Abv 1 - Lecture 4 - Omd Treatment

Front 1

VT used to help the development of proper visual function in young children

Back 1

Developmental VT

Front 2

VT designed to prevent visual problems that would otherwise occur

Back 2

Preventative VT

Front 3

VT used to help with vision conditions that have already been identified

Back 3

Rehabilitative VT

Front 4

Used to enhance visual skills for sports, work and academic demands

Back 4

Enhancement VT

Front 5

Name Peachey's 4 areas of VT

Back 5

1) Developmental
2) Preventative
3) Rehabilitative
4) Enhancement

Front 6

Hierarchy of training techniques designed to build more adequate VT skills

Back 6

Sequential training

Front 7

Therapy program develops depending on PROGRESS of the paitient

Back 7

Directional training

Front 8

What 3 consideration apply to all therapy?

Back 8

1) Correct the refractive error
2) Develop rapport with your patient at the start
3) Help patient understand their condition

Front 9

TQ: What are the 9 components of OMD Sequencing?

Back 9

1) Correct the refractive error
2) Develop rapport with your patient at the start
3) Help patient understand their condition
4) Work on developing fixation first
5) Develop SMALL pursuits before large pursuits
6) Develop LARGE saccades before small saccades
7) Intregration Stage: Integrate Ocular Motor Therapy with accomodative and vergence training
8) Work MONOCULAR skills before BINOCULAR
9) Incorporate BI-OCULAR skills if needed

Front 10

Name 4 Fixation VT Techniques.

Back 10

1) Dotting O's
2) AN Star Fixation
3) Monocular Stick-in-Straw
4) Stationary Peg-Board

***DANS***

Front 11

Name 5 Pursuits VT Techniques.

Back 11

1) Manual Pursuits
2) Marsden Ball
3) Flashlight Tag
4) Rotating Pegboard
5) Visual Tracing (Groffman Tracing)

Front 12

Name 5 Saccades VT Techniques.

Back 12

1) Thumb saccades
2) Four Corner Wall Fixation
3) Distance Hart Chart
4) Saccadic Workbook
5) Michigan Tracking

Front 13

Develop _________ pursuits before _________ pursuits.

Back 13

Pursuits - SMALL before LARGE

Think: SMALL purses were "in" before LARGE purses

Front 14

Develop _________ saccades before _________ saccades.

Back 14

Saccades - LARGE before SMALL

Front 15

OMD commonly present with _________ and _________ problems so usually we are incorporating these therapies with OMD therapy

Back 15

Accomodative and Vergence

Front 16

During VT, the patient must do what 4 things?

Back 16

1) Ready
2) Look
3) Execution
4) Self - Assessment

Front 17

VT techniques for fixation are performed in what way?

Back 17

Monocularly

Front 18

What other type of therapy is usually incorporated into OMD VT?

Back 18

Accommodative and Vergence

Front 19

What is a BI-OCULAR technique?

Give an example of this?

Back 19

Involve simultaneous perception; activities are done with both eyes open but the patient is NOT FUSED

Using dissociating prism during the Marsden Ball Pursuits

Front 20

When can you being binocular skills?

Back 20

Once monocular skills are adequate and equal between both eyes.

Little binocular training skills are needed once monocular skills are built.

Front 21

Which types of pursuits are easier to control, small or large?

What other ability does pursuit training develop?

Back 21

Small pursuits are easier to control

Visual attention

Front 22

If the patient is struggling or showing signs of frustration during pursuit VT, what should the examiner do?

In which 5 ways can this be done?

Back 22

Decrease difficulty of VT tasks

1) Increase interest in task
2) Reduce the task demand
3) Provide adequate feedback
4) Increase kinesthetic feedback
5) Reduce demands and distractions

Front 23

How long should it take to complete the Distance Hart Chart?

Back 23

15 seconds

Front 24

Give an example of how you would INCREASE TASK INTEREST during PURSUIT training?

Back 24

- Incorporate a bunting stick with Marsden Ball

- Incorporate computer techniques

Front 25

Give an example of how you would REDUCE TASK DEMAND during PURSUIT training?

Back 25

Slow down the rotating pegboard

Front 26

Give an example of how you would PROVIDE ADEQUATE FEEDBACK during PURSUIT training?

Back 26

- Make patient aware of the purpose of the task at hand

- Make patient aware when pursuits are inaccurate

- Use an AFTERIMAGE to "tag" the fovea to help give patient visual feedback as to the accuracy of their pursuits

- Computer activities use auditory feedback as to how accurate their performance is

- Encourage the patient to prove feedback as to how well they think they are doing

Front 27

Give an example of how you would INCREASE KINESTHETIC FEEDBACK during PURSUIT training?

