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Unit 17 > Pediatric Assessment/Atypical Development > Flashcards

Pediatric Assessment/Atypical Development Flashcards

1
Q

Purpose of discriminative test

A

identifies children with developmental delay

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2
Q

Does discriminative, evaluative or predictive consist of screening tools or diagnostic evaluations determining the etiology of the problem?

A

Discriminative

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3
Q

Does discriminative, evaluative or predictive determine appropriate placement or services?

A

Discriminative

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4
Q

Does discriminative, evaluative or predictive assess current skill level and document change over time

A

evaluateive

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5
Q

Does discriminative, evaluative or predictive allow you to select effectiveness of intervention?

A

evaluative

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6
Q

Is discriminative, evaluative or predictive NORM referenced?

A

Discriminative: whether or not a problem exists

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7
Q

Is discriminative, evaluative or predictive CRITERION referenced?

A

Evaluative: determines appropriate plan and goals and measures change over time

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8
Q

what does test-retest tell you

A

reliability in a test over a period of time (the other kind of reliability is inter-rater)

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9
Q

what is inter-rater reliability

A

the degree to which DIFFERENT raters obtain the same score

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10
Q

construct, concurrent and predictive are all parts of psychometric property?

A

validity

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11
Q

what is construct validity

A

does the test measure what it claims to measure

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12
Q

what is concurrent validity

A

the score correlates with that of another valid test that is administered at the same tim

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13
Q

what is predictive validity

A

predicting the performance on a future measure (two measures are taken at different times)f

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14
Q

what does a highly sensitive test find in terms of positives and negatives

A

true positives

avoid false negatives

good at ruling out

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15
Q

what does a highly specific test find in terms of positives and negatives?

A

avoids false positives

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16
Q

is specificity or sensitivity probably a better measure for making sure you don’t miss someone who needed intervention?

A

Sensitivity: avoiding false negatives and therefore not missing someone who needed PT

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17
Q

what kind of things in PT would you want to be super specific about?

A

fractures, surgical decision making

want to avoid false positives

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18
Q

detectors at airports are specific or sensitive?

A

Sensitive: rules out, if you go through and it doesn’t beep you can be pretty certain nothing is on them

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19
Q

For PT are we more concerned with specificity or sensitivity?

A

sensitivity: avoiding false negatives, making sure we’re getting to everyone we should

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20
Q

Norm referenced you compare against what?

A

you compare against other children in a given population (whether that is a “normal” child or a disordered population)

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21
Q

Criterion referenced you compare against what?

A

you compare against the child to themselves down the road.

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22
Q

how can you expect to administer a norm referenced test?

A

standardized items
rules to follow
you get a booklet

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23
Q

norm referenced test is discriminative or evaluative?

A

discriminative

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24
Q

criterion referenced test is discriminative or evluative?

A

evaluative

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25
Q

can you provide age equivalent values for a norm or criterion referenced test?

A

norm referenced

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26
Q

what is the big thing criterion referenced test does?

A

look at changes within an individual child overtime

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27
Q

which test can you NOT compare to a group

A

criterion referenced

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28
Q

PDMS2 is criterion or norm referenced?

A

norm

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29
Q

BOT2 is criterion or norm referenced?

A

norm

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30
Q

GMFM is criterion or norm referenced

A

criterion

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31
Q

If you’re doing a norm referenced test can you use the parent saying “yes ive seen them do that before?

A

no! Its super standardized you have to see them do it

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32
Q

criterion or norm referenced tests are you thinking about% nd SD?

A

norm referenced bc these are all about comparing performance to others

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33
Q

50% correlates to what on a standard bell curve?

A

the mean

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34
Q

Within how many SD’s of the mean is generally considered “normal”

A

= or - 2 SD

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35
Q

if a kid is within 2 SD of normal are they going to qualify for therapy?

A

no they are considered normal

below 2SD will qualify for therapy

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36
Q

percentile rank gives what information?

