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OTD 731 > Pediatric final > Flashcards

Pediatric final Flashcards

1
Q

Important oral structures in eating, feeding, and swallowing

A

oral cavity
pharynx
larynx
trachea
esophagus

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2
Q

Cranial nerves for eating, feeding, swallowing

A

CN V trigeminal: Sensory Innervation to the face​

CN VII facial: Controls facial movement and expression​

CN XII hypoglossal: Controls muscles that move the tongue​

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3
Q

Stages of swallowing

A

-anticipation (see,smell,think about food and start salivating)
-oral preparatory (tongue collects food/liquid forms bolus)
-oral propulsion (propels bollus into pharynx)
-pharyngeal (throat stage: epiglottis flips down, vocal cords close trachea, pharynx muscles squeeze down)
-esophageal (esophagus squeezes food gradually down to stomach)

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4
Q

Bolus

A

ball of food/liquid/saliva

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5
Q

Describe the positioning considerations for feeding: safety and function

A

alignment 90-90-90
stability at the trunk
midline orientation
head and neck aligned with slight chin tuck

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6
Q

Oral sensory dysfunction

A

Not neuromuscular or structural

oral over-registration or defensiveness
oral hypo-registration or under registration

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7
Q

Which sensory system comes first when a child is eating

A

the visual system

most children eat with their eyes and nose first

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8
Q

What role do the gustatory and olfactory systems play in feeding

A

gustatory perceives flavor
olfactory perceives odors

smell is an internal smoke alarm, can trigger memory
-inhibits or facilitates taste

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9
Q

Role of the tactile system in feeding

A

playing with food

largest sensory system and very powerful

it protects (hot/cold) and discriminates (hard/soft)

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10
Q

Proprioceptive system in feeding

A

allows one to lift spoon to mouth without spilling
tells body how much and what kind of food is in the mouth

decreased awareness could lead to overstuffing, gagging, spitting, fear of how to chew and swallow

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11
Q

Interoception in feeding

A

sensations alert that internal balance is off

e.g.: feeling thirsty, feeling hungry, feeling full

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12
Q

What is a common jaw control technique when feeding

A

jaw, lips, tongue

provides jaw control and oral support
can be done from front or from side (arm around back of head)

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13
Q

What are some sensory based feeding approaches

A

SOS
Food chaining (taste, texture, temperature)
getting messy (playing with food)
oral motor strategies

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14
Q

What is the SOS sensory based feeding approach

A

Sequential Oral Sensory

tolerates
interacts with
smells
touch
taste
eating

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15
Q

What are some oral motor strategies for sensory based feeding approaches

A

licking
biting

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16
Q

What are some possible environmental adaptations for mealtime

A

regularly scheduled meals
shorter meal lengths
sensory stimulation and distractions
order of food presentation

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17
Q

Responsive feeding therapy (RFT) principles

A

autonomy
relationship
internal motivation
individualized
competence

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18
Q

interventions to improve self feeding

A

Develop interest​

Gradually decrease amount of physical assistance​

Create balance between effort and swallowing safety​

Adaptive equipment​

Backward chaining​

Consistency in placement of food​

Prepare child for self-feeding ​

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19
Q

Pediatric feeding disorder

A

IMPAIRED ORAL INTAKE THAT IS NOT AGE APPROPRIATE AND IS
ASSOCIATED WITH MEDICAL, NUTRITIONAL, FEEDING SKILL,
AND/OR PSYCHOSOCIAL DYSFUNCTION.

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20
Q

What are the four domains of PFD

A

medical
nutrition
feeding skill
psychological

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21
Q

PFD diagnostic criteria for the Medical domain

A

A disturbance in oral intake of nutrients,
inappropriate for age, lasting ≥2 weeks,
associated with ≥1 of :

Medical dysfunction
a. Cardiorespiratory compromise during oral feeding
b. Aspiration or recurrent aspiration pneumonitis

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22
Q

PFD diagnostic criteria for the nutritional domain

A

A disturbance in oral intake of nutrients,
inappropriate for age, lasting ≥2 weeks,
associated with ≥1 of :

Nutritional dysfunction
a. Malnutrition
b. Specific nutrient deficiency or significantly
restricted intake of ≥1 nutrient resulting from
decreased dietary diversity
c. Reliance on enteral feeds or oral supplements to
sustain nutrition and/or hydration