Back 27

- Have patient perform thumb pursuits. This give the patient the advantage because they are able to use kinesthetic reinforcement

- Eliminate the need for the child to organize arm movements by holding their hand while training pursuits

Front 28

Give an example of how you would REDUCE DEMANDS AND DISTRACTIONS during PURSUIT training?

Back 28

- Have the patient SIT instead of stand

- Remove the effects of balance and perform Marsden Ball training while lying on their back

- Use larger targets

Front 29

What is a BI-OCULAR technique?

Give an example of this?

Back 29

Involve simultaneous perception; activities are done with both eyes open but the patient is NOT FUSED

Using dissociating prism during the Marsden Ball Pursuits

Front 30

When can you being binocular skills?

Back 30

Once monocular skills are adequate and equal between both eyes.

Little binocular training skills are needed once monocular skills are built.

Front 31

Which types of pursuits are easier to control, small or large?

What other ability does pursuit training develop?

Back 31

Small pursuits are easier to control

Visual attention

Front 32

If the patient is struggling or showing signs of frustration during pursuit VT, what should the examiner do?

In which 5 ways can this be done?

Back 32

Decrease difficulty of VT tasks

1) Increase interest in task
2) Reduce the task demand
3) Provide adequate feedback
4) Increase kinesthetic feedback
5) Reduce demands and distractions

Front 33

How long should it take to complete the Distance Hart Chart?

Back 33

15 seconds

Front 34

Give an example of how you would INCREASE TASK INTEREST during PURSUIT training?

Back 34

- Incorporate a bunting stick with Marsden Ball

- Incorporate computer techniques

Front 35

Give an example of how you would REDUCE TASK DEMAND during PURSUIT training?

Back 35

Slow down the rotating pegboard

Front 36

Give an example of how you would PROVIDE ADEQUATE FEEDBACK during PURSUIT training?

Back 36

- Make patient aware of the purpose of the task at hand

- Make patient aware when pursuits are inaccurate

- Use an AFTERIMAGE to "tag" the fovea to help give patient visual feedback as to the accuracy of their pursuits

- Computer activities use auditory feedback as to how accurate their performance is

- Encourage the patient to prove feedback as to how well they think they are doing

Front 37

Give an example of how you would INCREASE KINESTHETIC FEEDBACK during PURSUIT training?

Back 37

- Have patient perform thumb pursuits. This give the patient the advantage because they are able to use kinesthetic reinforcement

- Eliminate the need for the child to organize arm movements by holding their hand while training pursuits

Front 38

Give an example of how you would REDUCE DEMANDS AND DISTRACTIONS during PURSUIT training?

Back 38

- Have the patient SIT instead of stand

- Remove the effects of balance and perform Marsden Ball training while lying on their back

- Use larger targets

Front 39

What are the 5 ways you INCREASE the difficulty of PURSUIT therapy?

Back 39

1) Decreease the interest of the task

2) Increase task demand

3) Reduce Feedback

4) Reduce Kinesthetic Support

5) Increase demands for balance, cognition, and fusional vergence

Front 40

Give an example of how you would INCREASE TASK DEMAND during PURSUIT training?

Back 40

- Use the Rotating Pegboard or Groffman Visual Tracing (these are larger pursuit activities)

- Use smaller targets

Front 41

Give an example of how you would DECREASE KINESTHETIC SUPPORT during PURSUIT training?

Back 41

Do not allow the patient to use arm or finger to help support the pursuit

Front 42

Give an example of how you would REDUCE FEEDBACK during PURSUIT training?

Back 42

Patient should become less reliant on feedback mechanisms while performing task.

Have a patient carry on a conversation or

Front 43

Give an example of how you would INCREASING DEMAND during PURSUIT training?

Back 43

- Incorporate balance beam or balance board while performing task.

- Have patient carry on a conversation or perform math problems in their head while performing pursuits

- Incorporate vergence or accommodative activities with pursuit activities

Front 44

Give three examples of EARLY pursuit activities.

Back 44

EARLY pursuits are SMALL pursuit movements.

1) Thumb Pursuits (incorporate kinesthetic effect)

2) Rotating Pegboard (central target with pegboard)

3) Manual Pursuits (with or without kinesthetic support - emphasize small pursuits)

Front 45

Give three examples of LATE pursuit activities.

Back 45

LATE pursuits are LARGE pursuit movements.

