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Ped Neuro > Lecture 1: Intro to Pediatrics > Flashcards

Lecture 1: Intro to Pediatrics Flashcards

1
Q

What is the American with Disabilities Act?

A

Protection for all Americans regardless of age/gender

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2
Q

Serious disabilities used to be put away and did not recieve the services necessary to reach their potential

A
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3
Q

ICF
* created by world health organiaztion
* classification systems for health and disability

Originally in 1980 we had the internal classification of impairments, disabilities and handicaps and have now moved to ICF

Traditional classification systems focus on mortality; ICF focuses on life

What the ICF is trying to show is that “I dont have ankle DF, which means i dont have heel strike on initial contact, and if I don’t have heel strike on initial contact than maybe i dont have good push off that leads to being unable to have good toe off which could mean I’m not walking as fast. Well if I’m not walking as fast than functionally I cannot keep up with my peers.
* So it impliements how its functionally impacting the person

ICF is supposed to be gold standard, however, other systems are still implemented
* but we do tie it to goals in the clinic. “pt will be able to get 160 degrees of shoulder function so they can get things in the cabinet (we tied it to function which is essnetially to point of the ICF model)

A
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4
Q

Which model/system places mental disorders on par w/ physical illness?

A

ICF model

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5
Q

Which ICF component encompasses physiological functions of body systems (including psychological functions)

A

Body functions

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6
Q

Which ICF component encompasses anatomical parts of the body, such as organs, limbs, and their components

A

Body structures

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7
Q

Which ICF component encompasses problems in body function or structure, such as a significant deviation or loss

A

Impairment

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8
Q

Which ICF component encompasses execution of a task or an action by an individual

A

Activity

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9
Q

Which ICF component encompasses involvement in a life situation?

A

Partiicpation

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10
Q

Which ICF component encompasses difficulties an individual may have executing activtiies?

A

Activity limitations

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11
Q

Which ICF component encompasses problems an individual may experience in involvement in life situations

A

Participation restrictions

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12
Q

Which ICF component encompasses physical, social, and attinudinal environment in which people live and conduct their lives?

A

Environmental factors

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13
Q

KNOW: Just because someone can do an activity doesnt mean they participate in it. For instance maybe they can do it in the clinic, but there isnt carryover into their life at home.

A
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14
Q
A
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15
Q

Difference between Peds and adults
* congitive status
* communication
* interventions (add play)
*

A
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16
Q
A
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17
Q
A
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18
Q

If child comes in and says their elbow hurts, well i can rule out loads of other body parts immediately

A
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19
Q

shouldnt MMT under

A

3

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20
Q

Tests and measures that can be done

Sensory processing = cant handle touch, light, or sound

A
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21
Q

How often are reevals done on normal pt

A

every 10 visits

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22
Q

how often to reeval a pediatric pt

A

6 months

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23
Q

Evaluation

Interpret of results from tests and measures
* look at scores / everything else and find a diagnosis/prognsis/POC

Integration of subjective and objective data

determination of a diagnosis and progrnosis

development of POC

Synthesis of findings from hx/systems review/tests and measures

consideration of contextual factors

A
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24
Q

a twisting of the neck that causes the head to rotate and tilt at an odd angle.

A

torticollis

common pediatric diagnosis

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25
Q

PT treatment diagnosis
- gait abnormality
- limited ROM

Medical diagnosis
* torticolicollis
- spinabifida

A
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26
Q

Top down approach = want child to walk
* then “why cant they walk” and work down and develop POC

Bottom up
* examine them, find problems and determine the goals
* this is used more - but in realality its somewhere in between

A
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27
Q
A
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28
Q

Predicted optimal level of improvement in fucntion and the amount of time needed to reach that level, and also may include a prediction of levels of improvement that may be reached at various intervals during the course of therapy

A

Prognosis
* this is our best guess

Important to consider the childs environment

Environmental barriers or optimal environmental conditions

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29
Q

Plan of care

Developed in full collaboration with the child, family, and other service providers

Includes measureable goals, objectives, and outcomes

Specific interventions to be used

Proposed frequency and duration services - this is determined from:
- Co-pay
- money
- how often they can get there
- other kids
- etc…

A
30
Q

Functional impact that is anticipated from physical therapy interventions

A

Goals

31
Q

Actual results of the POC

A

outcomes

32
Q

Measureable statements regarding desire results

A

objectives

33
Q

Define smart goals

A

Specific
Measureanle
Attainable
realistic
Timely

34
Q

initial learning of a new activity

A

Acquisition

35
Q

Developing proficiency at the activity

A

Fluency

36
Q

PErforming the activity over time

A

Maintenance

37
Q

Performing the activity in numberous environments, with new people and different equipment

A

Generalization

can do this in an open (people are talking) and closed (back room w/ nobody around) environment
* this is a big one to work on w/ peds
* this is a good way to progress goals

38
Q
A
39
Q

Goal attainment scaling (GAS)

you make a goal w/ incremints

good content validity, relability, and responsiveness in studies of children w/ CP

you rate it like below

arbitray because you make these goals

typically places that utilize this are doing it more for research/peds - not seen much in general pop

A
40
Q
A
41
Q

CPGs are plans to assist in decision making, they are not formulas. not intended for a blueprint for everyone

not a protocol just guidance

lots more in ortho than peds (5)

