Neural Visual Postural Posttest 2017 Neural Visual Postural Posttest This posttest consists of 130 Multiple Choice questions. For each question, indicate the single, best answer from among the choices given. There is no time limit for completing the test. You must answer at least 91 of the questions correctly (70%) to successfully pass the course and claim your CE credits. Once you've submitted your answers, the posttest will be automatically scored and the results summarized. If you don't pass the test on your first attempt, you can retake the test to improve your score. Click the link to review the Course Summary for this course. NOTE: While you can use any source you wish to complete the exam, the final answers you submit must be based on your own work. Name* First Last Email* State*License No.*OE Tracker No.*Developing a model for rehabilitating vision dysfunction for persons who have had a neurological event involves:Creating a model of vision for neuro-rehabilitationPrismsThe need for understanding development related to posture and visionThe need to observe and assess postureAll of the aboveLight is:a. Both wave-like and corpuscular in natureb. Composed of quantac. Visible only when in wave-like formd. Visible only in coherent wave forma and bApproximately what percent of light reaches the retina?10%30%60%80%The neocortex is:a. Composed of the innermost layer of the cortexb. 2.5 mm. thickc. Composed of six layersd. 80% of the human brainb, c and dThe layers of the neocortex are:a. Layers I - III are mylenated fibers and axons (II and III project to other areas of the neocortexb. Layer IV receives input connections from outside neocortex especially from thalamus (feed forward)c. Layer V –VI are output connections to outside neocortex especially thalamus and brain stem (feedback)a, b and cNone of the aboveThe visual neocortex:a. Is composed of the original six sub-layers plus an additional 3b. Includes additional layers because of the significant increased input from midbrain and thalamusc. Is composed of only feature detectorsd. Combines information with auditory processinga and bThe visual neocortex:Serves by organizing lines and patterns of informationProvides simultaneous relays with other pattern recognizers to enhance or inhibit erroneous dataDetermines useful data by redundancy and averagingHas 300 million pattern recognizersAll of the aboveVision:a. Attempts to break down relationshipsb. Isolates itself from the sensorimotor systemc. Attempts to bring balance to reinforce sensorimotor informationd. Seeks form and containmentb and dVision is composed of:a. Magnocellular, parvocellular and knicocellularganglion cells from the retinab. Color detectors that recognize all of the primary colorsc. An ambient and a focal visual processa and cNone of the aboveThe ambient visual process is:a. Composed of both magno and parvo cellular cellsb. Preconscious in naturec. A slow process compared to the focal processd. Serves to organize visual spatial information with the sensorimotor systemb and dThe ambient visual process:a. Feedforwards information to 99% of the brainb. Supports binocularityc. Contributes spatial-temporal information to the visual cortex thereby providing the domain for the cortex to apply detail for attention and concentrationd. Contributes information about detaila, b and cThe most appropriate model of learning and performance theory to be applied to the bimodal model of visual processing is:Response-stimulus-responseStimulus-responseThe function model of visionThe medical-pathological model of visionNone of the aboveThe characteristics of Post Trauma Vision Syndrome (PTVS) are:Exotropia and exophoriaConvergence and accommodative insufficiencyOculomotor dysfunctionIncreased myopiaAll of the aboveThe symptoms of PTVS are:Diplopia and blurred visionPerceived movement of objects or patternsHeadaches and astenopiaHallucinations and photophobiaAll of the abovePTVS occurs following a neurological event and is caused by:a. Disease of the parvocellular systemb. Dysfunction affecting the ambient visual process and the motor-sensory systemc. Loss of sight in one eyed. Anismetropiab and cThe implications of PTVS are:Over-focalization and isolation on detail without spatial organization‘Focal-binding’Inability to release from fixationA lack of ability to organize spatial information with the motor base and a restriction of the response or ‘anticipatory’ response prior to the stimulusAll of the aboveThe effect of loss of spatial organization with ambient and sensorimotor matching can lead to:a. Difficulty readingb. Abnormal postural tonec. Changes in tastea and bNone of the aboveWhich of the following statements are true?The focal process is like a camera and uses mostly ‘snapshots’ through saccades (quick eye movements)The focal visual process slows down time and because of this it primarily uses the corpuscular (particle) nature of lightThe ambient process fills in the gap between focal and detail information with spatial contex and it provides an anticipation through its preconscious ability to create relationshipsThe ambient process is fast and speeds up time and uses mostly the