专利摘要:
The present invention comprises a device for orthoptic functional diagnostics of cerebral-induced visual disturbances in childhood. The device contains anamnesis sheets, worksheets, evaluation sheets and other two-dimensional and three-dimensional test objects, such as e.g. Puzzles or shapes.
公开号:CH713510A2
申请号:CH00215/18
申请日:2018-02-22
公开日:2018-08-31
发明作者:Schandl Elisabeth;Sieger Michaela
申请人:Verband Der Orthoptistinnen Und Orthoptisten Oesterreichs;
IPC主号:
专利说明:

Description: The invention relates to a device for visual functional diagnostics of cerebral-induced visual disturbances in children in order to comprehensively diagnose damage to the post-chiasmatic visual system in a valid, objective and age-appropriate manner. The invention includes a series of two- and three-dimensional test objects that detect all aspects of cerebral visual impairment and enable the creation of a comprehensive visual functional profile.
Impairments of visual capabilities, such as letter readiness, face recognition, limited visual attention, difficulty in detecting location in space, and the like, can be attributed to malfunction in the cerebral visual processing areas occipitoparietal and occipito-temporal. These damages or dysfunctions of the child's postchiasmatic (= central) visual system, whose cause may be brain development disorders as well as pre-, peri- or postnatal brain damage, are referred to as child cerebral vision disorders and summarized under the collective term cvi (cerebral or cortical visual impairment).
Diagnosis, treatment and promotion of disorders of development or further development of brain functions of a child or adolescent are therefore essential. An essential prerequisite for the correct treatment and promotion are therefore diagnostic procedures that allow to detect various dysfunctions of visual perception. These procedures must be valid, objective and age-appropriate. If there is a suspicion of interference with visual exploration and visual search, visual cognition or visual perception of space, including visual acuity, a visual function profile should be drawn up. It is looking for the first signs of disturbances of the cognitive visual perception performance in order to filter affected children (= preselection) and to be able to perform a targeted further diagnostic. This orthoptic diagnosis is understood as a differentiated indicator diagnostics that recognizes certain signs / forms / errors / answers as an indication of the existence of damage to individual visual perception modalities.
The object of the present invention is therefore to provide a device which is used in this diagnosis. Standardized test procedures are also used, for example, in the orthoptic testing of elementary visual performance in the context of the survey of extended orthoptic status. The orthoptic testing of the cognitive visual perception modalities takes place with the help of informal examination methods.
In particular, according to the first signs of disturbances of visual exploration and visual search, visual recognition or visual perception of space, including the Visuographomotorik affected children will be supplied to a continuing diagnostics.
If there is a suspicion of such a disturbance of the cognitive visual perception performance, a visual functional profile is created, whereby cerebral visual disturbances can be diagnosed so as to enable the affected children optimal treatment.
This visual function profile is created by visual and cognitive examination in orderly order and under guidance with system to enable a uniform diagnostic procedure.
These objects are achieved by a device having all the features according to claim 1.
The device may for example be a box, a box, a bag or the like. These can be made of wood, plastic, leather or fabric.
The inventive device contains anamnesis sheets, worksheets, evaluation sheets and other two-dimensional and three-dimensional objects. The anamnesis sheets are used to monitor the visual perception performance of sighted and visually impaired children by parents / relatives / caregivers for the purpose of obtaining quantitative information on whether and in which areas impairments of functional vision are present.
The worksheets contain different tasks that are adapted to the age of the child to be examined.
The two-dimensional objects are, for example, various kinds of puzzles, memory cards, cards with geometric figures, game chips, plastic tiles, and the like.
Suitable three-dimensional objects are, for example, different colorful shapes, such as blocks, Tangrame, Soma cubes, stacking towers, and the like. In addition, the device may also contain everyday objects in miniature form, such as an armchair or a small table, or the like.
The orthoptic examination of the visual perception behavior of the child is also highly dependent on parental observation. Parents and relatives / carers can describe the child's visual responses and behaviors to various domestic situations. Her impressions are subjective and situational. This must be taken into account in the evaluation.
The history sheets include, for example, the areas of everyday life and everyday school life, and optionally also the face recognition.