1) Groffman Visual Tracing

2) Rotating Pegboard (using outer target on the pegboard and increase the speed of the pegboard)

3) Flashlight Tag (emphasize large pursuits)

Front 46

Which saccades are easier to control, larger or smaller?

So which one should be trained first?

Back 46

Larger (2x)

Front 47

When trying to decrease the difficulty of a saccadic test, what is a good way to increase kinesthetic involvement?

How else does this ease the difficulty of the test?

Back 47

Wayne Saccadic Fixator incorporates the use of touch and arm movements.

Wayne Saccadic Fixator also uses afterimages and auditory feedback.

Front 48

What are 4 examples of EARLY saccadic activities?

Back 48

EARLY saccades are LARGE saccadic movements.

1) 4 Corner Fixations
2) Thumb Saccades
3) Wayne Saccadic Fixator
4) Distance Hart Chart

Front 49

What 3 LATE saccadic activities?

Back 49

LATE saccadic activities involve SMALL saccades.

1) Michigan Tracking
2) Computer Saccadic Activites
3) Distance Hart Chart

Front 50

What are 7 methods of DECREASING difficulty of therapy tasks?

Back 50

1) Negate gravity by having the patient in the supine position or be seated

2) Move the target at a slower pace

3) Use a larger target

4) Increase the interest of the target or change the target more often

5) Use kinesthetic support (touch the target)

6) Encourage verbalization of the target

7) Perform therapy in a quiet room

Front 51

What are 6 methods of INCREASING difficulty of therapy tasks?

Back 51

1) Remove kinesthetic support (do not allow patient to use finger)

2) Perform skill standing or on a balance board or on one leg

3) Increase target speed

4) Decrease size of target

5) Increase demands on the vergence and accommodation system

6) Increase cognitive demand

Front 52

Describe Thumb Pursuits.

What types of test is this?

Back 52

Patient hold thumbs at eye level and fixates on thumb while moving it around.

This is considered a early/small pursuit technique.

Front 53

Describe Four Corner Wall Fixations.

What types of test is this?

Back 53

Patient sits 10 feet from a wall and looks without moving their head toward the corner of the wall instructed by the examiner.

This is considered an early/large saccade technique.

Front 54

Describe Manual Pursuits.

What types of test is this?

Back 54

Manual pursuit is when a doctor moves the target.

Thumb pursuits are when the patient moves the target (their thumb)

A target (toy or penlight) is held in front of the patient at 50 cm and the patient is instructed to fixate on the target as the examiner moves it in all directions.

This is considered an early/small pursuit technique.

Front 55

Describe Stick - in - Straw.

What types of test is this?

Back 55

Tested monocularly because this is a FIXATION test.

Patient holds a pointer stick near their ear and tries to place the pointer stick in the straw that is being held by the examiner.

GOAL: 90 % accuracy without touching edges

Front 56

Describe Stationary Pegboard.

What types of test is this?

Back 56

Tested monocularly because this is a FIXATION test.

Patient is asked to choose a hole without hesitation and place a golf tee in the hole without touching the side of the hole.

Front 57

Describe Rotating Pegboard.

What types of test is this?

Back 57

Once you set the pegboard in motion, you get a pursuit movement. Have them follow a complete revolution. Because we want to test SMALLER pursuits first, we would have them put the peg in the CENTER of the pegboard.

This test can be used for both early/small (center of the pegboard) and late/large (periphery of the pegboard) pursuits.

Front 58

Describe the Distance Hart Chart.

What types of test is this?

Back 58

Involves having the patient read letters off a chart on the wall. Can increase difficulty by having them read letters diagonally and off different columns.

The standard activity (maybe reading the whole chart) should be completed in 15 seconds.

This test is can be used for both early and late saccades.

Front 59

Describe Michigan Tracking.

What types of test is this?

Back 59

Patient has to track from left to right and circle the letters in succession from A to Z. We want them to complete the paragraph within one minute.

This test is considered a late/small saccadic activity.

Front 60

Describe Marsden Ball.

What types of test is this?

Back 60

A ball on a string is attached to the ceiling. Sometimes they have an accommodative target on them. This promotes good pursuits and hand-eye coordination.

This is considered a pursuit activity.

Front 61

What is the flow of Ocular Motor Therapy?

Back 61

- Correct Refractive Error
- Develop rapport with your patient
- Get patient to understand their condition and why they are performing each specific task (this will continue throughout the entire therapy session)
- Fixation
- Large Saccades, Small Pursuits
- Small Saccades, Large Pursuits
- Integrate OMD Therapy with accommodative and vergence activities