Pedi PT Exam: Tests and Measures Flashcards
what are 3 positive impacts that early intervention has
reduce delay
reduce disability
enhance health outcomes
what are 5 areas of development that screening looks at
behavior
mental status
communication
gross motor skills dev
fine motor skills dev
what are the 2 goals of screening
identify potential for dysfunction
identify need for referral
what are the 2 main parts of the screening procedure
clinical observation
standardized screen
what is assessed when screening mental status as part of a PT exam
arousal
alertness
(not cog - other health providers)
expected mental status via clinical observations: infancy (4)
alert/arousal
eye contact
interest in people/surroundings
cause-effect
expected mental status via clinical observations: toddler (5)
- alert/arousal
- points & names objects/body parts
- knows own name
- follows simple directions
- hints of cog thru communication and motor systems (pointing, naming things)
expected mental status via clinical observations: preschooler (3)
makes needs/wants known
progression of play skills
how plays w peers
expected mental status via clinical observations: school-age (3)
school performance
A&O x4
adapt Qs (is it day or night?)
expected communication via clinical observations: infant (3)
coo, babbling, laughing approp
3-5 words by 12-15mo
receptive > expressive language
expected communication via clinical observations: toddler (3)
puts together simple 2-3 word phrases/sentences
at least 50 words by 2yo
able to say “i want ___”
expected communication via clinical observations: preschooler (4)
points to objects
answers simple Qs ab story
“W” questions - what, why, who
should be able to understand them
expected communication via clinical observations: school-age (2)
appropriate expressive/receptive language for age
develops reading, writing, etc.
what components are looked at during the motor part of a screen via clinical observation (3)
in different positions
self-selected motor activity
- active or passive in environment
what needs further exam (BSF)
what are 2 standardized screening measures she discusses and which one is a better measure
denver developmental screen (DDS)
ages and stages questionnaire (ASQ3) **
Denver Developmental Screen (DDS): age range, 4 areas assessed, possible results
birth - 6yo
FM, personal -social, GM, language
normal, suspect, delayed
- observer related, not parent reported
what is a consideration when using the DDS’s results
weak specificity and sample pop may be biased
- can lead to over identification and false positives
what is a consideration when looking at the results from any screening tool given to you by a new referral
as a screening tool, might miss things bc it is a screening
-> use w caution
ages and stages questionnaire (ASQ3): age range, 5 areas assessed, possible results
0 - 66mo (aka 5.5yo)
communication, person-social, GM, FM, problem solving
typical development, need for monitoring, need for further assessment
- parent/caregiver report
what uses the ASQ3 extensively
federal programs specifically looking for kids w developmental delay
what are the 4 steps for an exam’s general approach
- observe
- manipulate the task
- manipulate the environment
- hands on
what are 3 components to approaching behavior management
incorporate observations
- behavior, comm, likes/dislikes
set up for success - structure
when/then
what are 4 possible intended purposes of objective tests
- planning
- strengths & weaknesses of developmental motor skills - evaluative
- measure change over time
- at start and end of intervention - predictive/prognostic
- estimate future risk - discriminative/diagnostic
- who is different from the norm and who isn’t
what makes objective tests objective
standardized in admin, equipment/materials used, and scoring
what is the problem with using tests that are limited in their standardization
limited objectivity and won’t be able to use info to guide POC
what is a criterion referenced test
completion of criteria
what is a norm-referenced test and what types of tests is this commonly seen in
complete criteria and then compare to same aged peers (normative sample)
- balance tests
what is a criterion referenced test helpful with and what is it not helpful with
helpful in planning POC
not helpful in comparing to same aged peers
norm vs criterion referenced: reference points
norm: avg, relative points derived from performance of group
criterion: fixed at specific cut-off points
- don’t depend on reference points
norm vs criterion referenced: what does it evaluate
norm: individual performance in comparison to group of people
criterion: individual performance in relation to fixed standard
- child in comparison to self
norm vs criterion referenced: what is it designed for
norm: produce scores that are normally distributed, to maximize differences among individuals
criterion: discriminate b/w successive performances of one individual, to provide info for use in planning
a child is referred to PT to determine if they are delayed in gross motor development. What is the most appropriate type of test and measure to administer?
a. criterion reference
b. norm reference
B. norm
implies delay relative to same aged peers
what are 3 types of validity
construct
content
responsiveness
construct validity
characteristic/concept we want to measure
content validity
does it cover all aspects of that construct
responsiveness validity
to detect change beyond which would happen naturally
what are 2 types of responsiveness validity
minimal detectable change (MCD)
minimal clinically important difference (MCID)
MDC vs MCID
MDC - minimal change not likely d/t change variation or error
- naturally occurring change
MCID - clinically important change/difference in pt function that is perceived as beneficial and would change pt management
- clinically relevant
- changes PT management
- based on stats, expert op, pts
what are the 2 types of reliability we want
inter and intra rater reliability
what are standard scores and percentile ranks used for
to understand performance relative to means
what are developmental age equivalents
motor age at which 50% of the subjects in N sample achieved that score
what has to be done if you want to compare scores and why do we want this
convert raw scores to standard scores and percentile ranks
so you can understand individual performance relative to means
what are raw scores
point values, # of items completed
observer rated vs self report
observer rated:
- items directly assessed by PT
- clinical observation
- standardized procedures
self report
- survey/questionnaire
- individual perception of abilities
performance vs capacity
performance:
- typical performance of skill
- captures effect/influence of environment
- caution: may be overly accommodating
capacity
- what pt is capable of doing
- controlled testing environment, controlled parameters
- may not be realistic for every day
