Imitation & the Importance of Good Visual Processing Skills Dana M. Merritt, MS CCC Speech-Language Pathologist Association for Healthcare Documentation Integrity Annual Convention and Expo 2013 Orlando, FL August 3, 2013
Two Kinds of Imitation: Perceptually Opaque vs Perceptually Transparent
How do often do you use imitation skills in life? How do often do you use imitation skills in therapy?
“The Proper Diagnosis is Critical to Remediation” Why is our motto "The proper diagnosis is critical to remediation?" Actually, there are several reasons and here is "The Rest of the Story." As a child, I had a speech impediment and went through eight years of speech therapy without any improvement on my "r's". Finally in the ninth grade, one Speech Pathologist diagnosed me as being "tongue-tied." I had my frenulum clipped by our family physician. I went through three more months of speech therapy, and my life was changed dramatically. I became a Speech Language Pathologist, but my primary interest was not Developmental Disorders, no, it was the Rehabilitation of Stroke and Head Injury patients. My oldest son was reading two grade levels above his age-level, but he could not write (dysgraphia) or spell. I did everything I could as a Speech-Language Pathologist to help him. We even pulled him out of an excellent private school to home school him, but that did not help either. It was not until we read an article by Paul Harvey entitled "Learning Disorders are Correctable" that I learned about Visual Processing Disorders. Once my son received the correct diagnosis and treatment, he walked out of his dysgraphia problem. One thing though, he still doesn't like to spell. Remediating a processing disorder does not mean that you can change an individual's personality type. After my experience with my son, I became trained as a Vision Therapist. I grew frustrated that some of my visual patients did not make the radical improvement that my son had made. I began to do additional research about Auditory Processing Disorders. My research was leading me down three different paths. I believe the Lord gave me Ecclesiastes 3:7, "A time to listen, a time to speak," as confirmation that He wanted me to continue with the Fast ForWord approach to the remediation of Auditory Processing Disorders. So I took the required training and testing and became a certified Fast ForWord Provider in March, 1997. As a home school mom, my younger son was now in the second grade and had not learned phonics. We tried every phonics program available, but nothing helped. I immediately screened my younger son's Auditory Processing Skills, and to my shock' he flunked all the tests. He did not fit the classic pattern for a child with an Auditory Processing Disorder. His articulation was good, his language skills were good, his vocabulary was extensive, and he had a high verbal IQ. However, it did not matter one bit; he still had an Auditory Processing Disorder that was causing him to have a Phonological Processing Disorder. He became my first Fast ForWord patient, and I was thrilled with his progress. However, my son's temporal-auditory processing deficit was so severe that he needed Fast ForWord II to enable him to discriminate blends and multisyllabic words. After his Auditory Processing skills were "up to speed," he had to learn phonics and how to read. It was hard work, but it was worth it. Finally, as a Speech-Language Pathologist and a Visual Processing Therapist, I saw the majority of my patients make remarkable gains in their auditory and/or visual processing skills. But there were a few who did not reach criterion level with regards to speed in one of the therapies. Furthermore, these few children seemed "a little clumsy" or "slow to respond." In May, 2000, I attended a workshop about Interactive Metronome and learned about Timing, Concentration and Motor Processing Disorders. It made perfect sense to me. These children had a Timing, Concentration and Motor Processing deficit that was hindering their overall cognitive and communicative progress. I have since become trained as a Registered Interactive Metronome Therapist. I have seen amazing changes in the children/adolescents who have completed that program. I have re-affirmed my belief that "the proper diagnosis is critical to remediation." I now firmly believe that there are three primary gates through which we receive our instruction: the eye gate, the ear gate, and the motor gate.
www.MerrittSpeech.com
Personal experiences as a Speech-Language Pathologist, as a trained Vision Therapist and an Interactive Metronome Therapist have led me to verify three main gates: Eye Gate- Visual Processing Ear Gate- Auditory Processing Motor Gate- Motor Processing
Through these three gates we drive neuroplasticity…
We can drive neuroplasticity as a result of developing new neural pathways.
The Hebbian Learning Rule: “When neuron A repeatedly participates in firing neuron B, the strength of the action of A onto B increases.”
