Pediatrics Flashcards
the most common condition found in premature newborns; it can lead to heart failure and inadequate oxygenation of the brain
patent ductus ateriosus
opening in the septum between the right and left atrium; results in ‘wet lungs’ (blood) and may lead to respiratory infection; right ventricle works hard and may lead to heart failure; poor exercise tolerance and small for chronological age
atrial septal deficits
one or more openings in the muscular or membranous portions of the ventricular septum; 50% self-correct by age 5; may result in Eisenmenger’s complex, pulmonary vascular obstruction, increased blood flow. and high pressure; feeding difficulty, SOB, increased perspiration, increased respiratory infections, fatigue with activity, delayed growth
ventricular septal deficits
pressure in the pulmonary arteries becomes so high that it causes oxygen-poor (blue) blood to flow from the right to left ventricle and then to the body, causing cyanosis. The high pressure also causes the wall of your heart’s right ventricle to thicken (hypertrophy)
Eisenmengers syndrome
decreased pulmonary blood flow characterized by pulmonary valve or artery stenosis, ventricular septal deficits, right ventricle hypertrophy, and override of ventricular septum; central cyanosis, coagulation defects, finger/toe clubbing, feeding difficulty, failure to thrive, dyspnea
Tetralogy of Fallot
mixed pulmonary blood flow characterized by no communication between systemic and pulmonary circulations; result of coexisting congenital transposition of ventricles; cyanosis, CHF, respiratory distress
transposition of great arteries
abnormally slow heart rate (<60 bpm); typically atrioventricular block; may require a pace maker
bradydysrhythmia
abnormally fast heart rate for a child (>200-300 bpm); can lead to CHF; irritability, poor eating habits, palor
tachydysrhythmia
compromised oxygen absorption and carbon monoxide elimination caused by a deficiency of surfactant (produced 34-36 weeks gestation); many recover after a few days and some develop chronic lung conditions
respiratory distress syndrome
airway thickening, formation of excess mucus, and restricted alveolar growth as a result of prolonged use of mechanical ventilation and other traumatic interventions to treat acute respiratory problems; at greater risk for respiratory infections
bronchopulmonary dysplasia
bronchial smooth muscle hyperreactivity that causes airway constriction in the lower respiratory tract, difficulty breathing, and wheezing
asthma
degenerative condition (chromosome 7); muscle-producing glands malfunctioning and producing secretions that are thick, viscous, and lacking in water and block the pancreatic duct, bronchial tree, and digestive tract; abdominal distension, salty-tasting skin, excess sodium levels, greasy/foul stools; can lead to chronic pulmonary disease and enlarged R heart (heart failure)
cystic fibrosis
hematological disorder characterized by too many red blood cells and elevated white blood cells; experienced by 1 in every 150 children with down syndrome
eryhtocytosis or transient leukemia
blood disorder commonly affecting males; characterized by the absence or reduction of one of the clotting blood proteins; longer bleeding time, bleeding episodes, excessive bruising, nosebleeds
hemophilia
severe hemophilia is differentiated because of it’s effect on
joints and muscles
an iron deficiency in the blood treated through diet; may be symptom of lead poisoning, vitamin deficiency, leukemia, and sickle-cell disease
anemia
abnormally shaped red blood cells; common in African-Americans; decreased energy for daily tasks, at risk for organ damage, painful
sickle cell anemia
brittle bones with minor trauma able to cause a fracture; decreased bone deposition from inability to form type I collagen; transmitted by autosomal dominant; range from mild to severe (indicated by age of onset); handling and monitored weight bearing important
osteogenesis imperfecta (OI)
excessive growth at epiphyseal plates; long slender fingers, skull asymmetry, tall stature (joint/eye/heart differences); lax/hypermobile joints and poorly developed striated muscles; walking delayed but otherwise meets developmental milestones
Marfans syndrome (arachondactyly)
‘that MF is tall’
stunting of epiphyseal plate growth and cartilage formation; 4 feet tall or less; short limbs, prominent forehead, small nose and jaw, trunk normal; lumbar lordosis, coxa vara cubitus varas, back/leg pain
achondroplasia (chondrodystrophia/dwarfism)
hip deformity
coxa vara
part of limb deviates to midline of body
cubitus varas
reduced anterior horn cells in the SC; incomplete contracture (fibrous ankylosis) of many joints; thick/spindly extremities, thickened knee/elbow joints; muscles underdeveloped/paralysis; increase ROM and adaptive equipment
arthrogryposis multiplex congenital
fibrous connective tissue process which results in decreased range of motion.
