Medically based service delivery

Question 1

Pediatric Service Delivery Setting

Early Intervention

Answer 1

community based setting
occupational therapist is primary provider
work with ages birth - 3
naturalistic setting - must be in home or daycare

Question 2

Pediatric Service Delivery Setting

Educational/School-based setting

Answer 2

funded by government
services ages 3-21 must impact their education
provided in least restricted environment
teacher is primary provider, OT related provider
intervention must be educationally relevant
intervention can be direct, consultative and monitoring

Question 3

Pediatric Service Delivery Setting

Medical setting

Answer 3

Inpatient ( 1-2 wks)
Rehabilitation ( 2-8 wks)
Outpatient ( 6 mos)
day-patient
residential day treatment centers
OT is primary provider
intervention focus on habilitation and rehabilitation
establish/restore, modify/adapt, advocate, educate

Question 4

Rehabilitation

Answer 4

services are provided to persons experiencing deficits in key areas of function
provide tools and techniques needed to attain desired levels of independence and self-determination
(have been typically developing)

Question 5

Habilitation

Answer 5

assist people in acquiring, improving, minimizing the deterioration of, compensating for an impairment, maintaining partially or fully skills

Question 6

Health care laws

ADA

Answer 6

Americans with Disabilities Act = prohibits discrimination of individuals with disabilities, establishes standards for employment and access to public venues, allows for reasonable accommodations to be made for work, school and environment

Question 7

Health care laws

Autism Cares Act

Answer 7

used to be called Combatting Autism Act
first to be diagnosis specific
fosters collaborative partnerships with NIH and CDC to promote better health, education and resources
federal funding to help research on autism

Question 8

Health care laws

Affordable Health Care Act

Answer 8

Obama care
pre-existing condition could not be denied
children covered under parents insurance until 26
agencies have to cover woman’s healthcare and birth control

Question 9

Revisions to Affordable Healthcare Act under Trump administration

Answer 9

alternative healthcare plans, cheaper but don’t cover as much
HSA and FSA can increase amount and not taxed
state by state

Question 10

Medicaid

Answer 10

Government assistance program for
children, pregnant woman, elderly and individuals with disabilities or families who fall below the national poverty level (based on annual income)

Each state controls optional eligibility
KS and MO rejected Medicaid expansion = family of 4 annual income has to be less then $23,550

Question 11

Children’s Health Insurance Program (CHIP)

Answer 11

provides services to children whose families do not have medicaid b/c they make too much but still are low income

Question 12

Accrediting Agencies that oversee medically based services

Answer 12

Joint Commission for Accreditation of Healthcare Organizations ( JCAHO) = accrediting agencies for hospitals

Commission for the Accreditation of Rehabilitation Facilities ( CARF) rehabilitation facilities

Occupational Safety and Health Administration ( OSHA)
federal entity responsible for setting safety and environmental regulations

Question 13

Acute setting

Answer 13

LTG = 1-2 wks
STG = a few days
something you can change within 4-8 sessions

Question 14

Inpatient Rehab

Answer 14

Traditional:
LTG = 1 month
STG = 1 wk
3 hrs of therapy per day, 5 days per week
fewer hours on weekend

Neuro-Trauma Status:
< 3 hrs per day
reduced therapy status dur to medical severity or due to young age
may focus on family education

Question 15

Pediatric Rehabilitation FORs

Answer 15

Biomechanical = ROM, tone, track and tolerate sensory stimulation

NDT = weight bearing, synergistic patterns, trunk control

Sensory processing = lighting, music

Visual information processing

Question 16

Clinical Reasoning:
Diagnostic
Scientific
Narrative
Pragmatic
Interactive
Ethical
Conditional

Answer 16

Diagnostic = uses knowledge about a 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 they are at

Pragmatic = being resourceful and practical

Interactive = building a rapport with child and family

Ethical = using ethical reasoning to guide you in a moral dilemma

Conditional = highest level of reasoning, being able to predict where the child may be or how child may progress to envision realistic needs and expectations

Question 17

Continuum of care and types of hospitalization

Answer 17

Acute admission = child is usually typically developing prior to current referral reason; medical management of symptoms is key focus

Rehabilitation admission = usually follows acute stay, designed to be a longer time designated on restoring strength, endurance, function and impacted skills in order to return home

Chronic hospitalization = admission occurs due to exacerbations of chronic conditions or progression of illness, may need modified continuation of outpatient services

Special program admission = admission of child to a specialized program such as feeding or day rehab program

Question 18

Outpatient

Answer 18

LTG = 6 mos increments
STG = 1-2 mos ( 4-8 visits )
Outpatient day programs = 3-5x/wk (typically seen for 3-5 hrs (PT/OT/SLP)
Standard outpatient = 1-2x/wk or 1-2x/mth (typically seen for 45min-1hr sessions)