5-1 Discussion: Visual Dysfunction in Children.
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Amanda, a 16-year-old female suffers from a pituitary gland tumor. This tumor presses on the optic chiasm and results in a condition where Amanda’s right eye can no longer see the the right side of the visual field. It also affects her left eye such that it can no longer see the left side of the visual field.
Jacob, a 5-year-old, has scarring on the fusiform gyrus secondary to seizures. This damage has resulted in ventral stream disruption and in particular, problems with facial recognition.
What functional deficits might affect Amanda and Jacob? Considering their different developmental levels, list the deficits and describe their potential effects in the physical, cognitive-academic, and social-emotional areas of functioning. What interventions are appropriate, and how would they differ for each of these two individuals? When responding to your classmates, compare your chosen interventions to those proposed by the others.
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The left eye has a visual field, the right eye has a visual field, and there is a region of overlap between the fields (Carlson & Birkett, 2017). The left visual field sends information to the right hemisphere of the brain, and the right visual field sends information to the left hemisphere of the brain (Carlson & Birkett, 2017). The optic chiasm is an x-shaped collection of optic nerves at the base of the brain that connects these visual fields to their corresponding brain hemispheres (Carlson & Birkett, 2017). Just behind the optic chiasm is the pituitary gland which is attached to the base of the hypothalamus (Carlson & Birkett, 2017). The hormones produced in the hypothalamus control most of the endocrine system through the anterior pituitary gland and posterior pituitary gland (textbook) These glands control male and female sex hormones, growth hormones, and other functions (Carlson & Birkett, 2017).
Amanda is experiencing a lack of peripheral vision. At its worst, this lack of peripheral vision can result in tunnel vision or an eventual complete loss of vision (van Winsum, 2019). Amanda may require a combination of medicine, regular brain scans, and/or surgery to correct the effects of the tumor or remove the tumor entirely. Also, Amanda may need corrective eyewear. Her inability to use peripheral vision may cause her to be unable to play sports or engage in other gross-motor activities that require an ability to attend to her surrounding environment. This may also affect her ability to drive or pass a driving test. Amanda may experience hormonal deficiencies and require birth control or other medicinal hormonal regulation.
Prosopagnosia is the inability to recognize faces, so individuals with prosopagnosia may see a face but be unable to identify whose face it is (Carlson & Birkett, 2017). Even though a person with prosopagnosia can see the individual parts of the face, they cannot configure these features to identify the person (Carlson & Birkett, 2017). The fusiform face area (FFA), inside the fusiform gyrus on the base of the temporal lobe, controls this ability to recognize a face (textbook). The ventricle stream enables a person to know what an object is by providing visual information about the color, shape, texture, and size of objects (Carlson & Birkett, 2017).
Jacob’s diagnosis will likely have social ramifications. Being unable to identify the faces of friends, teachers, or other people in a school, especially at the kindergarten age, will have a significant impact on him. Jacob may also require medicine of eventual surgery in order to remove some of the scar tissue and reenable his ability to recognize faces. He may also need to receive therapy that teaches him how to match features to their associated person.
Carlson, N. R., & Birkett, M. A. (2017). Physiology of behavior (12th ed.). Harlow: Pearson.
van Winsum, W. (2019). Optic flow and tunnel vision in the detection response task. Human Factors, 61(6), 992–1003.
Amanda 16 year old family has pituitary gland tumor that is pressing on her optic chiasm. The pituitary gland is located at the base of the brain and controls central management as well as the glands throughout the body. Often times tumors such as these cause visual disturbances which in Amanda’s case it is effecting her peripheral vision. Other potential symptoms of this tumor consist of headaches, weight changes, sweating, nausea and vomiting, moodiness, fatigue, depression and anxiety, frequent urination and blood sugar levels (Lafferty & Chrousos 1999). Due to the fact Amanda is 17 it could also affect her growth and development. Therefore these symptoms can have a major impact on Amanda’s physical, cognitive-academic and social-emotional areas of functioning.
Treatment for Amanda would ideally be to remove the entire tumor and proceed with radiation due to the fact there is a high reoccurrence rate. If surgery is not an option due to the size or placement of the tumor, radiation would be a better option to reduce the tumor and offer some symptom relief (Lafferty & Chrousos 1999). When addressing Amanda’s symptoms a multi-disciplinary would be most efficient to address her medical and mental health needs in order to improve her physical, cognitive-academic and social-emotional areas of functioning.
Jacob is five year old with scarring to his fusiform gyrus which resulted in ventral stream disruption. The fusiform gyrus is located in the temporal lobe, it is responsible for facial recognition and color processing. The Ventral stream disruption will make it difficult for Jacob to identify and recognize objects. The Jacob will struggle with facial recognition, object recognition, spatial recognition as well as color processing all of which can have a major impact on Jacob’s physical, cognitive-academic and social-emotional areas of functioning. However due to Jacob’s age and the fact his brain is still maturing his condition could improve Collins & Olson 2014)
Jacobs’s treatment would require occupational therapy, as well as behavioral therapy. This would be to help him to strengthen and rely on his other senses to make up for what he is lacking. Behaviorally this would be very difficult for a child Jacob’s age due to the fact he would struggle to identify his own face or his mother’s face which I imagine could have long term emotional disruptions.
Antony R. Lafferty, George P. Chrousos, Pituitary Tumors in Children and Adolescents, The Journal of Clinical Endocrinology & Metabolism, Volume 84, Issue 12, 1 December 1999, Pages 4317–4323, https://doi.org/10.1210/jcem.84.12.6215
Collins, J. A., & Olson, I. R. (2014). Beyond the FFA: The role of the ventral anterior temporal lobes in face processing. Neuropsychologia, 61, 65–79. https://doi.org/10.1016/j.neuropsychologia.2014.06.005