Frames of Reference

Question 1

Biomechanical

Answer 1

“Fix”

Analyzes the use of joints and muscles during purposeful activities

Exercises and craft activities can be used

Deficits: structural stability, ROM, strength, endurance, a specific difficulty in form or function of body parts which makes them incompetent to perform specific tasks; disease is viewed as mechanical dysfunction

Question 2

Rehabiliation

Answer 2

Compensatory techniques

Teaches patients to compensate for underlying deficits that cannot be remediated; it considers the potential for improvement in human function

Traditionally used with the chronically ill and disabled

Work-simulated or other vocationally related tasks predominate; patient may engage in ADL’s or other activity tasks appropriate to the client’s needs

7 Methods:

1. Adaptive devices
2. UE orthotics
3. Environmental modification
4. W/C modification
5. Ambulatory devices
6. Adapted procedures
7. Safety education

Question 3

Developmental

Answer 3

Lela Llorens

Facilitate or assist the adaptation process of the client within their environment

Humans progress in an orderly way through growth stages; illness or dysfunction is shown by the absence of age-appropriate behaviors (may regress from higher to lower, too)

Dysfunction may be caused by neurological impairment, trauma, or environmental deficits and is defined as the failure to master or accomplish the life tasks expected of that particular stage of development

Particularly applicable to children but can be useful treating adults when regression or chronic conditions exist

Question 4

Role Acquisition

Answer 4

Human life is understood as a series of social roles, some which occur concurrently; humans learn their roles from other people and role behavior is influences by environment; expected to learn the roles of the culture they live in

Illness or dysfunction occurs when the role patterns are disrupted; trauma or environmental factors keep people from performing an expected role

Treatment activities: learning by doing; learning behaviors related to a particular goal

Question 5

Sensory Integration

Answer 5

A. Jean Ayres

Model of child development that considers the senses, the integration of their inputs, and their end products that include concentration, organization, self-control, self-esteem, self-confidence, abstract thinking, and specialization of the brain and body

Question 6

Cognitive Disabilities

Answer 6

Claudia Allen

A cognitive disability represents a physiologic or biomechanical restriction in the information processing capacities of the brain. Changes produce observable, measurable limitations in task behaviors.

Diagnostic categories: CVA, TBI, dementia, CP, DD, drug/alcohol abuse, schizophrenic, d/o’s, AIDS

Assess patient’s cognitive level according to task performance; treatment based on activities within patient’s current functional level; patient’s ability may change; identify environmental factors that can be modified to enable successful participation in activities that support desired social roles

6 levels of cognitive function

1. Automatic actions
2. Postural actions
3. Manual actions
4. Goal-oriented actions
5. Exploratory actions
6. Planned actions

Question 7

Model of Human Occupation (MOHO)

Answer 7

Influenced by work of Mary Reilly; introduced to OT by Gary Kielhofner and Janice Burke

Engaging in activities (occupations) is essential to the maintenance and restoration of health

People have an inherent need to explore and master the environment and to be competent; treatment focus on role reconstitution

Environmental interaction is the essence of human occupation; human occupation is OT’s ultimate domain of concern

Human beings are an open system that is affected by the environment and in turn acts on the surroundings; motivation exists to explore skills, develop competency, and achieve competent role behavior

Dysfunction: Lack of meaning or purpose and failure to explore and become involved with the environment; illness or dysfunction is not a static condition but has different levels and changes with the environment

Question 8

Adaptive Response

Answer 8

Lorna Jean King

Characteristics of the adaptive response:

1. Requires active participation (person must act rather than being acted on by another)
2. Must be evoked by demands of the environment
3. Usually most effectively organized subcortically (conscious attention directed to objects or tasks rather than specific movements)
4. Self-reinforcing (each success acts as a motivation for greater effort or a more complex challenge)

OT’s must know principles and milestones of human development and which adaptive response is needed so they can provide the proper environment and stimuli for a given action

Question 9

Mosey-Four Frameworks

Answer 9

Anne Cronin Mosely

1. Recapitulation of Ontogenesis: individual able to move from a state of dysfunction to function through participation in activities)
2. Activities therapy: individuals who are unable to learn to function in the community have mental health problems which are due to basic skill deficits such as failure in planning and carrying out ADL’s and inability to express feelings)
3. Biopsychosocial model: humans have a right to a meaningful and productive existence - free of disease and able to participate in the life of the community; OT’s must follow teaching and learning principles:
   a) begin where the learner is
   b) involve the learner actively
   c) repetition and practice
   d) move from simple to complex
4. Domains of concern and tools: model of pratice for OT - identified the performance components, contexts, and performance areas; tools of OT’s are the nonhuman environment, use of self, teaching-learning process, purposeful activities, and activity analysis