Intro to peds

Question 1

Describe Bronfenbrenners ecological system theory and the parts of it

Answer 1

This theory views child development as a complex system of relationships affected by multiple levels of the surrounding environment, from immediate setting of family and school to broad cultural values, laws, and customs

Includes macrosystem, exosystem, mesosystem, microsystem,

Question 2

What is the EBD framework?

Answer 2

Developmental, behavioral and educational problems in childhood can have both long-term and intergenerational effects​

Acknowledges concepts such as intergenerational trauma, childhood adversity and stress

Question 3

What are the social determinants of health? What are the 5 areas?

Answer 3

Definition: conditions of the places in which children and families live, work, play and learn

5 areas: economic stability, education, social and community contexts, health and health care, neighborhood and built environment

SoDH contributes to 80-90% of health outcomes!

Question 4

Examples of economic stability?

Answer 4

employment, food, housing security, sufficient resources

Question 5

Examples of education within SoDH?

Answer 5

early childhood education, HS education, higher ed, language proficiency and literacy

Question 6

Social and community contexts within SoDH?

Answer 6

civic participation, cultural social norms, attitudes

Question 7

Health and healthcare within SoDH?

Answer 7

access to care, health literacy

Question 8

Neighborhood and built environments within SoDH?

Answer 8

safety, access to healthy food, quality housing, opportunities for recreation

Question 9

What is health equity?

Answer 9

Attainment of the highest level of health for all people

Question 10

What is health inequity?

Answer 10

differences in health that are unfair, preventable, avoidable

Question 11

What is ACES?

Answer 11

Adverse childhood experiences, persistent health disparities associated with poverty, discrimination or maltreatment

Question 12

What populations are unrecognized and unmet therapy needs greater in?

Answer 12

Black and hispanic children

Question 13

What is the health leads screening tool?

Answer 13

Pretty easy thing that patients can feel out that give you an idea if their needs are being met at home.

Question 14

How does culture play into child development?

Answer 14

Culture frames child rearing – way child is introduced into society, toileting, feeding, handling, discipline, self help, play

The significance of a disability depends on the values and assumptions of the culture!

Culture influences maternal health seeking behaviors – problem recognition

Question 15

What is cultural humility? (from a clinician standpoint)

Answer 15

“the understanding that in order to work with individuals who are culturally diverse, we understand that they are the experts on their culture and thought processes – we remain humble”

Question 16

What are four goals of family centered intervention?

Answer 16

1. Support the family unit​
2. Enhance family competence​
3. Enhance the growth, development, and functional independence of the child through a partnership with the family and child​
4. Care directed towards goals that are important and relevant to the family and child

Question 17

Describe family centered care

Answer 17

Is a life span approach​

Is a process that respects the rights and roles of family members while providing intervention​

Fundamental premise: the child or person does not exist in isolation but functions within a family​

The child is totally dependent on family members

Question 18

What is the transactional model of development?

Answer 18

Reciprocal relationship between the child and the caregiving environment​

A supportive environment may minimize biological risks

Support from social networks and the political and economical culture can influence how a family interacts and cares for their child

Question 19

What constitutes a family?

Answer 19

Defined more by emotional and functional elements than by structural or legal elements​

“A group of people who love and care for each other”

Question 20

What is family systems theory?

Answer 20

all members are involved in each other’s lives so what happens to one member will effect the entire family

Question 21

What are some guidelines of family centered care?

Answer 21

Family is recognized as key member of the team​

Family is the consumer of services and retains ultimate decision-making authority​

Professionals must value the family’s knowledge of their child​

Therapists role: empowering, communication, enabling, support child

Question 22

What are childrearing practices?

Answer 22

goal directed actions that parents engage in to promote their children’s development

How parents structure the learning and caregiving home environment may promote motor development

Question 23

Describe parent-child interaction?

Answer 23

Intimate transaction​

Basis for subsequent relationships​

Influences skill acquisition​

Predicated upon the notion that the child and caregiver have a dual responsibility to maintain the interaction

Question 24

What are Barnard four features of successful child-parent interactions?

Answer 24

1. Sufficient repertoire of behaviors, such as body movements and facial expressions​
2. Contingent responses to each other​
3. Rich interactive content in terms of play materials, positive affect, and verbal stimulation​
4. Adaptive response patterns that accommodate the child’s emerging developmental skills

Question 25

How does PT play a role in parent-child interactions?

Answer 25

Atypical motor behaviors may influence the quality of parent-child interactions​

Children with motor difficulties often demonstrate slow responses to external stimulation​

Share information with parents about their child’s abilities and suggestions for optimizing interactions

Question 26

What is the overarching goal of therapy for the child?

Answer 26

to optimize the child’s participation in the home, school, and community

Question 27

What are the 4 parts of the intervention encounter?

