BRS Orientation & Mobility Instruction 5 — Questions and Answers
Question 1: An O&M specialist is working with a client who has Usher syndrome (combined visual and hearing impairment). Which communication adaptation is MOST important during outdoor training?
- Using hand signs exclusively throughout the lesson
- Establishing a tactile or vibrotactile communication system before beginning travel (Correct answer)
- Conducting all lessons with an interpreter present
- Limiting lessons to indoor environments to reduce noise interference
Correct answer: Establishing a tactile or vibrotactile communication system before beginning travel
A pre-established tactile or vibrotactile communication system ensures the specialist can convey critical safety information even when auditory communication is not possible outdoors.
Question 2: The primary advantage of a support cane compared to a long white cane for a client with low vision is:
- Greater arc coverage for detecting obstacles
- Weight-bearing support for clients with mobility impairments (Correct answer)
- Better detection of drop-offs and surface changes
- More visible to drivers than the standard white cane
Correct answer: Weight-bearing support for clients with mobility impairments
A support cane provides physical balance and weight-bearing assistance, making it appropriate for clients who have both visual impairment and mobility limitations.
Question 3: Which statement BEST describes the O&M specialist's responsibility regarding electronic travel aids (ETAs)?
- Prescribe specific ETAs based on visual acuity measurements alone
- Assess the client's needs and provide training on appropriate ETAs as supplements to the white cane (Correct answer)
- Discourage ETA use as it reduces environmental awareness
- Only recommend ETAs approved by the Veterans Administration
Correct answer: Assess the client's needs and provide training on appropriate ETAs as supplements to the white cane
O&M specialists assess individual needs and train clients to use ETAs as supplements — not replacements — for traditional cane travel techniques.
Question 4: A client with macular degeneration retains peripheral vision. The O&M specialist should train the client to use:
- Central fixation to maximize remaining acuity
- Eccentric viewing to position objects in the intact peripheral field (Correct answer)
- Telescopic lenses for all distance viewing tasks
- Increased illumination to restore central vision function
Correct answer: Eccentric viewing to position objects in the intact peripheral field
Eccentric viewing trains the client to use the preferred retinal locus (PRL) in the peripheral field to view objects that cannot be seen with the damaged central retina.
Question 5: During a route lesson, a client with adventitious blindness becomes disoriented and cannot locate a familiar landmark. The BEST immediate intervention is to:
- End the lesson and escort the client back to the starting point
- Guide the client back to the last known location and rebuild orientation systematically (Correct answer)
- Have the client stand in place and call for assistance
- Use GPS to provide turn-by-turn directions back to the route
Correct answer: Guide the client back to the last known location and rebuild orientation systematically
Returning to the last known point and reorienting systematically is the foundational O&M recovery strategy, teaching the client to problem-solve rather than becoming dependent.
Question 6: Which of the following is a PRIMARY consideration when determining appropriate cane length for a client?
- The client's grip strength and hand size
- The client's height and typical walking speed (Correct answer)
- The client's visual acuity level
- The primary indoor vs. outdoor travel environment
Correct answer: The client's height and typical walking speed
Cane length is determined by the client's height and walking speed to ensure the cane arc extends approximately one stride length ahead, providing adequate preview of the travel path.
Question 7: A client asks about using a guide dog instead of a white cane. The O&M specialist's MOST appropriate response is to:
- Discourage guide dog use as it reduces independence skills
- Explain that guide dogs and cane travel address different needs and that O&M training is typically a prerequisite for guide dog school (Correct answer)
- Refer the client directly to a guide dog school without further discussion
- Inform the client that guide dogs are only appropriate for clients with total blindness
Correct answer: Explain that guide dogs and cane travel address different needs and that O&M training is typically a prerequisite for guide dog school
Guide dog schools typically require applicants to demonstrate solid O&M foundational skills, and the specialist should provide accurate information about how the two modalities complement each other.
BRS Orientation & Mobility Instruction 5
An O&M specialist is working with a client who has Usher syndrome (combined visual and hearing impairment).
Which communication adaptation is MOST important during outdoor training?