Neural Visual Postural Posttest 2017 | Optometry Continuing Education

Neuro-Visual Optometric Rehabilitation and Visual Postural Dysfunction Following a Neurological Event Posttest, Level 1

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.

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1. Developing a model for rehabilitating vision dysfunction for persons who have had a neurological event involves:
- a. Creating a model of vision for neuro-rehabilitation
- b. Prisms
- c. The need for understanding development related to posture and vision
- d. The need to observe and assess posture
- e. All of the above
2. Light is:
- a. Both wave-like and corpuscular in nature
- b. Composed of quanta
- c. Visible only when in wave-like form
- d. Visible only in coherent wave form
- e. a and b
3. Approximately what percent of light reaches the retina?
- a. 10%
- b. 30%
- c. 60%
- d. 80%
4. The neocortex is:
- a. Composed of the innermost layer of the cortex
- b. 2.5 mm. thick
- c. Composed of six layers
- d. 80% of the human brain
- e. b, c and d
5. The layers of the neocortex are:
- a. Layers I - III are mylenated fibers and axons (II and III project to other areas of the neocortex
- b. 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)
- d. a, b and c
- e. None of the above
6. The visual neocortex:
- a. Is composed of the original six sub-layers plus an additional 3
- b. Includes additional layers because of the significant increased input from midbrain and thalamus
- c. Is composed of only feature detectors
- d. Combines information with auditory processing
- e. a and b
7. The visual neocortex:
- a. Serves by organizing lines and patterns of information
- b. Provides simultaneous relays with other pattern recognizers to enhance or inhibit erroneous data
- c. Determines useful data by redundancy and averaging
- d. Has 300 million pattern recognizers
- e. All of the above
8. Vision:
- a. Attempts to break down relationships
- b. Isolates itself from the sensorimotor system
- c. Attempts to bring balance to reinforce sensorimotor information
- d. Seeks form and containment
- e. b and d
9. Vision is composed of:
- a. Magnocellular, parvocellular and knicocellularganglion cells from the retina
- b. Color detectors that recognize all of the primary colors
- c. An ambient and a focal visual process
- d. a and c
- e. None of the above
10. The ambient visual process is:
- a. Composed of both magno and parvo cellular cells
- b. Preconscious in nature
- c. A slow process compared to the focal process
- d. Serves to organize visual spatial information with the sensorimotor system
- e. b and d
11. The ambient visual process:
- a. Feedforwards information to 99% of the brain
- b. Supports binocularity
- c. Contributes spatial-temporal information to the visual cortex thereby providing the domain for the cortex to apply detail for attention and concentration
- d. Contributes information about detail
- e. a, b and c
12. The most appropriate model of learning and performance theory to be applied to the bimodal model of visual processing is:
- a. Response-stimulus-response
- b. Stimulus-response
- c. The function model of vision
- d. The medical-pathological model of vision
- e. None of the above
13. The characteristics of Post Trauma Vision Syndrome (PTVS) are:
- a. Exotropia and exophoria
- b. Convergence and accommodative insufficiency
- c. Oculomotor dysfunction
- d. Increased myopia
- e. All of the above
14. The symptoms of PTVS are:
- a. Diplopia and blurred vision
- b. Perceived movement of objects or patterns
- c. Headaches and astenopia
- d. Hallucinations and photophobia
- e. All of the above
15. PTVS occurs following a neurological event and is caused by:
- a. Disease of the parvocellular system
- b. Dysfunction affecting the ambient visual process and the motor-sensory system
- c. Loss of sight in one eye
- d. Anismetropia
- e. b and c
16. The implications of PTVS are:
- a. Over-focalization and isolation on detail without spatial organization
- b. ‘Focal-binding’
- c. Inability to release from fixation
- d. A lack of ability to organize spatial information with the motor base and a restriction of the response or ‘anticipatory’ response prior to the stimulus
