutes as visual perceptual or sensory vision deficits may prove problematic, as precise and exact language is often required for clinical decision-making (e.g., referrals).

Biases for more familiar visual (perceptual) deficits held among clinicians during the screening process may lead to other visual deficits being missed.

To avoid problems being missed, clinicians should aim to use standardised assessments rather than stroke survivor self-report and observations of function when screening for visual perceptual difficulties.

Citation

Colwell, M. J., Demeyere, N., & Vancleef, K. (2022). Visual perceptual deficit screening in stroke survivors: evaluation of current practice in the United Kingdom and Republic of Ireland. Disability and Rehabilitation, 44(22), 6620-6632. https://doi.org/10.1080/09638288.2021.1970246

Journal Article Type Article
Acceptance Date Aug 13, 2021
Online Publication Date Aug 29, 2021
Publication Date 2022
Deposit Date Oct 31, 2022
Publicly Available Date Jul 25, 2023
Journal DISABILITY AND REHABILITATION
Print ISSN 0963-8288
Publisher Taylor and Francis Group
Volume 44
Issue 22
Pages 6620-6632
DOI https://doi.org/10.1080/09638288.2021.1970246

Files

Published Journal Article (5.6 Mb)
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Licence
http://creativecommons.org/licenses/by-nc-nd/4.0/

Publisher Licence URL
http://creativecommons.org/licenses/by-nc-nd/4.0/

Copyright Statement
(c) 2021The Author(s). Published by InformaUK Limited, trading as Taylor& Francis Group.
This is an Open Access article distributed under the terms of the CreativeCommonsAttribution-NonCommercial-NoDerivativesLicense(http://creativecommons.org/licenses/by-nc-nd/4.0/),whichpermitsnon-commercialre-use,distribution,andreproductionin any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.





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