Chapter 12: Assessment and Treatment of Activities of Daily Living, Sleep, Rest, and Sexuality

Question 1

Activities of daily living (ADLs)

Answer 1

Include eating and feeding; bathing and showering; personal hygiene and grooming; dressing; learning how to take care of one’s body, such as toilet hygiene, bowel and bladder management; functional mobility, caring for a personal device and learning to express sexual needs.

Question 2

Sleep and rest

Answer 2

Includes rest, sleep preparation, and sleep participation.

Question 3

Backward chaining

Answer 3

OT performs most of the task, and the child performs the last step of a sequence to receive positive reinforcement for completing the task.
Practice continues, with the OT performing fewer steps and the child completing additional steps.
Method is particularly helpful for children with a low frustration tolerance or poor self-esteem because it gives immediate success.

Question 4

Forward chaining

Answer 4

The child begins with the first step of the task sequence, then the second step, and continues learning the steps of the task in sequential order until he or she performs all steps in the task.
Helpful when sequencing and generalizing activities are difficult.
OT gives varying numbers of cues, or prompts, before or during an activity.
Therapist or person cues and environment or task cues may occur naturally or artificially in an environment. (uses a combination of natural, verbal, gestural, visual, or physical cues or prompts) (Vogtle & Snell, 2011). Cues are, where prompts are

Question 5

Cues

Answer 5

general hints to begin or continue an ADL task

Question 6

Prompts

Answer 6

More specific actions to assist the child in completing the task.

Question 7

Assistive Technology and Environmental Adaptations

Answer 7

An educational approach provides parents and children with the chance to make informed choices about the services, methods, assistive technology, and environmental adaptations they will use

Question 8

Environmental adaptations

Answer 8

• Modifications may include simple changes to lighting, floor surface, amount and type of furniture or objects, and overall traffic pattern of the room or building.
• For some children, OTs minimize sensory stimuli and eliminate visual and auditory distractions or increase environmental stimulation (ex. color or music) to cue their performance.

Question 9

Assistive devices

Answer 9

• Modify the method of the task

- Commercially available or are custom-made by the occupational therapist, skilled orthotist, or rehabilitation engineer

Question 10

Grading techniques

Answer 10

Adapting a task or portions of it to fit the child’s capabilities.
By using a task analysis, the OT rates subtasks of the activity and varies them according to their degree of ease or difficulty for the child.
OT may modify the activity demands to compensate for limited capabilities and performance skills.
May include gradually increasing the number of steps, fading the amount of personal assistance or cueing, and reducing the strength needed or length of time to complete an activity

Question 11

Partial participation

Answer 11

Occurs when a child performs some steps of the task and a caregiver completes the remaining steps; this allows the child to practice and often improves performance of the ADL task.

Question 12

Video self-modeling (VSM)

Answer 12

Allows children to observe and model from their own behavior

Question 13

Performance context

Question 14

Adaptive positioning