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Peds FAll 2024 > Interventions CP > Flashcards

Interventions CP Flashcards

1
Q

time –

A

Duration of intervention

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2
Q

Frequency -

A

How often (# of sessions per day, week or month) an intervention occurs

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3
Q

Intensity -

A

How hard the child works within the intervention session. Recorded as the number of repetitions per minute, day or week or amount of work.

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4
Q

Type -

A

Kind of intervention focused on any of the dimensions of the ICF.

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5
Q

Dosing -

A

Frequency, intensity, time and type of intervention

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6
Q

Which intervention approach is used to improve hand function, prevent joint contractures, relieve pain in a specific joint and can improve position of hand/thumb for hygiene -

A

Orthotics or Casting

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7
Q

Why are CIMT and Bimanual Therapy used together at times for children with CP?

A

CIMT forces the child to use the affected arm, essentially forcing it to improve at one handed task so that two handed tasks can improve. Bimanual therapy is the result and task practice of CIMT.

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8
Q

When used by an OT, what are guided imagery, myofascial release, yoga and meditation considered?

A

Complementary Health Approaches

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9
Q

movement interventions for high tone kids

A

Start with the base of support

Head and trunk control and alignment of spine

Relaxation- joint approximation, thoracic extension with rotation

Gaining range of motion and mobility

Use handling and facilitation to help gain functional developmental patterns

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10
Q

Evidence Based Movement Interventions

A

Home Programming- Task specific or activity focused

Family Centered Coaching

Intensive NDT

CIMT and BIT

Child Focused and Context Focused

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11
Q

Movement intervention steps

A

Sequence of Interventions is key!

STEP ONE: Preparation- an activity or controlled input provided to help regulate the child and/or prepare them for movement by practicing components of typical movement/development progressions

STEP TWO: Intervention- look for carryover of skills learned from your preparation to allow for greater/ more successful participation in task

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12
Q

Whatever you are doing for your prep carries over into your treatment

A

True

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13
Q

Gross motor at start of session and ______ _______ at the end of the session

A

fine motor

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14
Q

Birth History:
Born 39 weeks via vaginal birth
No complications during pregnancy
Birth weight: 6 lbs 13 oz
Diagnosis:
Developmental Delay
video in power point
What would your intervention look like for her

OT Evaluation
WNL A/PROM in all planes of movement
Limited visual scanning of toys
Limited active reaching & initiation of movement patterns
Difficulty with all developmental milestones

Formal Assessment: Peabody Developmental Motor Scales-2
Grasping: 2 months
Visual-Motor Integration: 4 months

A

strengthening core. Postureal control in sitting, yoga ball, working on midline reactions.

weight bearing to get rid of ATNR

bimanual arm use

Rolling

Rolling Development: Rolling from back to stomach leading with hips and thighs followed by stomach then shoulders

Prone Development: From stomach, raises upper trunk, shifts weight side to side, lifts free arm towards toy

Sitting Development: Maintains balances while moving hands and arms to grasp toy

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15
Q

Proximal stability yields distal mobility

What does this mean?

How can this help to create a fine motor intervention?

A

When we start to address fine motor needs we need to make sure we are supporting them proximally. Either they have that skill on their own or I am providing it.

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16
Q

What are the main tenants of a bio-mechanical approach

A

Postural alignment
Postural stability
Level of motor skills performance
Effects of gravity
Effects of the supporting surface
Posture for functional performance

17
Q

Which position would allow the least amount of impact on performance due to gravity?

A

Supported side-lying

18
Q

Why would you use any of these positions to work on fine motor skills?

Supported Side Lying - if they have trouble bringing hands to midline

Supine - great place to start practicing skills of midline if they don’t sit yet

Prone - lifting head, tricky because you need a little bit of movement against gravity

Sitting - allows both hands to be able to play

Standing - impact of gravity is more. good to work on dominent assist, one hand is supporting and the other hand is playing.

A

Supine - great place to start practicing skills of midline if they don’t sit yet

Prone - lifting head, tricky because you need a little bit of movement against gravity

Sitting - allows both hands to be able to play

Standing - impact of gravity is more. good to work on dominent assist, one hand is supporting and the other hand is playing.

