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nmr I > Health, Education, and Service Delivery Issues > Flashcards

Health, Education, and Service Delivery Issues Flashcards

1
Q

which pediatric PT settings use the medically based model?

A

NICU, PICU, scute care service, rehabilitation unit, outpatient clinic

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2
Q

which pediatric PT settings use the educational model?

A

home care (early intervention) and educational setting (preschools/schools)

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3
Q

who is served in the NICU?

A
  • high risk infants with a variety of diagnoses
  • family members
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4
Q

what is the role of the PT in the NICU?

A
  • examination and evaluation
  • intervention
  • re-examination and discharge planning
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5
Q

what does examination look like in the NICU?

A

history, observation, tolerance to handling, behavioral state and alertness, active movement and strength, muscle tone and reflexes, feeding
- *a lot of this is the babies ability to regulate their own state. muscle tone is usually low in the NICU. state and alertness relates to the maturity of the CNS

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6
Q

what are goals of PT in the NICU?

A
  • do no harm
  • education on handling and positioning for development
  • promote sucking
  • *need to position baby as they would be learning in utero –> missing out because born early
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7
Q

what does intervention look like in the NICU?

A
  • positioning (*promote flexion, sidling)
  • P/AROM
  • motor and sensory (*slowly inc. sensory inputs, can go into sensory overload (laws for this))
  • feeding
  • organization
  • pt/family ed (*won’t send baby home without good family)
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8
Q

what does the NICU transition look like?

A
  • typically baby needs to be 5ish lbs to leave
  • go to step down nursery, transitional facility, or home
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9
Q

what does acute care look like for PT?

A
  • pts vary
  • PT roles vary
  • goals for therapy are medical stabilization followed by mobility
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10
Q

what does the (step down) rehabilitation setting look like for PT?

A
  • pts who are intensive need, not safe to return to home/school, not reached full potential
  • role of PT varies
  • goals of therapy are maximize independence in least restrictive environment, promote safe mobility, and pt/family education
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11
Q

what does the pediatric outpatient setting look like for PT?

A
  • pts vary, typically post hospitalization, can be supplemental if the child didn’t qualify for school based services
  • role of PT is home exercise program and adaptive equipment- goals of therapy are less intense and are aimed at specific activity limitations for a specified period of time
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12
Q

what is the Education of All Handicapped Children Act of 1975

A

all children with handicapping conditions ages 6-21, regardless of severity, have available to them free appropriate public education which (special education services) to meet their unique needs

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13
Q

what is the Education of the Handicapped Amendment of 1986?

A
  • expands AHCA of 1975 to infants, toddlers, and preschool children/families
  • provides coordination of services between public and private agencies
  • multidisciplinary, strong family involvement, delivered in natural settings
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14
Q

what is the Individual with Disabilities Education Act Amendment of 1991 (IDEA)?

A
  • reauthorizes AHCA of 1975 and 1986 Amendment laws for ALL children of all ages, least restrictive environment, transition, family training, nutrition, and other related services
  • *basically says free and public education in the least restrictive environment
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15
Q

what does part C of IDEA implement?

A
  • coordinates payment from federal, state, local, and private sources
  • expand capacity and expand/improve Early Intervention services
  • expand opportunities for EI services to children who are at risk of having substantial developmental delay if they did not receive service
  • *part C allows early intervention
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16
Q

how do children become eligible under IDEA part C?

A
  • child shows developmental delay as defined by state in cognitive, physical, communication, or adaptive development (fine and gross motor)
    – *need 1 33% delay or 2 25% delays in any of these domains (cognitive, physical, etc) –> using normative reference to determine these delays
    OR
  • child has a diagnosed condition that has a high probability to result in a developmental delay
    OR
  • child is at risk for developmental delay by the states discretion and who are in need of EI services
17
Q

what are the key elements for EI under part C of IDEA?

A
  • team collaboration (*family at center of team)
  • non-discriminatory evaluation and assessment
  • family centered for both children (0-3) and their families in their NATURAL ENVIRONMENT
18
Q

what are some characteristics of team collaboration?

A
  • members demonstrate honesty, trust, responsiveness, and mutual respect for each other
  • open communication
  • equal participation
  • decisions made together
19
Q

what does an Individual Family Service Plan consist of?

