Examination and Documentation of the Pediatric Client Flashcards
What is the international classification of functioning, disability, and health?
Unified/standard language and a framework set forth by the World health Organization.
Shifts emphasis from disability and focuses on abilities of the individual.
ICF organizes info into 2 parts: part 1 is functioning and disability and part 2 is contextual factors
There is a child and youth version
What are the 6 categories of the ICF?
Body functions: physiologic and psychologic functions of the body (e.g. functions of the joints and bones, muscle functions, reflexes, voluntary movement, gait)
Body structures: organs, limbs, trunk and components
Activity: performance of task or action
Participation: involvement in life situations- home, school, community activities, social relationships
Environmental: physical, social, and environment in which people conduct their lives
Personal: background of person’s life and living that is not part of the health condition e.g. lifestyle, habits, coping styles
What are components of the PT examination?
History: systematic gathering of data to determine why client is seeking services, interview
Systems review: record review, collaboration with other team members, brief or limited examination of anatomical/physiological status of CV/pulm, integumentary, MS, and NM systems and communication, affect, cognition, language, learning style
Tests and Measures: used to investigate diagnostic hypotheses generated during the history and systems review
Observation
What are the parts of the subjective for pediatric exams?
Birth/Medical history
Developmental history
Social history, functional status/activity level (including self care, behavior)
Communication abilities
Cognition
Home/childcare/school environment
Current complaints/concerns (school, childcare, home)
What are parts of the history/medical status during pediatric exam?
GA at birth/birth weight
Current age
Medical complications, if any
Ongoing medical concerns, including diagnoses/conditions and medications
What tests and measures may be used during pediatric exam?
Assistive device, orthotics, gait/locomotion/balance/mobility, motor function, posture, ROM, self care, ventilation/respiration, home/school/play, pain, arousal/attention/cognition
Specific tests: anthropometrics, ADL, strength, functional ROM, reflexes, balance assessments, standardized assessment
What is ROM like in full term newborns?
Limited hip and knee extension and greater dorsiflexion when compared to adults
Can ROM be reliably used in children?
Reliably tested in healthy children, but reliability varies with pathology
Change in ROM measurements may not signify a meaningful, functional change
Can MMT be used in children?
Yes. Child must be able to follow instructions
What is MMT reliability?
Reliable with DMD and Down syndrome Not reliable in children with CP Hand held dynamometers reliable as young as 2 years with hand held Isokinetics reliable as young as 6 years Functional strength based on milestones
List the ways you must evaluate exam findings in pediatric clients?
Identify strengths
Identify barriers to movement/function
Prioritize movement problems
Hypothesize relationship of each of these factors to activity/participation limitations
Develop goals/intervention plan accordingly
Use findings of tests and measures to determine impairments of body function and structures
Use findings of observation, mobility assessments and/or standardized assessments to determine activity limitations
Use findings of observation and interview and to determine restrictions in participation
What are special things you must consider when examining an infant?
Time of day (feeding and nap time) Parent's schedules Natural environment Naturalistic observation Examination may be in random order based on desires/needs of infant
What are special things you must consider when examining a young child?
Time of day (nap time) One or both parent's schedules Natural environment Naturalistic observation Comprehensive developmental assessment- cognitive, motor, social, speech language and self help in natural environment (arena assessment)
What are special considerations for examining a preschooler or school aged child?
Schedule Natural environment Naturalistic observation Team approach Comprehensive developmental assessment- cognitive, motor, social, speech language and self help in natural environment (arena assessment)
What are intervention strategies for children?
Gross motor activities in a functional context: play Play based therapy from infants and young kids Incorporate toys and games Stretching exercises Strengthening Balance activities Natural environment Group with another child if possible
What are types of stretching, balance, and strengthening exercises?
Stretching: PROM, animal poses, yoga
Strengthening: core, tummy time, squatting games, upper and lower extremity weight bearing activities
Balance: kicking, squatting, stepping over, mini trampoline, different surfaces, therapy ball, obstacle course
What are types of toy and gam activities?
Gross motor games
scooters, twister, hula hoops, bubbles, tunnels, hopscotch, ball activities, rocker board, bean bag, music games, mirrors, scooter soccer, made up games
Goals and outcomes for pediatric clients should be..
Determined with help from child, parent, teacher, etc.
Related to functional skills
Focused on participation and activities
Realistic and achievable
Easily understood and free of professional jargon
Goals not intervention
