Since you’re already sitting down and pulled up to the table, let’s “Deal” you in.
Games, and the rules to games, can be very tricky for Corey. For those of you who know Corey well, rules didn’t really apply to her in general and she always changed them anyway regardless of the game!
When we use games in her therapy we don’t pay attention to most of the game rules; generally we adapt all board and card games to assess the skills Corey has. The game SKIP BO is a card game using cards numbered 1-12.
1st Deal – We placed the cards in sequential order, four cards per row and three rows high. Corey recognized and accurately identified each number.
2nd Deal – We took away two rows leaving cards 1-4. We scrambled the sequence and laid out the cards 4, 2, 1, 3. We asked Corey to tell us what she saw.
She recognized all but the #1 which she confused for #7 (the character looked like #7 so we forgave the error)
3rd Deal – We arranged all the cards in the original formation. Elaine asked Corey to identify a card that she held in front of her, then take the card from Elaine and match it to a card on the table. For the #2; Corey identified 12 but corrected her self. Corey misidentified #8 as #3; #9 as #6 and #1 as #7 (all very logical mistakes). The exercise required her to look straight ahead, identify the number and take the card to scan down and place it accordingly. Despite the sequential order, this round she was only 50% accurate.
4th Deal – We arranged all 12 cards in the original formation. We shuffled the identical matches. Corey held them in her left hand (a first!). (Elaine and I were silent…we gave no direction or hints) Corey picked each card out of her left hand with her right hand. She had to silently identify the card and find its match. She was 80% accurate with this round.
What we learned from today’s discoveries ~
We found throughout all levels, when we had three rows, Corey could not see the top row. We knew about her left neglect but there appears to be a field cut above a certain point as she looks top to bottom. It’s been over a year since her field of vision was tested at Wills Eye. At that time Corey couldn’t communicate as well as she can today. She relied on thumbs up and writing her responses. It may be time to return for a follow up evaluation!
The number identification and the misidentifications lead to additional questions; does she not see the number? Does she know what the number is but can’t recall the name associated with the number? Does she recognize the number only because it’s in sequential order? Is her field of vision the cause for misidentification? The answer is yes to all of these on any given day at any given moment. Just because today’s card game was successful, doesn’t mean she can repeat the game with the same accuracy or results tomorrow. Welcome to the world of TBI!
So where does this leave us? We’re still in the game, she’s playing the cards she’s been dealt and she won another hand today! Place your bet…mine’s on Corey!! xoxo