A

relative position within normative samples and rate of change over time

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37
Q

what does it mean if percentile rank decreaes?

A

they are not progressing at the same rate their peers are

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38
Q

Standard scores vs age equivalent?

A

standard score doesn’t have units

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39
Q

what is a scaled score?

who is it good for?

A

scaled score: performance as it relates to the ENTIRE RANGE of scores on the test

good for individuals <1 percentile of the measure. It will show performance overtime

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40
Q

What is age equivalents?

A

age which a score obtained correlates with tehe AVERAGE performance

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41
Q

criterion referenced scoring will not have what two kinds of data associated it

A

age equivalents, percentile ranks

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42
Q

age equivalents and percentile ranks can be found for criterion or norm referenced tests?

A

norm referenced

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43
Q

true or false: only doing a standardized assessment is a good examination

A

FALSE: standardized testing should only be a part of your full exam and eval

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44
Q

What is the point of neonate tests?

A

you want to catch it early and intervene

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45
Q

what are the two tests we talked about for infants/toddlers?

A

AIMS

PDMS2 (goes all the way until 6 years old)

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46
Q

what are the three school age tests we talked about?

A

BOT2

GMFM

PDMS2 (done up until six)

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47
Q

what is the one participation measure we talked about

A

CAPE/PAC

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48
Q

is AIMS criterion or noms referenced?

A

norms referenced

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49
Q

is AIMS elicited or observational?

A

observational

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50
Q

validated age range for AIMS

best age range?

A

birth to 18 months

3-9 months

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51
Q

what does AIMS do in the discriminative category

A

identifies gross motor delay

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52
Q

describe aims

A

48 GROSS motor skills

4 positions: supine, prone, sitting, standing

OBSERVE

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53
Q

how long does AIMS take?

can you continue in another session if you don’t finish in the first?

A

20-30 minutes

can complete across sessions if they’re less than one week apart

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54
Q

infants should be naked or in diaper

Observation of spontaneous movement

can present toys, auditory prompts etc

Items can be completed in any sequence

Which test is this?

A

AIMS

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55
Q

AIMS

number of trails per task

unilateral or bilateral?

A

unlimited number of trials

doesn’t look at laterality, just if they can do it

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56
Q

how does scoring work for aims

A

items marked as O or NO (observed or not observed)

find “motor window” items btwn least mature and most mature skill observed in each position

score each item in the window: 1 for observed, 0 for not observed

Give a point for everything below the window

57
Q

is parental reporting accepted for AIMS?

A

no! has to be observed

58
Q

where do you start working with the kid during AIMS

A

start with what they’re showing you then try to elicit harder motions, all to find the window

59
Q

what is the major numeric data you are trying to get for AIMS?

A

percentile rank

60
Q

what percentile rank is
normal
suspicious
abnormal

for AIMS?

A

normal: >16th percentile
suspicious. bwn 5th percentile and 16th percentile
abnormal: <5th percentile

61
Q

explain the limitation in AIMS

A

once you get to ~15 months the difference in AIMS score is basically nothing. There’s a ceiling effect

62
Q

is GMFM discriminative or evaluative?

A

evaluative: assess motor performance in children with CP

63
Q

is GMFM criterion or norm referenced?

A

criterion

64
Q

age range for GMFM

A

5 months to 16 years: appropriate for children whos motor skills are at or below those of a normal 5 yr old child

65
Q

Explain GMFM levels

A

I: walks without limitations
II: walk with limitations
III: walks with hand held mobility device
IV: self-mobility w/limitations, may use powered mobility
V: Transported in WC by another, dependent

66
Q

compare and contrast GMFM 88 and 66

A

88: all items must be scored
66: For higher functioning kids bc it takes out some of the some items can be NT

67
Q

what population is GMFM item set validated in?

A

CP

68
Q

what does the item set of the GMFM give you?

