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7 Pediatrics > L3 Torticollis > Flashcards

L3 Torticollis Flashcards

1
Q

Family Centered Services and Intervention

A
  • based on family preiorities and needs
  • strengths-based
  • collaborative
  • families involved in decision-making
  • PT should be ready to work with family even if/when differing ideas about what is best for child
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2
Q

Content of individualized family service plan

A
  1. Statment of infant’s or toddler’s present levels of physical development, cognitive development, communication, social/emtoional, and adaptive involvement
  2. Family’s resources, priorities, concerns
  3. Measurable results or outcomes expected to be achieved for the infant or toddler
  4. Specific early intervention services based on peer reviewed research
  5. Natural environments in which early intervention services will appropriately be provided, including justification
  6. Dates for initiation of services and anticipated length, duration, frequency
  7. Identification of service coordinator
  8. Support of transition of toddler with disability to preschool or other services
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3
Q

Service coordinator

A

case manager or service provider that monitors and matches family’s needs

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4
Q

EI Implementation in Natural Environments

A

settings that are natural or typical for a same-aged infant or toddler without a disability

child acts differently in environments that they are comfortable with

helps to appropriately gauge family resources

PTs may gain most reliable asssessment in these environments

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5
Q

Activity Based Instruction

A

also known as routines based instruction

should be child directed, activity focused, functional, and include timely feedback

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6
Q

Purposes of early intervention

A
  1. minimize developmental delay
  2. reduce educational costs
  3. maximize independence of child
  4. enhance capabilities of family to meet needs of child
  5. enhance capacity of state to to meet needs of children
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7
Q

ADA

A

ensured full civil rights to individuals with disabilities. guarantee equal opportunity in employment, public and private accomodataions, transportation, government services, telecommunications

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8
Q

Congenital Muscular Torticollis

A

asymmetrical cervical posture and positioning. Contracture of the SCM

unclear etiology, potentially intrauterine and perinatal compartment influence

prevalence has increased due to back sleeping to avoid SIDs

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9
Q

Types of Torticollis

A

Postural
Muscular
SCM Mass

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10
Q

Postural Tort

A

postural preference, no ROM impairments

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11
Q

Muscular Tort

A

tightness of SCM, passive ROM impairments

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12
Q

SCM Mass type

A

SCM fibrosis, ROM impairments

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13
Q

Typical presentation of CMT

A
  • ipsilateral lateral flexion and contralateral rotation, head tilted toward involved side and chin rotated to opposite side
  • limited ROM in lateral flexion toward uninvolved side
  • limited ROM in rotation toward involved side
  • skewed vertical and midline orientation
  • participation and activity limitations
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14
Q

Differential Diagnosis for CMT

A
  • neurological conditions like brachial plexus injuries
  • developmental dysplasia of hip
  • GERD
  • eye weakness or disease impairments
  • sandifer syndrome (acid reflux)
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15
Q

Treatment for CMT

A
  1. Early referral to PT (helps to decrease length of care, muscle thickeness, and improves QOL)
  2. Initiate within 3-4 months of age
  3. Strategies include PROM, ARM, environmental adaptations, education
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16
Q

How many children require surgical intervention?

A

5%

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17
Q

Plagiocephaly

A
  • misshapen head or facial asymmetries
  • often accompanies torticollis
  • may require helmet therapy, which is more helpful for 6 months yo
18
Q

treatment for plagiocephaly

A

head repositioning
prone when awake
education + PT (most helpful)

19
Q

Rule out with plagiocephaly

A

craniosynostosis–premature closing of cranial sutures

20
Q

Brachial Plexus Injuries

A

-nerve roots stretched, which can be transient, permanent, and cause diminished innervation
-may occur in vaginal delivery
-can be sports or trauma induced

21
Q

Increased risk of brachial plexus injuries in neonates

A

shoulder dystocia
gestational diabetes
breech delivery
use of forceps or evacuation pump during delivery

22
Q

Erb Palsy

A

C5 and C6 (axillary, suprascapular, radial, muscultaneous, subscap)

GHJ IR and adduction, wrist flexion, finger extension

presents as waiter’s tip position

can easily dislocate due to weak shoulder abductors, flexors, and extensors

23
Q

Kumpke Palsy

A

C8, T1 (median, ulnar)

affects muscles of hand, sensation, medial arm. loss of thumb opposition

claw position – MTP ext, DIP/PIP flexion, thumb abduction

24
Q

Prognosis for Brachial Plexus Injury

A

erb – very good prognosis with early therapy, should resolve in 6 mo

complete – neurosurgeon required

25
Q

According to Individuals with disabilities education act, early intervention services means services that…

A
  1. provided under public supervision
  2. provided at no cost (except in certain states)
  3. designed to meet the developmental needs of infant or toddler with disability
26
Q

When is early intervention provided?

A

children within the first three years of their lives

27
Q

Whose responsibility is it to know when reauthorization/regulations have changed for EI?

A

PT

28
Q

Key principles for providing EI services

A
  1. Infants and toddlers learn best through everyday experiences and interactions with people they know
  2. All familities, with necessary supports can enhance children’s learning
  3. Role of service provider is to work with and support the family members and caregivers in child’s life
  4. Process must be dynamic and individualized to reflect preferences of family, cultural beliefs, learning styles
  5. outcomes must be functional and based on kid’s needs
  6. Family’s needs and priorities are addressed by primary provider
  7. Interventions have to be based on explicit principles, validated practices, research, laws
29
Q

State eligibility criteria for EI

A

varies

30
Q

Federal description of kids who may receive EI

A

Infant or toddler with disability
1. individual under 3 years of age
2. Experiencing developmental delays
3. Has diagnosed physical or mental condiition that has a high probability of resulting in developmental delay
4. OR at risk toddlers/infants

31
Q

Individualized Family Service Plan

A

comprehensive document that outlines and guides EI services for specific child and family

includes demographics, history, current level of functioning, family’s priorities, EI services, service coordinator, transition plan

32
Q

Multidisciplinary Team

A

least active interaction among team members

individually assess and report their findings

not suitable for IDEA part C/EI because EI needs a lot of interaction

33
Q

Interdisciplinary Team

A

typically has formal channels of communication established

team may submit combined assessment report

34
Q

Transdisciplinary Team

A

-share info across disciplines and with family
-may include role release, a primary therapist will prioritizes what will be best
-assessment and treatment may coincide
-all team members share goals and strategies for child’s optimal development

35
Q

Optimal Teaming in Intervention

A

-ongoing communication
-interdisciplinary and transdisciplinary approaches
-coaching
-integrated programing
-cotreatment
-role release

36
Q

“Coaching”

A

conversation and self observation to support families and team members learning skills to help the child’s development

37
Q

Integrated Programing

A

development of strategies for parent-selected outcomes as a team

holistic perspective

38
Q

Cotreatment

A

two or more professionals involved in child’s intervention in a session

39
Q

Role Release

A

primary therapist prioritizes what will be best to be repeated most consistently throughout a week

40
Q

Strategies to Encourage Intervention

A

Cataloging
Matrix Development

41
Q

Cataloging

A

log of child’s daily activities from morning to night

work with family to see when therapeutic intervention

42
Q

Matrix Development

A

chart mapping daily activities and outcomes

7 Pediatrics (10 decks)

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