The worksheets are used to survey the visual search, visual exploration and visual attention. Visual exploration is the free, intentional, visual examination of the environment, a picture surface, a visual scene, an object without prior instruction. The visual search, on the other hand, is the ability to visually filter out a single stimulus from surrounding disturbing stimuli.
The visual exploration is examined by means of worksheets for testing for the presence of a neglect of a half-space (neglect, hemianopsia). These worksheets can show several round objects, such as dots, scattered on a page of paper that must be crossed out. But you can also show single or multiple horizontal, vertical and / or oblique lines, which should be halved by the test person.
The visual search is examined by means of worksheets, such as the Schleswig observation sheet for visual exploration behavior. On one side of the paper are several copies of different object representations. The subject must locate subjects given by the examiner quickly, which provides insight into the attention-seeking visual goal-directed search for a visual stimulus.
The inventive device further contains worksheets and test objects for testing the visual (re-) recognition of form, figure, object and face.
Visual form recognition, including figure-ground perception, refers to the visual discernment, identification and recognition of forms and shapes based on their spatial characteristics and the ability to re-form a shape as a same shape, even when internal or external factors change recognize (shape constancy). These abilities are important prerequisites for object and facial perception and the figure-ground distinction (different orientations of a contour can be discriminated against). The figure-ground distinction is the visual ability to delineate a form from its environment and to be able to identify that shape in a visual scene, an important prerequisite for object perception.
The figure-ground discrimination is checked using worksheets that show overlapping shapes, simple to complex, on a simple structured to highly textured background. The visual shape recognition is checked by visually assigning identical shapes or visually differentiating simple shapes on a worksheet and visually recognizing complex shapes that overlap one or more times and are monochrome or differently colored.
The visual recognition of an object proceeds in several stages: first, the object must be recognized as contiguous and delimited from other objects and the background. Afterwards characteristic features have to be filtered out, which are constant under all perspectives and lighting conditions, but also in all specimens of this object category.
The visual recognition of real and abstract object images is checked by means of tasks which have the task of assigning identical images or visually differentiating different images. Investigations that involve the assignment of objects from different angles and views check the object recognition and the form constancy. Worksheets with illustrations of parts of objects that need to be manually completed by the subject check the ability to "visually close" objects, an important requirement for visual object recognition.
The visual recognition of abstract figures denotes the correct visual recognition of the spatial orientation of a stroke to a circle, as a preliminary stage for the recognition of the letters "b", "d", "p" and "q" and the correct visual recognition of Tilt angles and line directions as precursors for recognizing numbers and letters. The visual recognition of the spatial orientation is a prerequisite for reading and writing acquisition.
By means of worksheets, which show circles and dashes in different spatial orientations, the visual recognition is checked.
Recognizing faces is the ability to recognize the individuality of a face and to name the person who owns that face. For this, it is not sufficient to recognize only the features common to all human faces, but it is also necessary to recognize the characteristic traits that distinguish the individual's face from others. Visual recognition and interpretation of facial expressions in the face of the other person: human facial expressions are an evolutionary heritage. There are about 10,000 different facial expressions recognized. Which of these are used and in what form they are carried out depends heavily on the cultural background and socialization. However, the seven basic emotions, such as grief, anger, surprise, disgust, contempt, fear and joy, are expressed in the same way everywhere in the world.
The visual face recognition ability is checked by evaluating the behavior through an anamnesis sheet or by worksheets showing images of various human faces or showing the same human face but with different emotions or facial expressions.
The device according to the invention further contains worksheets and test objects for checking the visual memory and the visual memory capability.
The visual memory, or the visual memory is as optical short and long-term storage essential for any type of learning performance. It is checked by means of picture cards, which must be combined in the memory method, or by means of visual pair recognition on worksheets.
The device according to the invention further contains worksheets and test objects for assessing the visual perception of space, in particular the visually-perceptual perception, the visual-spatial-cognitive perception, the visual-spatial-constructive perception and the visual-spatial-topographical perception.
The visual-spatial perceptual perception is a perceptual performance that relates to visual-spatial information to process visual sensory impressions from a spatial point of view. These include visual abilities, such as the perception of the visual vertical or visual straight-line orientation, the perception of length, distance, or position, and the ability to detect angles of inclination between two lines or two objects (orientation estimation).
