PEDIALEC_S1_L2 - P4-P6 Flashcards
(Attention/Concentration): with time component
attention
(Attention/Concentration): how easily a pt can go back to original task after a stimulus/distraction
concentration
Able to carry on task despite the difficulties
frustration tolerance
Ability to wait for your turn
impulse control
Turn – taking skills, waiting for instructions
Impulse control
(3) assessment tested for sensorimotor skills
ROM, FMT/MMT, Tone assessment
POOR Frustration tolerance: shows frustration after doing ___% of task; needs ____ prompting to continue c task
0-25; maximal
FAIR Frustration tolerance: Shows frustration after doing ____% of task; needs ____ prompting
26 - 75; moderate
GOOD Frustration tolerance: shows frustration after doing ___ % of task or does not show frustration; needs ___ prompting
> 75; minimal
a child was instructed to walk over small toy soldiers for 10 meters. The PT notes that the child has difficulty in walking and on the 2nd meter, the child cried and displayed tantrums and doesn’t want to continue with the task even when promised with rewards. How do you document this?
O> Behavior > P frustration tolerance
Standard position in postural analysis
standing
5 positions in postural analysis
supine, prone, sitting, standing, kneeling
Postural terms: Extension of the trunk due to stroking of paraspinalis; D/t spasticity of the paraspinalis muscle
Opisthotonus
Postural terms: UE in FABER (no tone)
Strap
Postural terms: LE in FABER
Pithed frog
(T or F) FMT is usually used when a child cannot follow instructions
T
MMT for children: w resistance
4
MMT for children: trace
1
MMT for children: against gravity
3
MMT for children: gravity eliminated
2
MMT for children: no movement
0
what age can modified MMT be used in children?
4 and above but can be used by 3 if child can follow instructions
What is under tone assessment
● Normotonic
● Hypotonic
● Hypertonic/spastic
● Fluctuating
Identify what Grade: Slight increase in muscle tone, manifested by
a catch & release or by minimal resistance at
the end of the ROM
1
Identify what Grade: More marked increase in muscle tone through
most of the ROM, but affected part is easily
moved
2
Identify what Grade: Slight increase in muscle tone, manifested by
a catch, followed by minimal resistance in less
than half of the ROM
1+
Identify what Grade: No increase in tone
0
Identify What Grade: Affected part is rigid in flexion/extension
4
Identify what Grade: Considerable increase in muscle tone, passive
movement difficult
3
Document this: A 5 y/o child diagnosed with CP Spastic (L) hemiplegia
was instructed to reach overhead for toy fruits using his
(L) UE. The PT decides to do the task in supine and in
sitting. The PT notes that the child is able to do the task
both in sitting and in supine. How do you document this
finding?
O: Sensorimotor skills > FMT > (+) Voluntary movements
> (L) UE: able to reach for toys
overhead in sitting
Document this: A 2 y/o child was dx to have CP Spastic Quadriplegia.
The PT notes that the elbow is fully bent and tried to
strengthen the pt’s elbow quickly then slowly. In quickly
straightening the elbow, the PT only felt resistance on the
last 10° of ext. However, when the PT slowly straightened
the elbow form a fully bent position, the PT notes that it is
easier to move the limb. The PT does the same on the
other limb and observed the same results. How do you
document the findings?
O: Sensorimotor Skills> Tone assessment> (+) Grade 1
spasticity on (B) elbow flexors (using Modified Ashworth
Scale)
Parallel to sensory testing to adults; used for kids as
sensory testing is too complex for children
sensoriperceptual skills
When holding the child, always support the __ &
__
head; hips
What are the perceptual skills
● Proprioception
● Kinesthesia, R/L Discrimination
● Figure-ground relations
● Stereognosis
● Spatial relation
May be tested if the child can already
understand instructions (same c
kinesthesia; usually for 7 y/o and above)
proprioception
“Ano mas harap/likod?”
Figure-ground discrimination
“Saan nakaturo ang daliri?”
proprioception
Saan papunta ang daliri?”
Kinesthesia, R/L Discrimination
Visual Perceptual Skills
Threat
Tracking
Localization
Tactile Perceptual Skills
Light touch
Pain
Pressure
Auditory Perceptual Skill
Localization
Threat Stimulus
Include distance
Tracking Stimulus
Include the distance
Localization Stimulus
And direction
How to test for threat
PT’s hand closes then opens spontaneously fast on the
child’s face
How far should be PT’s hand for threat
4 in away
Tracking is done after __ where they move the toy
Localization
What are the considerations for localization
Outside the visual field of the patient, PT can present a toy
away from the baby; toy toy should not have any sound to
differentiate from auditory localization
How far should be the toy for localization
~6 in away
Response for threat
Crying, cooing,
no response
Response for tracking
Baby follows
toy, no response
Response for localizaation
Baby looks at toy, no response
Stimulus for light touch
PT’s finger lightly
touching the baby
Stimulus for Pain
Slightly pinch the nail
of the baby
Stimulus for Pressure
Putting light pressure
on limbs
Stimulus for Localization
Distance and direction
Response for the light touch
Smiling, looking,
at the source,
etc…
Response for the localization
Baby looks at
where the
sound is
When documenting the perceptual skills, document
it in what format?
table format
Present at birth & become “integrated” or inhibited
or not evident later in development
reflexes
In CNS lesions, they may persist and interfere with
motor milestones
reflexes
What not to do during primitive reflexes
reflex hunting
PTs do not treat reflexes unless ___
it hinders
function
– intentionally stimulating
a reflex (e.g… To know they have ATNR,
the baby will unintentionally present the
reflex during any other activity/function
(kapag pinatigilid or during visual tracking)
= (+) ATNR)
reflex hunting
When is the only time we document reflexes
When reflexes show during an activity
example of reflexes showing up in an activity
PT is doing auditory localization with
a squeaky toy, pt localized the sound and
also grabbed the toy without letting go →
persistent grasp reflex
How to document reflexes
bulleted;
○ Reflexes > (+) ATNR
> (+) Palmar Grasp
Primitive reflexes
- Bleck’s reflexes
- Physiologic Postural Reflex Response
- Pathologic Reflexes
- DTRs
Bleck’s reflexes
moro, ATNR, STNR, step
placement, parachute, extensor thrust, neck
righting
Physiologic Postural Reflex Response
righting
reactions, protective extension, equilibrium
reactions
Pathologic reflexes
○ Babinski’s, Chaddock’s, Oppenheim
○ (+) Pathologic reflexes – indicative for
__
UMNL
T or F: we use reflex hammers for DTRs in infants
F, only for 3 y/o and up
Primitive reflexes are __ at a certain age –
integrated in the system
suppressed
