Intro to Interventions

Question 1

2 Things to focus on for the framework of interventions

Answer 1

• Focus on Key Diagnostic Categories
• Focus on Age

Question 2

Possible Key Diagnostic Categories

Answer 2

-cortical lesions – CP
-spinal cord lesions – MM
-genetic disorders/general nervous
system involvement – DS

Question 3

Top-Down Approach

Answer 3

• Goal driven approach
• Child, Family, PT –desired outcome
• PT - skills and abilities needed
• PT - obstacles and impairments
  —-> Plan of Care is developed

Question 4

3 Trainings

Answer 4

• Compensatory Training
• Neuromotor Training
• Functional Training

Question 5

When might compensatory training be utilized in pediatric rehabilitation?

Answer 5

If there is a point in their development when they have either plateaued or cannot make any more improvements (ie fixed scoliosis)

Question 6

Neuromotor Training - NDT Approach Philosophical Framework

Answer 6

– Lesions in CNS produce problems in
coordination of posture and movement
→ atypical mm tone = limitations in function

• Intervention strategies target specific
  posture and mvt dysfunction impairments through activities and within contexts that are meaningful
• Participation limitations are directly related to posture and movement dysfunction

Question 7

What is most important?

Answer 7

Function and participation

Question 8

What is a threshold ability?

Answer 8

What you need to begin to work on that activity

Question 9

Example of threshold ability

Answer 9

standing is threshold ability for standing

Question 10

What motor learning strategies do you HAVE to have?

Answer 10

instruction, practice and feedback

Question 11

Verbal Instructions

Answer 11

• Provide information about the task
• Internal: Toward intrinsic sensori-motor information
• External: Toward the result of the action

Question 12

Practice

Answer 12

• Physical practice of the skill or task
• Amount: time or repetition
• Structure: part vs whole
• Schedule: blocked vs random

Question 13

Verbal Feedback

Answer 13

• Form: quality vs Quantity
• Frequency: how often and when?

Question 14

What does activity focused intervention incorporate?

Answer 14

Motor Control and Motor Learning

Question 15

Three steps of activity focused intervention

Answer 15

– Develop activity-related goals (meaningful to
child)
– Activity-focused intervention
– Integrate impairment-focused intervention (active and passive)

Question 16

In order to develop prognosis, take into account:

Answer 16

• Diagnosis/progression of condition
• Age
• Levels of involvement

Question 17

Main ages where growth and development phases allow time to change brain plasticity

Answer 17

0-3 years old
10-14 years old

Question 18

Other times that are important for PT to be implemented:

Answer 18

• Medical Changes
• Significant Transitions

Question 19

3 Different Levels of involvement:

Answer 19

• 1 domain involved: cognition good
• > 1 domain involved: cognition may be affected
• All domains involved: cognition poor

Question 20

What is a motor development curve and why is it important?

Answer 20

• “motor growth curve”
• Developed from a large sample
• Graphic representation
• Used to describe patterns
• Used to estimate future motor capability

Question 21

Motor Growth Curve for children with DS

Answer 21

– require more time to learn movements
– 14% walk by 18 months
– 40% walk by 24 months
– 92% walk by 36 months
*** so, if they aren’t walking by 2 yo… its ok!

Question 22

What age does the motor growth curve level off for children with DS

Answer 22

3 years old

Question 23

Motor Growth Curve for children with CP depends on what?

Answer 23

GMFCS Level

Question 24

Gross Motor Function Classification System – Cerebral Palsy

Answer 24

• Five classification levels
• Self-initiated movement
• Sitting, transfers, and mobility
• Includes 12-18 years
• Abilities rather than limitations

Question 25

General GMFCS Headings

Answer 25

• Level I – Walks without limitations
• Level II – Walks with limitations
• Level III – Walks using a device
• Level IV – self-mobility with limitations,
  may use power wheelchair
• Level V – Dependent mobility in W/C

Question 26

review Myelomeningocele Functional Classification

Question 27

Considerations for Intensity of therapy Services

Answer 27

• Episodes of care
• Readiness for Activity and Participation
• Method of Service Delivery
• Relationship between Intensity and Practice
• Link between Skill Level and Method of Service Delivery

Question 28

3 parts of pediatric intervention session

Answer 28

Prep
Impairment Based Activity
Functional Activity

Question 29

6 F’s in Treatment Planning

Answer 29

• Functioning * Fitness * Fun * Friends * Family * Future