What is the role of visual-haptic interventions in the diagnosis of attention-deficit disorders and learning disabilities?

Updated: Aug 20, 2019
  • Author: Morris Steffin, MD; Chief Editor: Jonathan P Miller, MD  more...
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Answer

The attention-deficit disorders can be difficult to diagnose, and diagnostic modalities may not correspond well to clinical situations. VR appears to have the capability to link well-controlled multimodality stimuli to more objective physiological measurements of attention and discrimination. Electrophysiological and imaging abnormalities have increased the understanding of physiological mechanisms in these disorders. Characteristics of ERPs have, in some studies, shown good correlation with behavioral responses to appropriate medication.

Basic differences in brain physiology may exist with medication that are demonstrable with ERP monitoring and will allow carryover, with refinement, to the detection of such physiological perturbations in more complex, immersive environments. The study of ERPs allows dissection of the attention process, for example, into novel but nonmeaningful stimuli versus novel and meaningful stimuli.

ERPs have been shown to distinguish electrophysiologically between attention-deficit/hyperactivity disorder and combinations of attention-deficit/hyperactivity disorder with learning disabilities. The level of significance of stimuli, particularly if such significance is established by prior events, can be assessed using ERPs. ERPs have been shown to be a valid measure of the ability to discriminate phonemes. Visual-auditory cross-over tasks can produce alterations in ERPs indicative of cross-modality processing.

Mapping of cortical asymmetries involved in tonal versus phonetic processing can be achieved by ERP analysis. These approaches can be correlated with fMRI. Perception of phonemes as native or nonnative to the subject's language markedly influences ERPs, as does phonologic-semantic inconsistency. Early ERP components (N 100) have been shown to display less lateralization in dyslexic children than in nondyslexic children. Subtle ERP differences also arise in autistic patients.


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