A

minimum number of items that need to be administered to get an accurate GMFM 66 score

69
Q

how do you score GMFM

A

0-3:

0: couldn’t attempt
3: independent

70
Q

How is GMFM for other neurologic populations?

A

good reliability and validity

71
Q

Does GMFM score sides when its appropriate?

A

yes!

72
Q

how much time does full GMFM take to administer?

what can be done about this?

A

45-60 min

can complete the test over one week: DO NOT RETEST ITEMS ALREADY ADMINISTERED

73
Q

How much time does it take GMFM 66 to administer?

A

10-20 min

74
Q

true or false: GMFM you can hands on assist or facilitate the kid

A

false

75
Q

true or false: GMFM you can put the kid in the starting position

A

true: but you cannot assist or facilitate

76
Q

Do you get a trial test with GMFM

A

yes!

77
Q

what should the child be wearing for GMFM

A

NO SHOES

comfortable clothes

78
Q

how many trials does kid get in GMFM for each item?

A

max of 3

79
Q

what about Orthoses or AD for GMFM?

A

repeat and document

80
Q

is there a manual for GMFM?

A

yes! (even though its criterion referenced)

81
Q

GMFCS

A

gross motor function classification

82
Q

higher score on GMFM means what?

A

closer to level I, independence

83
Q

what kind of motor motion does PDMS2 look at

A

gross and fine

84
Q

is PDMS norm or criterion referenced?

A

norm!

85
Q

what is the age range for PDMS2?

A

birth to 6 years(ends on their 6th birthday)

86
Q

What are the three major categories for PDMS that you can test separately but cannot test the categories within the categories separately?

A

gross motor

fine motor

total motor

87
Q

what are the two things with the gross motor composite of the PDMS2 which change depending on the age you’re testing a child

A

reflexes you test 0-11 months

object manipulation you test 12 months and older

88
Q

what are the three things you would test under gross motor composite in PDMS for a child that was 10 months old

A

reflexes
locomotion
stationary: balance and postural control

in someone older than 11 months you would test object manipulation instead of reflexes

89
Q

does PDMS2 have a test kit?

A

yes!

90
Q

how long does PDMS2 take to administer

how many days can you do it accross

A

45-60 min

complete within 5 days

91
Q

how do you administer PDMS, where do you start

A

determine their age and start in the dark bracket

92
Q

scoring for PDMS
2
1
0

A

2: according to criteria
0: cannot or will not attempt

93
Q

how to establish basal and ceiling level of PDMS2

A

basal level: score a 2, 3 times in a row

ceiling: score a 0 on three items IN A ROW

everything before basal level they get full credit for, everything above ceiling they get 0

94
Q

how many trials does a child have on PDMS2

A

3

95
Q

is the BOT2 norm or criterion referenced

A

norm!

96
Q

what does the BOT look at?

A

various domains of motor skills

97
Q

what is the age range for BOT2?

A

4 to 21 years

98
Q

PDMS2, BOT2, AIMS are all norm or criterion referenced?

A

norm!

99
Q

how must you administer the 8 subsets of the BOT2

A

you have to administer them in their given pair, but they can stand alone as long as you do this

100
Q

Fine manual control, body coordination, manual coordination, strength and agility are all the test items of what test?

A

BOT2: each of these have two subsets under them

101
Q

how long does BOT2 take

A

60 minutes

but there is short form that takes ~15 minutes

102
Q

Can you score the BOT2 on your own

A

no there is a kit and an administration easel that has directions, diagrams photos, scoring examples etc.

103
Q

what is a scale score for BOT2

standard scores?

A

allows comparison btwn both subsets of the 4 domains

standard scores allow for comparison btwn the 4 domains

104
Q

what is the purpose of the CAPE and PAC

A

assess participation

105
Q

what is the age range for CAPE and PAC

A

6-21 years

106
Q

how long does CAPE and PAC take to administer?

