Wayfinding With Visuo-Spatial Impairment from Stroke and Traumatic Brain Injury

Abstract

Visuo-spatial impairments are common following brain injury. The impairments differ in severity, involving symptoms such as partial vision loss, unawareness of one side of space, and topographic disorientation. In this exploratory study we investigated wayfinding difficulties experienced by four community-dwelling individuals with visuo-spatial impairments due to brain injury. Semi-structured interviews were conducted to elicit information about the type of travel the informants undertook independently, the environments they frequented, and the strategies they used to compensate for disability.

One informant had a moderate visual field cut resulting from stroke, and was able to travel and work independently. Two informants had visual field deficits in addition to topographic disorientation. They used very systematic strategies based on landmarks and path learning to master navigating in a variety of settings. The fourth informant had diffuse brain injury resulting in topographic disorientation and short-term memory impairment. He relied on his spouse for transportation needs.

The interactions of these informants with the environment provide information that may be useful for enhancing independence and quality of life following brain injury, and for identifying future directions for research on wayfinding with visuo-spatial impairment. Simple environmental modifications in the home may improve orientation. Travel outside the home presents considerable challenges related in part to environmental design.