COTA Definitions for NBCOT EXAM
Updated Questions and Answers.
Agnosia -
\the inability to recognize objects by sight (despite adequate cognition, normal
language, normal visual acuity and intact visual fields)
Monofilament is used for? -
\nerve compression
two-point discrimination is typically used for? -
\nerve laceration and recovery
The three common phases of healing? -
\are inflammation, repair, and remodeling
Avulsion injuries -
\occur when the tendon separates from the bone and its insertion and removes bone
material with the tendon
-swan neck, boutonniere, mallet finger
Contrast sensitivity Test -
\measures how well a person can discern objects with fuzzy, poorly defined edges or
low-contrast objects that may be only slightly brighter or darker than their surroundings,
which is an important factor in night driving. Slides are also found on the Optec
Functional Visual Analyze
Depth perception -
\the ability to perceive the environment in three dimensions and to understand the
distance of objects in relation to each other. It is created by stereopsis, the two eyes
working together to view objects in the environment
Ocular movement -
\including ocular range of motion (ROM), convergence, divergence, saccades, and the
vertical and lateral phorias, is assessed functionally by the clinician (drawing the letter H
or a triangle and requesting that clients follow the pattern with their eyes)
Visual acuity -
\The Snellen wall chart is used to test static sharpness of visual focus at varied
distances
,\Client may be slow to recognize signs and show delayed response to the environment.
CSs: Use corrective lenses, drive on reduced speed roadways (required in many states
with reduced acuity limits), and limit driving to daylight only and good weather only.
Visual performance skill deficits: Contrast sensitivity/ Comp. Strat. -
\Client may be slow to recognize road signs or other roadway obstacles.
CS: Avoid area, time of day, and other conditions (e.g., cloudy or rainy weather) with
poor contrast.
Visual performance skill deficits: Night vision/ Comp. Strat -
\Client deficits may increase in low-light conditions or bad weather.
CSs: Restrict night driving, drive on roads with reduced speed limits, and increase
following distance at night.
Visual performance skill deficits:Glare recovery -
\Client may have difficulty adapting to the dark or to bright lights.
CS: Restrict night driving.
Visual field--Peripheral field deficits -
\Client may experience inefficient eye movements and limited roadside obstacle
identification.
CSs: Use prism lenses, and compensate with extra head turns and expanded-view rear
and side mirrors.
Visual Field--Field cuts or scotomas -
\Client may miss street signs, hazards, other road users, vehicles, or stimuli on the
affected side.
CSs: Use prism lenses, compensate with extra head turns and frequent eye
movements, and restrict driving at night or at high speed.
Visual Attention--Neglect -
\Client may miss roadway information while focusing on other details, may be slow to
respond to traffic signs, and may drift in or out of lanes.
CS: Increase insight into and impact of neglect on driving; if unable to adequately
compensate, client will need to refrain from driving.
Ocular motor skills: Pursuits, saccades, and scanning -
\Client may stare at road scenes or move eyes randomly, may have difficulty with lane
positioning and keeping track of other vehicles, may miss stimuli from the environment
(e.g., road signs), and may have difficulty sequencing mirror use or negotiating
intersections or cross traffic.
CSs: Use proper visual search patterns and efficient scanning techniques. Instruct in
systematic sequential strategies to perform driving maneuvers (e.g., when changing
lanes, use the acronym SMOG: Signal, look in side Mirror, look Over your shoulder, Go;
Drivingtips.org, n.d.).
,Stereopsis or depth perception -
\Client may have difficulty judging distance, timing turns, accepting gaps, merging, or
passing.
CSs: Learn to use environmental cues (e.g., stop lines or the tires of the car ahead),
expand the following distance behind other vehicles, and limit driving in low-light
conditions if experiencing difficulty or severe impairment.
Color perception -
\Client may have difficulty identifying signs, horizontal traffic lights, brake lights, or turn
signals on the basis of color.
CSs: Learn the sequence of the traffic lights and the shapes of turn signs, and expand
the following distance behind other vehicles.
Attention: sustained, selective, alternative, or divided -
\Client may be easily distracted and inefficient in monitoring the environment for traffic
signs and signals and may have difficulty maintaining lane integrity; maintaining vehicle
control while observing mirrors or blind spots; attending to traffic lights while waiting for
a safe gap; interpreting complex traffic scenes; and driving while talking, drinking, or
looking at a map.
CSs: Limit driving to familiar areas and to roads with reduced speeds, and avoid peak
traffic hours or complicated intersections.
Memory--driving -
\Client may have difficulty applying rules of the road, may signal for a turn and then
forget to turn, and may get lost in familiar environments.
CSs: Limit driving to familiar areas, drive in the daytime, and use a navigational system.
Notify designated contact about expected destination, route, and anticipated time of
return prior to driving.
Information processing--driving -
\Client may be slow to react to stimuli from the driving environment, with difficulty
increasing with speed or complexity of the traffic environment; client may brake
excessively or unnecessarily.
CSs: Limit driving to familiar areas, drive in the daytime, avoid peak times or
complicated intersections, and minimize distractions and conversations.
Visual information processing speed -
\Client may have difficulty recognizing signs, negotiating intersections, recognizing
hazards, interpreting traffic scenes, interpreting traffic-control devices, positioning the
vehicle in the center of the lane, operating the vehicle in reverse, or crossing or turning
against traffic at an intersection.
CSs: Limit driving to familiar areas and to roads with reduced speeds, and avoid peak
traffic hours or complicated intersections. Driving is not appropriate if skill is significantly
impaired.
Wheelchair with two wheel hand rims -
, \High-precision single-hand drive with double handrim
-functional for individuals with hemiplegia or able to use one side of body to manipulate
hand rims
Agraphia -
\impaired ability to write
Conductive -
\supportive; encouraging; helping to bring about; making a certain situation or outcome
likely or possible.
Darkness is conducive to sleep.
What is Cognition? -
\The ability of the brain to process, store, retrieve, and manipulate information. It
involves the skills of understanding and knowing, the ability to judge and make
decisions, and an overall environmental awareness.
How do Cognitive-Perceptual deficits occur? -
\They occur as a result of multiple pathologies including CVA, TBI, neoplasms, acquired
diseases, psychiatric disorders, and/or developmental delays.
What is Astereognosis? -
\Also known as Tactile Agnosia
The inability to recognize objects, forms, shapes, and sizes by touch alone.A failure of
tactile recognition although sensory testing (tactile and proprioceptive) is intact.
What are intervention strategies for Impaired Alertness or Arousal? -
\- increase environmental stimuli
- use gross motor activities
- increase sensory stimuli
What is Anomia? -
\Loss of the ability to name objects or retrieve names of people.
What is Agnosia? -
\A loss of ability to recognize objects, persons, sounds, shapes, or smells while the
specific sense is not defective nor is there any significant memory loss.
What is Executive Dysfunction or Dysexecutive Syndrome? -
\Impairments related to multiple specific functions; such as, decision making, problem
solving, planning, task switching, modifying behavior in the light of new information, self-
correction, generating strategies, formulating goals, and sequencing complex actions
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