[0032] The ability of the child to recognize where he / she is up / down, front / back, left / right or where seen from his / her in space up / down, front / back, left / right, is referred to as spatial termed proprioceptive perception. This is checked by means of one or more three-dimensional objects. This will investigate if the child can detect where the object is in space and which of the objects is closer / farther away or left / right.
Another part of the visual-spatial perceptual perception is the ability to visually recognize spatial relationships of objects in real space to each other and is checked by means of various three-dimensional objects. On the one hand the relation of the objects in the space to each other (three differently colored objects in a row - which lies in front of the red one Behind the blue Beside the green , etc.), on the other side objects in relation to the surface: what lies in a circle / what lies outside the circle and adjusting three-dimensional scenes (an object lies on / behind / under / right / left of the table) - with template and verbal request.
These checks are also abstracted to the two-dimensional plane to verify the ability to delineate a surface. The child must determine where the top / bottom margin and the right / left margin of a leaf are. This study can also be extended to include a color object, such as a color wheel, and the child must determine where the color wheel is in relation to the sheet: top / bottom, left / right edge.
By means of worksheets is also checked whether the child line directions and angles (top, right and flat) and inclinations / main spatial axes can recognize. The ability to halve lines, to visually assess positions, to recognize spatial orientation / alignment of drawn objects and to be able to visually estimate sizes and lengths is checked by means of worksheets.
Visual-spatial-cognitive perceptual services include mental operations with space, e.g. mental representation, the ability to hold an object in one's own imagination, to manipulate it (for example, rotate, tilt, and in a changed spatial orientation) and to understand it from a different perspective (change of perspective). The capacity for mental representation is not developed after a gradual development before the seventh year of life.
Visual-spatial-cognitive perception performances are checked by means of worksheets, on which a male with an object on an arm, seen from different perspectives, can be seen. The child must find the same male with the object on the same arm as shown in the guideline from the pictures.
Visual-spatial-constructive perception refers to the ability to guide individual elements under visual guidance with one's own hands, both two-dimensionally in drawing, and three-dimensionally in building and constructing. For this ability, a high proportion of executive functions, e.g. Plan and problem-free required, as well as a good visual attention and sufficient working memory. Thus, the viscous structure represents a very complex performance. Impairments, especially in more complex visuoconstructive tasks are often found in cvi children. In visuoconstructive tasks, the mental notion (mental division of a whole figure into individual pieces [uzzle]) and the mental rotation are strongly demanded to be able to draw and construct efficiently.
Visual-spatial-constructive perception is on a two-dimensional level using puzzles in different degrees of difficulty, Tangram ("cat") and worksheets on which shapes and figures are traced after submission and including guides and points are determined.
On a three-dimensional level, the visual-spatial-constructive perception, for example by means of Soma cube, which must be recreated according to templates, and / or a stacking tower, which must be recreated according to certain specifications, checked.
The visual-spatial-topographical perceptual performance, including visual memory of places, landmarks and spaces relates skills, to memorize new ways well and to find ways to a greater extent again. At the age of six, children are able to memorize familiar routes without any problem.
The visual-spatial-topographical perception performance is by means of anamnesis sheets, where especially after the ability to memorize unknown ways to find their own way in a foreign environment after a single exploration, paths and premises even in places that are not so often were visited (eg bathroom in the apartment of the grandparents, cloakroom in the school, ...) and ways to find back to the starting point again, determined.
The visual-spatial-topographic perception performance is also tested by means of two-dimensional labyrinth tasks, the child having to follow a labyrinth with a pen or a finger.
The device according to the invention also contains worksheets and test objects for checking the visuo-motor coordination, with a focus on Visuographomotorik.
Everything we do with our hands is about the coordination of eye (s) and hand / hands, the so-called eye-hand coordination. The interaction of vision (and visual perception) and the musculoskeletal system is called visuomotor, eye-hand coordination is a partial aspect of this performance. When the eye (s) and the hand (hands) work together, children learn to understand connections through this attacking. The visuomotor is an important aspect in the development in childhood. The writing movement as a special function of fine motor skills is called graphomotorics ("grapho" = writing). To underline the influence of the visuomotor (eye movements) on the writing movements (graphomotorics), the term Visuographomotorik is also used.
