Environmental Mastery Flashcards
Other, Driving, Community Mobility, Wheelchair Seating
a method of assisting the client with parts of the task that are too difficult and the client finishes the task themself
scaffolding
a method of communicating expectations and support in a way that helps the client perform and improve in task skills
coaching
hook-and-loop fasteners, grab bars, and built-up handles are examples of
no technology
inexpensive items that are readily available commercially (jar opener, sock aid, reacher)
low technology
devices, hardware, or software that may require specific training to use (augmented communication, powered mobility)
high technology
assistive technology frame of reference that includes interaction and balance among 4 major elements (activity, context, human skills, assistive technology)
Human Activity Assistive Technology Model
assistive technology frame of reference that considers sensors, sensory processing, and effectors
Information-Processing Model of the Assistive Technology System User
tactile substitution method of tactile lipreading by putting the thumb on the speakers lip and the fingers along the speakers jawline (vibration)
Tadoma method
assessment method of understanding the clients current needs and predicting future needs
predictive assessment
assessment method of continuing evaluation to meet changing needs
serial assessment
helps coordinate and integrate the use of AAC in the classroom
curriculum-based assessment
competency in operating an AAC device
operational competence
thorough understanding of an AAC devices symbol system and rules of organization
linguistic competence
knowledge of skills in sociolinguistic and sociorelational areas (ex. turn taking)
social competence
principles for universal design
Equitable; Flexible; Simple and Intuitive; Perceptible information; tolerance for error; low physical effort; size/space for approach and use
an area in which the individual competence is in balance with the environmental demands
adaptive zone
assessment used to evaluate the environment
home safety checklist
assessment used to evaluate the interaction of the person with the environment in the home
home evaluation checklist
measure of color perception test for red or green color deficiency
Ishihara color test
the two eyes working together to view objects in the environment
stereopsis
assessment the provides a series of illuminated slides used to measure depth perception, acuity, contrast sensitivity, phorias, glare recovery, and color perception/recognition
Optec Functional Visual Analyzer
timed test where clients match numbers to a series of symbols according to a reference key to assess attention, visual scanning, and motor speed
symbol digit modalities test
observational measure used to assess quality of performance in completing standardized ADL tasks
Assessment of Motor and Process Skills
two part standardized evaluation to determine driver competence. (1) computer-based cognitive assessment, (2) on road evaluation
DriveABLE
paper and pencil tracing activity correlated with on-road driving performance (untimed)
Porteus Maze Test
brief 6-item assessment used to identify cognitive function related to dementia
Short blessed test
assessment battery developed by the American Medical Association to address the domains of vision, cognition, and motor function required for driver fitness. used by physicians
Assessment of Driving Related Skills
computer based assessment battery to assess domains of vision, cognition, and motor function as they pertain to increased crash risk
Driving Health Inventory
driving assessment performed in an area without traffic and pedestrians to assess knowledge and understanding of vehicle features and vehicle control at low speeds
closed route on-road evaluation
driving assessment that uses neighborhood streets and intersections with naturally occurring traffic and other road users; extraneous variable can be controlled; increasingly complex
open road with fixed route
driving assessment that occurs under real-world conditions with data collection occurring through vehicle instrumentation such as video, and vehicle kinematics
naturalistic driving and instrumented vehicles
assessment instrument that captures information about avoidance behaviors that are often identified as compensatory strategies to older drivers
driving habits questionnaire
helps clients look at their driving knowledge and skill in relation to their health conditions and medications
SAFER driving: the enhanced driving decisions workbook
hierarchy of driving behavior that involves higher level decision making to determine trip goals, mode of travel, and navigating or mapping routes
strategic level
hierarchy of driving behavior that involves decisions made during driving maneuvers including making left-hand turns or slowing to pass a vehicle
tactical level
hierarchy of driving behavior that involves decisions made to control the vehicle safely by executing the necessary visual-motor or coordination skills
operational level
depth perception
stereopsis
assessment of driving in the clients community (occupation-centered); used for planning and decreasing risk
variable route
controls that are engaged when the vehicle is in motion and affect direction and speed of the vehicle
primary controls
controls installed under the steering column; acceleration activated by pushing the hand control lever to the knee and breaks activated by pushing the level forward at a right angle from the dash
push-right angle hand controls
controls installed only on the left side with L-shaped handle that rocks backward for gas and forward for breaking
push-rock hand controls
controls installed on either side that twists similar to a motor cycle throttle to accelerate and break when the handle is released and pushed forward