A

theres not a ton of research because you need to prove what your doing is not risk to the kid and the kid cannot sign for theemselves

also diagnosis vary greatly

42
Q
A
43
Q

Kids can get formal graduations for when they finish therapy, make them feel special

Discharge or “graduation” from services
1) goals, objects or outcomes are achieved
2) Child or family declines to continue itnervention
3) Child is unable to progress toward the anticipated goas, objectives, and expected outcomes
4) therapist determines that the child and family will no longer benefit from physical therapy

When termination of services occurs before achievement of the goals, objects, or outcomes, the rationale for discontinuation must be documented
* parents will throw you under the bus the the Dr. and you’ll need to be able to back up your decision

A
44
Q

Professional works independently of others

A

Unidisciplinary

This is a PT just working as a PT

45
Q

members of the same profession work together without significant communication with members of other professions

A

Intradisciplinary

You’re working in the clinic by them but not actually with them

46
Q

Professionals work independently but recognize and value the contributions of other team members. Draws on knowledg from different displines, but there may be little interaction or ongoing communication among progessionals
* work independently but talk to one another

A

Multidisciplinary

Work independently but talk to each other

47
Q

Individuals from different disciplines work together cooperatively to evaluate and develop programs. Emphasis is on teamwork, and role definitions are reflaxed. There is analysis, synthesis, and harmony between disciplines, creating a coordinated and coherent whole

A

Interdisciplinary

So they’re actaully working together and developing programs w/ one another

48
Q

There is teaching and ongoing work among team members that transcend traditional disciplinary boundaries. Team members work together to develop and carry out interventions. Role release occurs when a team member assums the responsabilities of other disciplines from service delivery

A

Transdisciplinary

She doesnt like this one
* they call it roll release, where they want a team member to assume responsibility for other roles
* “I want 1 therapist to be PT/OT/Speech”. However, were not qualitfied to do all this

49
Q

All team members work together in equal participation and consensus decision-making. The team interaction of the transdisciplinary model is combined with the integrated service delivery model. Coaching is a form of a collaborative team interaction

A

Collaborative

Think family members are members of the team

50
Q

Family members are members of the team and make decisions w/ outcomes / interventions etc… everyone has a role

A

Collaborative team

51
Q

Multidisplinary typically has a team leader that calls everyone together and sets up meetings and were all going to talk about our roles and critque eachother

“lets work together to find the best way to address the problems”

A
52
Q

Which model has formal channels of communication and all information is shared

A

Interdisciplinary model

53
Q

Transdisplinary is for infants that shouldnt be handled by multiple individuals. So one person takes on multiple roles so they dont come into contact w/ loads of people

A
54
Q

Service models mostly used in schools

A
55
Q

Direct model:
* I am going to treat them. 1:1. Directly doing intervention. I’m the therapist you’re the pt

A
56
Q

Integrated model: teaching others how to do things for the pt
* have family invovled in teaching

A
57
Q

Consultative model:
* Therapist meets with and demonstrates activities to all appropriate staff that carry out itnerventions to achieve determined goals and objectives

So you’re consulting w/ other people in this model

A
58
Q

Monitoring model
* I give them what they need and have someone else follow up on this
* common in school system - tasks are delegated to teacher
* Follow up of children who have impairments that might deterirate over time or limitations that might requre, integrated, or consultative intervention at a later date
* allows a more rapid transition of services if needed

A
59
Q

Collaborative:
* ongoing interventions while collborating w/ everyone else in their life
* combination of transdisciplinary team interaction and an integrated service delivery model

A
60
Q

Direct model is when you need 1:1 with actual skilled hands
* more PT one

A
61
Q
A
62
Q
A
63
Q

big idfference between adults and peds

Their behavior is entirely different

Don’t ask yes/no question if theres not a yes/no answer
* “Do you want to clea your room” - no
* instead ask “do you want to clean your room or clean the basement”

Use play to get theuerapeutic outcomes

structured behavior management plan is something that is “if you do this” than this
* Im going to put 3 clips on your shirt now, if they’re all there at the end of therapy you get a prize. You lose a clip if you do this behavior

A
64
Q

Manipulation of the environment through the use of positive reinforcement of desired behaviors and ignoring unwated behaviors

A

Behavioral programming

NOTE: kids typically respond better to positive reinforcement. however, there are still times to use the words “no, and stop”.

65
Q

neuro covers peds but peds doesnt cover neuro

A
66
Q

lifespan summary

A
67
Q

inconsistency of performance - when they’re first trying something they should be trying it lots of different ways. However, if they’re being inconsistent w/ something they already know how to do then im worried

Perseveration-response repeittion, the inability to stop when appropriate - if they’re walking and they cant stop, or tapping and cant stop moving them im woried

Extraneous movement - kids sitting and cant stop moving

Mirroring or the inability to transpose right-left cues. So if they cant mirrior what you do on both sides

Asymmetry and difficulty in bilatearl coordination - if they arent the same on both sides htem im worried

LOss of dynamic balance and falling after finishing a motor task

Inability to maintain rhythm or movement pattern - “I cant walk and keep the pattern”

Inability to contorl force, whether unable to generate enough force or using too much force

inappropriate motor planning -

A
68
Q

7 atypical motor behaviors

A

any of these in a peds pt is cause for worry

69
Q

atypical or delayed milestones

play w/ adults more than kids

A
70
Q
A

Ped Neuro (5 decks)

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