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Special Needs > 3. Communication > Flashcards

3. Communication Flashcards

1
Q

Parent complains: my child squints- what is the first question?

A

Are they squinting or screwing the eyes- know the difference

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2
Q

When child squint eye?

A

Uncorrected myopia

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3
Q

What arethe 4 causes headache in children?

A

Uncorrected hypermetropia, decompensating phoria, accommodative insufficiency, convergence insufficiency

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4
Q

How to check for decompensating phoria?

A

Cover test

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5
Q

How to check for accommodative insufficiency?

A

Checked using convergence

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6
Q

How to check for convergence insufficiency?

A

Dynamic ret

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7
Q

4 reasons- child moves at a very close working distance to the tv?
1 reason that doesn’t relate to vision?

A
  1. Myopia - under or uncorrected.
  2. Accommodative problem
  3. General blur vision
  4. General visual impairment - cataract
  • children just generally immerse themselves into the tv and they have no visual problem?
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8
Q

Accommodative lead is over or under accommodating?

A

Over

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9
Q

4 reasons of why children might rub eyes a lot?

A
  1. Dry eye
  2. Something in Anterior eye
  3. Allergy
  4. Refractive error
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10
Q

Causes of: “My child closes one eye a lot”

A
  • Diplopia – caused due to poor convergence.
  • Over accommodation leading to a turn or a recent onset of phoria- could be due to a phoria/ break down of a phoria/ poor convergence/ over accommodation.
  • Anisometropia
  • Accommodative leak
  • Assess motility since the child might be getting diplopia in only 1 position of gaze.
  • One pupil larger
  • Photophobia
  • Intermittent exotropia
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11
Q

What causes : “My child turns her head when reading”- AHP
3 reasons

A
  • Strabismus
  • Any Comitant deviation – turning head to get any binocular vision, because deviation present in straight ahead position.
  • Nystagmus
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12
Q

How to check incomitant deviations?

A

CT at different points of gaze. OR motility.

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13
Q

What causes: “My child tilts her head to look at me”

A

Cyclodeviation – oblique palsy OR nystagmus.

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14
Q

What causes: “My child bumps into things a lot”

A
  • Lack of stereopsis
  • Diplopia caused by strabismus
  • Neurological issue—eye movement coordination, VF defect
  • Retinitis pigmentosa – peripheral field deteriorates.
  • Uncorrected refractive error (>7D)
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15
Q

What causes : “My child is falling behind in school” “The teacher says my child does not pay attention in class”

A
  • Uncorrected refractive error, not wearing RX at school.
  • Cerebral visual impairment
  • Severe colour vision defect- colour used a lot in nursery school. They are not hence very confident
  • Headaches
  • Poor contrast
  • Accommodation lag
  • Convergence insufficiency
  • Visual field defect
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16
Q

Reasons for: “I took a photo of my child and one eye looked white”

A
  • Retinoblastoma – life threating
  • Cataracts
  • Corneal scaring
  • Opacities – e.g. scar, ulcer.
  • Coloboma – the retina doesn’t cover whole of the sclera in this condition, seen with large coloboma.
  • Total retinal detachment caused by prematurity – usually more grey in appearance.
  • Could be nothing at all- caused by reflection for instance.
17
Q

 How are visual fields measured in a child?

A

Confrontation with a toy.

18
Q

Give examples of communication support available?

A

BSL interpreter, Communication aid, Support with key word signing (e.g. Makaton), Large print, Braille, Easy to read information.

19
Q

5 difficulties people have in receiving information?

A
  1. Problems hearing
  2. Problems seeing- lip movement, gestures
  3. Difficulties understanding- vocabulary.
  4. Difficulties remembering information
  5. Difficulties using past experiences
20
Q

5 communication difficulties in providing information?

A
  1. Problems speaking
  2. Problems formulating speech
  3. Problems with vocabulary
  4. Difficulties in making appropriate gestures and signs
    5, Difficulties with theory of mind.
21
Q

What is the False- Belief problem?

A

A type of task used in theory of mind studies in which children must infer that another person does not possess knowledge that they possess.

22
Q

What is the Sally- Ann demonstration?

A

Task used to demonstrate a child’s ‘theory of mind’
Refers to their ability to understand how other people think, feel and behave.

23
Q

Do children with DS vs autism pass the sally and ann test?

A

Majority of the children with DS pass the Sally- and ann test but not children with autism

24
Q

How to px’s with difficulties expressing opinions affect eye exams?

A

The child doesn’t give the right answer, they try to say something to please the optom.

25
Q

Impact of the optom completing sentences for patient with learning diabilities?

A

The patient feels less confident

26
Q

Simplify this: Hold this occluder over your right eye and read the top line of the chart for me please:

A

“I’ll cover your eye”

27
Q

Read the letter on the letter chart?

A

Read the big letters please

28
Q

What is the 5 second rule?

A

When giving instructions to patients with learning disabilities give them 5 seconds before you repeat the question- to process what you have said. After the 5 seconds- the question can be repeated.

29
Q

7 non-verbal ways of communicating?

A
  • Facial expression
  • Body posture
  • Proximity
  • Physical touch
  • Gesture
  • Mime
  • Intonation
30
Q

How to use gestures with speech for example in cover test and when measuring VA?

A
  • Cover your own eye first.
  • Point to the letters.
31
Q

Advantages of non-verbal methods of communication

A
  • Removes pressure to speak
  • Avoids problems of auditory processing and memory
  • Limits vocabulary
  • Simplifies language used
  • Adjusts presentation to comprehension
  • Easier to direct attention
  • Can be more consistent
  • Multi-modal helps comprehension
  • Adjustable duration
32
Q

What is object of reference?

A

Means using real objects to signify actions, times etc.

33
Q

What is PECS?

A

Picture exchange communication system.
Using pictures to communicate what the child wants.

34
Q

What tools can be used to aid communication?

A
  • Sequence strips and visual timetable
  • Talking Mats
  • Communication books and boards
  • Technology
  • Pictures are put together to make
    more complex information.
35
Q

What are sequence strips ? 2 advantages? How can it be used in eye examinations?

A

Explain the progression of an action or Visualising temporal concepts which are otherwise abstract.
- Reducing anxiety
- Enabling completion of activity / task

–Can have this to show stages of an eye exam. It also helps them identify when the test has really ended.

36
Q

Communication board is most useful in?

A

Particularly useful for those with cerebral palsy where they can be attacked to the wheelchair – may be a pre-cursor for technology – Voice Output communication aids.

37
Q

What is a communication passport?

A
  • A useful introduction to the individual and the ways they communicate.
  • Always ask patients if they have one. It allows you to tailor exams to particular individuals.
38
Q

Books in the waiting room- with how eye examinations work is helpful, because?

A

Books in the waiting room or recommend to carriers or patients to have to help them and the patient prepare better for an eye exam.

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