Much as this great Police concert features Synchronicity, the key to utilizing Press Lites for visual field awareness and expansion is working toward synchronicity.
I blogged previously about the application of synchronicity in fusion vs. rapid alternation when working with young children with strabismus or intermittent suppression. The lyrics by Sting capture the elusive transition that patients with ABI must undergo in recapturing visual field awareness lost to brain injury:
A connecting principle,
Linked to the invisible
Logic so inflexible
Yet nothing is invincible.
In the original journal article discussing Press Lites, I briefly addressed synchronicity as Procedure Six. Here I’ll elaborate a bit more, since perceiving synchronicity of the two stimuli is a key feature. First, a 16 second video just so that we’re on the same page for what I mean by synchronicity.
It is important that the patient reliably demonstrates the ability to say “now” for the brief moment when the two Lites are in synch, and not when they are out of phase. As noted in the journal article, you’ll want to begin with one Lite on the midline, and the other Lite in the preferred or seeing field. When the patient demonstrates the awareness of both Lites simultaneously, vary the location of the Lite in the periphery to map as much of this simultaneously perceived space as possible. Some patients who have difficulty registering synchronicity when the examiner or therapist holds the Lites may be aided by holding the Lite and bringing it in from the periphery toward the midline.
Layered onto synchronicity is the flexibility of working in different planes of the field being stimulated. Again, run the patient through this in the preferred field first before moving into the troublesome field. So often when we work on field awareness – whether it is traditional “peripheral awareness” procedures intended to counteract eso projection, as used for myopia control, or for “quadrant loading” related to ABI, we work in two dimensional planes. But the real world – whether one is navigating malls, driving, or engaged in sports presents us with a volume of space, and these procedures can and should be done in a variety of vectors that represents that full volume. This appears to be one of the keys enabling transfer of what is done during the procedure to expanded field awareness outside of the therapy environment.