Answer 27

1.Establish a common ground for communication and information sharing​

2.The process of information gathering should involve methods acceptable to both parties

3. Therapists and families should seek to create a good match among the child’s functional abilities, the family’s resources, the amount of information necessary to level the playing field, and the various environments that are important in the child’s daily life
4. Intervention should focus on supporting the caregiving environment and the child’s participation regardless of the severity of the disability

Question 28

What is the child abuse prevention and treatment act of 1974?

Answer 28

“the physical or mental injury, sexual abuse, negligent treatment or maltreatment of a child under the age of eighteen by a person who is responsible for the child’s welfare”

Requires every state to have a system for reporting suspected child abuse and neglect​

Child abuse mandates a breach of confidentiality that is supported by federal law

Question 29

Why are children with disabilities at an increased risk for abuse/neglect?

Answer 29

increased frustration from parents

Question 30

Signs of abuse for child?

Answer 30

Sudden change in behavior or school performance​

Has not received help for physical or medical problems brought to the parents’ attention​

Has learning problems or difficult concentrating that cannot be attributed to specific physical or psychological causes

Is always watchful, as though preparing for something bad to happen​

Lacks adult supervision​

Is overly compliant, passive, or withdrawn​

Comes to school or other activities early, stays late, and does not want to go home

Question 31

Parent signs of abuse?

Answer 31

Shows little concern for the child​

Denies the existence of – or blames the child for – the child’s problems in school or at home​

Asks teachers or other caregivers to use harsh physical discipline if the child misbehaves​

Sees the child as entirely bad, worthless or burdensome

Demands a level of physical or academic performance the child cannot achieve​

Looks primarily to the child for care, attention, and satisfaction of emotional needs

Question 32

Interactions between child and parent that indicate abuse?

Answer 32

Rarely touch or look at each other​

Consider their relationship entirely negative​

State that they do not like each other

Question 33

What are the different types of abuse?

Answer 33

Physical​

Neglect​

Sexual​

Emotional​

(usually found in combination)

Question 34

Signs of physical abuse?

Answer 34

Unexplained burns, bites, bruises, broken bones or black eyes​

Fading bruises or other marks noticeable after an absence from school​

Seems frightened of the parents and protests or cries when it is time to go home​

Shrinks at the approach of adults​

Head and brain injuries​

Internal injuries​

Question 35

Signs of neglect

Answer 35

Signs of Neglect: neglect occurs when the child’s basic needs are not being met ​

Malnourishment including reports of hunger, nutritionally inadequate diet​

Medical neglect (parental refusal to seek or maintain necessary medical intervention including dental care, excessive cancellations)​

Educational neglect (parental indifference to the child’s school attendance or cognitive development)​

Emotional neglect (parental indifference to child’s need for physical contact and psychological nurturance)​

Evidence of poor hygiene including soiled clothing and skin, skin breakdown in diaper area)

Question 36

Signs of sexual abuse

Answer 36

Signs likely to be behavioral including anorexia, bulimia, eneuresis, encopresis, abdominal pain without organic cause, atypical shyness, extroverted or hostile behavior, sexual acting out​

Difficulty walking or sitting​

Suddenly refuses to change for gym or participate in physical activities

Nightmares​

Bizarre or unusual sexual knowlegde​

Becomes pregnant or contracts VD ​

Runs away

Question 37

Signs of emotional maltreatment

Answer 37

Extremes in behavior – overly compliant or demanding, extreme passivity or aggression​

Is inappropriately adult or infantile​

Delayed physical or emotional development​

Attempted suicide​

Lack of attachment

Question 38

What is Munchausen syndrome by proxy?

Answer 38

Specialized form of child abuse is which a physical or mental disorder of the child is either fabricated or induced by a parent or other adult caretaker

Question 39

Warning signs for munchausen syndrome by proxy?

Answer 39

Persistent or recurrent illnesses for which a cause cannot be found​

Discrepancies between history and clinical findings​

Symptoms and signs that do not occur when a child is away from the mother​

Unusual symptoms that do not make clinical sense​

Persistent failure of a child to tolerate or respond to medical therapy without clear cause

A parent less concerned than the physician, sometimes comforting the medical staff​

Repeated hospitalizations and vigorous medical evaluations of mother or child without definitive diagnoses​

A parent who welcomes medical tests on her child, even if painful

Question 40

What are the models of service delivery?

Answer 40

-Multidisciplinary​

Professionals work independently but recognize and value the contributions of other professions​

Interdisciplinary​

Individuals from different disciplines work together cooperatively to evaluate and develop programs.​

Emphasis is on teamwork. Role definitions are relaxed.​

-Transdisciplinary​

There is teaching and ongoing work among professionals across traditional disciplinary boundaries. Role release occurs when a team member assumes the responsibilities of other disciplines for service delivery​