Midterm Flashcards
What are the common frames of reference in hand skill remediation?
NDT, Developmental (need to know what level they are at), Motor Learning, Biomechaniacal
T/F: We need to look at the gross motor because it affects the fine motor?
True, positioning is important for fine motor activities
What things can OTs do to inhibit muscle tone?
warmth, massage, stretching, slow rocking, weigh bearing, splinting
T/F: Spasticity is triggered by slow movement, therefore we must move faster?
False, spasticity is triggered by fast movement must move slower
What can be used to improve hand strength?
strengthening activities, use of neuromuscular electrical stimulation, use of resistant materials
What must you do in order to see results in hand strengthening?
you must go to the point you see fatigue; look at end function and engagement
What type of approaches are NDT and biomechanical? What understanding are they based on?
Biomechanical and NDT are bottom up approaches.
Based on the understanding of normal movement patterns and body alignment and incorporate handling and positioning of the child to facilitate movement
How can we use sensory enhancement in fine motor activities?
Add tactile and proprioceptive input (shaving cream, finger paint, toys… etc)
How can we promote isolate arm and hand movements for fine motor skills?
Focus on specific movement patterns
Embed movements in games and songs
Supination control
Is supination or pronation harder to get and maintain?
Supination
T/F: Supination helps support in hand manipulation by biasing you towards those in hand manipulation positoins.
True
What is the order of development for reach?
Gross arm movement –> specific arm/hand placement–> reach with wrist extension and orientation to object
What must first be stable in order for a child to be able to begin carrying things?
Trunk
What can we do for children with visual impairments for them to find the objects easier?
may need to use objects that are contrasting colors or that make noise
A child has spasticity and needs to enhance his grasp skills, what should we do first?
we first need to inhibit tone
What should we do to help a child’s enhancement of grasp skills?
use different positions, emphasize wrist extension with grasp, consider splinting, address sensory issues, intentionally select objects
What treatment should we use for enhancing voluntary release skills?
vary the size of the area in which releasing and/or the height of surface
What parts make up visual perception?
- visual receptive component (oculomotor control and acuity
- visual cognitive component
T/F: The Visual Sensory Stimuli is integrated with other sensory systems and associated with past experiences.
True
What is visual attention?
Alertness, selective attention, visual vigilance, shared attention
What is visual memory?
Long and short term memory
What is visual imagery?
“picture” things in your mind’s eye
Where is object (form) vision? What is object (form) vision?
temporal lobe
visual identification of objects (what)
Supports object identification and visual learning
Where is spatial vision? What does it do?
inferior parietal lobe
visual location of objects (where)
needed to guide action
How does object (form) vision develop?
first perception through tactile, kinesthetic, vestibular info
General –> Specific
Whole –> Parts
Concrete –> Abstract
How does spatial vision develop>
vertical –> horizontal –> diagnol
What is form constancy?
Recognition of forms and objects as the same in various environments, positions & sizes
What is visual closure?
Identification of forms or objects from incomplete presentations
What is figure ground?
Differentiation between background and objects
What is position in space?
Spatial relationship of figures or objects to oneself or other forms or objects
What is depth perception?
Relative distance between objects, figures or landmarks and oneself
What is topographic organization?
Determination of the location of objects and settings and the route to the location
What are the two areas a child can have visual perceptual problems in?
- visual-receptive functions (occulomotor difficulties)
- visual-cognitive functions (attention, memory, visual discrimination)
What is an assessment you can use to test visual-cognitive functions?
BOT-2
What is an assessment you can use to test visual motor and visual perceptual problems?
Beery
What are some models of practice for visual perception interventions?
- developmental
- neurophysiologic
- compensatory
What do you do when using a compensatory model of practice?
the child who’s vision cannot be completely corrected, change the text, high contrast, seated close to front,
What are some intervention strategies for visual attention?
SI approach, eliminate distractions, place increasing demands on attention, modify workplace and activities
What are some intervention strategies for visual memory?
maintenance rehearsal, elaborative rehearsal, mnemonic devices, notebooks, hand held computers
What are some intervention strategies for visual discrimination?
teaching a child to scan and search, assisting teachers to reorganize worksheets, reducing amount of print on the page
What are some intervention strategies of visual spatial processing?
blocks, shapes, craft sticks, dough etc.
