Case 7: CP - Elementary School Flashcards
IDEA Part ___ is federal legislation for early intervention for 0-3 years old, while IDEA Part ___ is for ages _____
Part C: 0-3 years
Part B: 3-21 years –> school aged students with disabilities
comprehension questions:
A school-based physical therapist is working with a kindergarten student diagnosed with CP, GMFCS level III. The student is able to ambulate with rolling walker. She enjoys being with her classmates, but becomes frustrated when she has difficulty keeping up with classmates during PE class or while outside on the playground and school sports fields. The student is on grade level for all academic areas.
Which tool would be MOST appropriate to measure student’s participation in the school setting and activity in school-related tasks?
A. Children’s Assessment of Participation and Enjoyment (CAPE)
B. Gross Motor Function Measure (GMFM)
C. Quality Function Measure (QFM)
D. School Function Assessment (SFA)
D: School Function Assessment: criterion-referenced tool for kinder-6th grade. Measures participation in school and activity in physical and cognitive/behavioral tasks.
CAPE: measures children’s engagement and participation in recreation, not school
GMFM and QFM: gross motor performance
comprehension questions:
A school-based physical therapist is working with a kindergarten student diagnosed with CP, GMFCS level III. The student is able to ambulate with rolling walker. She enjoys being with her classmates, but becomes frustrated when she has difficulty keeping up with classmates during PE class or while outside on the playground and school sports fields. The student is on grade level for all academic areas.
Which of the following objective measures would be most appropriate to measure this student’s mobility and endurance?
A. 6-minute walk test (6MWT)
B. 30-second walk test
C. Early Activity Scale for Endurance
D. MobQues28
A: 6MWT –> mobility AND endurance
30-second walk test and MobQues28 measure mobility, not endurance
EASE measures endurance, not mobility in children
comprehension questions
A school-based physical therapist is working with a kindergarten student diagnosed with CP, GMFCS level III. The student is able to ambulate with rolling walker. She enjoys being with her classmates, but becomes frustrated when she has difficulty keeping up with classmates during PE class or while outside on the playground and school sports fields. The student is on grade level for all academic areas.
To address the student’s frustration with keeping up with her classmates during physical education and recess, which intervention is most important for the physical therapist to initiate?
A. Convene a meeting with the student’s physical education teacher to provide the student with a separate physical education class.
B. Help the student problem solve and identify strategies to increase her participation in physical education and recess.
C. Increase lower extremity strength and balance.
D. Request that the student’s teacher allow the student to play inside during recess.
B. It is important to include the student in addressing such issues, in order to help increase her independence, self-advocacy, and problem- solving ability regarding her disability.
Options A and D would isolate the student and not allow her to integrate with her peers.
Increasing her lower extremity strength and balance (option C) may help her keep up with her classmates, but it neither directly addresses the student’s current frustration, nor allows her the opportunity to problem-solve.
Multidisciplinary report containing at least two student evaluations completed by the school district; if a student is found to qualify for special education, the educational team has 30 calendar days to complete an IEP. This is called an _____
Evaluative Report
legally binding document developed annually for students who require specially designed instruction; identifies the special education and related services the student will receive for one calendar year
INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Document that classifies type of classroom and programming that a child will receive for the duration of the IEP
NOTICE OF RECOMMENDED EDUCATIONAL PLACEMENT (NOREP)
Document that parents/guardians are required to sign before a school system may evaluate a student for special education services
PERMISSION TO EVALUATE (PTE)
Federal legislation that makes discrimination against individuals with disabilities illegal;
Section 504 provides that students who do not require specially designed instruction may receive accommodations and services including PT if they are considered to have a disability that impacts a major life function.
SECTION 504 OF THE REHABILITATION ACT OF 1973:
What are general PT POC/goals for management of a child with CP transitioning from early intervention to school based services?