19
Q

Neurodevelopmental Therapy (NDT)

A

Uses biomechanical principles with focus on handling and positioning techniques to promote motor function.
Recognized that spasticity interfered with normal movement patterns.
Through sensory feedback a child could learn Normal Movement
Goals of therapeutic handling
inhibit spastaticity
facilitate more normal muscle tone
Guide child through normal movement patterns

20
Q

Principles of NDT

A

Postural alignment

Postural stability

Weight shift and equilibrium responses

Control of isolated and dissociated extremity movements

Enhanced mobility and dynamic stability.

21
Q

Top- Down Approaches:Dynamic Systems Theory

A

Motor control is dependent on nonlinear and transactive person factors (i.e., cognitive, musculoskeletal, neurologic, sensory, perceptual, social-emotional), task characteristics (i.e., goals, rules, object properties), and environmental systems (i.e., contexts).

22
Q

principles of dynamic systems theory

A

Child learns movement more easily and effectively if:
(1) the movement is taught as a whole (versus part)
(2) the movement is performed in variable situations
(3) the child is allowed to actively problem-solve the actions required
(4) the activity is meaningful to the child.

23
Q

Child learns movement more easily and effectively if:

(1) the movement is taught as a whole (versus part)

A

Engaging in a whole activity (occupation) facilitates
Children will engage in task for
Requires children to process and respond

Not pretending with playdough but actually making cookies

24
Q

Child learns movement more easily and effectively if:

(2) the movement is performed in variable situations

A

Variability is inherent in activity as well as within and between systems

Adapt to environmental or internal changes

Intervention expects children to perform movement in a variety of ways

same skill in a variety of different objects and environments

25
Q

Child learns movement more easily and effectively if:

(3) the child is allowed to actively problem-solve the actions required

A

Children learn and retain motor skills better from

Set up environment to facilitate encouragement for the child to discover and

If the child has to problem solve they will remember that motor plan better.

26
Q

Child learns movement more easily and effectively if:

(4) the activity is meaningful to the child.

A

Children are more motivated to engage in difficult motor skills if they find the activity

High object affordance - activities in which the objects used conveyed functional and purposeful information.

CO-OP model engages children in goal setting and problem solving

tie it into the things that the child likes it will be more meaningful.

27
Q

Occupation Based Approaches
Top down approach

A

The therapist will select and create activities that:
- reflect the child’s motivation and interests
- consider the context of performance
- working within the child’s strength and limitations

create a balance of using their strengths to address their limitations or needs

28
Q

Occupation Based ApproachesPediatric Constraint Induced Movement Therapy

Core Elements:

A

Constraint of less impaired upper extremity

Activities and techniques to

High intensity intervention with

Natural environment - but requires a lot of training for the parents

Systematic reinforcement that encourage - want them to be successful to encourage higher level skills

Transfer of intervention program to caregivers - makes sure parents understand so they are able to carry it over.

29
Q

pediatric constraint induced movement therapy what is the cycle?

A

select activity
observe performance
encouraging repetition
reinforcing performance
monitoring refinement of movement

30
Q

Occupation BasedMotor Learning Theory

Meaningful, goal-directed activity is selected
Repetition and practice.

What activities could address these areas?

A

Bimanual coordination
Managing fasteners
In hand manipulation

31
Q

What occupations, performance areas and/or skills will fine motor difficulties impact?

A

toileting and hygiene
feeding
writing
dressing

32
Q

Variety of diagnoses
Down syndrome, Cerebral Palsy, Prematurity, Autism, various syndromes, genetic disorders etc.
What are the Impacts development of occupations?

A

Play
* Dressing
* Self-feeding
Performance skills:
* Fine motor strength/endurance
* Bimanual coordination
* Grasp
* in hand manipulation skills

33
Q

girls stands places weight on hands on a table
Why wasn’t hand function specifically addressed in this session?

A

proximal stability leads to distal mobility

34
Q

What are the main goals of his treatment?

What changes occurred throughout the session?

A
35
Q

kid places balls in a gumball machine

What skills did you see?

What would you work on next session?

Preparation
Treatment activity

A

grasp, release, bang to two together

work on release, dropping things into smaller openings

change the position and keep the general idea of activity but modify to address express support piece.

36
Q

video
threading bead on a wire
in hand manipulation
bilateral manipulation

What skills did you see?
What would you work on next session?
Preparation
Treatment activity

A

next session - make string easier to hold. brighter colored blocks and strings. pipe cleaners

Peds FAll 2024 (20 decks)

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