Fibrous ankylosis
unilateral or bilateral forefoot adduction and supination, heel varus (midline), equinus of the ankle (tightness), and medial deviation of the foot; underdeveloped LE musculature; passive treatment
congenital club foot (talipes equinovarus)
bilateral hip laxity causing increased uterine pressure and poor presenting positions (hereditary or in utero); sudden passive extension with legs extended/adducted when caused in utero; breech presentation; if not treated early with splinting, trendelenburg sign can result and may need surgery
developmental dysplasia of the hip (congenital hip dislocation)
assess for dysplasia by examining whether clicking is present when the leg is abducted and pressure placed on the medial thick
barlow test
hip drop to the opposite side of dislocation and trunk shift toward the dislocated hip when standing on one foot
Trendelenburg’s sign
physical anomaly in which a person has an excess of finger or toes (relatively common); amputation or reconstruction in childhood
polydactyly
condition in which webbing occurs between the fingers or toes; frequent in the UE’s of boys; splinting and scar reduction
syndactyly
overly small digits (plastic surgery may be performed)
microdactyly
absence of a limb or distal segment of a limb
amelia
fully or partially formed distal extremity and absence of one of more proximal segments
phocomelia
proximal segments of the limb are correctly develoed but either the medial or lateral side of the rest of the limb is missing
paraxial deficiencies
amputation of a limb segment across the central area; common for bilateral or hemilateral presentations
transverse hemimelia
muscle injury caused by too strong an effort or excessive use of a particular body part; trauma to the muscle or muscle-tendon insertion
strain
ligament injury caused by trauma to a joint characterized by rapid swelling, heat, and impaired function
sprain
childhood arthritis occurring between 2 and 4; characterized by persistent arthritis in one or more joints for >6 weeks; joint inflammation, joint stiffness, joint contractures; splint, AROM/PROM, prevent deformity, energy conservation, adaptive equipment, joint protection
juvenile rheumatoid arthritis (JRA)
JRA involving fewer than 5 joints
pauciarticular
JRA involving more than 5 joints
polyarticular
polyarticular JRA with organ involvement; high fever, rash, anorexia, elevated WBC, enlarged liver and spleen
systemic JRA (Still’s disease)
fracture where the bone is broken into many splintered pieces
comminuted
fracture where broken bone leads to external wound at side and bone often protrudes through the skin
compound
fracture occurs between the shaft of the bone and epiphysis; only occurs in pediatric clients
epiphyseal
fracture where bone is partially broken and partially bent; only occurs in children and frequently with Rickets
greenstick fracture
anteroposterior curvature directed posteriorly (hollow back) as a result of anterior pelvic tilt in the lumbar region (common); secondary to obesity, hip flexion contractures, and muscular dystrophy; treat underlying cause
lordosis
posterior convexity (round back) primarily in upper back; result of faulty posture (skeletal growth outpaces muscular growth); common in spina bifida cystica and arthritis; postural training, strengthening, Milwaukee brace, spinal release/spinal fusion
kyphosis
brace that runs from pelvis to base of skull; useful for kyphosis
Milwaukee brace
lateral curvature, spinal rotation, and thoracic hypokyphosis; treat if lateral curvature > 10 degrees; < 20: mild; > 40 permanent deformity; 65-80 reduced cardiopulmonary function; Boston brace (children), TLSO; strengthening, ADL adaptations
scoliosis
scoliosis caused by poor postural tone, hip contractures, leg length discrepancy, pain; spine flexible
functional scoliosis
scoliosis that is usually structural, caused by abnormal spinal or spinal cord structure or disease of the nervous system
congenital scoliosis
non progressive condition the includes neurologic, motor, and postural deficits; common comorbidities include language, cognitive, sensory, and psychosocial deficits; feeding and seizure disorders common; difficulty maintaining normal muscle postures because of a lack of muscle co-activation and development of abnormal compensatory movement patterns
cerebral palsy
congenital CP is most commonly the result of ________ and infants are at risk __________ weeks gestations
prematurity; 26-32 weeks
retention of primitive reflexes, abnormal/variable tone, hyperresponsive tendon reflexes, asymmetrical extremity use, clonus, poor feeding/tongue control, and involuntary movement may indicate
cerebral palsy
quadriplegia with mild UE involvement and significant LE involvement