wave form of light and without the ambient process vision would appear as a series of overlain images that compress like an accordion or the bellows of a cameraAll of the aboveThe ambient visual process:a. Does not map behavioral space around the bodyb. Is restrictive and the focal process is expansivec. Incorporates ‘complimentary receptor functions’ to enable segregation of focal and ambient information which leadd. Together with the focal process involves a second form of interaction for reciprocal inhibitory coupling and serves attention shifts from one mode to the otherc and dVisual skills such as pursuits, saccades, accommodation and vergence of the eyes are brought into functional relationship with vast variety of:a. Practiceb. Movements of the body that are whole and fine and which include head rotations, lateral flexion and extension, lateral extension and flexion with rotation of the bodyc. Extension of the body away from gravity and flexion of the body with gravitya and cb and cVision involves:A spatial preconscious matching with the sensorimotor systemsOrganization of pattern recognition together with spatial applicationEmanation from an action systemVergence movements that utilize a preconscious spatial mapping prior to identificationAll of the aboveTemporal relationships applied to vision includes:The speeding up of temporal processing relative to ambient visual processing and a slowing down of temporal processing relative to the focal processNo change between focal and ambient processingThe slowing down of temporal processing relative to ambient visual processing and a speeding up of temporal processing relative to the focal processStreamlining information about facial detailsNone of the aboveIn development:a. Vergence and version movements require a ‘top-down’ or conscious mode of processingb. Abduction and adduction of ocular movements emanate from early exploration for movements involving extension, flexion and then extension, flexion together with rotation of body movementsc. Vision is both “bottom-up” and “top-down” processing although the preconscious spatial processing should precede conscious visual processingb and ca and bThe organization of the ambient or spatial visual process together with matching between the sensorimotor system:a. Creates a spatial domain that is grounded in the motor ‘action’systemb. Enables suppression of the early primitive reflexesc. Creates ‘plasticity’ of the visual processAll of the abovea and cPost Trauma Vision Syndrome (PTVS) is only diagnosed through analysis by:a. An eye examination to determine if there is a convergence insufficiencyb. A P-100 cross pattern reversal binocular analysis using the PTVS protocol which involve the addition of a low amount of base in prism placed before both eyes following testing without the base in prismc. Determination of an increase in the amplitude response following introduction of the base in prismb and cNone of the aboveA P-100 followed by multiple peaks indicates:Lack of validity of the P-100An inability to release the focal responseAn over-reaction of the ambient visual processAn improved ‘top-down mode of conscious procession over spatial visual processingNone of the aboveAn increased negative wave potential of the N-75 can often:a. Be reduced or eliminated with the introduction of a low amount of base in prisms before both eyesb. Indicate that the ambient process is not primary in providing an anticipatory spatial organization of vision that is grounded in a motor or proprioceptive base of supportc. Indicate ‘focal binding’a and ca, b, and cConduction the VEP P-100 cross pattern reversal analysis to ‘rule out’ PTVS should be done with:Both low and high spatial frequency stimuliOnly low spatial frequency stimuliOnly high spatial frequency stimuliFlash stimuliTemporal-spatial stripes and a variable frequency patternVergence is brought into developmental organization through:a. Conscious effort to see more clearlyb. A driving force to look at near objects through a ‘top-down or conscious orientation to seeingc. A developmental organization of the ambient visual process together with the motorsensory systems in relationship with extension and flexion active motor movementsa and bNone of the aboveReflexes occur to:a. Create sensory stimulationb. Develop the ability to have reflexes to respond to stimulationc. Ground the senses within the motor systema and bb and cBinocularity is a result of:a. ‘Top-down’ streaming and conscious effort to attain singular binocular visionb. An introduction of seeing more clearly for the infant to create a conscious mode of visual attentionc. A conscious effort to create convergent or; base-our’ visual fusiond. Spatial feedforward from the midbrain following an ambient motor spatial match to bonicular cortical cells to integrate the images from each eyea and bPostural tone relates to:a. Differentiation of position senseb. A feeling of balancec. A motor-sensory processing organization related to posture upright against gravityd. Characteristics of spastic muscles in the neck and shoulder areaa and bThrough development a prone extension away from the ground develops visual