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23
Q

PFD diagnostic criteria in the feeding skill domain

A

A disturbance in oral intake of nutrients,
inappropriate for age, lasting ≥2 weeks,
associated with ≥1 of :

Feeding Skill dysfunction
a. Need for texture modification of liquid or food
b. Use of modified feeding position or equipment
c. Use of modified feeding strategies

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24
Q

PFD diagnostic criteria for the psychological domain

A

A disturbance in oral intake of nutrients,
inappropriate for age, lasting ≥2 weeks,
associated with ≥1 of :

Psychosocial dysfunction
a. Active or passive avoidance behaviors by child
when feeding/fed
b. Inappropriate caregiver management of child’s
feeding and/or nutrition needs
c. Disruption of social functioning within a feeding
context
d. Disruption of caregiver-child relationship
associated with feeding

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25
Q

What is the goal of sensory integration

A

to help children achieve functions through sensory experiences

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26
Q

What are the end products of a functioning sensory system

A

ability to concentrate
ability to organize
self-esteem
self-control
self-confidence
academic learning ability
capacity for abstract thought and reasoning
specialization of each side of the body and the brain

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27
Q

According to Ayres Sensory Integration what is the foundation for participation (bottom of pyramid)

A

Sensory integration: rapid and accurate registration, modulation, and discrimination/perception of sensory information

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28
Q

What are the neurological structures for senstation

A

spinal cord: basic pathways to transmit sensory information
brainstem: integration of sensory information
cerebellum: grading of the force and speed of movement
cerebral cortex: connects previous sensory experiences with current ones to allow engagement in tasks

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29
Q

Foundational sensory systems used in sensory integration therapy

A

Tactile (discriminative & protective touch)
Vestibular (static & dynamic)
Proprioception (conscious & unconscious)

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30
Q

SIPT

A

Sensory Integration and Praxis Test

Norm-referenced series of tests designed to measure the sensory integration processes that underlie learning and behavior among children 4 years through 8 years, 11 months

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31
Q

What are the guiding principles of the Ayres SI Intervention Methods

A
  • follow typical development
    -just right challenge
  • use sensory rich environments
    -child directed but not child dictated
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32
Q

Sensory processing

A

the way the nervous system receives messages from the senses

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33
Q

Sensory Processing Disorder (SPD)

A

sensory information goes into the brain but does not get organized into appropriate responses

symptoms may results in motor, behavior, social, emotional, or attention problems

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34
Q

three categories of sensory processing disorder (SPD)

A

Sensory Modulation Disorder (SMD)
-SOR: sensory over-responsivity
-SUR: sensory under-responsivity
-SC: sensory craving

Sensory- Based Motor Disorder (SBMD)
-Dyspraxia
-Postural Disorder

Sensory Discrimination Disorder (SDD)
-visual, auditory, tactile, taste/smell, position/movement, interoception

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35
Q

What are the neurological thresholds in Winnie Dunn’s Sensory Processing Framework

A

Quick response- low threshold
(sensitization/high sensitivity)

Slow response- high threshold
(habituation/low sensitivity)

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36
Q

What is habituation in the Winnie Dunn model

A

extreme end of high threshold

recognizing that familiar stimuli do not require special attention

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37
Q

What is sensitization in the Winnie Dunn model

A

extreme end of low threshold

enhances an awareness of potentially important stimuli

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38
Q

What is modulation

A

ability to regulate and grade responses that are appropriate to sensory situation experienced in daily life

balance between habituation and sensitization

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39
Q

What are self regulatory behaviors and the two ends of the spectrum

A

The way people behave to manage their own needs

passive: let things happen and then respond
active: one works to control the amount of and type of sensory input

40
Q

intervention for individuals with low registration

A

More/ much more: require aditional sensory information

less/ much less: prefer predictable activities or repetition

41
Q

intervention for sensory seeking individuals

A

More/ much more: provide a variety of sensory experiences

less/ much less: activities that provide graded sensory experiences

42
Q

Intervention for individuals with sensory sensitivity

A

more/ much more: relatively consistent and predictable environment

less/ much less: activities that provide additional variety to everyday events

43
Q

intervention for sensation avoiding individuals

A

more/ much more: relatively consistent and predictable environment

less/ much less: activities that provide additional variety to everyday events

44
Q

What are the skills needed in the educational readiness skills

A

Fine motor skills
visual motor skills
social skills
self-help skills
attention/self regulation

