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OTA 140 - Pediatrics > Adolescence and Transition > Flashcards

Adolescence and Transition Flashcards

1
Q

Who are students in Transition?

A
  • Ages 12-22 (begins middle school)
  • School districts responsible for students with disabilities until 22.
  • Focus shifts from remediation of skills to occupation-based adaptation/functional skill building for max indep.
  • Services designated/covered by IDEA
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2
Q

Individuals with Disabilities in Education Act (IDEA)

A
  • Federal Law that explains/funds service delivery in public schools
  • Continues evolving as needs of students/parents/school districts change
  • Designates OT/COTA as “RELATED SERVICES” to support students in educational environment
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3
Q

IDEA’s Law on Transition

A

PART A, 20 U.S.C. Section 1401, part 34 – Transition Services
• Includes provisions for movement to post-school, incl. secondary ed., voc. ed., adult ed./services, indep living, community participation
• Incl instruction, related services, community experiences, dev of employment, post adult living objectives, acquisition of daily living skills, and functional vocational ed.

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4
Q

What IDEA/Transition Means

A
  • Schools must prep students w/disabilities for adult life
  • Incl any student with IEP: students w/physical disabilities, learning disabilities, mental retardation, and mental illness
  • Schools must come up with transition plan before student’s 16th bday.
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5
Q

Brief History of Independent Living Movement

A

• 1975, Education for All Handicapped Children Act (EHA) (nothing prior to this)
• Most districts not compliant until 1980s
• 1990, becomes IDEA
• Revised many times, and continues
• Never has been fully funded!
• Indep Living mvmt started Berkeley 1970s (part of Civil Rights mvmt)
• Philosophy that every person with a disability is expert on their own needs/has right to meaningful, indep life
** Original students from 80s/90s now adults! Must have transition plan!

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6
Q

People First Language

A

Always put the PERSON first!
• Not “disabled student,” but better “student who has disability”, but best “NAME”
• Respect indiv who happens to have disability
• Notable exceptions: Deaf, Autism, Blind

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7
Q

Office of Special Education and Rehabilitative Services (OSERS)

A
  • Federal govt office to provide leadership to achieve full integration/participation in society of ppl with disabilities by ensuring equal opp, access to, excellence in educ, employment, community living.
  • Sets federal policy and guidance around IDEA/IEPs etc.
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8
Q

What Skills OT Brings to Transition

A
  • Task analysis
  • Task skill leveling
  • Problem solving
  • Outside vantage
  • Observational skills
  • Point person (informational clearing house); “on student’s team” along w/parent(s)
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9
Q

OT Provided in Transition

A
  • Functional life skill support
  • Independent living skill support (ADL)
  • Job skill support
  • Self-regulation support
  • Adaptations for independence
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10
Q

Functional Life Skill Support

A
  • Community Mobility (ie:bus riding)
  • Shopping (clothing, groceries)
  • Family and Friends
  • Recreation and Leisure
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11
Q

Independent Living Skill Support

A
  • Grooming/Self-Care
  • Cooking
  • House Cleaning (dust, sweep, mop, etc.)
  • Laundry
  • Safety
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12
Q

Job Skill Support

A
  • Interviewing
  • Time Awareness/Scheduling
  • Job Skills
  • Task Completion
  • Social Interaction
  • Safety
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13
Q

Self-Regulation Support

A 
• Skills must be functional/socially appropriate
• Must be able to be done in community (as adult)
• Wide variety of interventions:
-	Breathing techniques
-	Sunglasses/ear plugs
-	Water bottles in backpack for weight
-	Socially approp fidgets (keychains)
-	Incorp workout/gym routines
-	Chewing gum/crunchy granola bars
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14
Q

Adaptations for Independence

A
  • Goal of OT intervention at this stage is to assist in becoming indep as possible
  • ANY adaptation that achieves that end can be successful
  • Get creative
  • As OT in this setting, you will find yourself stretched to creative limits!
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15
Q

Role of OTP in Transition

A
  • Support in previous areas in community
  • Services must be provided in “natural environment”
  • Bring expertise of task analysis/problem solving—can be new eyes on situation!
  • Must also bring respect for knowledge of job coach/parent/rec therapist/etc. - primary caregiver in natural environment (they will share with you!)
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16
Q

Age Range of Adolescence

A

10-19 yo (10-24 for OT)

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17
Q

Self-Efficacy

A

One’s view of his/her own physical performance. Belief that they possess abilities to participate/perform adequately.

18
Q

Middle Adolescence

A

Most intense period of development; peers replace parents as primary influence; conformity is desirable.

19
Q

“Contradictory Typical Behavior”

A

When behaviors, thoughts, emotions seem contradictory, particulary ages 13-15. Example: 14 yo who breaks rules and pierced nose, but holds a job after school. Becoming a vegetarian/healthy but smoking.

20
Q

Identity Achievement

A

Exploration of possibilities and the healthy resolution of the quest. Usually final years of high school, college. Commitment to interests, values, gender`, political views, career, moral stance. Ex: earning money to pay for chosen major in college.

21
Q

Feedback Strategy for Adolescents

A

Give specific feedback with concrete examples. Describe incorrect skill/behavior demonstrated. Do not say just “good.”