organization that leads to what type of ability to move the eyes and awareness?a. Vertical saccadesb. Divergence of the eyesc. Horizontal pursuitsd. Peripheral awarenessa, b and dFlexion in development is a means for the child to organize visual processing and establishes which visual skills?a. Peripheral awarenessb. Convergencec. Accommodationd. Lateral movements of the eyesb and cLateral extension in development with rotation assists to establish what type of visual organization and visual skill?a. Cyclo-rotation of the eyesb. Diagonal eye movementsc. Convergenced. Divergencea and bLateral body displacement develops what quality of visual performance?a. Horizontal motilitiesb. Isolation on detail or ‘focal binding’c. The ability to maintain a stable fixation point as a reference of orientation with displaced movementd. Near-far fixationsa and cThe ambient visual process establishes which visual skills in relationship with postural alignment?a. Pursuitsb. Saccadesc. Convergence and accommodationd. Increased postural tone against gravitya, b and cThe ‘righting response’ begins with:a. Aligning the upper body over the legs and feetb. Sitting upc. Lifting the head off of a surfacea and bNone of the aboveVisual Midline Shift Syndrome (VMSS) is:A shift of orientation of the object relative to the visual egocenterA shift in orientation of the egocenter relative to the object of regardA shift of the ‘top-down’ conscious orientation between the object of regard and the egocenterA shift in conscious visual spaceNone of the aboveA hemiparesis will initially cause a shift in visual midline _____ and then _______ from the affected side? (fill in the correct order of the shift)Toward and then awayAway and then towardNeither toward nor awayIt depends on which side is affectedNone of the aboveWhen there is a left hemiparesis following a CVA the person will usually have a weight shift:To the leftTo the rightAnterior or forwardsPosterior or backwardsNone of the aboveWhen there is an abnormal weight shift following a neurological event caused by a hemiparesis. The abnormal weight shift will be reinforced by a shift in spatial visual information or visual midline. The shift in visual midline is:Always in the direction of where the person is lookingAlways in the direction opposite to where the person is lookingUsually toward the affected sideUsually away from the affected sideUsually toward the weaker sideFollowing a neurological event yoked prisms can be used to affect imbalance between the ambient or spatial visual process and the base of support (BOS). In order to prescribe yoked prisms to affect the posture the clinician should look for key characteristics related to a possible shift in visual midline:One shoulder higher than the other during ambulationThe pelvis on the side of the elevated shoulder will often be depressedIncreased weight shift to one side, and/or in the anterior posterior directionSliding of the feet on the floor or ‘toe-walking’All of the aboveIn a standing or seated posture, the clinician should observe postural alignment to determine if there is a lack of extensor tone. A low extensor tone will often be demonstrated by:a. A tilt of the head to one sideb. A slouching of posture with rounded shouldersc. Abduction of the scapulae and a lack of organization of the upper thorax relative to a visual spatial imbalance with the sensorimotor systemd. Capital extensionb, c and dToeing in during ambulation may be an indication of:a. A posterior VMSSb. An anterior VMSSc. An anterior tilt of the pelvisd. A posnterior tilt of the pelvisb and cYoked prisms may be prescribed to affect a VMSS reinforcing an abnormal weight shift. The base of the prisms should always be oriented:Toward the direction of weight shiftOpposite from the direction of weight shiftBase-in direction for both eyesOpposite the direction of the deviating eyeNone of the aboveThe yoked prism should be positioned in which direction for an anterior VMSS?a. Base down for both eyesb. Base up for both eyesc. It depends on the direction of the deviating eyed. It depends on the orientation of the head and neckc and dWhen there is a strabismus, the base end of the yoked or asymmetrical yoked prisms should always be positioned:a. Opposite the direction of the deviating eyeb. In the direction opposite the abnormal weight shift causing VMSSc. In the direction of the deviating eyeb and cNone of the aboveFor a person with a right exotropia and a right hemparesis the asymmetrical yoked prisms would be best oriented in which direction if the person demonstrates an abnormal weight shift to the left?OD base out and OS base inOD base in and OS base inOD base in and OS base outOD base out and OS base outNone of the aboveFor the previous question, the best approach to affect the strabismus as well as the VMSS would be to prescribe asymmetrical yoked prisms in the following orientation:OD high base in prism and OS low base out prismOD low base out prism and OS high base in prismOD low base in prism and OS high base in prismOD high base out prism and OS low base in prismNone of the aboveWhen considering to prescribe prisms for a person with a TBI who has