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Medically Based Pediatrics > Introduction to Medically-Based Pediatrics > Flashcards

Introduction to Medically-Based Pediatrics Flashcards

1
Q

What is the OT process in pediatric practice?

A

1) Evaluation:
- - Occupational profile
- - Analysis of occupational performance
- - Gathering of information through multiple sources
- - Clinical and naturalistic observation
2) Intervention
- - Collaboration, consultation, and education with others involved
- - Direct intervention - use best practice guidelines and evidence-based intervention
3) Assess Outcomes

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2
Q

What are the different types of OT interventions in Medically-Based Pediatrics?

A
  • Direct intervention
  • Adaptation and Modification
  • Consultation, education, and advocacy
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3
Q

What is direct intervention?

A
  • Enhance occupational performance in ADLs, education, play, and pre-vocational occupations
  • Foster increased engagement and participation
  • Provide just right challenge
  • Habilitation vs. rehabilitation
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4
Q

What is adaptation and modification intervention?

A
  • Adapt tasks, foster adaptation of the child to meet challenges
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5
Q

What is the pediatric OT early intervention setting?

A
  • Occupational therapist is primary provider
  • Works with children and families ages birth to three
  • Naturalistic setting
  • State funded
  • Can be community based service setting or naturalistic setting (home or daycare)

MO: First Steps
KS: KS Infant Toddler Services

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6
Q

What are the pediatric OT educational/school-based services?

A
  • Services children 3-21 years with educational needs
  • Designed to be provided in the least restrictive environment (hand over hand is most restrictive)
  • OT is a related service provider. Primary provider is teacher
  • Funded by government (state and national)
  • Intervention must be educationally relevant
  • Intervention may be direct, consultative, and monitoring
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7
Q

What are pediatric OT medical settings?

A
  • Inpatient rehabilitation, day-patient, outpatient
  • Specialty areas: NICU, Feeding Units, Neuro Units
  • Residential day treatment centers
  • OT is primary service provider
  • OT intervention is focused on habilitation or rehabilitation (establish/restore, modify/adapt, advocate/educate)
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8
Q

What are pediatric OT community settings?

A
  • May be working on larger population level
  • Coordination services for children or family
  • Advocacy and education
  • OT helps advocate and helps with development of policies/laws
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9
Q

What is the purpose of pediatric OT rehabilitation services?

A
  • Provided to persons experiencing deficits in key areas of physical and other types of function or limitations in participation in daily life activities
  • Interventions are designed to enable achievement and maintenance of optimal physical, sensory, intellectual, psychological, and social functional levels
  • Provide tools and techniques needed to attain desired levels of independence and self-determination
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10
Q

What is the purpose of pediatric OT habilitation services?

A
  • Health care services designed to assist people in acquiring, improving, minimizing the deterioration of, compensating for an impairment of, or maintaining (partially or fully) skills, function, or performance for participation in occupation and daily life activities
  • Early onset, acquired injuries, and congenital disorders
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11
Q

What are external factors that influence pediatric hospital-based services?

A
  • Health care laws
  • Health care costs
  • Insurance/3rd party reimbursement
  • Accrediting Agencies - oversee if a site can perform the duties that they claim they can
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12
Q

What are examples of health care laws affecting medically-based pediatric OT?

A
  • Americans with Disabilities Act
  • Combating Autism Act/Autism Cares Act
  • Affordable Health Care Act
  • Revisions to Affordable Health Care Act under Trump Administration
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13
Q

What is the Americans with Disabilities Act (ADA) (1990, 2008)?

A

Prohibits discrimination of individuals with disabilities and establishes standards for employment and access to public venues and agencies. It allows for people to have reasonable accommodations made in the work and educational environments

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14
Q

What is the Autism Cares Act (2006, 2014)?

A

The first law to be diagnosis specific and designed to foster collaborative partnerships with the NIH and CDC to promote better health, education, and resources for children with autism. Helps federal funding for research to take place

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15
Q

What is the Affordable Health Care Act/Obama Care (2013)?

A

Persons cannot be denied health insurance coverage due to preexisting conditions. Children up to age 26 can stay on parents coverage. Agencies had to cover birth control and other preventative care

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16
Q

What are the revisions to the Affordable Health Care Act under the Trump Administration?

A

Removal of federal mandates to allow states to take over mandating of Affordable Care Act. States can opt out of Medicaid expansion, can alter essential healthcare requirements, can offer HSA plans or short-term plans (do not cover as much as a comprehensive plan), flex spending account amounts have increased without a tax penalty. Certain states can repeal funding for preventative care and public care. States can repeal Planned Parenthood. States can require individuals that are not disabled, not elderly, and not pregnant to show employment to be eligible for Medicaid (state funded program)

17
Q

What is Medicaid?

A
  • Government assistance program for: children, pregnant women, elderly, and individuals with disabilities, or families who fall below the national poverty level based on annual income
  • There are federal mandates of necessary coverage, but each state controls optional eligibility
  • Medicaid expansion was to increase income level for more families to qualify
  • Families are eligible for routine check-ups, dental, vision, doctors appointments, inpatient and outpatient care for those that qualify.
  • To qualify for Medicaid must make less than 133% of the poverty level (ex: family of 4 would need to make less than $23,500 annually)
  • KS rejected the bill but under new leadership, Laura Kelly is for expanding Medicaid allowance
18
Q

What is the Children’s Health Insurance Program (CHIP)?

A
  • Referred to as KANCare in KS and MO Health Net for Kids in MO
  • Covers routine check-ups, immunizations, doctors visits, prescriptions, dental and vision care, inpatient and outpatient hospital care, laboratory and x-ray services, and emergency services
  • Provides services for children who do not qualify for Medicaid because family makes too much to qualify for Medicaid
19
Q

What is private insurance?

A
  • Insurance plans must cover some form of habilitation and rehabilitation services, but there is great variation
  • Facilities may have contracted insurance plans - selected providers
  • Services may be billed for as individual CPT units or by service discipline
  • All medically-based 3rd party reimbursement companies require a physician referral and script
  • Durable medical equipment coverage greatly varies
  • More difficult to obtain extended visits
  • Never write goals based on insurance limitations. OTs are not considered autonomous providers with private insurance
20
Q

What are JCAHO, CARF, and OSHA?

A
  • Accrediting agencies
  • JCAHO: Joint Commission for Accreditation of Health Care Organizations - accrediting agency for hospitals
  • CARF: Commission for the Accreditation of Rehabilitation Facilities - accrediting agency for rehab facilities
  • OSHA: Occupational Safety and Health Administration - federal entity that is responsible for setting safety and environmental regulations
21
Q

What types of critical reasoning are used in pediatric OT practice?

A
  • Diagnostic: uses knowledge about diagnosis to anticipate what symptoms/deficits a child may present with
  • Scientific: uses evidence-based practice research to select and guide interventions
  • Narrative: being able to actively listen to the family and meet the family where the family is at
  • Pragmatic: being resourceful and practical (ex: what is the best way to use 20 visits?)
  • Interactive: building rapport with child and family. Therapist needs to have emotional fortitude in order to support the family
  • Ethical: using ethical reasoning to guide you in a moral dilemma
  • Conditional: highest level of reasoning - being able to predict where child may be or how child may progress to envision realist needs and expectations (ex: helps with LTG writing and predicting what sources may be needed)
22
Q

What is the order of decreased function when a child has failure to thrive?

A

Weight > height > head circumference > brain

Medically Based Pediatrics (12 decks)

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