“neurons that fire together wire together”
Description of SLP Services
According to the 2013 State of Florida statutes Title XXX11 Chapter 468 section. (7)(a): "Practice of speech-language pathology" means the application of principles, methods, and procedures for the prevention, identification, evaluation, treatment, consultation, habilitation, rehabilitation, instruction, and research, relative to the development and disorders of human communication; to related oral and pharyngeal competencies; and to behavior related to disorders of human communication. "Disorders" are defined to include any and all conditions, whether of organic or non-organic origin, that impede the normal process of human communication, including, but not limited to, disorders and related disorders of speech, phonology, articulation, fluency, voice, accent, verbal and written language and related non-oral/non-verbal forms of language, cognitive communication, auditory and visual processing, memory and comprehension, interactive communication, mastication, deglutition, and other oral, pharyngeal, and laryngeal sensory-motor competencies.
The Eye Gate
Schematic of the Retina
The Macula The macula is the highly sensitive area of the retina which is responsible for our critical focusing of vision. It is the part of the retina most used to read or to stare intently at an object.
Occipital Lobe
The Ear Gate
The Importance of Capturing Small Sounds: 10s milliseconds long
/b/ and /d/ are rapid acoustical signals /ba/
/da/
Stark & Tallal 1988
Left Hemisphere of Cerebral Cortex
The Motor Gate
Motor & Sensory Areas of Left and Right Cerebral Cortex
www.fmrib.ox.ac.uk/~stuart/thesis/chapter_3/section3_2.html
Motor & Sensory Homunculus
Pincer Grip & Index finger
Proprioceptors are specialized sensory receptors on nerve endings found in muscles, tendons, joints, and the inner ear.
Proprioceptors: Are Not in Skin
•http://www.medical-look.com/Skin_diseases/
•http://www.medical-look.com/human_anatomy/organs/Proprioceptors.html
The Mirror Neuron System
“Mirrors in the Brain: How our Minds Share Actions and Emotions”
Edited by Rizzolatti, Giacomo & Sinigaglia, Corrado
(2008) Oxford, New York
The Discovery of the Mirror Neurons:
Macaque monkey & brain
•Blue areas in the frontal lobe are only activated during observation of action.
•Yellow areas in the frontal lobe are activated during execution of action and during observation. •Red areas in the parietal lobe are activated during execution of action and during observation.
Imitation
“Perspectives on Imitation” Volumes 1 and 2 Edited by Hurley, S. and Chater, N.
(2005) Cambridge, Massachusetts London, England
What is Imitation? Definition by Andrew Meltzoff
(1) “The observer produces behavior similar to that of model.” (2) “The perception of an act causes the observer’s response.” (3) “The equivalence between the acts of self and other plays a role in generating the response.”
To imitate an action a person must translate a sensory representation of the observed action into his own motor program for that same action. The challenge is the observation of that action and sensory input about that action occur in different modalities and different frames of reference.
The Correspondence Problem
1. “Associative Sequence Learning: The Role of Experience in the Development of Imitation and the Mirror Neuron System.”
Philosophical Transactions of The Royal Society Biological Sciences (2009) 364: no 1528 2369-2380 Catmur, C., Walsh, V. & Heyes, C
“Studies have revealed that imitative behavior can be automatic.” The sight of action X primes an imitative response and participants were unable to prevent this from happening automatically.
Catmur, Walsh and Heyes propose:
The Associative Sequence of Learning (ASL) theory of imitation where the correspondence problem is solved by eXcitatory links.
Their hypothesis for a set of excitatory links or matching vertical associations: a sensory representation of an action
V Λ a motor representation of the same action
Contingent at the same time Recognition of being imitated
The sensorimotor experience of this kind comes from socially synchronous actions and from being imitated.
The accuracy and range of imitative behaviors increase over time as individual acquire more experience of seeing and doing the same actions. The quality of social interactions between adult and infant will impact these skills.
2. “Imitation in New Born Infants: Exploring the Range of Gestures Imitated and the Underlying Mechanisms.” (who are 32 hours old)
Infant Behavior and Development (1989) 25, 953-962 Meltzoff, A., & Moore, M.
http://www.lea-test.fi/leaweb/slidecom.html
Procedure: Started with 93 newborn infants, only 40 completed the test. Did the gesture for 20 seconds, then wait for 20 seconds, did the same gesture for 20 seconds, then wait for 20 seconds…continue for 4 minutes. Then redid the procedure for another 4 minutes using the alternate gesture. The two gestures were tongue protrusion and head rotation. Very tight parameters were enforced to be scored as true imitation. Results: Showed the infants imitated each gesture at a significant level.
