ADL Interventions Flashcards
Considerations for ADL interventions
Family Life Cycle and Developmental Stage
Social Environment
Cultural Context
Physical Environment
Activity Demands
Evaluations that cover ADLs
- Assessment of Motor and
Process Skills (AMPS) - WeeFim
- Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT)
- School Function Assessment (SFA)
- Vineland Adaptive Behavior Scales-III - similar to dayc and bayley
- Adaptive Scales of DAYC & Bayley
How do we create and promote ADLs?
Creating supports within the environment that offer children the ability to engage in age-appropriate occupations
Educating parents. we would use this there is no attempt to do these things on their own.
Have visuals of free play
How does the OTPF suggest we create ADL interventions
Create or promote
Establish, restore and maintain
- Backward chaining
- Forward chaining
Modifying or adapt
Prevention, education
How do we Establish, restore and maintain- treatment which can address child’s difficulties according to developmental sequence for ADLs?
Backward chaining - child does the last step
Forward chaining - child does the first step.
Backward chaining -
child does the last step. Your progress to backing off more each time. You give them success to finish the task
forward chaining
child does the first step. Then the first two, eventually they do the whole thing.
How do you create ADL interventions that Modify or Adapt
using adaptive equipment
velcro shoes
adaptive spoons
sippy cups
In order for a assistive device to be worthwhile it must:
Do not need to memorize but review for good practice purposes.
Assist in the task the child is trying to complete
Be acceptable to the child and family
Be practical
Be durable and easy to clean
Be expandable
Be safe for the child to use
Have a system of maintenance or replacement
Meet the cost constraints of family or purchasing agency
How can we modify the environment ?
Architectural Barriers
Structural changes
Assistive Devices
Task modifications
Work surface
Positioning
prevention and education
how can we best prevent contractures
how can we achieve independence to prevent a further need down the line.
this might mean that we need to educate parents.
ADLs by one years old, what can we expect?
1 year old:
Cooperates
Pulls off shoes and socks
ADLs by 2 years old, what can we expect?
2 year old:
Helps undress
Dresses with assistance
ADLs by 3 years old, what can we expect?
3 year old:
Puts on shoes
Zips and unzips with help
Dresses with supervision
ADLs for 4 year old, what can we expect
4 year old:
Puts on socks and shoes
Can identify front and back of garment
5 year old ADLs what can we expect?
Dresses unsupervised
Interventions for cognitive and sensory needs as it relates to dressing
Modify demands of task- color coding, labeling dressers, picture charts or checklists
Environmental and task adaptations- social stories, video modeling, and easy to manipulate clothing
Interventions for physical or motor limitations for dressing
Modify demands- supportive positioning, use of button hooks, rings on zippers etc.
Adaptive Methods- Positioning, choice of clothing
if texture is a problem they child might need deep pressure first.
video modeling may help with the sequencing of dressing or showering
Using adapting equipment
Typical development of toileting
1 year old
1 year old:
Indicates discomfort when soiled
Will sit on toilet while supervised
Typical development of toileting 2 years old
2 year old:
Shows interest in potty training
Can stay dry for 2 hours or more
May need help getting onto the toilet
Typical development of toileting 3 years old
3 year old:
Independent toileting
May need help with hygiene
May need help with managing clothing
Typical development of toileting 4-5 year old:
Independent in toileting including hygiene and clothing management
Toileting Interventions
Limited Motor Skills
smaller toilets
something to roll over your toilet to provide trunk support and proper seating
transition from toilet to wheelchair.
Toileting interventions for Intellectual Limitations
Schedule or visual checklist to make sure they do all the parts like handwashing.
What is the OT’s Role in toilet training
modifying the task or environment
or
consulting with classroom and parents on how to modify the environment to best support the routine.
What is a fastener board good for?
practice fasten the things that the kid needs to fasten on their clothes.
5 main problems of sleep
Bedtime resistance or falling asleep
Awakening during the night
Irregularity of amount of time in sleep
Snoring
Sleepiness during the day
Sleep issues
Asthma
ADHD
Allergies
Cerebral Palsy - difficult with circadian rhythm
Brain Injury - difficult with circadian rhythm
Autism
How can OT’s play a role in sleep
- Create a nighttime routine
- equipment recommendations
- positioning suggestions and modifications
- modifying the environments with humifiers and such.
Questions for parents:
Does your child have a regular sleep pattern?
Where does the child sleep?
When is the child put to bed or to sleep?
What are typical bedtime routines?
Routines and Habits to help with sleep interventions.
Creating a “wind down” routine to bedtime
Looking at child’s sensory preferences and needs
Consistency in routine and environment
Routine for night waking
Buddy the Elf
3 year old child being seen in outpatient OT
Buddy is a focused worker but easily distracted
Sensory Profile indicates that he falls within the seeker category.
Occupational profile indicates parent concerns with sleep stating that Buddy will only sleep 4 hours per night.
Goal: Buddy will participate in 3 step nighttime sensory schedule with no more than 2 verbal cues within 2 months
Objective: With use of visual schedule, Buddy will complete one sensory activity, after 2 verbal prompts in 5 consecutive days.
Play development through infancy through preschool
Infancy: Exploratory play, then object play
2nd year: abstract, Pretend play
Preschool years: Constructive play, Complex imaginary play, Rough and Tumble Play
Social play
When making play goals make sure that they are developmentally appropriate what does that mean.
Amount of time child plays
Developmental complexity of play content
Availability of play objects
Learning object functions
Pretense of play ( for example, exploratory, pretend)
Building broad repertoire of object uses
Increasing independence with play initiation and discontinuation
Physical limitationn of play
Fear of movement, decreased active play and preference for sedentary activities
Children with CP
Sensory processing difficulties
Limited or distorted perception of themselves and their world, decreased ability to plan and execute motor and cognitive tasks, poor organization of behavior.
cognitive limitation of play
Delayed skills, difficulty in structuring their own behavior or lack of sustained attention
visual impairment effects on play
Delays in developing an integrated perception of the world.
What kind of attitude should a therapist should have when they are doing an intervention of play
The therapist should express a playful attitude through speech, body language and facial expressions.
For play intervention
Child must develop:
Intrinsic motivation
Internal control
Ability to suspend reality
Ability to read verbal and nonverbal cues
Aspects of Play interventions
Parent Education and Training
Play spaces
- Considering the environment and the objects, equipment and opportunities to play.
- Toys may need adaptations
- Spaces should offer variety of experiences and allow for creativity
- Universal access
