Evaluation and Treatment Flashcards

1
Q

Explain what makes an assessment effective

A

-Standardized, easy to use, has validity, has a baseline to refer to, reliable, can pick up on limitations, ecological validity intact

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2
Q

What is ecological validity?

A

How the assessment is compared to real-life environments, and situations

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3
Q

What are the two evaluation approaches?

A

Top-down (Functional) uses ADL’s or purposeful activities to evaluate why a task cannot be completed (performance components)

Bottom-up (Skill based) uses enabling activities to evaluate specific impairments

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4
Q

What are the advantages/disadvantages of using a top-down approach?

A

Advantages: related to a goal (ADL), High ecologic validity, provides pre/post-treatment data, demonstrated impact of impairment, context taken into account, Root of OT practice

Disadvantages: Requires training, observational/analytical skills, validity, and reliability may be poor if training is limited, test environment still not the real world

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5
Q

What are the advantages/disadvantages to using a bottom-up approach?

A

Advantages: easy to administer, easy to grade, can see pre/post results easily, focuses on diagnosing the impairment

Disadvantages: Poor ecological validity, can be costly, isolation for one skill in an attempt to diagnose but skills are not used in isolation, does not address context.

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6
Q

Name some limitations to Functional evaluations.

A

Environments are typically set up to optimize performance which can help the client but it is not really the same as them doing it at home. it is typically distraction-free, cues may be provided, time demands are minimized, and clients can receive clear repeated instructions.

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7
Q

What are common functional assessments?

A
  1. Activity analysis, helps to breakdown where performance is limited and what performance components are needed.
  2. Kitchen Task: Assesses level of cognitive support needed to complete cooking task
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8
Q

What is the OTA role in Cognitive Activity Analysis?

A

To use activity analysis to determine where barriers to independence are, what performance components are affected to direct treatment

Also can be used to determine a client’s progress

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9
Q

What are the common skill-based evaluations and what do they assess?

A

MMSE (Mini-Mental Status Exam)- orientation (3 p’s), registration, attention and calculation, recall, language.

MoCA (Montreal Cognitive Assessment)- Visuospatial and executive functioning, naming, memory (immediate and delayed), attention, language, abstraction, orientation

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10
Q

What does the delivery of cog-perceptual treatment require?

A

-Strong ability to grade up or down
-Sharp observation skills to monitor where challenges exist
-Understanding of the impact of context/environment
-Employing a client-centered approach

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11
Q

When is a remedial approach used?

A

When cognitive/perceptual recovery is anticipated

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12
Q

What are table top activities?

A

Typically enabling activities that focus on skills. they are repetitive, graded and scored to monitor progress

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13
Q

What are functional activities?

A

Functional activities focus on ADLs and is more meaningful to a client. They are repeated, graded and observed to monitor success. Emphasis is on the just right challenge for a client.

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14
Q

Bottom-up vs Top-down remedial treatment

A

Bottom-up treatment focuses on cognitive and perceptual performance skills using enabling activities.

Top-down treatment focuses on purposeful/functional activities to engage the client in ADL which are context-driven and will help improve performance with ADLs and skills

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15
Q

What Cog-perceptual skills are required to perform almost all ADLs?

A

-Short-term memory
-Problem-solving
-Sustained Attention
-Divided Attention
-Sequencing

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16
Q

What are some grading strategies that can be used on purposeful activities?

A

-increase or reduce time to complete a task

-increase or decrease the number of objects used in the task

-increase or decrease the amount of cuing, prompting, helping

-Familiar vs unfamiliar environment

-Arrangement/organization of objects

-Simple vs complex task (number of steps/skills)

17
Q

When is compensatory treatment used?

A

Cog-perceptual skills are not anticipated for recovery

18
Q

What is compensatory treatment dependent on?

A

Learning capacity (memory and insight)

19
Q

What are some compensatory strategies?

A

-Establish Routines
-Cues/Prompts
-Internal strategies (imagery, mental rehearsal)
-Client education
-Modifying the environment
-Modifying the task (short cuts)

20
Q

What is the ultimate measure of rehab success?

A

Skill transference (same skill transferred to a similar task or similar environment

Generalization (Same skill applied to new context or environment)