push-twist style hand controls
controls mounted on either side under the steering column with acceleration achieved by pulling back and braking achieved by pushing forward
push-pull hand controls
controls accessible when the vehicle is in motion but does not affect the speed or direction of the vehicle (turn signals, horn, dimmer, wipers, cruise control)
secondary controls
controls that do not need to be activated when the vehicle is in motion but must be accessible to the client (ignition, gear shift, AC)
tertiary controls
reasoning used to determine what activities to use to increase clients level of functional independence in consideration of the disease or disability
procedural reasoning
reasoning used during face to face experience with the client to get the clients perspective on the illness, injury, or disability and to involved the client in goal making for the intervention plan
interactive reasoning
reasoning that occurs when the bigger picture is evaluated; practitioner reviews the clients functional status before the disability and at present
conditional reasoning
ability to perceive object form by touch
stereognosis
law acknowledging the role of state and local transportation decision makers in bringing attention to safety concerns related to individual users of different transportation modes (older drivers, pedestrians, children walking to school, bicycle/motorcycle safety)
The Safe, Accountable, Flexible, Efficient Transportation Equity Act
services for clients who are eligible for Medicare or Medicaid waivers for transportation related to non medical emergency transportation
supplemental transportation
the extent to which a community fulfills 6 core principles (1) housing (2) transportation (3) inclusiveness (4) opportunity for work, volunteer, and education (5) access to health care (6) encourages participation
livability
transportation alternative for clients with functional impairments that limit access to regular fixed-route services. picks up riders outside of their home and takes them to specific locations. most require rider to be able to meet them at the street
paratransit services
volunteer, nonprofit, or community-based transportation options serving older adults and people with disabilities for peopl eunable to use existing services or who desire more flexibility
supplemental transportation
categories for eligibility of paratransit services
- unable to navigate fixed-route
- unavailable public transportation at time/place of need
- impairment-related inability to board or disembark at a specific location
legislation that funded the _______________ program that creates safe environments surrounding schools that encourage children to bike and walk to school to devel healthy lifestyle
SAFETEA-LU Act/Transportation Alternatives Program
Safe Routes to School Program
means of assessing the readiness of older adults to make transitions regarding their mobility, such as driving cessation
Assessment of Readiness for Mobility Transitions (ARMT)
short-term, direct, intensive training to teach older adults and people with disabilities to use fixed-route public transportation safely and independently
travel training
services that promote collaboration and cooperation among transportation providers and connect clients to those providers
mobility management
system design emphasis for a hands-free sitter
mobility, stability (stable base of support), and comfort
system design emphasis for hands-dependent sitter
pelvic and trunk support to free the hands for activities
system design emphasis for propped sitter
total body support for posture and repositioning
one side of the pelvis is lower than the other side, which can lead to scoliotic posture and pressure ulcers on the ischial tuberosity
pelvic obliquity
the pelvis rotate posteriorly resulting in sacral sitting and flexion of the lumbar spine; patients slide forward in seat
kyphosis
pelvis rotates to one side, resulting in the spine and trunk moving to the opposite side
scoliosis
the pelvis rotates anteriorly, increasing the curvature of the lumbar spine; patients use upper extremities for support
lordosis
the pelvis rotates laterally, with the thighs moving to the other side
windswept deformity
soft pliable cusion that can mold itself around the buttocks; light weight; low cost; heat and moisture can build up
foam cushion
cushion that conforms to the shape of the buttocks and provides adequate postural control; heavy; sensitive to temperature
gel filled cushion
cushion that is light weight, provides even pressure relief, but reduces postural stability
air filled
cushion that provides un even pressure relief; lightweigh
honeycomb shaped plastic
cushion that incorporates a combination of materials (typically foam and gel)
hybrid cushion
cushion that provides scheduled pressure relief through alternating levels of inflation and deflation; reduce postural stability
alternating pressure
how to measure wheel chair width
measure the widest part of the thighs and add 1-2 inches
how to measure wheel chair depth
measure from base of back to popliteal space and subtract 1-2 inches
how to measure wheel chair height
measure from popliteal space to the bottom of the heel with 2 inch clearance for foot rests
how to measure seat back height
measure from the seat surface (including the cushion) to the top of the clients shoulder; a higher back needed if trunk control is poor; less for minimal trunk support (under the scapula)
what does seat dump do
slopes the seat of a WC down toward the rear for pelvis stabilization
how to measure arm rest height
measure from seating surface to bottom of flexed elbow then add 1 inch
WC meant for short term temporary use; 35 lbs; rear axle fixed; limited adjustability (product code); must have sufficient UE strength