22
Q

Physical Changes in Adolescence

A
  • Gain 50% of adult weight and 20% of height
  • Growth and sex-related hormones released
  • Average growth period lasts 4 years
  • Begins as early as 9, to around 17 yo
  • Average peak of growth: girls age 11, boys age 13
  • Girls reach full height within 2 yr of start of menstruation
  • Head, hands and feet reach adult size first
  • Bones calcify, become stronger
  • Muscles increase in size/strength
  • Strength greatest 12 mo after peak of growth
  • Boys’ performance peaks around 17-18 yo
  • Girls increase motor performance around 14
23
Q

Cognitive Changes in Adolescence

A
  • Increased capacity for abstract/logical thinking
  • Advanced hypothetical/deductive reasoning
  • Impulse control/self-regulation
  • Increased ability to risk-assess and problem-solve
  • Improved working memory
  • Improved language skills (esp girls)
  • Future planning/goal-setting
  • Moral reasoning/morality
  • Ability to perceive others’ perspectives
  • Focus on role obligations/how perceived by others
  • Questioning values of parents/institutions
24
Q

Psychosocial Issues in Stages of Adolescence

A

Phase 1: early/middle school (age 10-13)
Phase 2: middle/high school (14-17)
Phase 3: late/first years of work/college (17-21)
• Emotional separation from parents
• Exploration of interests, ideas, roles
• Experimentation w/interests/preferences
• Formation of personal identity
• Identification with peer group
• Exploring romantic relationships
• Sense of one’s sexuality/orientation
• Establishing occupational identity for future worker role

25
Q

How Self-Identity Develops

A

Achieving stable self-identity is a critical task of adolescence.
• 2 components: Individual “Who am I;” and contextual “Where do I fit in my world”
• Visible in values, beliefs, interests, commitments to work, and social role
• Includes gender orientation, identification to culture/ethnicity, and perceptions of one’s personality traits (ie: introverted, open, etc.)

26
Q

What OT can do to develop positive identity

A

Those with disabilities may be marginalized/stereotyped, which becomes a barrier to others seeing their qualities. OT can assist with not internalizing these labels as integral to their identity; help define interests, values, competencies in social/occupational roles.

27
Q

How teens develop body image

A
  • Compare themselves with ideal images
  • Shapes attitude of one’s body
  • Many struggle with image and are critical of body
  • Poor body image can lead to depression, anxiety, eating disorders
  • 40-70% of girls dissatisfied with 2+ aspects
28
Q

Strategies for Teens with Cognitive Impairment

A
  • ID how teen works best
  • ID strengths
  • Offer choices
  • Match abilities
  • Break down to simple steps
  • Use many methods of instruction
  • Learn in familiar setting first
  • Give specific feedback with concrete examples
  • Be consistent, use repetition
  • Do not introduce variety without reason
29
Q

Behavioral Indicators of Positive/Neg Self-Esteem

A 
POSITIVE:
• Expresses opinions
• Interacts with other teens
• Makes eye contact/faces others
• Volunteers for tasks
NEGATIVE:
• Avoids eye contact
• Overly confident/brags
• Class clown
• Self-critical (humor)
• Submissive/overly agreeable
• Puts others down
30
Q

Play/Leisure in Adolescence

A
  • Adolescents spend over half waking hours in free time/leisure activities
  • Choices made important to development
  • Can use to assess strengths, values, interests, social positions
  • Recommended to have 1 hour physical activity/day
  • Contributes to participation in age-related groups and self-efficacy
31
Q

Issues Teens with Special Needs Face

A
  • Fewer opportunities to engage in typical adolescent experiences
  • Fewer chances to make own choices/explore
  • May have negative self-perceptions, lower expectations, social isolation
  • Some confront stigma/discrimination
  • Struggle with social acceptance
  • Barriers to making friends
  • Typical access points for inclusion are limited
  • Problems with accepting their bodies
32
Q

Interventions/Therapy for Adolescents

A

OT interventions may address:
• decreased participation in leisure/hobbies
• poor time management
• poor coping skills (self-regulation of anger/stress/unhealthy lifestyle)
• Goal of OT is to optimize each adolescent’s functioning at his/her full capacity.

33
Q

Portion of Population that are Adolescent

A

1/6 of world population; 13.2% of U.S.

34
Q

Adolescents in families below poverty

A

Almost 16%

35
Q

Number of high school students who are working

A

1/3

36
Q

Identity Foreclosure

A

When adolescent chooses to avoid experiencing an identity crisis by prematurely committing to an identity experience.

37
Q

Identity Moratorium

A

State when adolescent openly explores alternatives, strives for autonomy, tries out different interests, and pursues sense of individuality. (Early/Mid adolescence)

38
Q

Identity Diffusion

A

Least defined sense of personal identity; adolescent avoids/ignores task of exploring identity and has little interest in exploring options. Seldom think about the future. (Early adolescence)

39
Q

Identity Achievement

A

Follows moratorium; exploration of possibilities and healthy resolution of the quest. Commitment to interests, values, gender, sexual orientation, politics, career, moral stance. Autonomous, mature moral reasoning, independent. (Final years of high school/college/work)

40
Q

Sleep recommended for adolescents

A

8.5-9.25 hours daily

OTA 140 - Pediatrics (18 decks)

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