Case Specifc Flashcards
What antenatal CP risk factors are present in Jared’s Case?
- Prematurity
- Low Birth weight (<2.5kg)
- Pregnancy complications
Jared rolled at 12mths. What is the normal? Is this a red flag?
Normal 3-4 mths
Red flag: 6 mths (yes)
Jared sat at 10mths. What is the normal? Is this a red flag?
Normal: 6 mths
Red flag: 9mths (yes)
Jared began cruising at 20mths. What is the normal?
10-11 mths
Jared began walking at 24mths. What is the normal? Is this a red flag?
Normal: 12-18mths
Red flag: 18 mths (not attempting to walk without support)
Jared is unable to run. What is the normal? Is this a red flag?
Normal: 18mths
Red flag: 2 years
Jared is unable to go up/down stairs without significant support. What is the normal? Is this a red flag?
Normal: 24mths
Red flag: 2 years (holding on) or.3 years (independently)
What exercise is giving for retained babinski
Brushing integration
How would a retained babinski present?
Toe walking
Altered gait
Difficulty with balance
What exercise is given for a retained grasp/palmar reflex?
Pincer grip rubber band exercises
How would a retained grasp/palmar reflex present?
A weak grasp
Poor fine motor skills
Poor handwriting
What exercise given for a retained moro/startle reflex?
Starfish exercise
How would a retained moro/startle present?
- Hypersensitive or undersensitive to sensory stimuli
What exercise is given for a retained galant reflex?
Snow angel
How would a retained galant reflex present?
Delayed bladder control
Intolerance of food textures
Scoliosis
Poor concentration/inability to sit still
What exercise is given for a retained rooting reflex?
Brushing integration
How would a retained rooting reflex present?
Picky eater ie resistance to some textures
Issues with speech articulation
Thumb sucking
What exercise is given for a retained ATNR?
Bear walking while holding a toy between neck and shoulder
Opp fencing posture
How would a retained ATNR reflex present?
Abnormal gait
Ear/eye/foot/hand dominance
Poor balance
Difficulty rolling
What exercise is given for a retained STNR?
Bear walking on hands and feet instead of crawling on hands and knees.
Why prescribe stretching for Jared?
To prevent spasticity and contractures
What is the purpose of modular seating?
Support growth of Jared spine’s
Prevent hip dislocation
Provide stability & support to the head/neck which will make swallowing easier and reduce tantrums around mealtime
What education will you provide to Jared’s mother?
- Encourage self reliance ie Jared should do as much as possible on his own
- Supportive home environment –> safe spaces for practice eg stable furniture he can use to practice cruising/standing. Toys within reach for independent exploration.
- Ensure he is reviewed periodically so his intervention and goals can be adjusted as needed
- Encourage trial and error + repetitive practice
- Parent support and education groups that may be able to provide additional advice regarding navigating daily challenges
- NDIS funding for adaptive equipment and home modifications
- Environmental modifications eg installing handrails on stairs and steps, using non-slip mats to prevent falls, stools and stable chairs to help with his ADL’s, minimise obstacles that may make it challenging for him to navigate the home
What are the assessment tools that can be used for Jared?
Gross motor function measure (every 3-6mths)
Manual ability classification system (6-12 mths). Functional use of hands (grasping, manipulating and coordination)
Communication function classification system. Designed to assess how well children communicate in everyday situations (send, receive and understand messages)
Observation of walking/mobility/self care
ROM and lower limb strength
Tone: tone can fluctuate so its important to reassess how its affecting Jareds mobility
Please list 3 SMART Goals for Jared (walking, stair preparation and balance)
All within 3 mths:
Walk independently on a flat surface for 10m with fewer than 2 stumbles to improve walking stability and confidence
Ascend and descend a 10cm step using alternating legs with minimal assistance from a handrail
Jared will stand on one foot with minimal support for atleast 2 seconds to promote balance and prepare for more dynamic activities
Please list 3 SMART goals for Jared (run, stairs and ADLs)
Within 9-12 mths for each of the following:
Independently run a distance of 5m with controlled speed to facilitate engagement in playgroups and social activities with peers
Ascend and descend a staircase with one hand support on a railing
Independently remove and put on simple clothing items (eg shoes, jacket) to support independence in ADLS
What is GMFCS II
Can walk in most settings but may need support on uneven surfaces and use handrails on stairs. They experience some difficulty with stability, speed and coordination.