What are the 6 prerequisite skills to handwriting?
Small muscle Eye-hand coordination Ability to hold tools Capacity to form basic strokes smoothly Letter perception Orientation to printed language
At what age does the cylindrical grasp develop?
1 - 1.5 years
At what age does the digital grasp develop?
2 - 3 years
At what age does the modified tripod grasp develop? Quadripod
3.5 - 4 years
At what age does the tripod grasp develop?
4.5 - 7 years
T/F: It is better to change a grasp at an older age because they are more accepting to change.
False, better to change a grasp at a younger age
What are some visual motor interventions for teaching handwriting?
multisensory approach, eyes closed, concrete clues, draw spacers between words
What areas should we target when providing a handwriting intervention?
posture, muscle tone, proximal joint stability
For handwriting skills, using an acquisitional intervention can use these techniques: ..
practicing, repetition, feedback, reinforcement
For handwriting skills, using a sensorimotor intervention can work on these techniques:
- Proprioceptive, tactile, visual, auditory, olfactory, and gustatory
- Incorporate a variety of senses into the intervention
When working on handwriting skills using a biomechanical model we are focusing on…
Sitting posture
Paper position
Pencil grip
Writing tools
When working on handwriting skills using a psychosocial model we are focusing on…
Self-control
Coping
Social behaviors
T/F: Sensory input is not a neurological process.
False, it is a neurological process
Feedback is when..
there is a stationary object and stationary person
Feedforward is when…
there is a moving object and moving person
When something is stationary it’s using the BLANK and BLANK systems.
tactile and proprioceptive systems
When something is moving it is using the BLANK and BLANK systems.
Vestibular and proprioceptive
T/F: Feedback is the basis for feedforward.
True
When SI is being practiced what are 3 models of service?
- individual treatments in the clinic (one-one-one)
- compensatory skill and strategy development
- consultative - reframing dificulties and offering strategies
Why was the fidelity measure created?
created to help standardized research
What are some parent questionnaires for assessing modulation disorders?
Sensory Profile 2 and SPM
A jumping jack or catching a ball is an example of…
motor sequencing
What is motor planning?
Performing a novel motor act
T/F: An emphasis of SI therapy is extrinsic motivation of the child.
False, emphasis is intrinsic motivation, active approach child must be engaged
What is an adaptive response?
brain organizing incoming sensory information, then provides a basis for action
What happens when a child makes an AR more complicated than the previous?
the brain attains a more organized state and its capacity for further SI is enhanced
What is Sensory Integration?
The neurological process that organizes sensations from one’s body and from the environment and makes it possible to use the body effectively in the environment
T/F: SI is based on the assumption that the more primitive parts of the CNS develop before higher brain centers mature.
True
Where are peripheral sensors located?
on the skin
What is the importance of the tactile system?
motor control and emotional development
T/F: Proprioception modulates only a few of the sensory systems.
False, it modulates all of them
What is the importance of the proprioceptive system?
modulation of sensations and discrimination
What is the importance of the vestibular system?
emotional stability, postural control and motor coordination
What is modulation?
the nervous system’s ability to grade behavioral responses in relation to the sensory stimulus; allows us to function in an optimal range of arousal
What is discrimination?
discerning the qualities, similarities and differences of stimuli
What is Dyspraxia?
a disorder of sensory integration interfering with the ability to plan and execute skilled or non-habitual motor tasks
What is somatodyspraxia?
poor tactile discrimination and proprioceptive processing
What is visuodyspraxia?
impairment in visual perception with visually directed praxis tasks
What should the sensory environment be like if the child is hyporesponsive?
needs increased sensory experiences
(Light touch, light placement of the hands; soft textures; rotary, vertical linear, dysrhythmic, and fast vestibular input)
What should the sensory environment be like if the child is hyper responsive?
needs inhibitory sensory experiences and the ability to deal with the environment
(Deep pressure, firm touch, resistance, brushing (sometimes), neutral warmth, rhythmic vestibular, slow vestibular)
What type of sensory environment would an organized one be?