The visuographomotor skills are checked by means of worksheets on which lines are traced as accurately as possible, points connected to a pen with a pen and lines must be continued as straight as possible.
The invention will be explained in more detail with reference to an embodiment according to the figure, wherein
1 shows exemplary embodiments of the device according to the invention for visual object recognition.
FIG. 1A shows a two-dimensional puzzle in the form of a clown for determining visual-spatial-constructive vision. The puzzle is cut into various inconsistent pieces.
Fig. 1B shows identical and non-identical images for determining the ability of visual object recognition. Identical images must be assigned.
Fig. 1C shows images for determining the ability of visual object recognition. The incomplete forms must be closed according to the template.
FIG. 2 shows exemplary embodiments of the device according to the invention for visuographomotor and for visual-spatial-topographical vision.
Fig. 2A shows a labyrinth, which must be traced with a pen.
Fig. 2B shows two dotted lines which must be connected.
The device is for example a wooden box in which the documents, worksheets and test objects are provided. The device comprises, for example, further following two-dimensional and three-dimensional objects: Memory cards in the format 6 cm x 6 cm (different motives) Cards with geometric figures 6 cm x 6 cm (various motives) Puzzle clown about 20 cm + matt foil Original - colorful shapes, 6 cm x 6 cm (various motifs) - A4 manuals, 4-color, printed on both sides with softcover and binding - folders with a total of over 180 different exercise and examination sheets - BVE2; Schleswig Observatory on Visual Exploration Behavior, 2nd extended edition; Susanne Mundhenk - Tangram with matt foiled template - colorful plastic sheets - 2m long rope - soma cubes - stacking tower, 4eckig - wooden armchairs - USB-stick for download (worksheets and materials) The evaluation and findings are made by means of the evaluation sheets. For each examination, the results are entered in these evaluation sheets.
Three to five repetitions are carried out per series of examinations. The assessment uses the 60% rule. That is, 60% of the answers must be correct for the task to be judged successful, for example, three answers require at least two tasks to be properly resolved, five reps require at least three correct answers. Each exam is started with the most difficult, age appropriate task. If the child to be examined can solve this task, then none of them
Dysfunction. If this task can not be solved, then easier tasks will be offered one after the other. This procedure considerably shortens the examination process and (to) demands a smaller degree of concentration of the child.
Exemplary Embodiment - Use of the cvi Box in an Orthoptic Screening The use of the cvi box in an orthoptic screening makes it possible to quickly and effectively determine whether there is a suspicion of a cerebrally caused visual disturbance.
A. General Setting: Applicable to All Tasks Given The worksheet must be straight centered to the upright child. Known, visually caused head compulsions or head postures may be taken.
The worksheet must not be compensatorily rotated during the examination (possibly, with adhesive tape on the table or lectern fix).
B. Visual search [0056] Test object:
A white DIN A4 page from the CVI box on which at least two different black, equal sized objects / basic shapes are clearly depicted in a randomized distribution. These objects can be stars, hearts, squares, triangles.
[0057] Task:
The DIN A4 page is presented to the child in landscape format with instructions to find and show / cross out all the symbols given by the examiner. The child is given no search help, such as «Start at the top left and search down to the right». The child has to search the entire page independently = attention-driven visual goal-oriented search for a visual stimulus = serial search. Asked search tasks will check the visual exploration behavior.
Evaluation:
This test is used to observe how / which system scans an area, for example symmetric, unsystematic or searching. It is the observation of the search strategy in the foreground. The following problems may occur:
The child experiences difficulty in visually exploring the A4 page WITHOUT any historically known visual neglect of a half-space. The child has no recognizable search strategy, e.g. not on the top left, but somewhere in the middle or somewhere else. Striking visual search behavior without a known neglect of a half-space: the visual search is unstructured, chaotic, structureless, slow, searching, not starting from top left. It shows a visual neglect of a half-space or a quadrant with known visual field problem or neglect.
C. Visuographomotorics [0060] Test object:
A white DIN A4 page from the CVI box, on which a labyrinth clear of the background is shown, see for example Fig. 2A.