diplegia
fluctuation of tone from low to normal with little spasticity
athetosis
constant fluctuation from low to high tone without co-contractions; appear as jerky movements
choreoathetosis
tone within normal range but involving LE flexion patterns
ataxia
2 functional classification systems for CP
manual ability classification system
gross motor function classification system
eye alignment deviation (CP)
strabismus
reflexive back and forth movement of the eyes when the head moves (CP)
nystagmus
difficulty pronouncing or articulating words (CP)
dysarthria
associated with poor language development; looks as though person has difficulty comprehending the meaning of certain words (CP)
aphasia
seizure that involves the entire cerebral cortex
generalized seizure
most frequent type of generalized seizure; person experiences a sensation that seizure is about to begin; followed by LOC and rhythmic clonic contractions; may last as long as 5 minutes; incontinence common; may be drowsy and sleep 1-2 hours
tonic clonic seizures
generalized seizure with a brief lapse or loss of awareness along with absence of motor activity (including eye blinking); lasts 30 seconds or more; mistaken as day dreaming
absence seizures
generalized seizure with contractions of single muscles or muscle groups
myclonic seizures
generalized seizure with loss of muscle tone for more than 30 minutes
akinetic seizure
seizure that begins in a single location and then spreads or remains limited to one area of the cortex
partial seizure
partial seizure that originates in the temporal lobe and appears as lip smacking, chewing, or buttoning and unbuttoning clothing; similar to absence seizures
complex partial seizure
partial seizure that originates in the motor cortex and results in clonic activity of the face/extremities; may experience visual/auditory hallucinations or olfactory sensations
simple partial seizure
experiencing both generalized and partial seizures
mixed seizure disorder
spasms that begin between 6 and 24 months; development stops or slows considerable; some skills lost
infantile spasms
condition that results in progressive degeneration and weakness of a variety of muscle groups and could lead to death; result of biochemical and structural changes of the surface and internal membranes of muscle cells; hereditary link
muscular dystrophy
muscular dystrophy that affects the proximal muscles of the pelvis and shoulder girdle; occurs within first 30 years of life; slow progression
limb girdle muscular dystrophy
muscular dystrophy that affects the face, upper arms, and scapular region; onset in adolescence; slope shoulders and limited ability to raise arms over head; ‘masklike’ appearance of face
Facioscapulohumeral muscular dystrophy
most common form of muscular dystrophy affecting only boys; deficiency in production of dystrophin causing muscles to degenerate; develops after birth with signs between 2-6; enlarged muscles and positive Gower’s sign; difficulty going up/down stairs and getting up from lying-down; die in 20’s as result of respiratory/cardiovascular complications
Duchenne’s muscular dystrophy
when asked to get up from sitting on the floor, the child will move the hands on the legs as though crawling up to the thighs and then assume a standing position
Gower’s sign
muscular dystrophy characterized by brain involvement, neuromuscular functioning, hypotonia, generalized muscle weakness, and contractures; clubfoot, torticollis, diaphragm involvement, heart/spinal defects
congenital muscular dystrophy (CMD)
CMD that does not involve intellectual functioning
CMD I
CMD that does involve muscle and brain abnormalities
CMD II
CMD that involves muscle, brain, and eye abnormalities
CMD III and IV
protrusion in the occipital region of the brain; associated with severe cognitive impairments, hydrocephalus, motor impairment, and seizures
encephalocele
neural development above the level of the brain stem lacking; do not survive infancy
anencephaly
congenital defect of the vertebral arches and spinal column
spina bifida
mild spina bifida with 1 or 2 affected vertebrae and no SC involvement; may have no symptoms
spina bifida occulta
extensive spinal opening with an exposed pouch of CSF and meninges
meningocele (spina bifida)
excessive spinal opening with an exposed pouch of CSF and meninges with nerve roots exposed; severe; sensorimotor problems, LE paralysis, hip/spine/foot deformities; complications include hydrocephalus and arnold-chiari syndrome
myclomeningocele (spina bifida)
is a condition in which brain tissue extends into your spinal canal. It occurs when part of your skull is abnormally small or misshapen, pressing on your brain and forcing it downward.
