Perceptual Changes

Perception is our internal awareness of our body and the space around us. Occupational Therapists help you to improve your perception by teaching strategies to compensate for these changes and to re-train your brain. Depending on where in your brain the stroke occurred, you may have the following perceptual changes:


  • Apraxia is common in people who have had a stroke on the left side of the brain. 
  • This means an inability to organize and plan out movements despite having the necessary range of motion, strength, and coordination. 
  • Examples include placing your arms in the head-hole of a shirt, positioning a toothbrush incorrectly in the mouth, missing your mouth when eating, difficulty positioning your feet

Left neglect:

  • Left neglect/inattention is common in people who have had a stroke on the right side of the brain.
  • This means an unawareness of the left side of the body and/or left visual field. With a left visual field deficit, you may be aware that your left side exists but you can't see it. With left neglect, you may be completely unaware that your left side exists.  
  • Examples include not attending to your left arm or leg, colliding with furniture on your left side, not giving eye contact when communicating with people on your left side, and not safely driving due to an inattention to your left side. 
  • Occupational therapists treat left neglect with visual scanning training. The Lighthouse Visual Scanning technique is one training method. Video Source: Martha Burns. Medbridge

Visual Discrimination:

  •  The ability to distinguish features of different objects, including the ability to understand position, shapes, and forms
  • It is most apparent when reading and writing. Examples include confusing letters and numbers, difficulty with puzzles, and losing your place when reading.

Spatial Relationships:

  • Difficulty understanding the positions of objects in relation to oneself and to other objects.
  • Examples include difficulty reaching for objects (overshooting/undershooting), difficulty handwriting


  • Difficulty locating an object from the background or surrounding objects
  • Examples include not being able to locate an item on your bathroom vanity, not being able to locate a spoon in your silverware drawer, or not being able to locate your shirt in your drawer or laundry bin. 

Visual memory:

  • Difficulty remembering an object you just saw a few seconds ago. 
  • Examples include placing your television remote down and not remembering where you put it, reading a telephone number and not remembering what you just read, transferring appointments from your phone to your calendar and not remembering the information you just read.  

Visual closure:

  • Difficulty finding a whole figure when only fragments are shown.
  • Examples include difficulty finding your TV remote which is partially hidden under the couch cushion and difficulty finding a cup in the cupboard which is partially hidden. 

Video Source:

Page last updated: 12/2020