a left exotropia, the clinician should:a. Measure the exotropia and prescribe the amount of prism determined from the angle of deviationb. Assess postural imbalances while seated and standing and then assess posture during ambulation in order to prescribe for a visual midline shiftc. Assess for visual midline shift first and then assess the exotropia after the patient is wearing the yoked prismsd. Prescribe asymmetrical yoked prismsb, c and dWhen viewing a distant acuity chart, a head turn may indicate:Visual Midline Shift SyndromeA strabismusPost Trauma Vision SyndromeA cervical mis-alignmentNone of the aboveNeuro-Visual Postural Therapy (NVPT) is an approach for:a. Incorporating postural adjustments manually to affect strabismusb. Rehabilitating persons who have had a neurological event and who have been diagnosed with visual dysfunction as well as postural imbalancesc. Rehabilitation of Visual Midline Shift Syndrome (VMSS) and Post Trauma Vision Syndrome (PTVS)a and cb and cA Paradoxical VMSS is:a. A shift of the visual midline toward the non-affected sideb. A shift of the visual midline away from the affected sidec. A shift of the visual midline toward the affected sidea and bNone of the aboveFollowing a CVA or TBI, in the early stages the person will lean:a. Toward the non-hemiparetic sideb. Toward the hemiparetic sidec. Away from the hemiparetic sidec. In flexion toward the hemiparetic sideb and cThe Compensated State of posture following a CVA or TBI that occurs usually within a week following the event is reinforced by the shift in visual midline:a. Away from the hemiparetic sideb. Toward the hemiparetic sidec. Toward the non-affected sidea and bb and cWhen considering treatment for a person with a Paradoxical Visual Midline Shift the clinician should:Wait one year and what ever the patient is left with is what they have to live withWait one month after the event and prescribe yoked prismsPrescribe yoked prisms as soon as possible and confer with the neurologist, physiatrist, physical and occupational therapistRefer for physical therapy before prescribing yoked prismsNone of the aboveWhen prescribing yoked prisms for a person with a Paradoxical VMSS, the prism base should be oriented:a. Toward the affected sideb. Away from the affected sidec. Away from the non-affected sidea and cNone of the abovePusher’s Syndrome is a VMSS where the person shifts their weight:a. Away from the affected sideb. Toward the affected sidec. Toward the non-affected sidea and cNone of the aboveIn the Compensated State of posture following a CVA or TBI the person will often demonstrate a posture of:a. Lateral extension on the affected sideb. Lateral extension on the affected side and flexion on the non-affected sidec. Rotation and extension into the affected sided. Lateral extension on the non-affected side and flexion on the affected sidea and bWhen looking through a prism at an object, the focal process sees and experiences:An image shift toward the apex and a visual midline shift opposite the image shiftAn image shift toward the apex of the prism and a visual midline shift with the imageThe image shifts toward the apex end of the prism and no relationship to the visual midlineThe image shift toward the base of the prismNone of the aboveWhen looking through a prism at an object, the ambient or spatial visual process sees and experiences:An image shift toward the apex and a shift of the visual midline opposite the image shiftAn image shift toward the apex of the prism and a visual midline shift in the same direction as the image shiftNo shift of the image but instead experiences a shift of the visual midline toward the base end of the prismA shift of the visual image toward the base end of the prism with a shift of visual midline in the same directionNone of the aboveBase up yoked prisms have the effect of:a. Expanding the distance spatial volume and compressing the near spatial volume for the ambient processb. Compressing the distance spatial volume and expanding the near spatial volume for the ambient processc. Shifting the image experienced by the focal process downward toward the apexd. Shifting the image downward toward the apex for the focal process and compressing the distance spatial volume for the ambient processa and cBase left yoked prisms:a. Compress left space and expand right space in the horizontal planeb. Expand left space and compress right space in the horizontal planec. Expand near-far space in the left field and compress near-far space in the right fieldd. Compress near-far space in the left field and expand near-far space in the right fielda and cA person with a hemiparesis following a CVA or TBI should:a. Receive physical and occupational therapy as soon as possible following the eventb. Receive a neuro-optometric rehabilitation assessment before the physical or occupational therapy beginsc. Utilize yoked prisms prescribed by an optometrist who understand neuro-visual processing rehabilitation to maximize potentials of the rehabilitationd. Wait one year after the event to go to an eye doctor to see if there are any changes with visiona and cFor the paradoxical visual midline shift:Physical