3. “Infants Use Multimodal Information to Imitate Speech Sounds” (3-months old)
Infant Behavior and Development (1990) 13, 343-354
Legerstee, Maria
Procedure: 39 babies, who are 3 to 4 months old, are familiarized with two demonstrations. A woman is positioned only 30 cm from the child and seems to say /a/ five times, then wait 15 sec, then seems to say /u/ for five times. She is actually being completely silent. The baby has on headphones and the vowel sound is being presented to the baby simultaneously. This is done one more time. Then the test is begun. Half the babies were then given a mismatched visual/auditory stimulus.
The dominant source of information for speech and language is vocal output. But in this study – the 3 to 4 month old babies are using visual cues from the movements of the face, including mouth, lips, teeth, tongue, cheeks and eyes to discriminate and imitate the matching the vowel sounds. Results: Only the infants who saw and heard matched cues imitated the vowel sounds.
4.“The Chameleon Effect: The PerceptionBehavior Link and Social Interaction”
Journal of Personality and Social Psychology” (1999) 76(6), 893-910
Chartrand, T.L. & Bargh, J.A.
Experiment #1 Procedure: 39 college students participated in 2 didactic sessions taking turns describing various pictures. C1 did 1 BM and 1 FE. C2 did the opposite ones.
Behavioral Mannerisms
Facial Expressions but no eye contact allowed
Results: The participants did indeed mimic the mannerisms and the facial expressions of the confederates. They also took on these mannerisms of confederates without the intention or reason to do so. What about likability manipulation?
It did not matter……
Experiment #2 Procedure: 72 college students had 15 minute session with a confederate. The confederates either mirrored behavioral mannerisms or engaged in neutral non-descript mannerisms, while describing the same pictures. Questions: How much did they like the confederate? How smoothly had the interaction gone?
All confederates were trained to mirror the body positions and the mannerisms of the participants. or The confederate sat in a neutral position with both feet on the floor and with both hands holding the photos or resting in the lap.
Results: The mimicry increases liking and fosters smooth harmonious interactions. Participants were not even aware they had been mimicked.
“The Chameleon Effect” “If I mimic you unconsciously in posture, mannerisms and /or facial expressions you will like me better and we will have smoother interactions.”
What is the Chameleon Effect? • The perception-behavior link posits the existence of a natural and unconscious connection between the act of perceiving and the act of behaving. When we perceive an action by another, we are more likely to engage in that same behavior.
• The tendency of people to take on the postures and mannerisms of those around them.
So…What is the value of Imitation? (1) Learn new skills quickly without going through trial and error. (2)Imitation is linked to increased positive social attitudes by those being imitated.
5.“The Mirror Neuron System and the Consequences of its Dysfunction”
Nature (2006) 7, 942-951 Iacoboni, Marco & Dapretto, Mirella
Procedure: 12 NL children and 12 high functioning ASD children were compared while they underwent fMRI while they viewed and imitated several emotions.
They found low mirror activity in the right inferior frontal gyrus: Brodman’s 44 area for the ASD.
Dr. Dapretto was quoted saying, “The fact that we found this relationship says that the system is there; it is just not functioning to the full extent that it should.”
She further stated that researchers and clinicians should now focus on developing ways to boost the mirror neurons in individuals with developmental disorders.
“The Mirror Neuron System is responsible for imitation.” Catmur 2009
A schematic of a Bi-modal Mirror Neuron : 2 fuses!
I propose to you that in the 2nd aspect of Meltzoff’s definition of imitation:
“The perception of an act causes the observer’s response.”
That the perception of the act is dependent on the development of Good Visual Processing skills.
The Eye Gate
Muscles of the Eye Selection and control of the image falling on the retina is carried out by three muscle systems. Two located inside the eye ball and the third located outside: – Extraocular muscles – Iris – Ciliary muscle
Cross Section of the Eye
Iris at Work
Ciliary Muscle at Work
Six Extraocular Muscles A given extraocular muscle moves an eye in a specific manner, as follows: • medial rectus (MR)—moves the eye toward the nose • lateral rectus (LR)—moves the eye away from the nose • superior rectus (SR)—primarily moves the eye upward and secondarily rotates the top of the eye toward the nose • inferior rectus (IR)—primarily moves the eye downward and secondarily rotates the top of the eye away from the nose • superior oblique (SO)—primarily rotates the top of the eye toward the nose and secondarily moves the eye downward • inferior oblique (IO)—primarily rotates the top of the eye away from the nose and secondarily moves the eye upward
Extra ocular Muscles at Work
The image traveling to the optic nerve has already been altered by the muscles of the eye.