45
Q

Fine motor skills involve:

A

reaching
grasping
manipulating objects

46
Q

What are the norms for fine motor skills

A

0-3 months: bringing hands to mouth, swinging arms at toys, hands start to open more​

3-6 months: reaches for toys with both arms, grasps small object, briefly holds rattle, holds hands in midline​

6-9 months: brings toys to mouth, shakes rattle, uses raking grasp, transfers objects between hands​

-12 months: releases object voluntarily, develops refined pincer grasp, bangs two toys together, points to objects, turns pages in book​

12-18 months: claps hands together, waves bye bye, uses both hands to play, scribbles​

18-24 months: build 3-4 block tower, stacks rings on ring stacker​

2-3 years: uses digital pronate grasp>tripod grasp, stringing beads​

3-5 years: scissor skills, button and unbutton, place small objects into container​

47
Q

timeline of grasping development

A

raking grasp: 4-6 months
radial digital grasp: 7-9 months
isolation of index finger: 8-10 months
fine pincer grasp: 10-12 months
tripod pencil grasp: 4-5 years

48
Q

When does hand preference usually emerge

A

2 years but children often switch hand use up to 5 year

49
Q

T/F : Crawling is essential in developing muscles and arches on the ulnar side.

A

True

50
Q

T/F: Reaching and grasping objects is important for developing the muscles on the radial side of the hand. ​

A

true

51
Q

Basic developmental progression of hand use

A

radial>ulnar
gross grasp>precision grasp
mass action > refined control of fingers
straight plane>rotation

52
Q

When do children need to focus on “worker” hand and “helper” hand to foster consistent motor memory for paper/pencil skills and scissor use?

A

3-5 years

53
Q

in-hand manipulation

A

Translation (moving object from fingers to palm or palm to fingers)

Shift (e.g shifting a pen to hold it closer to the tip)

Rotation (rotating an object along one or more axes - e.g. turning a screw top bottle)

54
Q

What skills are important building blocks to develop pre-writing readiness?

A

hand and finger strength
crossing midline
pencil grasp
hand-eye coordination
bilateral coordination
upper body strength
object manipulation
visual perception
hand dominance
hand division (using thumb, index and middle finger together to manipulate objects)

55
Q

What is the first writing stroke in pre writing skills

A

vertical line

56
Q

What are the types of attention

A

focused attention
selective attention
shifting attention
sustained attention
divided attention

57
Q

visual acuity

A

acuteness or clearness of vision, which is dependent on the sharpness of the retinal focus within the eye.

(Normal visual acuity is commonly referred to as 20/20 vision, tested on a Snellen chart.)​

​

58
Q

Visual perception

A

The total process responsible for the reception and interpretation of visual stimuli, allows us to accurately interpret and compare/contrast visual information

59
Q

components of visual perception

A

visual discrimination
form constancy
visual memory
visual sequential memory
visual closure
visual spatial relationships
visual figure ground

60
Q

visual discrimination

A

The ability to determine differences or similarities in objects based on size, color, shape, etc.​

61
Q

visual constancy

A

The ability to know that a form or shape is the same, even if it has been rotated, made smaller/larger, or looked at from up close or far away.​

62
Q

visual memory

A

The ability to recall visual traits of a form or object.​

63
Q

visual sequential memory

A

the ability to recall a sequence of objects or forms in the correct order

64
Q

visual closure

A

the ability to recognize a form or object even when the whole picture of it isn’t available

65
Q

visual spatial relationships

A

understanding the relationships of objects within the environment

66
Q

figure ground

A

the ability to locate something in a cluttered or busy background

67
Q

assessments for vision

A

Beery Test of Visual Motor Integration (VMI)

Motor Free Visual Perception

Test of Visual Perceptual Skills (TVPS)

68
Q

What are the 3 main components of the Beery VMI

A

visual motor integration
visual perception
motor coordination

69
Q

What are the perceptual areas of the TVPS-4

A

visual discrimination
visual memory
spatial relationships
form constancy
sequential memory
visual figure-ground
visual closure

70
Q

what are the frames of reference for handwriting without tears

A

Acquisitional FoR : emphasizes learning/teaching process

Sensory and motor based approaches (biomechanical, sensory processing, motor learning)