and occupational therapy is critical in conjunction with use of prescribe yoked prismsOnly yoked prisms should be used and the prism base should be in the direction opposite the weight shiftThe optometrist as well as the therapists should perform lateral weight shift activities and delay considering use of yoked prismsThe physical and occupational therapist should apply bi-nasal occlusion and delay referring for a neuro-visual processing evaluationNone of the aboveThe understanding within Neuro-Visual Processing Rehabilitation (NVPR) is that:a. The ambient process interprets motor-sensory distortion as a distortion of space that is internal or withinb. The expression of this distortion by the ambient process is a COMPRESSION and EXPANSION of spacec. This compression and/or expansion will reinforce postural imbalance as well as visual field loss (homonymous hemianopia)All of the abovea and cVision is a dynamic process that:Provides awareness of space and the organization of posture and movement.Affects only how the person sees at farAffects only how the person sees at nearIs always the same after 7 years of ageIs always the same regardless of neurological statusVisual dysfunction:Is present in brain damageAffects acuity at nearAffects acuity at farIncludes headaches, double vision, and photophobia problems with balanceAll of the aboveThe visual system includes:External and internal brain structuresOnly external structuresOnly internal structuresOne neural pathwayReceptors for detailed stimulusThe ambient visual process is responsible for:Our ability to activate feed-back processesOur ability to activate feed-forward motor performance and anticipatory processesIdentifying detailsAnswering the question "What is it?"Recognizing facesTo use vision efficiently, we need to:Be able to see clear and single at all distancesHave 20/20 acuity at farBe able to know the alphabetHave good light receptionUnderstand timeThe ambient process:Speeds up orientation to timeSlows down orientation to timeIs independent from time and spaceAllows for recognizing placesIs related to short term memoryThe ambient process:Is related to acuity at farIs related to acuity at nearHelps to anticipate changeIs related to intellectual abilitiesNone of the aboveThe inability to match ambient vision and movement:Often results in a lack of confidence in moving through spaceDoes not affect quality of movementDoes not affect quality of postureDoes not interfere with eye hand coordinationDoes not interferes with movement transitionsThe visual process develops and refines skills through its relationship with the motor system:Through movement experiencesThough memory exercisesIndependently of sightIn the first months of lifeBut does not change with new experiencesReading requires the ambient visual process:To see clear at nearTo organize spatial information prior to focalizationTo see clear at farTo use both eyes at the same timeTo be flexibleThe visual system:Is a static process of receiving lightIs a dynamic system that responds to light and movementIs a sensory systemIs a motor systemIs a cognitive systemResearch shows that the use of low amounts of base in prisms OU and bi-nasal occlusion for individuals with visual dysfunction after head trauma:Increases the amplitude of VEP and is termed Post Trauma Vision Syndrome (PTVS)Does not change amplitude of VEPSometimes changes the amplitude of the VEPShows improvement on the MRIChanges refraction errorVisual midline shift:Includes symptoms of distortion of the perception of space including leaning to one side, the floor tilting, walls moving, etc.Includes distortion in auditory inputDoes not affect postural toneDoes not causes trunk misalignmentIs a psychological aberrationA prism added to the spectacle prescription:Is always used in a Myopia prescriptionIs always used in AstigmatismIs used depending on patient’s ageExpands space on one side and compresses space on the other sideIs always used as a permanent prescriptionOnce there is a distortion of the sensorimotor process:The patient can solve it by using conscious effortThe visual process reinforces the problemUsing external aids reduces the problemTeaching good posture solves the problemHaving the patient bare foot reduces the problemOcular pursuits:a. Are controlled maintaining contact on a stationary objectb. Are controlled by the cilliary musclesc. Are organized by the balance of feedforward ambient spatial processing and feedback from the focal processd. Are dysfunctional with postural imbalancec and dThe ambient visual process:Is a conscious processIs a preconscious processIs a result of cognitive developmentIs developed after the focal system has developedIs controlled by conscious effortIndividuals with a neurological disorder:a. Often move their bodies and "drag" their eyes as opposed to the vision leading the movementb. Are capable to separate body movement from eye movementsc. Lack the postural base of support to reinforce visual processingd. Develop abnormal visual processing relative to abnormal state of postural toneb, c and dSaccades refer to the:a. Ability to move the eyes from one fixation point to anotherb. Ability