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Perceptual problems result from a difficulty in processing the information that comes either through ears, eyes, touch, or movement.

Auditorially, your family member's ability to hear sounds will probably be fine. However, he may not be able to understand what is said to him. This may happen because he does not perceive the different sounds in words. For example, he may misunderstand addresses, directions, or names because he mishears similar-sounding words.

Visually, your family member' s ability may be intact (i.e., 20/20 vision); however, he may have difficulty recognizing shapes or following written directions because he does not lift the information correctly from the page. In the same manner, he may have difficulty with left/right, top/bottom orientation.

Your family member may not be able to obtain as much information through touch as he once did. This does not mean that he won't feel sensations as he once did, but his interpretation of what he feels may take longer (i.e., identifying coins placed in his hand). He may not be accurate at discriminating objects by touch.

Your family member may not move as quickly or precisely as he did before (this will be covered in depth in the section on slowed response time). He also will not receive as distinct or accurate feedback from his movements as he once did.


The following are examples of perceptual problems you may observe in your family member:

1. He may have difficulty understanding similar-sounding numbers and words, particularly new information such as room numbers and addresses. Often 15 will be confused for 50, 30 for 13, Mike for bike.

2. It may seem as if your family member does not hear what you are saying. He may ask you to repeat it. It may seem as if he does not hear simply because it takes him longer to process information.

3. Your family member may have extreme difficulty finding new places. He may become lost easily, confuse north, south, east, and west, and therefore lose confidence in going places by himself.

4. It may take him longer to find keys, lock and unlock doors, and manipulate hand-held tools. He may also take longer to write or type words than prior to the TBI.

Management Techniques

Many perceptual difficulties improve with time; however, some remain. Your family member may always have difficulty following directions, either written, graphic, or verbal. Therefore, he may also always need to rely on writing down information.

1. Before giving your family member any directions, make certain you first have his attention.

2. Ask your family member to repeat numbers, letters and directions back to you. That way you can be sure he heard it correctly. Encourage him to write down important information so he can refer to it.

3. Walk your family member through new environments. Also, talk your way through them. Reinforce directions for a new environment with maps and written directions for easy reference.

4. Give your family member more time for tasks that require manual dexterity. Remember that activities he once enjoyed (such as doing home improvements) may now be frustrating for him. He may also experience difficulty with fine manipulation skills, such as opening envelopes, unscrewing lids, or working locks.