standard chair (K0001)
WC similar to standard chair but lighter in weight <35 lbs; adjustability limited (product code)
lightweight chair (K0003)
WC available with rigid or folding frames which fold for transport; adjustable axle; quick-release wheels; customizable <30 lbs (product code)
ultra light weight chair (K0005)
WC designed to be bigger and stronger for clients who are obese or have severe spasticity; rear axle positioned forward (product code)
heavy duty chair (K0006 >250; K0007 > 350)
used for clients with limited walking ability; difficult to steer; large turning radius; seat swivels (ease of transfer); limited adjustability; must have sufficient strength and postural stability
scooter
WC used for clients with hemiplegia or arm amputation (product code)
one arm drive chair (K0002)
for amputees, WC axles need to be displaced _______
back
a chair is more stable when the center of mass is ______ of the drivers wheel axle
ahead
a chair is more easily moved when the center of mass is ___________ the drivers wheel axle
close to or slightly behind
when the axle is aligned ____________, access to push rims is improved and movement efficiency is increase
below the shoulder
a positioning belt to stabilize the pelvis should be positioned so that it pulls on the pelvis at a _________ angle to the base of the seat back
45
backrest with adjustable tension to accommodates what disorder
kyphosis
MRADLS
mobility related ADLs
MRADLS
mobility related ADLs; include toileting, feeding, dressing, grooming, or bathing according to Medicare
principle of universal design that states that the design is useful and marketable to all people
equitable use
principle of universal design that states that the design accommodates a wide range of individual preferences and abilities
flexible use
principle of universal design that states that the design is easy to understand, regardless of user experience, knowledge, language skills, or concentration level
simple and intuitive use
principle of universal design that states that the design communicates necessary information effectively to the user, regardless of ambient conditions or users sensory abilities
perceptible information
principle of universal design that states that the design minimizes hazards and adverse consequences of accidental/unintended outcomes
tolerance for error
principle of universal design that states that the design can be used efficiently and comfortable with minimum fatigue
low physical effort
principle of universal design that states that the design has appropriate size, space, reach and manipulation regardless of body size, posture, and mobility
size and space for approach and use
diameter of circular railings
1.5-2 inches
diameter of non-circular railing
4-6 1/4 inch diameter
2 1/4 inch cross section
minimum door swing space
18 inches
assessment to identify possible safety concerns in the home and ability to respond to safety situations; interview and observation
Safety Assessment of Function and the Environment for Rehabilitation (SAFER)
assessment to assess potential safety risks for neuro cognitive deficits; observation and caregiver interview
safety assessment scale (SAS)
assessment for neurocognitive disorders that looks at safety/lack of common home hazards, support of daily function through adaptation, support of orientation through visual cues, and support of comfort through meaningful items; validated for dementia
home environment assessment protocol (HEAP)
assessment to identify activities performed in the home required for aging in place; activity cards that reflect performance; for older adults who wish to age in place
In-Home Occupational Performance Evaluation (I-HOPE_
assessment that measures fear of falling during non hazardous BADL, meal prep, and mobility; measures perceived self-efficacy and level of concern about falling
fall efficacy scale (FES)
size of a landing to allow for rest for excessively long ramps, for turns, and before the door
5x5
4x8 for 180 degree turn
angle of WC wheels in relationship to the surface of the floor
camber
whom should you not prescribe a reclining WC too
someone with spasticity (can elicit spasms) and for limited hip/knee ROM
how should an individual using a tenodesis grasp preform a slide-board transfer and why
with clenched fists to limit the lengthening of digit flexors
model that uses a stepwise approach to intervention in order to choose AT according to needs; 1-2 adaptations introduced at a time to acclimate a person to the system prior to adding additional components
Human Activity-Assistive Technology (HAAT) model
cooperative project that promotes universal access to transportation for people with disabilities
Easter Seals Project ACTION
what percentage of the population does not have access to public transportation
75%
program aimed to decrease employer costs related to work place injuries, improve worker fitness and safety, and bridge employer and worker in a collaborative plan to improve workplace safety
injury prevention
federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness
national institute for occupational safety and health (NIOSH)
data base of requirements, worker attributes, and information about jobs that can be helpful when documenting demands
occupational information network (O*NET)
work environment redesign through workstation modification, proper tool access and fit, proper materials handling, and environmental adjustments such as temperature and lighting
environmental fit
non adaptive static approach to manipulating society with display of symptoms; can be conscious or unconscious
symptom magnification
deliberate conscious faking of symptoms and disability to avoid work or responsibility to achieve personal gain
