Is it ever okay to use a worksheet to treat visual neglect?
The answer is yes! Pen and paper tasks are an effective treatment for some patients with visual neglect (Cicerone et al., 2022).
In this article, you’ll learn:
- How visual scanning worksheets can treat visual neglect
- How to transition from worksheets to daily activities
- What worksheets to use—with a FREE fillable visual scanning PDF!
To Worksheet…or Not To Worksheet?
Worksheets in cognitive rehabilitation remain a topic of hot debate, and rightfully so.
Many worksheets aren’t functional, and the skills they teach may not generalize to real life.
However, some patients need a contained way to learn a new skill. A pen-and-paper task removes the multi-tasking and distractions of everyday tasks so that they can focus on internalizing the skill. From there, they can scaffold that skill out to daily tasks.
In the case of severe visual neglect, there is strong evidence that patients do well when they start with a systematic, contained activity (Cicerone et al., 2022). A great example of this is a high-quality worksheet!
Use worksheets to teach visual scanning, an evidence-based treatment for visual neglect (Luauté et al., 2006). We’ll dive into the visual scanning techniques below.
If you suspect another vision disorder, like a visual field cut, or need more help treating neglect, don’t hesitate to refer out to a qualified OT or vision specialist.
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Visual Scanning Techniques
Visual scanning is the bread-and-butter treatment for visual neglect. Pair it with The Lighthouse Strategy for even better outcomes.
Here are effective visual scanning techniques. Try them with your patients to see which are a good fit:
- Anchor line (Luauté et al, 2006). Add a vertical line down the affected side of the page. It serves as an ‘anchor’ for the patient to scan to. This may be a red line or a colored line of masking tape.
- Use the hand. This is another way to anchor. Have your patient put their hand on the affected side of the page and tap their fingers. Then, have them scan to that hand during each line of a reading or worksheet task. Teach them to say, “Scan to my hand, ” to cue themselves to find the anchor.
- Finger scanning. Have them scan a finger across each line while reading or completing the worksheet.
- Tap. Have them tap each target as they scan. This can slow them down, which improves accuracy.
- Guides. Put a contrasting piece of paper under each line as they read or complete the worksheet.
- Number the lines. If a patient needs more support than the anchor line, add sequential numbering down each line of the worksheet to orient and scan in a more organized way. Get a free, fillable version below!
(Cicerone et al., 2022)
Numbered Visual Scanning Worksheet (Free PDF)
We made you a fillable visual scanning worksheet! Download the PDF, save it, and then type in your text to make a customized worksheet. Click to download:
How to use the Numbered Visual Scanning Worksheet:
- Have the patient scan all the way to the left until they find number 1. You may also add an anchor to the affected side, like a red vertical line down the page.
- They’ll scan across the first line while reading, crossing out a target, etc.
- Next, they’ll scan to the anchor line again and look for number 2.
- Repeat!
How To Use Visual Scanning Worksheets
Where To Start: Teach Visual Scanning
Use worksheets to teach your patient how to visually scan. Start with simple worksheets, like a cancellation task, to teach the techniques described above.
For more severe neglect, start by having them search for a single item. For example, a single letter or symbol on a cancellation task. Have plenty of space between targets at this early phase.
Cue as needed to teach visual scanning. You might tap the page, give verbal cues, or add another anchor.
When your patient has gotten the hang of visual scanning, increase the challenge. Add more items to find, have them read phrases, add in writing, and so on. Gradually decrease cueing and external supports as they improve.
Transition to Functional Tasks
As soon as possible, transition from pen and paper to functional activities.
Try these activities when your patient is ready to practice their visual scanning techniques during everyday tasks:
Tabletop ADLs
- Simple seated cooking tasks
- Buttoning shirts
- Sorting laundry
Tabletop IADLs
- Sorting medications or filling out a medication box
- Filling out a calendar
- Reading (menu, receipt, billing statement, etc.)
- Writing a check
- Using a computer
- Playing a card game
Moving Through Their Environment
- Finding items in the fridge or cupboards
- Locating items in their house or a room while navigating through the space
- Daily activities while navigating through a space, like shopping
Read Environmental Modifications for Visual Neglect for tips on how to make their home or your clinic safer.
Types of Visual Neglect Worksheets
Here are the types of worksheets you can use to teach visual scanning:
- Cancellation worksheets
- Word search worksheets
- Mazes
- Picture description worksheets
- Reading worksheets
- Writing worksheets
- Copying an image
- Worksheets that help transition to everyday reading material. For example, mock bills, menu boards, or receipts designed for your patient (high contrast, large, sans serif font, etc.)
Visit our shop for visual neglect worksheets made for speech therapy patients!
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References
- Brewer, C., Aparo, M. (2021) The Adult Speech Therapy Starter Pack. Harmony Road Design Publishing.
- Cicerone, K. D., Dams-O’Connor, K., Eberle, R., Fraas, M., Ganci, K., Langenbahn, D., Shapiro-Rosenbaum, A., Tate, R. L., Trexler, L. E., & American Congress Of Rehabilitation Medicine. (2022). ACRM Cognitive Rehabilitation Manual & Textbook Second Edition: Translating evidence-based recommendations into practice.
- Luauté, J., Halligan, P., Rode, G., Rossetti, Y., & Boisson, D. (2006). Visuo-spatial neglect: A systematic review of current interventions and their effectiveness. Neuroscience & Biobehavioral Reviews, 30(7), 961-982. https://doi.org/10.1016/j.neubiorev.2006.03.001
- Varindani Desai, R. (n.d.). How To: Visual Scanning Treatment for Neglect. Tactus Therapy. Retrieved October, 2024, from https://tactustherapy.com/visual-scanning-treatment