Pediatric conditions and Interventions Flashcards
Autism Spectrum Disorder
Etiology: Unknown
Problems:
- impaired communication and social skills
- repetitive behaviors
- Impaired intellectual development
- Perseveration on specific topics
- excessive routines/rigid
- hard transitions
- decreased eye contact
- decreased safety awareness
- decreased reciprocal interactions
OT interventions:
- Sensory assessment and integration intervention
- feeding/eating therapy
- schedules/timers to anticipate transitions
-social stories
- start treatment w/ less desirable task, followed by preferred task
- development of play skills, sharing, turn-taking
- increase body awareness to improve motor planning via massage, swings, weighted materials, hanging activities
- Educate caregivers on safety modifications
- peer mediated approach (teach typically developing children ways to help those w/ ASD
Child abuse, neglect, and shaken baby syndrome
Etiology: child is victim of physical, emotional, or sexual abuse, or neglect of proper care and nutrition resulting in harm
Problems:
- delayed growth, delayed development, and/or cog deficits
OT Intervention:
- ADL training in self-care
- school-based OT for academic success
- symbolic play, social stories and art activities to promote expression of feelings
- sensory assessment and providing appropriate sensory input to regulate/modulate sensory systems for calming
- coping skills
- BABIES- swaddling, swinging, deep pressure and warmth, massage/gentle touch, soft/soothing music and sounds.
Cystic fibrosis
Etiology: genetic disorder caused by mutations in the gene for the CF transmembrane conductase regulator
Problems:
- Accumulating thick, sticky mucus that causes coughing, SOB, and frequent chest infections.
- Symptoms: poor growth/weight gain, salty sweat, fatty BMs, trouble digesting food, enlarged heart
OT intervention:
- training in daily routine management, including med management, and respiratory treatments
- energy conservation for I/ADLs
- for teens, IND in disease management
Developmental delay
Etiology: usually caused by other conditions/disorders
Problems:
-excessive fxl limitation in one or more of the following areas: self-care, communication, motor development, sensory processing, social skills, cog.
OT intervention:
- determine underlying diagnosis to facilitate intervention
- self-care training
- sensory strategies
- smaller step learning for developing complex skills and concepts
- visual supports
- GM activities
- FM activities
- postural activities
- backward chaining
- coping skills
- social skills
Developmental coordination disorder (dyspraxia)
Etiology: unknown
Problems:
- clumsiness
- excessively delayed motor development that negatively influences daily functional tasks
- not related to any other diagnoses
OT intervention:
- pullover/elastic clothing until child learns to manage fasteners
- alternatives to fork/knife use to cut meats etc.
- adaptive scissors
- activities to develop bilateral coordination and hand use (L/R discrimination and crossing midline)
- sensory-based tasks to develop motor learning/planning
- activities to develop postural control/stability
- teach how to plan and check progress
- environmental modifications
- forwards and/or backwards chaining and task breakdown
Down Syndrome
Etiology: Trisomy 21 (error in cell division causes extra 21st chromosome)
Problems:
- slanted eyes, protruding tongue, flat nose, epicanthal fold over the eyes, shortened fingers/limbs, hypotonia/hyperextension of joints, delayed development of reflexes, delayed/impaired sensory development, cog. impairment, may have heart defect, creases in the hands
OT intervention:
- place food to sides of mouth to encourage lip closure while eating- repetitive activities to promote mastery of skills
- compensatory strategies for ADLs
- early intervention and school-based OT to promote intellectual development, incorporating problem solving, org skills, life skills, vocational skills, social skills training to prepare for transition from school to work
Failure to thrive
Etiology: medical or environmental factors, home environment may influence condition
Problems:
- decreased body weight
- feeding difficulties
- delay in age appropriate development (self-care, play, cog.)
OT intervention:
- oral-motor skills, eating/feeding schedule based on child’s expression of hunger
- food additives for increased nutrition
- small, more frequent meals
- pleasurable eating environments and child-selected dinnerware/utensils
- food play
- meal routine
- compensatory strategies
- remediation
Fetal Alcohol Syndrome
Etiology: excess alcohol intake during pregnancy, resulting in various birth defects
Problems: neural/facial/cranial/cardiac abnormalities
OT intervention:
- monitor vital signs
- organizational, proprioceptive activities (wheelbarrow walking)
- motor planning tasks (obstacle courses and mazes)
- appropriate sensory diet
- calming tasks, deep pressure
- schedules and timers to prepare for transitions
- task breakdown
- GM for body awareness, coordination, alerting behaviors and cog.
- VM and VP activities
Intellectual disability
Etiology: various causes
Problems:
- intellectual functioning significantly below average
- delays in 2+ areas of occupation (play, ADLs etc.)
- deficits in intellectual functioning and adaptive behaviors
OT interventions:
- develop behavior modification plans
- alternatives for communication as needed (w/ SLP)
- Reciprocal play
- ADL skills
- handwriting skills and mods
- development of performance patterns that include rituals, habits, roles to enhance engagement in meaningful occupation
Learning disability
Etiology: various causes, often secondary to other conditions
Problems:
- difficulties in learning
OT intervention:
- School-based OT including sensory integration strategies
- CBT techniques
- handwriting, organization training, motor planning tasks
Rett Syndrome
Etiology: neurodevelopment disorder that affects almost exclusively girls; caused by mutation of the MECP2 gene which is needed for brain development
Problems:
- 4 stages
- loss of normal movement/coordination
- loss of communication ability
- abnormal hand movements
- unusual eye movements
- breathing problems
- abnormal behaviors
- cognitive disability
- sleep disturbances
OT intervention
- look for potential use of eye movement or gaze or initiation of movement towards a desired object
- dyspraxia may cause delay between a prompt and a response
- progress is slow, but improvements in self-care and hand skills can happen throughout lifespan
- maximize hand use for fxl activities
- develop ability to access AE
- increase IND in feeding
Spina Bifida
Etiology: malformed development of SC, meninges and brain resulting from abnormal closure of vertebrae; non-curable
Problems:
- poor prognosis for those with high level spinal cord involvement and congenital abnormalities
- visual deficits
- four levels of involvement (mild to severe)
OT intervention:
- Increase BADLs, self-care, and IADLs w/ AE, ADevices, and WC
- bladder and bowel training (self-cath)
- skin integrity edu
- ROM, strengthening, GM/FM activities within patient’s level of ability
- home accessibility and safety training
- consult w/ educators and school-based OT to collab
Traumatic brain injury
Etiology: caused by traumatic injury to the skull that impacts brain tissue
Problems:
- ACUTE: loss of consciousness, slow/slurred speech, vomiting, irritability, lethargy, confusion, severe headache
- LONG-TERM: changes in personality, abnormal muscle tone, hemiplegia, affect changes, memory loss, cog. deficits, impulsiveness/quick-tempered, visual deficits
OT intervention:
- schedules to prepare child for environment
- textures to improve sensory awareness and muscle tone
- develop ADL/play skills (visual attention, memory, UE strength)
- weight shifting/weight bearing tasks
- I/ADL engagement
Visual impairments
Etiology: various causes, including abnormal eye development, strabismus, amblyopia (lazy eye), optic nerve hypoplasia, decreased binocular function, retinopathy of prematurity
Problems:
- difficulty focusing on faces or toys
- hold object close
- tilts head to look at object
- crossed eyes
- jerky eye movement
- decreased school performance
- poor FM and GM skills
CO-OP approach
Cognitive orientation to occupational performance