Proprioceptive, active interaction, resistance (push, pull, proximal joint stability, weight bearing, antigravity positions, climbing), oral motor (chewing, blowing)
What are the implications of having a just right challenge?
Active participation
Increase in frequency, duration, complexity
Generalizability outside of sessions
T/F: The OT can write any goals they wish to work on with a client.
False, the format and goals are determined by the funding source
What are the core elements of goals?
Functional, measurable outcome, measurable time length for achievement, assistance level, related to funding source rationale
What do ABCDE goals stand for?
Actor, Behavior, Condition, Degree, Expected Time
What do SMART goals stand for?
Specific, Measurable, Achievable, Realistic, Timely
What does the S in SOAP notes stand for?
Subjective: just what you saw, subjective comments by the client/ caregiver (ex: coming down with a cold, took a nap right before session)
What does the O in SOAP notes stand for?
Observations: data, facts (descriptive statements: able to..completed), measurable changes in status related to occupational skills and performance
What does the A in SOAP notes stand for?
Assessment: interpretations of what S and O mean; apply clinical reasoning, goal progress, justify need for OT (impaired, improved, decreased)
What does the P in SOAP notes stand for?
What happens next? suggestions for treatment, relate to plan for goal achievement
What does the Lanterman act provide?
Provides rights to individuals with developmental disabilities and their families to services and supports they need to live like persons without disabilities.
What is early intervention funded by?
Part C
When do children begin phasing out of EI?
2.5 years
T/F: Once identified by a primary source a child must be referred to a regional center or LEA within 5 working days.
False, they must be referred within 2 working days
Once a regional center or LEA receives the referral how many days do they have to get the process started?
45 calendar days
In CA children are eligible for EI services if they have…
Developmental Delay
Established Risk Condition
High Risk Condition
infants or toddlers with a developmental delay in one or more of which areas?
Cognitive development Physical (motor, vision, hearing) Communication development Social or emotional development Adaptive development
What is the criteria for a child to be below expectations in one or more developmental area?
Before 36 months: 33% below expectations in one or more developmental areas (Cognition, Language, Motor, Social-Emotional, Adaptive Behavior)
What does it mean when a child has an established risk?
Conditions known to lead to developmental delay;
Even if no delay exists at the time of diagnosis
What does it mean if a child has a high risk?
High risk of having a substantial developmental disability due to combination of biomedical risk factors (ex: Full term with low birth weight, short NICU stay with oxygen, and torticollis dx)
What does IDEA part B cover?
children with disabilities age 3 -22
What does FAPE mean?
Free Appropriate Public Education; means special ed and related services are provided at the public’s expense, available in an appropriate school and are provided in conformity with the IEP
T/F: OT is a related service with IDEA part B.
True, they must be getting special education first
What is the PEO model? What happens when all three overlap?
Person, Environment, Occupation
When all overlap occupational performance and skill patterns
Under what conditions do we find the adjusted age?
When the child is under the age of 2 AND is born prematurely (36 weeks or less)
What therapeutic interventions can be used for ASD?
ABA, DIR- Floortime, SI
What symptoms occur for spastic CP?
- Constant increased muscle tone
* Mild, moderate, severe
What symptoms occur for Athetosis CP?
- Fluctuation of tone from low to normal
- No co-activation of flexors and extensors
- Writhing involuntary movements
What symptoms occur for Ataxia CP?
- Tone is normal to near normal
* Lacks stability & co-contraction
What symptoms occurs for Flaccidity CP?
- Fluctuating tone, but usually low
* Usually seen only in infants/toddlers
What are the 3 stages of development in motor control?
- Cognitive (skill acquisition)
- Associative (skill refinement)
- Autonomous (retains skills, transferred to other environments)
At what age do rolling and sitting (unpropped) occur?
Rolling: 4 months
Sitting: 6 months
What age do crawling and cruising occur?
Crawling: 7 -10 months
Cruising: 8 -11 months
What age should children be able to walk?
18 months
What are some common GM interventions?
NDT, CIMT, Bimanual training, Co-OP, Biomechanical
What is the differentation between the ulnar side and radial side?
Ulnar: power
Radial: dexterity