- coordination transition to kindergarten with related services
- provide efficient means to access school environment, including class, school building, cafeteria, playground
- create meaningful adaptations to promote participation in school activities (recess, field trips, etc)
What are PT interventions for a child with CP transitioning from early intervention to school based services?
- coordinate/communicate with all team members
- education to school staff, including strategies promoting student self-efficacy, safe strategies for assistance with transfers/mobility
- procedural interventions for specific goals
- develop emergency evacuation plan
- varied positioning during school day to meet kid’s needs
- accomodation of school activities and environments to enhance participation
What’s a mainprecaution during PT of school-aged child with CP?
fatigue, esp during school day
What are complications interfering with PT related to kids with CP in school services?
- increased time required for educational activities/related services
- increased energy/time demands of activity during school day
- increased time/energy demands of mobility with ADs
In educational environments, the PT is a member of the ______, including parents/guardians, regular and special education teachers, individual aide, school nurse, occupational therapist, special area teachers (e.g., physical education teacher), and transportation personnel.
educational team, part of student’s comprehensive educational program
What are other non-traditional school settings that are considered school settings?
- individual or group homes and skilled nursing facilities for medically fragile students
- individual homes for students who are home-schooled
- community environments for educational activities that take place off of school grounds (educational/field trips, community-based instruction, and pre-vocational training), school-related transportation.
The PT often serves as a liaison between the student’s __ and __ team
educational and medical team
What is a criterion-referenced tool that measures **participation **in school setting and activity in cognitive and behavioral tasks for students in kinder-6th grade?
School Function Assessment (SFA)
2 separate criterion cut off score scales, 1 for kinder-3rd grade and 1 for 4th -6th grade
Balance and postural control in young children with CP may be assessed using a wide variety of balance tools. For the student in this case, appropriate measures include the Pediatric Balance Scale, Pediatric Reach Test, and the Early Clinical Assessment of Balance. T or F
True
For students with CP who are ambulatory, mobility may be assessed with what 4 outcome measures?
30 second walk
6 minute walk
TUG
Timed Up and Down Stairs
For students 4 to 13 years of age with CP who are able to walk (GMFCS levels I-III), mobility may also be assessed through parent report using the _____
MobQues28
mobility questionnaire that asks parents to rate their child’s level of difficulty completing a variety of mobility tasks including level surface mobility, mobility on uneven surfaces or over changes in elevation, transitioning between positions and recreational activities (e.g., kicking a ball, running on various terrains).
What are 2 good endurance measures for children with CP?
Early Activity Scale for Endurance (EASE)
the 6MWT (for ambulatory students).
For children 6 years and older, CV fitness can be assessed with the ___.
For kids at GMFCS level 1 or 2, CV fitness can be assessed with ____
Energy Expenditure Index (EEI)
Shuttle Run 1 and 2 (SRT-1, SRT-2)
What are 2 good self report measures of exertion for kids with CP at school age
Pictorial Children’s Effort Rating Table (PCERT) or the Children’s OMNI Walk/Run Scale of Perceived Exertion.
Child with CP: she ambulates using a walker, uses a wheelchair for traveling longer distances or outdoors, and can sit in a regular chair with pelvic or trunk support.
She is a GMFCS level ____
GMFCS level 3
As children with CP age, instruction should be directed towards _____
fostering independence!
*self advocacy, self management, participation in medical/educational decisionamking, and positive self concept
Independent mobility is especially important during the school years to enable children to interact with peers and to learn from exploring their environment T or F
True
PT interventions include:
transition planning
mobility recs/activity accomodations for energy conservation
equipment for ambulation
supported standing program
ROM, stretching
aerobic, strength, CV fitness
_____ _is especially important during the school years to enable children with disabilities to interact with peers and to learn from exploring their environment.
Independent mobility
Grade B
PTs can help families understand the _____ __ when children begin school-based services. Grade C evidence
transition planning
____ is a reliable and valid tool for assessment of participation and activity in elementary school students.
The School Function Assessment GRADE A evidence
