L4.1 4QM Flashcards
describe the link between theory and intervention
- relationship between underlying concepts enabling prediction of expected behaviours
- delineate perspective of therapist when approaching child- information gathering and intervention
describe vtgotsky-principle of learning (zone of proximal development)
different supports are required at different stages. of learning to facilitate successful task performance. as competence increases scaffolding moves from facilitator to child.
what are some different teaching methods?
- direct instructions: command, inform learner of key elements of task
- indirect instructions: self-teaching, cognitive
describe the four quadrant model of facilitated learning (4QM)
WHAT
framework to inform selection of effective learning strategies used to promote autonomy
1. task specification (facilitator initiated, direct)
2. decision making (facilitator initiated, indirect)
3. recall (learner initiated, direct)
4. autonomy (learner initiated, indirect)
HOW
- groups cognitive and physical learning strategies in a way that reflects directness of strategy and who initiates it
- alerts therapist to learner needs
- provide structure that allows response to changing needs of learner as skill acquisition progresses
describe how to use quadrant 1 (task specification) and apply it to toothbrushing
facilitator initiated, direct
questions to ask:
- Does the child know what to do and how to do it?
- Requires facilitator to indicate nature of task and characteristics of performance e.g. model it
- Task goals, foundation knowledge, characteristics of task, key elements of response
toothbrushing:
- Explicit instruction and explanation- the facilitator says, “hold your brush with your thumb on top and the bristles pointing down”
- Demonstration- the facilitator shoes the learner the correct way to grasp the toothbrush
- Physical patterning- the facilitator holds the toothbrush by grasping over the top of the learner’s hand. The learner remains passive while his/her hand is moved to manipulate the brush over the teeth
- Lower order questions- the facilitator says, “where does your thumb go?” having previously described and/or demonstrated this
describe how to use quadrant 2 (decision making) and apply it to toothbrushing
facilitator initiated, indirect
questions to ask:
- Is the child making astute decisions? Is child aware of errors?
- Requires facilitator to stimulate cognitive performance: planning, organising, monitoring, problem solving
toothbrushing:
- Higher order questions- the facilitator says, “how could you hold the brush differently to get to your top teeth?”
- Physical prompts- the facilitator taps the learner’s elbow to indication the need for a change of brush position and/or grasp
- Non-verbal prompt- the facilitator points to the left upper group of teeth, and the Learner works out how to orient the brush to clean that part of the mouth
- Feedback- the facilitator says, “you are missing some spots up the back”
- Think-aloud modelling- “the facilitator says, “when I brush my teeth, I always ask myself ‘am I getting all those teeth up the back’”
describe how to use quadrant 3 (key points) and apply it to toothbrushing
learner initiated, direct
questions to ask:
- Is the child recalling procedures and key features of their performance?
- Utilises self-mediating strategies to recall and monitor characteristics of performance
- Strategies used are obvious to observers
- Remembering information, recalling key points, remembering sequences of tasks, attending to appropriate information
toothbrushing:
- Priming- before starting the task, the learner rehearses the various grasps necessary for brushing the different parts of the mouth
- Mnemonics- the learner recites the rhyme “thumb on the spot, helps a lot” to prompt correct grasp of the toothbrush
- Verbal self-instruction- the learner says, “I put my thumb on here, then I turn my hand over,” to prompt the correct upper limb position for bushing the top teeth
- Visual cues- the learner refers to a picture of the correct grasp to prompt finger and thumb position on the toothbrush
- Kinaesthetic self-prompting- the learner touches the side and part of the face (e.g. right upper, left lower) that should be brushed next before commencing brushing that part
describe how to use quadrant 4 (autonomy) and apply it to toothbrushing
learner initiated, indirect
questions to ask:
- Can the learner generalise skills to new and novel contexts?
- Are there any signs of self-prompting?
- Performance completed successfully: error corrected, self-mediation of performance not obvious
toothbrushing:
- Mental Imagery (not visible)– The Learner imagines the surface of the teeth they are going to brush next, and uses that to orient the toothbrush appropriately.
- Problem Solving – The Learner identifies a better finger and thumb position on the brush when the existing grasp is not successful in cleaning the tooth surface.
- Self-Instruction (not visible)– The Learner uses inner speech to remind him/herself of the sequence cleaning (e.g., lower left, lower right, upper left, upper right).
- Self-Questioning – The Learner judges the success of a particular grasp in cleaning the surface of one section of teeth.
- Self-Monitoring – The Learner ensures that all surfaces of the teeth are being brushed successfully and adequately.
- Automaticity – The learner brushes teeth while watching television.
what are the types of intermediate strategies? apply this to toothbrushing
- Exhibit characteristics of adjoining quadrants
- Leading- partial information provided to client
- Orienting- remind client to use self-prompting strategies
- Fading- internalisation of self-prompts
Toothbrushing
- Leading – The Facilitator grasps the toothbrush over top of the Learner’s hand and restricts the brushing motion to ensure the brush does not protrude into the back of the pharynx when the learner brushes.
- Orienting – The Facilitator says, “Where could you look for help?” to encourage the Learner to use his/her picture chart.
- Fading – The Learner whispers, “I put my thumb on here, then I turn my hand over,” to prompt the correct upper limb position for brushing the top teeth.
what are the aspects of ALERT factors?
activity, learner, environment, relationship, teacher
describe the ‘A’ in ALERT factors
ACTIVITY
- Impact of nature of task
- Can the task be pre-planned or does decision making need to occur during task execution? Open vs closed; Generalizability
- How long does the task take- does it occur swiftly or over a period of time? Discrete or continuous
- What is the nature of the task? Is it primarily physical, cognitive or social? Adaptability; Physical facilitation or higher order questioning?
describe the ‘L’ in ALERT factors
- How does the child prefer to learn? Verbal or visual strategies?
- Does the child have specific abilities or limitations that impact on learning ability or suitability of strategies? Cognitive, physical and psychological abilities
- What will motivate the child and encourage engagement? Known reinforcers, learned helplessness
- What is an appropriate level of task difficulty to engage the child?
- What impact will the child’s past learning experiences have? Wait for help
- What does the child attribute success and failure to? internal or external factors
describe the ‘E’ in ALERT factors
- What strategies are able to be used in the physical environment in which the occupation is to be completed? Is there a place to locate visual prompts?
- Are there sensory characteristics of the strategies that preclude their use for this occupation or context? Is it a quiet context- would verbal self-regulation be disruptive to others?
- What are socially valid strategies for this child and the context in which they will be used? Would the child be perceived as different if they were using kinaesthetic self-prompting in this situation?
- What strategies will the learning climate support? does it promote risk taking?
describe the ‘R’ in ALERT factors
- What happens to power balance when child engages in teaching learning process?
- How will you demonstrate empathy throughout teaching and learning process?
- Remember to provide unconditional positive regard and consider this may not be experience of child in all situations
- What strategies will help child feel empowered?
describe the ‘T’ in ALERT factors
- What is your competency in facilitating learning and how will this impact on your selection of strategies? Are you familiar with using all strategies?
- How will you communicate with the child to get best effect from strategies?
- How do you attribute success/failure? Do you expect success or failure? Do you expect task completion?