71
Q

M-FUN (The Miller Function & Participation Scales)

A

developmental tool using observation and demanded performance

child’s motor competency affects his/her ability to engage in home and school activities

72
Q

What is the age range for the M-FUN

A

2.5 years - 7 years 11 months

73
Q

what are the two domains of the M-FUN

A

performance assessment
participation assessment

74
Q

executive funtioning

A

allows us to multi task, remember instructions / details, and come up with and carry out plans

75
Q

causes of executive functioning delay

A

ADHD
Depression and anxiety
Bipolar disorder
Schizophrenia
OCD
Autism
TBI
Epilepsy (hemispherectomy)

76
Q

executive functioning skills

A

planning
organization
self-control
task initiation
time management
metacognition
working memory
attention
flexibility
perseverance

77
Q

Development of executive functioning

A

combines sensory cognitive, communication, and motor skils which children develop and utilize around school age

starts with baby’s response to caregivers, learning through repetition and games

78
Q

important concepts of foundational theory

A

-motivation
-choice
-active involvement
-supportive environmental context
-scaffolding to attain “just right”
-self-discovery process
-learning continues through the lifetime

79
Q

cognitive interventions

A

cognitive behavioral
video modeling
coaching
four quadrant model of facilitated learning
CO-OP approach

80
Q

video modeling

A

applies cognitive theory to teach children with ASD and intellectual disabilities by providing a visual role model using technology

81
Q

coaching

A

Based on child and adult cognitive and educational learning theory ​

Involves a reciprocal process and collaborative relationship between the individual and coach (facilitator)​

Engages the child or youth to participate in a meaningful activity or occupation to the maximal extent possible by applying cognitive strategies

82
Q

Guiding principles of coaching

A

Acknowledge prior knowledge​

Offer choice ​

Involve in goal setting and collaborative planning​

Promote active involvement and practice​

Utilize scaffolding by an adult or competent peer to support performance​

Observe performance and provide feedback​

Involve in self-discovery/reflection​

Encourage self-evaluation ​

Utilize resources and the environment to support participation​

83
Q

Four quadrant model of facilitated learning (4QM)

A

based on Vygotsky’s theory

employs teaching and learning as an intervention strategy to achieve occupational performance

More easily applied to perceptual motor activities like handwriting​

84
Q

key aspects of Four quadrant model of facilitated learning (4QM)

A

Considers the interact of the person, occupation, and environment

Student can do the task but lacks the ability to independently plan/perform/evaluate/adapt the task within a specific context

Learner’s needs change dynamically and require a changing level of support

85
Q

CO-OP Approach (Cognitive orientation to daily occupational performance)

A

based on cognitive and behavioral psychology, health, human movement science, and occupational therapy

Emphasizes the interaction between individual and environmental factors to support participation in daily activities​

Uses a top-down approach in context of daily activities and occupations​

86
Q

Key features of the Co-Op approach

A

goal
plan
do check

87
Q

four enabling principles of the CO-OP approach

A

make it fun
promote learning
work toward independence
promote generalization/ transfer

88
Q

guided discover in the CO-OP approach

A

one thing at a time
ask, don’t tell
coach, don’t adjust
make it obvious!

89
Q

Hippotherapy

A

refers to how OT, PT, and SLP professionals use evidence-based practice and clinical reasoning in the purposeful manipulation of equine therapy tool to engage sensory, neuromotor and cognitive systems to promote functional outcomes

90
Q

Why the horse?

A

horses emotional intelligence
multidimensional movement
horse’s rhythmic movement
movement can be manipulated
motor and sensory input

91
Q

Hippotherapy vs. therapeutic riding

A

hippotherapy: purposeful manipulation of equine movement

therapeutic riding: correct riding position and utilization of reigns

92
Q

positions for clients in hippotherapy

A

forward sitting
backward sitting
side sitting
prone over barrel
quadruped

93
Q

types of holds for side walkers in hippotherapy

A

cuff hold: provides stability for foot/lower leg
heel hold: prevents foot from turning inward and provides support
thigh hold: provides more support and stability for client
pelvis hold: most support

94
Q

Activities used during hippotherapy sessions

A

fine motor
gross motor
visual motor

95
Q

Benefits of hippotherapy

A

increased strength, muscle coordination, sensory processing

increased motivation and participation in treatment

OTD 731 (3 decks)

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