Hypothesis Oriented Pediatric Focused Algorithm (HOP-FA)

Question 1

What is the HOPFA and what does it provide

Answer 1

Decision making model involving the patient/family in decision making (family centered care)

Provides a framework for science based clinical practice

Deductive reasoning process for peds

Question 2

Key characteristics of HOPFA

Answer 2

-Systematic planning independent of a particular approach to intervention
-Can be applied to a patient regardless of age or disorder
-Elements selected based on practicality
-Allows for prevention
-Elements can be used to organize documentation

Question 3

How to determine initial hypotheses

Answer 3

Consider information and develop a mental picture including typical developmental skill + social expectations

Anticipate impairments that may be associated with the diagnosis

Question 4

History

Answer 4

Obtained from referral info, medical record, informal observation, and interview

Question 5

Points to consider with history taking

Answer 5

How the child’s presentation fit what is known about the diagnosis

Additional questions for family based on diagnosis

Question 6

Components of initial data collection

Answer 6

Talk
Watch

Question 7

Purpose of initial data collection

Answer 7

Provides an opportunity to gather expectations of therapy and the environment of the child/family

Develops initial impression of child’s functional capabilities + status

Question 8

Hypothesized goals

Answer 8

Can be modified

Tool to help prioritize tests + measures

Question 9

Can initial problem statements and goals be altered?

Answer 9

Yes; once exam + assessment are finished it can be determined if initial problem statement is reasonable and complete

Question 10

Examination planning

Answer 10

-Determine what other info is needed
-Causes of problems
-Select appropriate tests + measures appropriate + related to goals
-Avoid extraneous procedures
-Consult if necessary

Question 11

ICF model in children

Answer 11

Fitness (impairments)
Function (activity)
Friends (participation)
Family
Fun

Question 12

Components of pediatric exam procedures

Answer 12

Systems review + screening
Standardized tests + outcome measures
Specific functional skills dependent on age + ability
Impairments

Question 13

Problem list

Answer 13

Identify impairments (fitness)
Activity limitations (function)
Participation restrictions (friends)

Question 14

Where do goals come from

Answer 14

Problem list

Question 15

Diagnosis

Answer 15

Supplement to medical dx: movement dysfunctions

Question 16

Questions to consider with diagnosis prognosis

Answer 16

Can impairments be changed through intervention?
Is the patient functioning optimally or can therapy improve strategies?
Should assistive tech be considered to improve function and reduce disability?
Can goals be achieved?

Question 17

Goal categories to consider

Answer 17

Alleviation of impairments limiting function or preventing secondary impairment

Development or retraining functional skills

Compensation for functions that cannot be improved

Attending to goals with highest priority for family

Life preparation with max self determination

Question 18

4 components of goal

Answer 18

Audience
Behavior
Conditions
Duration

Question 19

Intervention session planning

Answer 19

Base each session around specific functional goal
Prep activities
Motor activities
Link to next session

Consider motivation + feedback, challenge of activity

Question 20

Reflection

Answer 20

Assess effectiveness of intervention

Consider progress with overall plan of care

Question 21

Stages of HOPFA

Answer 21

Initial hypotheses
Mental picture
Initial data collection
Problem statement + hypothesize goals
Family’s goals + concerns
Exam planning
ICF
Exam + evaluation
Problem list
D/P
Goals
Intervention planning
Reflection

Question 22

Importance of developing mental picture

Answer 22

Helps to plan exam or make decision to reach back out to referring physician if presentation doesn’t make sense

Question 23

Key difference between pediatric and adult ICF model

Answer 23

Consideration of the future