[0061] Task:
Use a pen to make your way through the vertical bars without touching them, without stopping and without going over the boundary lines. Between the two given lines let draw a line without dropping off, without abutting on an edge line, without going beyond the boundary lines. Setting specifically:
The child is allowed to use his own writing utensils. Children with limited hand motor skills (for example, no pen hold possible) can follow the tasks with their finger or wrist as well, but then the assessment criteria are not met. This is simply noted. It certainly makes a statement about a visually guided hand movement. Pay attention to right- and left-handedness - place examination material in such a way (worksheet rotated by 180 °) that even left-handers can clearly see the task. The writing hand must not cover anything. Evaluation: handedness is noted, pin retention observed. No problems with the visuograph motor skills exist if the child can draw the line quickly without losing weight. The child can draw relatively centrally between the two predetermined lines. If the child draws slowly, often seeking, self-controlling, problems can exist.
D. Figure-ground discrimination [0065] Test object:
A white DIN A4 page from the CVI box, on which overlapping outlines of simple basic shapes are clearly depicted, see, for example, FIG. 1C. The basic forms (star, square, rectangle, triangle, circle, heart) in complex form are offered to the child in two dimensions. This complex form must now be broken down into the individual parts and assigned.
[0066] Task: Possible questions:
How many shapes can you recognize
Can you show me the shapes as well
Can you also name the forms (A quadrangle must already be recognized as such by a schoolchild and may no longer be called "triangle").
Tracing with a pen, so that the Visuographomotorik will be tested again.
Setting specifically:
If the forms are not recognized or if there are naming problems (such as children with a migration background), they can also be offered in 3D. These may also be attacked by the child - possibly, the tactile perception is better than the visual.
Evaluation:
The perception of form seems to be affected in children with CVI only in isolated cases. Noticeable is the fact that children can not (re) recognize the basic forms and are very unsure about the naming / evaluation. Problems in visual form recognition often result in a lack of visual object recognition.
E. Face recognition [0070] Test objects:
Photographic images of multiple faces showing different basic emotions such as laughter, crying, surprise, anger or joy or no emotion. A reference image, with only one face showing one of the basic emotions or no emotion.
[0071] Task:
The facial expression of the reference image must be assigned to one of the faces shown. The child should name the facial expressions of his own accord. If this is difficult for the child, ask: who is, for example, happy, surprised, angry Evaluation:
Child can not make a safe assignment, not even confidently name - cave children with migrant background.
F. Visual-Spatial-Constructive [0074] Test Object:
A white DIN A4 page on the continuous or dotted lines, curved or angled are shown, see for example Fig. 2B.
[0075] Task:
Trace complex shapes and figures according to the template, including guides and points (no freehand drawing).
[0076] Setting specifically:
The originals must be traced quickly and as accurately as possible with the pen, with tools such as ruler, eraser are not allowed. Compensatory turning of the blade is not allowed.
Evaluation:
In the case of visual-spatial-constructive disturbances, rotations, tilting and incorrect reproductions of size and length relationships occur. Drawing requires a lot of visual motor skills (fine motor skills), so badge work is not meaningful for children with impairments in these skills; Often problems with drawing curves and circles are also evident. For these children, three-dimensional, more complex tasks to assess the viscous structure are better suited.
G. Visual-Spatial-Perceptive Test Objects:
A white DIN A4 page from the CVI box on which a reference object and several comparison objects are displayed. The reference object is a short thick black line with a black dot on one side. The comparison objects are also short thick black lines with dots on different sides, a comparison object is identical to the reference object. Alternatively, different angles can be shown, which must be assigned to a reference angle.
[0080] Task:
Child must recognize which of the four angles / positions is identical to the reference object.
[0081] Setting specifically:
In this task, it is particularly important to ensure that the worksheet is just centered in front of the child sitting upright (a lollipop or crooked sitting is not allowed in this task). Known, visually
权利要求:
Claims (8)
[1]
Conditional head compulsions or head postures may be taken. The worksheet must not be turned compensatorily during the examination (if necessary, fix with adhesive tape on the table or lectern). Evaluation: The child can not detect the reference figure from the comparison objects as ident. H. Visual-Spatial-Cognitive Test Object: A white A4 page from the CVI box on which a black grid field, divided in the middle, is shown. On the one hand, a certain number of fields in the grid are filled in black, which give a certain shape. This shape must be mirrored on the page with the empty grids. Task: Lines, shapes and figures must be mirrored in the imagination or rotated in their position in space, so that the / the pattern / shape / figure can be completed. Reflections are queried both vertically and horizontally. Setting special: The worksheet must be just in front of the child, a compensatory turning of the sheet is not allowed. Right and left handedness should be considered. Evaluation: Children with visual-spatial-cognitive disorders, this exercise almost never or only very rarely without errors, very often is copied and not mirrored. Again, there is often a very slow pace of work. New Swiss patent application Association of Orthoptists Austria's representative: P5496CH00 claims
1. A device for visual function diagnosis of cerebral vision disorders, characterized in that the device contains anamnesis sheets, worksheets, evaluation sheets and other two-dimensional and three-dimensional test objects.