- e. All of the above
17. The effect of loss of spatial organization with ambient and sensorimotor matching can lead to:
- a. Difficulty reading
- b. Abnormal postural tone
- c. Changes in taste
- d. a and b
- e. None of the above
18. Which of the following statements are true?
- a. The focal process is like a camera and uses mostly ‘snapshots’ through saccades (quick eye movements)
- b. The focal visual process slows down time and because of this it primarily uses the corpuscular (particle) nature of light
- c. The 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 relationships
- d. The 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 camera
- e. All of the above
19. The ambient visual process:
- a. Does not map behavioral space around the body
- b. Is restrictive and the focal process is expansive
- c. Incorporates ‘complimentary receptor functions’ to enable segregation of focal and ambient information which lead
- d. Together with the focal process involves a second form of interaction for reciprocal inhibitory coupling and serves attention shifts from one mode to the other
- e. c and d
20. Visual skills such as pursuits, saccades, accommodation and vergence of the eyes are brought into functional relationship with vast variety of:
- a. Practice
- b. 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 body
- c. Extension of the body away from gravity and flexion of the body with gravity
- d. a and c
- e. b and c
21. Vision involves:
- a. A spatial preconscious matching with the sensorimotor systems
- b. Organization of pattern recognition together with spatial application
- c. Emanation from an action system
- d. Vergence movements that utilize a preconscious spatial mapping prior to identification
- e. All of the above
22. Temporal relationships applied to vision includes:
- a. The speeding up of temporal processing relative to ambient visual processing and a slowing down of temporal processing relative to the focal process
- b. No change between focal and ambient processing
- c. The slowing down of temporal processing relative to ambient visual processing and a speeding up of temporal processing relative to the focal process
- d. Streamlining information about facial details
- e. None of the above
23. In development:
- a. Vergence and version movements require a ‘top-down’ or conscious mode of processing
- b. Abduction and adduction of ocular movements emanate from early exploration for movements involving extension, flexion and then extension, flexion together with rotation of body movements
- c. Vision is both “bottom-up” and “top-down” processing although the preconscious spatial processing should precede conscious visual processing
- d. b and c
- e. a and b
24. The 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’system
- b. Enables suppression of the early primitive reflexes
- c. Creates ‘plasticity’ of the visual process
- d. All of the above
- e. a and c
25. Post Trauma Vision Syndrome (PTVS) is only diagnosed through analysis by:
- a. An eye examination to determine if there is a convergence insufficiency
- b. 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 prism
- c. Determination of an increase in the amplitude response following introduction of the base in prism
- d. b and c
- e. None of the above
26. A P-100 followed by multiple peaks indicates:
- a. Lack of validity of the P-100
- b. An inability to release the focal response
- c. An over-reaction of the ambient visual process
- d. An improved ‘top-down mode of conscious procession over spatial visual processing
- e. None of the above
27. An 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 eyes
- b. 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 support
- c. Indicate ‘focal binding’
- d. a and c
- e. a, b, and c
28. Conduction the VEP P-100 cross pattern reversal analysis to ‘rule out’ PTVS should be done with:
- a. Both low and high spatial frequency stimuli
- b. Only low spatial frequency stimuli
- c. Only high spatial frequency stimuli
- d. Flash stimuli
- e. Temporal-spatial stripes and a variable frequency pattern
29. Vergence is brought into developmental organization through:
- a. Conscious effort to see more clearly
- b. A driving force to look at near objects through a ‘top-down or conscious orientation to seeing
- c. A developmental organization of the ambient visual process together with the motorsensory systems in relationship with extension and flexion active motor movements
- d. a and b
- e. None of the above
30. Reflexes occur to:
- a. Create sensory stimulation
- b. Develop the ability to have reflexes to respond to stimulation
- c. Ground the senses within the motor system
- d. a and b
- e. b and c
31. Binocularity is a result of:
- a. ‘Top-down’ streaming and conscious effort to attain singular binocular vision
- b. An introduction of seeing more clearly for the infant to create a conscious mode of visual attention
- c. A conscious effort to create convergent or; base-our’ visual fusion
- d. Spatial feedforward from the midbrain following an ambient motor spatial match to bonicular cortical cells to integrate the images from each eye
- e. a and b
32. Postural tone relates to:
- a. Differentiation of position sense
- b. A feeling of balance
- c. A motor-sensory processing organization related to posture upright against gravity
- d. Characteristics of spastic muscles in the neck and shoulder area
- e. a and b
33. Through 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 saccades
- b. Divergence of the eyes
- c. Horizontal pursuits
- d. Peripheral awareness
- e. a, b and d
34. Flexion in development is a means for the child to organize visual processing and establishes which visual skills?
- a. Peripheral awareness
- b. Convergence
- c. Accommodation
- d. Lateral movements of the eyes
- e. b and c
35. Lateral extension in development with rotation assists to establish what type of visual organization and visual skill?