to move the eyes over a moving targetc. Conscious ability to control eye/hand movementsd. Use of the ambient spatial process to release from focalizationa and dBinocularity refers to the ability to:Maintain fusion at nearMaintain fusion at farMaintain fusion smoothly on a visual target a various distancesFuse two images from each eyeAll of the aboveBalance and movement relate to:The ambient processThe focal processThe cognitive processEmotional stateRefractive errorPoor visual pursuits are:Often caused by imbalance between ambient spatial-temporal organization in combination with postural organizationA sign of focal problemsA sign of emotional disturbanceA sign of lack of interest on the visual inputA sign of blindnessDifficulties in motor development relate to:Imbalances in ambient-focal visual processing and cause a lack of development with visual skillsCognitive developmentEmotional developmentSocial circumstanceClearness of visionVision develops:Independently from motor experiencesFrom its motor baseWithout matching the motor experienceFrom its auditory baseAt birthDevelopmental elongation of the neck:Does not affect gaze positionAllows the head to move easily in all directions, and cover all visual spaceIs present at birthIs independent of postural toneIs independent of cervical alignmentGood neck alignment is critical for:Establishing head control and the ability of the eyes to eventually lead movementEstablishing functional relationships between visual system and motor systemsOptical righting to be integrated with head righting reactionGood balance and equilibrium reactionsAll of the aboveQuality of body and eye movements is refined through:Feed forward informationFeed back informationFeed forward and feed back information20/20 visionNone of the aboveThe development of an efficient visual system:Requires an active and normal motor system together with a stimulating environmentIs not affected by the environmentIs only affected by the environmentDepends only on normal sight None of the aboveIn normal development head righting responses:Are paired with optical righting reactionsAppear once the baby sees clear at nearAppear once the baby sees clear at farAppear once binocularity is establishedAppear late in developmentA disturbance of posture and movement:a. May affect visual motilities, flexibility and amplitude of both accommodation and vergencesb. Disturbs postural tone, and muscle skeletal alignmentc. Interferes with balance and equilibrium reactionsd. Causes mental retardationa, b and cOrganization of basic components of eye movements parallels with organization of basic components of body movements:Only after 7 years of ageFrom the earliest stages of sensorimotor developmentWhen the infant is beginning to talkAt school ageWith 20/20 visual acuityVision is the primary incentive for movement:In normal motor development in the sighted childOnly after the primitive reflexes have disappearedRegardless of visual acuityWhen sound is presentWhen the infant is crawlingVertical ocular motilities:Are paired with head extensionAre paired with head rotationAre paired with head flexionAre independent from head movementsOccur only with head movementsAn efficient Neuro Postural base requires good muscle skeletal alignment:For normal postural toneFor normal muscle rangeTo be in an erect position against gravityNone of the aboveIn normal development early head lift as a survival skill:Is very soon paired with visual fixations on a visual targetIs present at birthDoes not interact with visual inputIs present only after primitive reflexes are integratedOccurs when the baby is side lyingRefined body movements:Do not affect visual responsesAre a basis for balance between focal and ambient processAre related to 20/20 visual acuityAre independent of a efficient visual systemAre related to primitive reflexesTrunk elongation of the weight bearing side with shortening of the non-weight bearing side:a. Is a quality feature in normal movementb. Is an automatic response when the body prepares for a transitionc. Is not related to efficient movementd. Requires the body to be in a standing positiona and bChanges in body segment relationships over the Base of Support (BOS):Can be elicited through the use of yoked prismsAre achieved only by verbal commandOccur after repetition of a movement patternDepend only on strength of musclesRequire a wide base of supportPositioning and facilitation of movement in NVPT:Allows the body to be stable and mobileElicits better quality ocular motilitiesChange motor responses of eyes and bodyAre techniques used in NVPTAll of the aboveAnterior and posterior body shifts:Refer to body misalignment in the sagittal planeRefer to body misalignment in the frontal planeAre only seen when the person is sittingDo not relate to body planesDo not relate to spine misalignmentHead and trunk rotation around the vertical body axis facilitate:a. Visual mid-line crossingb. Lateral eye movementsc. Accommodation of the focusing mechanismd. Attention at neara and bAnalysis of posture is always done in:Prone lyingSupine lyingHalf kneeling independent sittingSide lyingIn the best upright posture the