Pediatrics Flashcards
Categories of Play
- Exploratory Play (0-2 years)
- Symbolic Play (2-4 years)
- Creative Play (4-7 years)
- Games (7-12 years)
Exploratory Play
0 to 2 years old
Play experiences which develop body schemes, sensory integrative and motor skills
Child explores the properties and effects of actions on objects and people
Symbolic Play
2 to 4 years old
Formulates, tests, classifies and refines ideas, feelings and combined actions
Associated with language development
Parallel play which can become more cooperative over time
Creative Play
4 to 7 years old
Sensory, motor, cognitive and social play experiences…refining relevant skills
Combination actions, participate in cooperative peer groups
Games (Play)
7 to 12 years old
Participating in play with rules, competition, social interaction and opportunities for development of skills
Friends become important for validation, parents assist and validate in the absence of peers
Asthma OT treatment implications
Chronic lung condition, typically appears before 5 yo
- Education: reducing exposure to irritants
- Self-management strategies: pacing, stress, etc.
- Structured peer-group activities - to reduce isolation
- Breathing exercises, stretching, controlled breathing
Bronchopulmonary dysplasia
Prolong mechanical ventilation, traumatic acute respiratory interventions…
…leads to thickening of airways, excess mucus, restricted alveolar growth
High risk for respiratory infections
A common symptom that may be treated in sickle cell anemia is…
Pain, requiring pain management techniques
Decreased energy
Remember, it means the red blood cells are abnormally shaped.
With cystic fibrosis, one of the most serious complications is…
Chronic pulmonary disease
Characterized by chronic cough, wheezing, and lower respiratory infections
May result in enlarged right side of heart leading to heart failure!
Osteogenesis Imperfecta
Brittle bones - congenital defect
Severe forms lead to progressive deformities and underdeveloped muscles. Mild forms may be fractures in childhood but bones harden by puberty.
Critical OT components:
Parental education on safe handling and positioning
Monitored activities to promote weightbearing
Epiphyseal plate congenital anomalies
Marfan’s Syndrome - excessive growth at epiphyseal plates
Lax and hypermobile joints, delayed walking, some potential deformities
Achondroplasia - stunting of epiphyseal plate growth
Do not grow past 4 ft, back and leg pain
Arthrogryposis
Characterized by incomplete contracture of many or all of the client’s joints
OT intervention to focus on:
- Increasing ROM and strength - stretching, splinting, serial casting
- Adaptive equipment for occupational participation
Soft Tissue Injury Categories
Strain = muscle injury Sprain = ligament injury Bruise = contusion and discoloration of subcutaneous tissue
Juvenile Rheumatoid Arthritis OT Implications
- Splinting
- Involve client in AROM and PROM
- Monitor joint function and development of deformity
- Education: energy conservation and adaptive equipment
Lordosis
Hollowback (I also think like belly out…)
Common in…severe obsesity, hip flexion contracture, muscular dystrophy
Treatment:
- Stretch hip flexors
- Strengthen abdominals
- Postural training
- Back bracing
Kyphosis
Round back (sometimes called hunchback) Think skeletal growth outpacing muscular growth
Common in…spina bifida cystica and arthritis
Treatment:
- Postural training
- Strengthening
- Milwaukee brace
- Anterior spinal release and postural spinal fusion (only for severe cases)
Scoliosis
Most serious curvature of spine!!
Lateral curvature
Functional causes: poor postural tone, hip contractures, leg length discrepancies, pain
Congenital causes: abnormal spinal cord structure, nervous system diseases
65-80 = cardiopulmonary dysfunction
Treatment:
- Orthotic intervention
- Surgical spinal fusion
- Bracing
- Postoperative strengthening of abdominal muscles
- ADL adaptations
Key markers of cerebral palsy
- Retention of primitive reflexes and automatic reactions
- Abnormal or variable muscle tone
- Hyperresponsive tendon reflexes
- Asymmetrical use of extremities
- Clonus
- Poor feeding and tongue control
- Involuntary movements
Scales for assessing function with cerebral palsy include…
- Manual Ability Classification System: describes how children with CP use their hands to handle objects in daily activities (5 levels)
- Gross Motor Function Classification System: looks at movements such as sitting, walking and use of mobility devices
Gower’s Sign
Positive Gower’s sign is linked to Duchenne’s Muscular Dystrophy (DMD)
When asked to get up from the floor, the child will move the hands on the legs as through crawling up to the thighs and then assume a standing position
Intellectual Disability levels (eye roll)
Mild (55-70): Academic skills at 3rd - 7th grade level, able to work with minimal support
Moderate (40-55): Academic skills to 2nd grade level, some unskilled and skilled work tasks
Severe (25-40): Communicates and performs BADLs, often requires support to complete routines
Profound (below 25): Caregiver assistance for basic tasks, other comorbid deficits typically
Congenital infections transmitted from mother to child
Storch
Syphilis Toxoplasmosis Other infections Rubella Cytomegalovirus Herpes simplex virus-2
Peabody (PMDS-2)
Development motor scale
Ages: 0-5 years old
(five pea peapod)
Gross motor, fine motor, grasp, VMI, reflexes (how are you going to open and eat this peapod?)
Standardized
Sensory Processing Measure (SPM)
Preschool: 2 - 5 years
Standard: 5 - 12 years
Home, classroom, school environment form
Sensory processing, social participation*, and praxis
Beery (VMI)
Visual motor
Standardized
2 - 100 years old
Culture free and nonverbal
Very easy to use as a classroom screening
Visual perception and visual motor integration
Sensory Processing Measure (SPM)
Preschool: 2 - 5 years
Standard: 5 - 12 years
Home, classroom, school environment form
Sensory processing, social participation, and praxis
Sensory Profile 2
Toddler: 7 - 35 months
Child: 3 - 14 years
Caregiver/parent questionnaire
Sensory processing patterns and impact on functional performance
Bruininks-Oseretsky Test of Motor Proficiency
Age: 4 - 21 years old
Fine motor and gross motor, manual coordination, bilateral integration
Standardized ask-based assessment
Norm referenced