- a. Cyclo-rotation of the eyes
- b. Diagonal eye movements
- c. Convergence
- d. Divergence
- e. a and b
36. Lateral body displacement develops what quality of visual performance?
- a. Horizontal motilities
- b. Isolation on detail or ‘focal binding’
- c. The ability to maintain a stable fixation point as a reference of orientation with displaced movement
- d. Near-far fixations
- e. a and c
37. The ambient visual process establishes which visual skills in relationship with postural alignment?
- a. Pursuits
- b. Saccades
- c. Convergence and accommodation
- d. Increased postural tone against gravity
- e. a, b and c
38. The ‘righting response’ begins with:
- a. Aligning the upper body over the legs and feet
- b. Sitting up
- c. Lifting the head off of a surface
- d. a and b
- e. None of the above
39. Visual Midline Shift Syndrome (VMSS) is:
- a. A shift of orientation of the object relative to the visual egocenter
- b. A shift in orientation of the egocenter relative to the object of regard
- c. A shift of the ‘top-down’ conscious orientation between the object of regard and the egocenter
- d. A shift in conscious visual space
- e. None of the above
40. A hemiparesis will initially cause a shift in visual midline _____ and then _______ from the affected side? (fill in the correct order of the shift)
- a. Toward and then away
- b. Away and then toward
- c. Neither toward nor away
- d. It depends on which side is affected
- e. None of the above
41. When there is a left hemiparesis following a CVA the person will usually have a weight shift:
- a. To the left
- b. To the right
- c. Anterior or forwards
- d. Posterior or backwards
- e. None of the above
42. When 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:
- a. Always in the direction of where the person is looking
- b. Always in the direction opposite to where the person is looking
- c. Usually toward the affected side
- d. Usually away from the affected side
- e. Usually toward the weaker side
43. Following 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:
- a. One shoulder higher than the other during ambulation
- b. The pelvis on the side of the elevated shoulder will often be depressed
- c. Increased weight shift to one side, and/or in the anterior posterior direction
- d. Sliding of the feet on the floor or ‘toe-walking’
- e. All of the above
44. In 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 side
- b. A slouching of posture with rounded shoulders
- c. Abduction of the scapulae and a lack of organization of the upper thorax relative to a visual spatial imbalance with the sensorimotor system
- d. Capital extension
- e. b, c and d
45. Toeing in during ambulation may be an indication of:
- a. A posterior VMSS
- b. An anterior VMSS
- c. An anterior tilt of the pelvis
- d. A posnterior tilt of the pelvis
- e. b and c
46. Yoked prisms may be prescribed to affect a VMSS reinforcing an abnormal weight shift. The base of the prisms should always be oriented:
- a. Toward the direction of weight shift
- b. Opposite from the direction of weight shift
- c. Base-in direction for both eyes
- d. Opposite the direction of the deviating eye
- e. None of the above
47. The yoked prism should be positioned in which direction for an anterior VMSS?
- a. Base down for both eyes
- b. Base up for both eyes
- c. It depends on the direction of the deviating eye
- d. It depends on the orientation of the head and neck
- e. c and d
48. When 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 eye
- b. In the direction opposite the abnormal weight shift causing VMSS
- c. In the direction of the deviating eye
- d. b and c
- e. None of the above
49. For 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?
- a. OD base out and OS base in
- b. OD base in and OS base in
- c. OD base in and OS base out
- d. OD base out and OS base out
- e. None of the above
50. For 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:
- a. OD high base in prism and OS low base out prism
- b. OD low base out prism and OS high base in prism
- c. OD low base in prism and OS high base in prism
- d. OD high base out prism and OS low base in prism
- e. None of the above
51. When 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 deviation
- b. Assess postural imbalances while seated and standing and then assess posture during ambulation in order to prescribe for a visual midline shift
- c. Assess for visual midline shift first and then assess the exotropia after the patient is wearing the yoked prisms
- d. Prescribe asymmetrical yoked prisms
- e. b, c and d
52. When viewing a distant acuity chart, a head turn may indicate:
- a. Visual Midline Shift Syndrome
- b. A strabismus
- c. Post Trauma Vision Syndrome
- d. A cervical mis-alignment
- e. None of the above
53. Neuro-Visual Postural Therapy (NVPT) is an approach for:
- a. Incorporating postural adjustments manually to affect strabismus
- b. Rehabilitating persons who have had a neurological event and who have been diagnosed with visual dysfunction as well as postural imbalances
- c. Rehabilitation of Visual Midline Shift Syndrome (VMSS) and Post Trauma Vision Syndrome (PTVS)
- d. a and c
- e. b and c
54. A Paradoxical VMSS is:
- a. A shift of the visual midline toward the non-affected side
- b. A shift of the visual midline away from the affected side
- c. A shift of the visual midline toward the affected side
- d. a and b
- e. None of the above
55. Following a CVA or TBI, in the early stages the person will lean:
- a. Toward the non-hemiparetic side
- b. Toward the hemiparetic side
- c. Away from the hemiparetic side
- d. In flexion toward the hemiparetic side
- e. b and c
56. The 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 side
- b. Toward the hemiparetic side
- c. Toward the non-affected side
- d. a and b
- e. b and c
57. When considering treatment for a person with a Paradoxical Visual Midline Shift the clinician should:
- a. Wait one year and what ever the patient is left with is what they have to live with
- b. Wait one month after the event and prescribe yoked prisms
- c. Prescribe yoked prisms as soon as possible and confer with the neurologist, physiatrist, physical and occupational therapist
- d. Refer for physical therapy before prescribing yoked prisms
- e. None of the above
58. When prescribing yoked prisms for a person with a Paradoxical VMSS, the prism base should be oriented:
- a. Toward the affected side
- b. Away from the affected side
- c. Away from the non-affected side
- d. a and c
- e. None of the above
59. Pusher’s Syndrome is a VMSS where the person shifts their weight:
- a. Away from the affected side
- b. Toward the affected side
- c. Toward the non-affected side
- d. a and c
- e. None of the above
60. In the Compensated State of posture following a CVA or TBI the person will often demonstrate a posture of:
- a. Lateral extension on the affected side
- b. Lateral extension on the affected side and flexion on the non-affected side
- c. Rotation and extension into the affected side
- d. Lateral extension on the non-affected side and flexion on the affected side
- e. a and b
61. When looking through a prism at an object, the focal process sees and experiences:
- a. An image shift toward the apex and a visual midline shift opposite the image shift
- b. An image shift toward the apex of the prism and a visual midline shift with the image
- c. The image shifts toward the apex end of the prism and no relationship to the visual midline
- d. The image shifts toward the base of the prism
- e. None of the above
62. When looking through a prism at an object, the ambient or spatial visual process sees and experiences:
- a. An image shift toward the apex and a shift of the visual midline opposite the image shift
- b. An image shift toward the apex of the prism and a visual midline shift in the same direction as the image shift
- c. No shift of the image but instead experiences a shift of the visual midline toward the base end of the prism
- d. A shift of the visual image toward the base end of the prism with a shift of visual midline in the same direction
- e. None of the above
63. Base up yoked prisms have the effect of:
- a. Expanding the distance spatial volume and compressing the near spatial volume for the ambient process
- b. Compressing the distance spatial volume and expanding the near spatial volume for the ambient process
- c. Shifting the image experienced by the focal process downward toward the apex
- d. Shifting the image downward toward the apex for the focal process and compressing the distance spatial volume for the ambient process
- e. a and c
64. Base left yoked prisms:
- a. Compress left space and expand right space in the horizontal plane
- b. Expand left space and compress right space in the horizontal plane
- c. Expand near-far space in the left field and compress near-far space in the right field
- d. Compress near-far space in the left field and expand near-far space in the right field
- e. a and c
65. A person with a hemiparesis following a CVA or TBI should:
- a. Receive physical and occupational therapy as soon as possible following the event
- b. Receive a neuro-optometric rehabilitation assessment before the physical or occupational therapy begins
- c. Utilize yoked prisms prescribed by an optometrist who understand neuro-visual processing rehabilitation to maximize potentials of the rehabilitation
- d. Wait one year after the event to go to an eye doctor to see if there are any changes with vision
- e. a and c
66. For the paradoxical visual midline shift:
- a. Physical and occupational therapy is critical in conjunction with use of prescribe yoked prisms
- b. Only yoked prisms should be used and the prism base should be in the direction opposite the weight shift
- c. The optometrist as well as the therapists should perform lateral weight shift activities and delay considering use of yoked prisms
- d. The physical and occupational therapist should apply bi-nasal occlusion and delay referring for a neuro-visual processing evaluation
- e. None of the above
67. The 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 within
- b. The expression of this distortion by the ambient process is a COMPRESSION and EXPANSION of space
- c. This compression and/or expansion will reinforce postural imbalance as well as visual field loss (homonymous hemianopia)
- d. All of the above
- e. a and c
68. Vision is a dynamic process that:
- a. Provides awareness of space and the organization of posture and movement.