patient can be in independently or with external aidPostural imbalances:Are reinforced by shift in visual midlineDo not relate to visual spaceCan be overcome voluntaryCan be changed through verbal commandAre noticeable only when the person is still or without motionGraded motoric control of the neck:a. Is required for efficient visual developmentb. Will affect visual developmentc. Does not relate to visual developmentd. Is independent of visual inputa and bThe ambient visual process establishes the organization of:Posture with the vestibular, kinesthetic and proprioceptive systemsVisual inputInternal languageFine motor responsesBi-ocular responsesIn order to support development of posture/movement:a. Only sight is importantb. Vision must remain plasticc. Movement experiences are indispensabled. Experience in moving is not neededb and cInstability in ambient process:Affects acuity at nearIs almost never present in TBICan be the cause of spatial disorientationOnly alters gross motor functionRelates to normal developmentAny change in sensorimotor information:Is reflected in visual responsesIs ignored by the visual systemChanges perception of auditory informationIs reflected in muscle strengthAffects languageDisturbances of posture/movement in both congenital and acquired brain damage:Can be positively influenced by proper use of lenses and prismsCan be positively influenced by verbal directionAre caused by lack of cultural experiencesnCan’t be changed by therapyHave a psychological causeA wheel chair bound patient:Can be affected in posture and movement through the use of yoked prismsIs not a candidate for visual therapyPlateaus after 2 years of treatmentOnly can be treated by a PTWould not respond to NVPTAbnormal high tone:In the large muscle groups will affect accommodation and binocularityIs an isolated muscle responseIs only present in congenital brain damage individualsDoes not change with treatmentIs an early development responseDisorganized Posture/Movement:Negatively influences visual responses needed for learningIs not related to efficiency in academic performanceIs always related to mental retardationIs recognized through clinical laboratory testingAffects only gross motor responsesPostural and visual imbalances:a. Have the potential to cause emotional imbalancesb. Only affect efficiency in walkingc. Relate to efficiency in the learning processd. Are of late onset in the developmental processa and cVisual training using fixations and fusion without postural organization of persons who have had a neurological event:Will lead the patient to his optimal functional levelMay cause the patient to plateaus below his potential due to ‘focal binding’Is a good alternative for the TBI patientCan also be performed without the use of lensesIs a good alternative for perceptual trainingNVPT as a treatment approach is:Only for the pediatric populationOnly for normal intelligent childrenFor all TBI patients and persons with neuro-visual-postural imbalancesFor treating only non-degenerative neurological disordersPerformed at hospitalsPosture/movement and vision dysfunctions:Are always developmental disordersCan result after brain injuryAre always caused by damage at birthShould only be treated through pharmaceutical interventionDo not improve if treatment is delivered after 18 months of onsetAutomatic postural control:Is the ability to orient to sound and postureIs necessary for conscious attentionIs necessary for mobilityIs necessary for the dual purposes of stability and orientationIs achieved through a ‘top-down’ conscious controlAn efficient neuro-postural base requires:Normal postural alignmentEqual distribution of weightAbility to weight shift in all directions with graded controlEfficient righting and equilibrium reactions as an underlying foundation for volitional movementAll of the aboveNormal musculoskeletal alignment:Establishes alignment of the sensory systems [visual(ambient)-vestibular-cervical] in the best possible vertical orientation for maximizing efficient integration and matching between the systemsDepends on muscle strengthHappens only in sitting postureIs independent of joint alignmentHas no impact on efficiency of movementAn efficient visual system:a. Relies on an organized neuro postural baseb. Is related to normal postural tonec. Is independent from the quality of the neuro postural based. Depends on where the visual targets are presenteda and bIn normal development, alignment:Is maintained in all transitional movementsIs maintained only in still positionsDepends on the BOSIs not developed until the infant begins to walkIs related to muscle strengthA wheelchair bound person:Functions visually better if body alignment is maintainedDoes not needs to be in good postural alignmentDepends on focalization to know where are things in spaceDoes not need to wear glasses for looking at farCannot be prescribed with prism to realign his/her bodyPosture movement and vision development depends on the:Integrity of the neurological structuresIntegrity of the muscular skeletal structuresIntegrity of the sensory receptorsOpportunity to experience sensory and motor inputs in contextAll of the above
