Intro to Service Delivery and Development I Flashcards
Inter-professional
Improved communication and coordination
Services promote each other, may have internal overlap
Used with students who have IEPs in traditional inpatient settings
Communication at IEP meetings, parent/teacher conferences
Trans-disciplinary
Less disruptive to the family
Primary and consultant team members
A little bit of role release
Use for children with IFSPs
Proximal natural environment
Home
Childcare centers
Schools
Distal natural environment
Neighborhood
Community
IFSP
EI 0-3 years
Goals must be family centered
Primary team member is identified based on child’s needs
IEP
Atypical to not relate the goal to education
Pre-school and school-aged 3-18
Many service providers working together
Barriers to provision of family centered care
Economical level
Cultural or ethnic
Educational
Stress-Limiting Strategies
Listen sympathetically and with understanding of the family’s perception of the situation
Explain your perception of the situation
Acknowledge and discuss the similarities and differences between the two perceptions
Recommend interventions
Negotiate an agreement on the interventions
Organizations
Refers to the places or groups from which a child and family receive services and may include…
Community programs School based programs Early intervention Hospitals Rehabilitation centers
Service provider
Refers to the individuals who work directly with the child and family, and may include…
Physical, occupational, and speech therapists
Special educators, child life specialists
Service coordinators, social workers
Respite workers
Intervention
Refers to the services and supports provided to the child and family. Interventions may include…
Direct therapy
Meetings for established programs of interventions, monitoring progress, and problem solving
Advocacy, calls
Coordination between providers and families
Goal components
Specific
Measurable
Time sensitive
Functional
ABCDEF
Actor Behavior Condition Degree Expected time period Functional
Goal Attainment Scaling
- 2 Least favorable
- 1 Patient making minimal to low progress
0 Expected level of progress
+1 More progress than expected
+2 Most favorable outcome, patient is making extremely rapid progress
Pediatric SOAP
Subjective - patient presentation. Patient or parent reports on status, pain, function, disability
Objective - treatment performed, measurable outcomes achieved, equipment provided
Assessment - patient response to treatment and modifications needed, progress being made toward the goal, setting or modifying goals
Plan - what is to be done next visit, steps to achieve goals
Motor development
Dependent upon…
Individual genetic coding or predisposition
Child individual experiences
Environmental experiences
Maturation of the CNS
Term babies
Born between 38 and 42 weeks gestation
Age correction
Up to 18 months or 2 years
Delaying
Motor (and other skills) are developing in an appropriate manner/pattern but at a slower pace = developmental delay
Atypical
Child demonstrates motor patterns associated with a specific disorder usually neuromuscular or musculoskeletal = Abnormal muscle tone (low/high/mixed)
CP, club foot, etc.
Maturationist’s theory
Motor development is correlated with changes in the nervous system as it develops
Dynamic Systems Theory
Applied DST to development
No one system is responsible or director of development; it is a confluence of many factors
Developmental biodynamics - used to explain the organization of motor behavior based on the interaction between perception, action, body morphology, and task
Prenatal stages
Germinal (1-2 weeks gestation)
Embryonic (2-8 weeks gestation)
Fetal (9-38 weeks gestation)
Infancy
Birth to 2 years
Childhood
2-10 years female
2-12 years male
Adolescence
10-18 years female
12-20 years male
Young adulthood
18-40 years
Maternal infections
STORCH
Syphilis Toxoplasmosis Rubella Cytomegalic virus Herpes
Sub-clinical infection
May be a factor in development of CP
Not overtly sick, but it does affect fetal development
Embryonic stage
Cell differentiation and layer formation
Lasts until the 8th week of gestation
Embryo most susceptible to environmental disruptions as moms may not be aware of pregnancy
Blastocyst into germinal layers into different tissues of the body
Germinal layers
Ectoderm - skin, hair, nails, teeth, and nerves
Mesoderm - muscle, bone, heart, and blood vessels
Endoderm - major digestive organs, liver, alimentary tract and linings, and endocrine glands
Fetal stage
Begins at 9th week of gestation
Times of growth, maturation, adding dimension and refinement of the system
Seeing fetal movements
10 weeks
Mother perceiving fetal movements
16-18 weeks of gestation
Physiological flexion begins in…
3rd trimester
Sleep/wake cycles
26-28 weeks
Surfactant
28 weeks
Considered premature…
Before 37 weeks
CNS myelination
Continues through the first year
Patterns of growth and development
Cephalocaudal direction
Proximally to distally
General to specific
Sagittal > Frontal > Transverse
Elongation precedes activation
Control is indicated by balance around a joint
All movement involves a weight shift
Righting reactions
Function to keep the head oriented to the body and to the gravity and to keep eyes level with the horizon
Equilibrium reactions
Adjust for changes of the body in space, to keep you balanced over a point
Protective reactions
Help to protect ourselves from harm and falls
Propping responses in UE
Ankle strategies in LE
Scarf sign in preterms
Arm passively moved across chest of child in supine with head in midline
No resistance to passive movement
Ankle dorsiflexion in preterms
Preterm 60-90 degrees
Slip-through in preterms
Completely slips through hands, does not set shoulders
Rooting reflex in preterms
Absent
Sucking reflex in preterms
Weak or absent
Grasp reflex in preterms
Absent
ATNR in preterms
Absent
Multi-disciplinary
Many disciplines
Independent practice
Works within discipline boundaries
Most common in outpatient settings
Risks - duplication of services, different answers to the same question