[2]
2. A device according to claim 1, characterized in that the worksheets and the further two-dimensional and three-dimensional test objects of the evaluation of visual exploration / attention, the visual (re) recognition of form, figure, object and face, the visual spatial perception and the Serving visuo-motor coordination.
[3]
3. Device according to one of claims 1 or 2, characterized in that the worksheets for the evaluation of the visual function are selected from: - worksheets for checking for neglect of a half-space, - worksheets for checking the visual search and the visual search strategies, - Worksheets for checking the visual recognition of abstract figures, including, but not limited to, detecting the spatial alignment of dot and dash and / or visually detecting tilt angles, worksheets for checking visual object recognition, worksheets for checking visual differentiation, worksheets for checking basic visual form recognition, - worksheets for checking visual memory and / or visual memory, worksheets for checking visual-spatial-constructive perception, - worksheets for checking visual-spatial-perceptual perception - worksheets for the examination of visual-spatial cognitive perception, and - worksheets for the examination of visuomotor coordination.
[4]
4. Device according to one of claims 1 to 3, characterized in that the three-dimensional test objects for evaluating the visual function are selected from: - Test objects for testing the visual object recognition, - Test objects for testing the basic visual form recognition, - Test objects for testing the visual Memory and / or visual memory, - test objects for the examination of visual-spatial-cognitive perception, - test objects for the examination of the visual-spatial-constructive perception, and - test objects for the examination of the visual-spatial-perceptual perception.
[5]
5. Device according to one of claims 1 to 4, characterized in that the device anamnesis sheets, evaluation sheets and other two-dimensional and three-dimensional test objects selected from the group consisting of worksheets, memory cards, cards with geometric figures, puzzles, colorful shapes, tangram, Spieljetons, Containing plastic sheets, ropes, soma cubes, stacking towers, and everyday objects in miniature form.
[6]
6. Use of the device according to one of claims 1 to 5 in a method for determining a visual dysfunction in children, characterized in that the method comprises the following steps: a. Determine the visual perception performance of the child and record in anamnesis leaves, b. Performing at least one examination for visual search / visual exploration / visual attention, visual recognition / re-recognition of shape, figure, object and face, visual space perception, and / or visuomotor coordination, c. Evaluation of the results, d. Creating a Findings Report, and optionally e. Recommendation of promotional measures.
[7]
7. Use of the device according to claim 6, characterized in that a. the study series with the most difficult, age-appropriate task is started for the child to be examined, b. solve less than 60% of the task, use the lighter version.
[8]
8. Use of the device according to one of claims 1 to 5 for the prediction or diagnosis of visual dysfunction in children.
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同族专利:
公开号 | 公开日
AT16041U1|2018-12-15|
DE202018100899U1|2018-03-29|
引用文献:
公开号 | 申请日 | 公开日 | 申请人 | 专利标题

FR2948865A1|2009-08-07|2011-02-11|Ct Hospitalier Universitaire De Clermont Ferrand|Individual's e.g. brain injured child, data e.g. neurovisual function related data, collecting method, involves checking memory lapse and open ended statement of child and observing exploratory visual strategy during test|
法律状态:
2018-10-31| PCAR| Change of the address of the representative|Free format text: NEW ADDRESS: GRELLINGERSTRASSE 60, 4052 BASEL (CH) |
优先权:
申请号 | 申请日 | 专利标题
ATGM50033/2017U|AT16041U1|2017-02-23|2017-02-23|DEVICE FOR VISUAL FUNCTIONAL DIAGNOSTICS|
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