A
  • review of medical records
  • family interview (id resources, priorities, concerns, supports)
  • observation
  • assessment of five areas of development: physical, cognitive, communication, social/emotional, adaptive
20
Q

what are the key elements of family centered care?

A
  • parents as solution and experts
  • parents in active roles (*whole purpose of EI)
  • expanding the definition of family
  • individual needs of family
  • legal mandates include families
  • cultural sensitivity and competency
  • challenges and stresses to family
21
Q

what is documentation under IDEA part C?

A
  • IFSP 0-3 y/o
  • diverse needs of child and family driven plan
  • families are ACTIVE participants
  • outcomes are functional and can be implemented into the Childs daily routine
22
Q

what is IDEA part B?

A

outlines the right to free and appropriate education and related services for eligible children 3-21 y/o

23
Q

what is “zero reject” under IDEA part B?

A

no matter the severity/type of condition, education is free and appropriate

24
Q

what is the definition of least restrictive environment (LRE) under part b?

A
  • scoops probed education with non-disabled children to as maximal extent as possible
  • special classes/separate schooling/remove from class only when disability is such that education in regular class with aides and services can not be satisfactorily achieved
  • if district thinks they don’t have a good enough program, they are responsible to find a place that does and the home district pays a tuition to the district with that program
25
Q

what is due process under IDEA part B?

A

*parents can question care and hire counsel, call expert witnesses, seek out independent evals, etc and its all paid for federally

26
Q

what is parental participation under IDEA part B

A
  • parental consent required prior to eval, for services, and to release info
  • participation is a continuity of care
  • parents have access to all records and can request due process hearing
27
Q

what are related services under IDEA part B?

A
  • transportation, speech, audiology, PT, OT, medical for diagnostic purposes, assistive tech, school health, orientation and mobility, psychology
  • each are provided to assist the child in benefiting from special education
28
Q

what is transition under IDEA part B?

A
  • transition plans from EI to preschool, preschool to school age, at critical points during school and from age 14 to exit from school must be documented on IEP and implemented
  • may include continued therapy, accessibility, equipment, mobility, medical self-management, fitness
29
Q

what is covered under assistive technology for IDEA part B?

A
  • supplies assistive technology that stays in school ONLY (can’t use at home, so not orthotics, power wheel chair, etc)
30
Q

what is documentation under IDEA part B?

A
  • Individual Educational Plan (IEP) 3-21 y/o
  • annual document of service plan with specific services child relieves and goals/objectives that are educationally relevant
  • SOAP note, 10 week progress reports
  • responsibility for service provision
    – committee on preschool education 3-5 years; committee on special education 5-21 years
31
Q

what is Section 504 of Rehabilitation Act of 1973 and Amendment of 1992?

A
  • anti-discrimination statute/civil right protection for individuals with disabilities
  • ensures schools treat individuals with and without disabilities the same
  • broader definition of handicapped = broader provision of related services
  • *don’t necessarily need special education, just accommodations (like extended testing time)
32
Q

what is the case law for related services?

A

medical services necessary for student to access environment must be provided and allowed

33
Q

what is the case law for best possible education?

A

has to be free and appropriate to meet needs, not necessarily the best possible

34
Q

what is the case law for extended school year

A
  • proof that children are regressing when not in school
  • allowed ESY for those who qualify –> functional outcome measures used before and after breaks
  • typically need significant disability to qualify
    – they have 3x the time of the break to relearn the skill
  • services based on need, may get some not all (ex OT but no PT)
35
Q

what is the case law for least restrictive environment

A

can’t assume child needs operate restrictive setting

36
Q

what is collaborative team interaction?

A
  • working on own and other services’ goals
  • equal participation in the team
  • consensus decision making
  • all skills embedded throughout the intervention program
37
Q

what is the Americans with Disabilities Act of 1990?

A
  • protection for all persons in areas of employment, transportation, public services, public accommodations, and telecommunications regardless of how services are funded (public or private)
  • assists children in day care centers and those transitioning to employment; schools and public transport should be accessible
  • able to use skills learned at school in an acceptable workplace
  • protects parents of child with disability from discrimination

nmr I (3 decks)

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