malingering
uses symptoms to escape an unresolvable conflict
refugee
responds the the physical changes in the body in an extreme manner because of difficulty processing sensory and kinesthetic input or unrealistic belief systems about the manner in which the body workds
symptom misinterpreter
consciously attempts to convince those working with him or her of the reality of symptoms for positive gain
game player
assumes the patient role as a lifestyle
identified patient
client who keeps symptoms hidden so he or she can return to normal activity or avoid appearing weak
symptom minimizer
to determine maximum effort, what can the clinician do
use dynamometer on all 5 settings (should be strongest on 2nd and 3rd with scores falling on bell curve)
injury prevention to identify and reduce the risk factors early before injuries occur and to promote healthy habits and lifestyle
primary prevention
injury prevention for early identification of symptom-related risk factors; ultimately to minimize or reduce the duration, severity, and cost of work related injuries
secondary prevention
occurs after an injury or illness has been diagnosed; interventions focus on medically treating the work-related injury and restoring the worker role
tertiary prevention
modification of the environment, the work station, and set-up with or without the use of assistive devices
engineering controls
modification of work habits through the use of assistive devices or adaptive strategies
work practice controls
changes in line speed, staffing, and physical demands of the job, such as decreasing production rate or limiting overtime work
administrative controls
the use of work tasks to improve function; can occur at any point in the healing of an injury but is typically part of the acute phase of rehabilitation
work rehabilitation
provides individuals with a process to help them identify goals for work and identify a plan for returning to work; prepares a person for return to work
work readiness programs
outcomes-focused, individualized, interdisciplinary program that addresses all components of employability and return to work; relies heavily on actual task replication; focuses on a hierarchy of functional return and gradation of activities
work hardening
specifically designed to restore the clients systematic, neuromuscular-skeletal function and typically involves only one discipline; focus on limited work tasks with more emphasis on exercise, aerobics, and education
work conditioning
on the job assessment to determine whether an individual can return to work after onset of disability with or without reasonable accommodations
worksite evaluation
used to define the demands of the job completed in the real work environment; interview of supervisors and workers, observation, measurements; identify strength demands, physical demands, and frequency of work tasks
job demands analysis
objective assessment of a persons ability to perform work-related tasks and is the core of all return-to-work programs; can be administered by a wide variety of disciplines
functional capacity evaluation (FCE)
percentage of whole-body function that translates into a final monetary settlement for an injured worker at their maximum medical end point; can be obtained through FCE
impairment rating
combines the workers impairment and the impact of that impairment on the ability to perform the pre injury job or any job
disability rating
how should an FCE begin
with the most physically demanding components with gradual increase
what is the core of an FCE
musculoskeletal evaluation
is work simulation an evaluation or treatment approach
treatment approach
provides information about a persons capacities and interests for work in situations when he or she has not worked before or is looking for a new job after injury or illness; may examine interests and abilities to explore work opportunities; can take 3-10 days
vocational evaluation
comprehensive assessment to evaluate a persons potential to do any type of work; used to determine aptitudes, abilities, and interests to explore all reasonable options for work
general vocational evaluation
assesses a persons readiness to return to a particular occupation
specific vocational evaluation
offered when a client can complete some but not all job tasks and includes coaching, education, instruction, and monitoring of return to work programs; environmentally focused intervention to facilitate return to work
transitional programs
occurs in the work place setting while the individual is performing the assigned work duties; necessary when a client is unable to return to work because of illness or injury
job coaching
identified physical, social, cognitive, and psychological demands of a specific position
job analysis
assessment to identify risk-factors for work related injury and is conducted in the work environment with the worker present performing the job as normally as possible
ergonomic assessment
description of an activity or condition that occurs as much as 1/3 of the day
occassionally
description of an activity or condition that occurs 1/3 to 2/3 of the day
frequently
description of an activity or condition that occurs 2/3 to the full day
constantly
total body deconditioning may require ______ to _______ months of reconditioning
1-3
exerting as much as 10 lbs of force occasionally; requires walking or standing significantly; requires sitting most of the time but involves pushing/pulling; working at a production rate
light work
exerting as much as 20-50 lbs occassionaly; 10-25 lbs frequently; or 10 lbs constantly
medium work
exerting as much as 50-100 lbs occasionally, 25-50 lbs frequently, or 10-20 lbs constantly
heavy work
exerting an excess of 100 lbs constantly, 50 lbs frequently, or 20 lbs constantly
very heavy work