A

20-60 minutes

107
Q

CAPE and PAC look at the nature of activity (formal and informal ) as well as what?

A

activity type: recreational, physical, social, skill based, self improvement

108
Q

what tests asks you if you have done an activity in the past four months

A

CAPE, PAC

109
Q

JUST READ THIS SUMMARY: Standardized tests can be used as a part of an examination for screening, determining the need for therapies, evaluation, and/or monitoring progress depending on the specific test
Test selection should include consideration of a child’s age and abilities as well as the purpose of test administration
Tests need to be administered in a standard method when drawing conclusions and considering change over time and understanding of norm-referenced and criterion-referenced test development is important when interpreting examination findings

A

Remeber there is variability and a range of typical development in the first place

110
Q

what are three three balls that go into milesstone aquisition?

A

environment/exposure

predisposition

MSK

111
Q

what are the four developmental domains that you have to think about the interplay of for development

A

sensory

cognitive

motor(fine and gross)

communication

112
Q

what is it important to educate family on in terms of development and atypical development

A

there is a range of normal! Walking goes up to 18 months

113
Q

first day of last menstrual period –> time of birth is what

A

gestational age

114
Q

First day of last menstrual period –> date of assessment is what age

A

postmenstrual age

115
Q

date of birth to date of assessment is what age

A

chronological age

116
Q

expected date of delivery –> date of assessment is what age

A

adjusted age

117
Q

what standardized test that we talked about might you want to look at adjusted age in?

A

PDMS2

adjusts until 2 years of age

118
Q

full term is how many weeks when they’re adjusting for prematurity

A

40 weeks

119
Q

what range of weeks is considered full term baby

A

37-42

120
Q

what range of weeks is considered a preterm baby

A

<37 weeks

121
Q

Late preterm is considered how many weeks

A

34-36 weeks 6 days

122
Q

late preterm at a lot of risk for CP?

A

no, more moderately and very preterm

123
Q

how many weeks is very preterm

A

<32

very high risk of CP

124
Q

benefit and risk of adjusting for gestational age

A

benefit: qualm parents fears, maybe the kid just needs to work on growing
risk: miss something that can potentially be worked on

125
Q

explain what CP is in as few words as possible

A

perminant non-progressive neuological deficit

126
Q

is CP normally rule out or in diagnosis?

A

rule out

127
Q

compare and contrast the lesion vs. the sequelle of CP

A

lesion: static

Sequelle: progressive

128
Q

what is the most common kind of CP

A

spastic

129
Q

characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases, arms, legs, neck and tongue.

A

Athetosis

130
Q

number of cases of CP in 1,000

A

1 or 2

131
Q

what birth weight are you at high risk of CP?

A

<1,000g

1000-1499g

132
Q

how many weeks of gestation does to risk of CP drastically decrease?

A

32 weeks and beyond

133
Q 
spastic 
vs. 
diskinetic
vs.
ataxic
A

spastic: stuck
diskinetic: involuntary, repetitive twisting
ataxic: unsteady, no coordination, NOT stuck

134
Q

what can you see on an MRI that might point docs towards a CP diagnosis?

A

PVL: periventricular leukomalacia

decreased white matter (has abnormal white signal)

not direct correlation but still a risk factor

135
Q

Can you treat PVL?

A

not the cause itself but you can maximize function

136
Q

what is the GMA

who uses it?

what is it used for

A

gross motor assessment

Healthcare practitioners in the NICU use it.

Done to see if child is at risk of CP later in life

137
Q

does PVL correlate super well with CP later in life?

A

no but it is a factor to consider for kids to be assessed for needs early

138
Q

what is the huge concept for the NICU

A

there might be movement characteristics that you can observe that can cue you off to think who might need therapy before they have a true diagnosis of CP (lack of fidgetiness, only synergistic patterns of motion)

139
Q

what is the one thing that kept coming back under unhelpful for treating CP

A

NDT

Unit 17 (9 decks)

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