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Course Outline

NORA Skills Level 1
Course Learning Objectives

Prevalence of Brain Injury
1. Describe the incidence, prevalence and epidemiology of brain injury.
2. Describe the systems of care available in the rehabilitation continuum.

Understanding the Nervous System, the Brain, and Brain Injury
1. Describe the function of the autonomic and sympathetic nervous systems.
2. Identify basic brain structures and functions.
3. Describe brain-behavior relationships.
4. Describe how an injury to the brain can result in various behaviors and challenges.
5. Understand the importance of the motor system in guiding rehabilitation.
Health, Medications and Medical Management
1. Understand the role of the case history in identifying the uniqueness of each individual with a brain injury. Know the strategies for gathering Information about the person's background, injury, treatment and factors that impact their potential for optimum recovery.
2. Understand, identify and report signs and symptoms of potential medical and ocular complications that are commonly encountered in persons after a brain injury.
3. Demonstrate knowledge of the most commonly prescribed categories of medications and commonly used drugs after brain injury and their impact on vision.
4. Understand the role nutrition and exercise plays in the healing process.
Understanding Functional Impacts of Brain Injury
1. Describe common cognitive, physical, emotional, behavioral, and social changes after brain injury.
2. Describe how these changes affect the person's functioning.
Children and Adolescents with Brain Injuries
Recognize developmental issues for children and adolescents after brain injury, as well as, neurologic deficits.

Visual Pathways in the Brain
1. Describe the various visual pathways and note their significance.
2. Understand the significance of the brain stem in the control of eye movements.
3. Understand how to test the function of the cranial nerves.
4. Review the various disorders of the cranial nerves involved in vision.
Evaluation of the Oculomotor System 
1. Know how to test the function of extraocular muscles.
2. Understand the different testing procedures for the oculomotor system.
3. Understand the integration of the vestibular system, oculomotor system and somatic feedback.
4. Review the various disorders of the oculomotor system.
Specific Visual Deficits Following Brain Injury
1. Understand Post Traumatic Vision Syndrome.
2. Understand Visual Midline Shift.
3. Describe visual field defects.
4. Describe visual spatial neglect.
5. Understand how to differentiate between visual field deficits and visual spatial neglect.
6. Understand the various visual information processing deficits.
The Examination of the Brain Injured patient
1. Know how to conduct a thorough case history.
2. Know the goals of the patient and family.
3. Understand what functions needs to be assessed.  
4. Know what tests will be appropriate to administer.

Treatment Protocols for the Brain Injured patient
1. Understand the importance of lenses, prisms and occlusion. 
2. Understand how to set up a treatment plan (in office). 
3. Understand what procedures to use for a specific visual deficit.

Working with the Vision Rehabilitation Team
1. Know the components of a vision screen.
2. Understand the process of communication with other professionals.
3. Know how to communicate to the patient and their family.
4. Understand how to integrate vision rehabilitation into the general rehabilitation treatment plan.
5. Understand the optometrist’s role in guiding the vision therapy program.  
6. Understand the optometrist’s role in the hospital setting.

The course addresses

1.    Working with the Rehabilitation Team
2.    The Continuum of Rehabilitative Care
3.    Functional Outcomes and Therapeutic Expectations
4.    Review of the Twelve Cranial Nerves
5.    The Vestibular System
6.    Concepts in Rehabilitation