The Retina…The Photoreceptors
The photoreceptor layer is composed of light-sensitive cells called rods and cones. Light is converted into electro-chemical signals inside the photoreceptors. This signal then travels through the Bipolar cells and Ganglion cells. There are five kinds of ganglion cells including: Magnocellular and Parvocellular.
Making Sense of the Signals Light Photoreceptors
Bipolar Cells
Retina
Ganglion Cells
Optic Nerves
Optic Chiasm
Primary Visual Centers
Area Striata
Vision
Brain
Visual Acuity vs. Visual Processing
• Visual Acuity determines how well your eyes see. • Visual Processing determines how well your eyes use the information they receive.
Description of Visual Processing Skills
Venn Diagram of Visual Processing I
Visual Gathering & Visual Efficiency
II Visual Motor Integration Skills
III Visual Perception
The Gestalt of the Three Components I
Visual Gathering & Visual Efficiency
II Visual Motor Integration Skills
Visual Processing
III Visual Perception
First Component of Visual Processing I. Visual Gathering and Efficiency
Eye Teaming (Binocularity) B. Eye Focusing (Accommodations) C. Eye Tracking (Pursuits and Saccades) A.
Second Component of Visual Processing II. Visual-Motor Integration The ability to use the eyes and the body to work together in smooth efficient patterns.
Third Component of Visual Processing III. Visual Perceptual Skills Visual Discrimination Visual Memory Visual Spatial-Relationships Visual Form-Constancy Visual Sequential-Memory Visual Figure-Ground Visual Closure
Development of Normal Visual Processing Skills
I. Visual Gathering & Efficiency A.
Eye teaming or Binocularity
Development of Binocularity
Birth
Four-Months
I. Visual Gathering & Efficiency B.
Eye Focusing or Accommodation
Smooth muscle fibers found in the ciliary muscle are not under a person’s direct volitional control.
Development of Accommodation
6-9 months old
3 years old
I.
Visual Gathering & Efficiency C.
Eye Tracking or Ocular Motor Skills
Three types of eye tracking: – Fixation – Pursuits – Saccades
Reading Requires Efficient Saccades When people read, do their eyes move smoothly across the page? No, the eyes make short jumps across the line toward the right. These short jumps are called saccades. When the eyes reach the end of the line they must make a long lateral jump in the opposite direction to the beginning of the next line. The eyes must do this smoothly throughout the entire passage. If a child has problems with saccadic eye movements he will lose his place and will struggle with reading fluency and with reading comprehension.
Development of Saccadic Eye Movements John 3:16 “For God so loved the world that He gave His only begotten Son, that whosoever believeth in Him should not perish, but have everlasting life.” King James Version
61:3 nhoJ 6 1 : 3 n h o J
Development of Ocular Motor Skills
Ocular Motor skills develop slowly; they continue to mature through junior-high and high school and into college.
An analysis of 16 years of doing an Auditory & Visual Processing Screening on every child in my practice: Visual Gathering & Visual Efficiency
Visual Motor Integration Skills
Visual Perception
Resources for Visual Acuity & Visual Processing Disorders
If you want to go learn more about Visual Processing Disorders.. I would suggest:
If you want to go learn more about Imitation & the Mirror Neuron System. I would suggest:
Beyonce Clip: “Baby Dance” Cory was born on November 11th 2007 in New Zealand. This video was shot at his grandmother’s home when he was just 13 months old... at that time he was not walking and just pulling himself up on furniture. The TV was on then Cory noticed Beyonce’s music video “Single Ladies.” He crawled over and began to dance!
References Every book and journal article referenced in this presentation has the identifying information listed in your handout. If you did not receive a handout contact me at
[email protected]
My Goal My presentation is provided to encourage you to learn more about the subject of visual processing and its impact on speech, language and learning. By providing these resources, I hope to serve as a "gate" to help you do so.
Dana M. Merritt MS, CCC-SLP
Thank you! Dana M. Merritt, MS CCC-SLP
Merritt Speech & Learning 1309-110 St. Johns Bluff Rd N. Jacksonville, FL 32225 www.MerrittSpeech.com (904) 721-4122
