Frames of Reference Flashcards
Developmental
(Llorens)
• Dev. occurs over time and between skills
• Some children have developmental gap due to physical, emotional and/or social trauma
• OT must bridge gap
POPS: Down syndrome; Intellectual disab.; Failure to thrive; Cerebral palsy; Pervasive dev. disord.
TX: Identify current level; work on next step to achieve skill; Use practice, repetition, education and modeling of skills
Biomechanical
(Pedretti and Paszuinelli)
• Assess/improve strength, endurance and ROM
• Prevent/reduce contracture/deformities
POPS: Children with cardiac concerns; Brachial plexus; Cerebral palsy; Juvenile RA; Down syndrome
TX: Graded activites: Strength=Increase weight/repetitions; Endurance=Increase time engaged; ROM=Repetitively provide slow, sustained stretch
Sensory Integration
(Ayres)
• Children have difficulty processing sensory info (vestibular, proprioceptive, tactile)
• Improvements in sensory processing lead to improved engagement in occupations
POPS: Sensory integrative dysfunction; Devel. coordination disorder; Sensory modulation disorder; Pervasive developmental disorder
TX: Provide controlled sensory input to improve ability to process; Use suspension equip and “just right” challenge; Provide activities that are child directed
Motor Control
(Shumway-Cook)
• Acquisition of motor skills based on dynamic systems theory, like the steps to learning to walk (all systems—sensory, motor, cognitive—interact for movement to occur)
POPS: Cerebral palsy; Devel. coordination disorder; Down syndrome
TX: Children learn motor skills by repeating occupations in natural settings, varying requirements/grading; Learn from motor mistakes
Neurodevelopmental
(Bobath, Schoen and Anderson)
• Children learn motor patterns when they “feel” normal movement patterns
POPS: Cerebral palsy; TBI
TX: Use handling techniques and key points of control to inhibit abnormal muscle tone and facilitate normal movement patterns; Children learn through “feeling” normal patterns and should not make mistakes
Model of Human Occupation
(Kielhofner)
• Volition; Habituation; Performance; Environment (all-encompassing); About how they process info internally. By acting and receiving info, people change actions and adapt to environment. Occupational behavior is continuously created (by reaction to info).
POPS: All diagnoses
TX: Human as open system (affected by environ.); Gather info about volitions (e.g., the child’s or parents’ goals or occupational choices), habituation or routines (e.g., how the child spends the day), performance (e.g., the child’s physical abilities), and environment (e.g., the physical layout of home)
Rehabilitation
(Early, Pendleton and Schultz-Krohn)
• Children relearn skills lost; develop compensatory strategies and adaptive techniques
POPS: Acquired brain injury; Trauma; Stroke
TX: Help children regain function for independence in occupations; Help children practice to improve strength, ROM, endurance
P-E-O Model
(Law)
• Person-Environment-Occupation model; about the transaction between the three/how they impact each other. Person-centered, where person changes through time/experience. Where the three intersect is occupational performance (venn diagram).
POPS: All diagnoses
TX: Find best environment for success in that person’s occupation. Environment easier to change than person.
Canadian Occupational Performance Model (COPM)
(Townsend et al.)
• Spirituality, Occupation, and Context; Used alongside P-E-O model; client-centered subjective assessment documenting client’s perception of his/her performance over time. Uses 1-10 rating system. Used to determine goals/priorities.
TX: Understand client’s spirituality to facilitate engagement; performance takes place within social, physical, and cultural environments.
Cognitive-Behavioral Frame of Reference
(Allen)
• Maladaptive thinking patterns affect emotions and contribute to dysfunctional behavior (ie: overgeneralizing, catastrophizing). Increase performance by decreasing negative thinking.
TX: Identify patterns, restructure thinking/self-talk, reduce stress, develop problem-solving skills for client-identified problems.
Why use a Frame of Reference?
- Clarify evaluation
- Understand reasoning behind interventions
- Articulate with other discliplines in common language
- Provide consistent info to families/caregivers
- Justify services to payers
Aspects of Effective Collaboration
- Common purpose
- Professional competence
- Interpersonal skills
- Trust
- Respect
- Value each other’s knowledge
- Sense of humor
Multidisciplinary vs. Interdisciplinary/Interprofessional Models of Intervention
Multidisciplinary: All parties work separately. May review others’ notes. Family involvement is limited.
Interdisciplinary/Interprofessional: Parties work together. Interact prior to, during, and after evals and treatment. Families are part of team. May incorporate other disciplines’ goals into treatment.
Assisted Performance vs. Supervised vs. Functional vs. Dependent
Assisted= Child participates with some assist from caregiver.
Supervised= Child requires supervision to complete task.
Functional= Child completes task independently with/without AE and without human assist.
Dependent=Child is unable to perform task, so caregiver required to perform for him/her (ie. holding a cup for a child with cerebral palsy)