- b. Affects only how the person sees at far
- c. Affects only how the person sees at near
- d. Is always the same after 7 years of age
- e. Is always the same regardless of neurological status
69. Visual dysfunction:
- a. Is present in brain damage
- b. Affects acuity at near
- c. Affects acuity at far
- d. Includes headaches, double vision, and photophobia problems with balance
- e. All of the above
70. The visual system includes:
- a. External and internal brain structures
- b. Only external structures
- c. Only internal structures
- d. One neural pathway
- e. Receptors for detailed stimulus
The ambient visual process is responsible for:
- Our ability to activate feed-back processes
- Our ability to activate feed-forward motor performance and anticipatory processes
- Identifying details
- Answering the question "What is it?"
- Recognizing faces
To use vision efficiently, we need to:
- Be able to see clear and single at all distances
- Have 20/20 acuity at far
- Be able to know the alphabet
- Have good light reception
- Understand time
The ambient process:
- Speeds up orientation to time
- Slows down orientation to time
- Is independent from time and space
- Allows for recognizing places
- Is related to short term memory
The ambient process:
- Is related to acuity at far
- Is related to acuity at near
- Helps to anticipate change
- Is related to intellectual abilities
- None of the above
The inability to match ambient vision and movement:
- Often results in a lack of confidence in moving through space
- Does not affect quality of movement
- Does not affect quality of posture
- Does not interfere with eye hand coordination
- Does not interferes with movement transitions
The visual process develops and refines skills through its relationship with the motor system:
- Through movement experiences
- Though memory exercises
- Independently of sight
- In the first months of life
- But does not change with new experiences
Reading requires the ambient visual process:
- To see clear at near
- To organize spatial information prior to focalization
- To see clear at far
- To use both eyes at the same time
- To be flexible
The visual system:
- Is a static process of receiving light
- Is a dynamic system that responds to light and movement
- Is a sensory system
- Is a motor system
- Is a cognitive system
Research 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 VEP
- Sometimes changes the amplitude of the VEP
- Shows improvement on the MRI
- Changes refraction error
Visual 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 input
- Does not affect postural tone
- Does not causes trunk misalignment
- Is a psychological aberration
A prism added to the spectacle prescription:
- Is always used in a Myopia prescription
- Is always used in Astigmatism
- Is used depending on patient’s age
- Expands space on one side and compresses space on the other side
- Is always used as a permanent prescription
Once there is a distortion of the sensorimotor process:
- The patient can solve it by using conscious effort
- The visual process reinforces the problem
- Using external aids reduces the problem
- Teaching good posture solves the problem
- Having the patient bare foot reduces the problem
Ocular pursuits:
- a. Are controlled maintaining contact on a stationary object
- b. Are controlled by the cilliary muscles
- c. Are organized by the balance of feedforward ambient spatial processing and feedback from the focal process
- d. Are dysfunctional with postural imbalance
- c and d
The ambient visual process:
- Is a conscious process
- Is a preconscious process
- Is a result of cognitive development
- Is developed after the focal system has developed
- Is controlled by conscious effort
Individuals with a neurological disorder:
- a. Often move their bodies and "drag" their eyes as opposed to the vision leading the movement
- b. Are capable to separate body movement from eye movements
- c. Lack the postural base of support to reinforce visual processing
- d. Develop abnormal visual processing relative to abnormal state of postural tone
- b, c and d
Saccades refer to the:
- a. Ability to move the eyes from one fixation point to another
- b. Ability to move the eyes over a moving target
- c. Conscious ability to control eye/hand movements
- d. Use of the ambient spatial process to release from focalization
- a and d
Binocularity refers to the ability to:
- Maintain fusion at near
- Maintain fusion at far
- Maintain fusion smoothly on a visual target a various distances
- Fuse two images from each eye
- All of the above
Balance and movement relate to:
- The ambient process
- The focal process
- The cognitive process
- Emotional state
- Refractive error
Poor visual pursuits are:
- Often caused by imbalance between ambient spatial-temporal organization in combination with postural organization
- A sign of focal problems
- A sign of emotional disturbance
- A sign of lack of interest on the visual input
- A sign of blindness
Difficulties in motor development relate to:
- Imbalances in ambient-focal visual processing and cause a lack of development with visual skills
- Cognitive development
- Emotional development
- Social circumstance
- Clearness of vision
Vision develops:
- Independently from motor experiences
- From its motor base
- Without matching the motor experience
- From its auditory base
- At birth
Developmental elongation of the neck:
- Does not affect gaze position
- Allows the head to move easily in all directions, and cover all visual space
- Is present at birth
- Is independent of postural tone
- Is independent of cervical alignment
Good neck alignment is critical for:
- Establishing head control and the ability of the eyes to eventually lead movement
- Establishing functional relationships between visual system and motor systems
- Optical righting to be integrated with head righting reaction
- Good balance and equilibrium reactions
- All of the above
Quality of body and eye movements is refined through:
- Feed forward information
- Feed back information
- Feed forward and feed back information
- 20/20 vision
- None of the above
The development of an efficient visual system:
- Requires an active and normal motor system together with a stimulating environment
- Is not affected by the environment
- Is only affected by the environment
- Depends only on normal sight
- None of the above
In normal development head righting responses:
- Are paired with optical righting reactions
- Appear once the baby sees clear at near
- Appear once the baby sees clear at far
- Appear once binocularity is established
- Appear late in development
A disturbance of posture and movement:
- a. May affect visual motilities, flexibility and amplitude of both accommodation and vergences
- b. Disturbs postural tone, and muscle skeletal alignment
- c. Interferes with balance and equilibrium reactions
- d. Causes mental retardation
- a, b and c
Organization of basic components of eye movements parallels with organization of basic components of body movements:
- Only after 7 years of age
- From the earliest stages of sensorimotor development
- When the infant is beginning to talk
- At school age
- With 20/20 visual acuity
Vision is the primary incentive for movement:
- In normal motor development in the sighted child
- Only after the primitive reflexes have disappeared
- Regardless of visual acuity
- When sound is present
- When the infant is crawling
Vertical ocular motilities:
- Are paired with head extension
- Are paired with head rotation
- Are paired with head flexion
- Are independent from head movements
- Occur only with head movements
An efficient Neuro Postural base requires good muscle skeletal alignment:
- For normal postural tone
- For normal muscle range
- To be in an erect position against gravity
- None of the above
In normal development early head lift as a survival skill:
- Is very soon paired with visual fixations on a visual target
- Is present at birth
- Does not interact with visual input
- Is present only after primitive reflexes are integrated
- Occurs when the baby is side lying
Refined body movements:
- Do not affect visual responses
- Are a basis for balance between focal and ambient process
- Are related to 20/20 visual acuity
- Are independent of a efficient visual system
- Are related to primitive reflexes
Trunk elongation of the weight bearing side with shortening of the non-weight bearing side:
- a. Is a quality feature in normal movement
- b. Is an automatic response when the body prepares for a transition
- c. Is not related to efficient movement
- d. Requires the body to be in a standing position
- a and b
Changes in body segment relationships over the Base of Support (BOS):
- Can be elicited through the use of yoked prisms
- Are achieved only by verbal command
- Occur after repetition of a movement pattern
- Depend only on strength of muscles
- Require a wide base of support
Positioning and facilitation of movement in NVPT:
- Allows the body to be stable and mobile
- Elicits better quality ocular motilities
- Change motor responses of eyes and body
- Are techniques used in NVPT
- All of the above
Anterior and posterior body shifts:
- Refer to body misalignment in the sagittal plane
- Refer to body misalignment in the frontal plane
- Are only seen when the person is sitting
- Do not relate to body planes
- Do not relate to spine misalignment
Head and trunk rotation around the vertical body axis facilitate:
- a. Visual mid-line crossing
- b. Lateral eye movements
- c. Accommodation of the focusing mechanism
- d. Attention at near
- a and b
Analysis of posture is always done in:
- Prone lying
- Supine lying
- Half kneeling independent sitting
- Side lying
- In the best upright posture the patient can be in independently or with external aid
Postural imbalances:
- Are reinforced by shift in visual midline
- Do not relate to visual space
- Can be overcome voluntary
- Can be changed through verbal command
- Are noticeable only when the person is still or without motion
Graded motoric control of the neck:
- a. Is required for efficient visual development
- b. Will affect visual development
- c. Does not relate to visual development
- d. Is independent of visual input
- a and b
The ambient visual process establishes the organization of:
- Posture with the vestibular, kinesthetic and proprioceptive systems
- Visual input
- Internal language
- Fine motor responses
- Bi-ocular responses
In order to support development of posture/movement:
- a. Only sight is important
- b. Vision must remain plastic
- c. Movement experiences are indispensable
- d. Experience in moving is not needed
- b and c
Instability in ambient process:
- Affects acuity at near
- Is almost never present in TBI
- Can be the cause of spatial disorientation
- Only alters gross motor function
- Relates to normal development
Any change in sensorimotor information:
- Is reflected in visual responses
- Is ignored by the visual system
- Changes perception of auditory information
- Is reflected in muscle strength
- Affects language
Disturbances of posture/movement in both congenital and acquired brain damage:
- Can be positively influenced by proper use of lenses and prisms
- Can be positively influenced by verbal direction
- Are caused by lack of cultural experiencesn
- Can’t be changed by therapy
- Have a psychological cause
A wheel chair bound patient:
- Can be affected in posture and movement through the use of yoked prisms
- Is not a candidate for visual therapy
- Plateaus after 2 years of treatment
- Only can be treated by a PT
- Would not respond to NVPT
Abnormal high tone:
- In the large muscle groups will affect accommodation and binocularity
- Is an isolated muscle response
- Is only present in congenital brain damage individuals
- Does not change with treatment
- Is an early development response
Disorganized Posture/Movement:
- Negatively influences visual responses needed for learning
- Is not related to efficiency in academic performance
- Is always related to mental retardation
- Is recognized through clinical laboratory testing
- Affects only gross motor responses
Postural and visual imbalances:
- a. Have the potential to cause emotional imbalances
- b. Only affect efficiency in walking
- c. Relate to efficiency in the learning process
- d. Are of late onset in the developmental process
- a and c
Visual training using fixations and fusion without postural organization of persons who have had a neurological event:
- Will lead the patient to his optimal functional level
- May cause the patient to plateaus below his potential due to ‘focal binding’
- Is a good alternative for the TBI patient
- Can also be performed without the use of lenses
- Is a good alternative for perceptual training
NVPT as a treatment approach is:
- Only for the pediatric population
- Only for normal intelligent children
- For all TBI patients and persons with neuro-visual-postural imbalances
- For treating only non-degenerative neurological disorders
- Performed at hospitals
Posture/movement and vision dysfunctions:
- Are always developmental disorders
- Can result after brain injury
- Are always caused by damage at birth
- Should only be treated through pharmaceutical intervention
- Do not improve if treatment is delivered after 18 months of onset
Automatic postural control:
- Is the ability to orient to sound and posture
- Is necessary for conscious attention
- Is necessary for mobility
- Is necessary for the dual purposes of stability and orientation
- Is achieved through a ‘top-down’ conscious control
An efficient neuro-postural base requires:
- Normal postural alignment
- Equal distribution of weight
- Ability to weight shift in all directions with graded control
- Efficient righting and equilibrium reactions as an underlying foundation for volitional movement
- All of the above
Normal 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 systems
- Depends on muscle strength
- Happens only in sitting posture
- Is independent of joint alignment
- Has no impact on efficiency of movement
An efficient visual system:
- a. Relies on an organized neuro postural base
- b. Is related to normal postural tone
- c. Is independent from the quality of the neuro postural base
- d. Depends on where the visual targets are presented
- a and b
In normal development, alignment:
- Is maintained in all transitional movements
- Is maintained only in still positions
- Depends on the BOS
- Is not developed until the infant begins to walk
- Is related to muscle strength
A wheelchair bound person:
- Functions visually better if body alignment is maintained
- Does not needs to be in good postural alignment
- Depends on focalization to know where are things in space
- Does not need to wear glasses for looking at far
- Cannot be prescribed with prism to realign his/her body
Posture movement and vision development depends on the:
- Integrity of the neurological structures
- Integrity of the muscular skeletal structures
- Integrity of the sensory receptors
- Opportunity to experience sensory and motor inputs in context
- All of the above