arnold-chiari syndrome
caused by an injury to the upper brachial plexus (C5/C6) such as extreme shoulder flexion (with arm overhead); breech deliveries; weakness or wasting of small hand muscles and sensory discrimination in hand/arm; unilateral; UE paralysis affecting more shoulder musculature; recovery depends on extend and occurs 3-24 months
Erb-Duchenne palsy
characteristic arm position for Erb-Duchenne palsy
should adduction/internal rotation, elbow extension, forearm pronation, wrist flexion (waiters tip position)
injury resulting from compression or traction of the lower brachial plexus (C8/T1); paralysis of hand and wrist muscles (claw hand deformity); severe can result in full paralysis of entire UE
Klumpke’s palsy
class I peripheral nerve injury with some degree of paralysis but no peripheral degeneration
neurapraxia
class II peripheral nerve injury with the endometrium intact but the axon degenerated distal to the lesion
axonotmesis
class III peripheral nerve injury where the axon and endometrium are severed
neurotmesis
when is a child considered to have an intellectual disability (3 factors)
(1) scores on psycho educational assessment > 2 SD below normative range for child’s age (2) before age 18 (3) impairment in adaptive abilities
IQ between 55 and 70; able to learn academic skills at 3rd to 7th grade level; work with minimal support
mild intellectual disability
IQ between 40 and 55; able to learn academic skills at 2nd grade level; perform unskilled and some skilled work tasks
moderate intellectual disability
IQ between 25 and 40; able to communication and perform basic ADLs and health habits; requires support to complete routines
severe intellectual disability
IQ below 25; requires caregiver assistance for basic tasks; neuromuscular, orthopedic, or behavioral deficits
profound intellectual disability
neurologic soft signs indicative of intellectual disabilities (4)
(1) poor balance, (2) motor asymmetry, (3) decreased perceptual-motor skills, (4) decreased fine motor skills
assesses sensory processing in the home and school environment
sensory processing measure
difficulty taking others’ perspectives and hypothesizing about what they might do next; common for individuals with ASD
theory of mind
acute sense for detail almost to the point of missing the bigger picture; common for individuals with ASD
weak central coherence
poor motor planning ability; common for individuals with ASD
dyspraxia
using variation in pitch, emphasis or rhythm of speech; difficult for individuals with ASD
prosody
use of language in social situations; difficult for individuals with ASD
pragmatics
progressive neurological disorder caused by a genetic mutation found in girls; development appears normal for 6 months; head growth then slows, hand skills lost, and poor trunk/gait coordination; initial loss of social skills with re-emergence; handwringing and hyperventilation common; non-ambulatory and non-verbal by late childhood
Rett’s syndrome
what area of the brain is diminished in ADHD and what does this brain area control
parietal lobe; inhibition and attentional control
difficulty with reading
dyslexia
difficulty with writing
dysgraphia
difficulty with math
dyscalculia
involuntary swearing (Tourette’s)
coprolalia
precautions for children with atlantoaxial instability (down syndrome)
clearance for sports, avoid neck hyper flexion, do not perform front rolls
chromosomal disorder with short stature, small head, low-set ears, flat nose, slack jaw, short extremities and phallanges, simian hand; cardiovascular abnormalities, obesity, respiratory infection, and poor visual acuity common; atlantoaxial instability (AAI)
Trisomy 21/Down syndrome
chromosomal disorder with multiple anomalies affection the eyes, ears, nose, lip, palate, and digits; microcephaly and neural tube differences; 20% survival rate
Trisomy 13/Patau’s syndrome
chromosomal disorder with neck webbing, congenital edema of the extremities, and cardiac problems; short/obesity/lack sexual characteristics; no intellectual disabilities but visual perception deficits
Turner’s syndrome
chromosomal disorder with weak and ‘cat like’ cry in infancy, microcephaly, down-slanting eyes, cardiac abnormalities, failure to thrive, intellectual disability, hypotonia, feeding/respiratory problems
Cri du char syndrome
condition where the head circumference is smaller than normal
microcephaly
boys with extra C chromosome; learning disabilities, emotional/behavioral problems, tall/slim, small genitalia, unable to father children
Klinefelter’s syndrome
genetic disorder marked by intellectual disability, craniofacial deformity, elongated face, prominent jaw and forehead, large ears, high-arched palate, pes planus (flat feet), and hyper mobile joints
Fragile X syndrome
genetic disorder marked by multiple tumors (fibromas) on the central and peripheral nerve, cafe-au-lait birthmarks, and vascular/visceral lesions
neurofibramatosis
genetic disorder marked by moderate intellectual disability, food-seeking behavior, hypotonia, poor thermal regulation, underdeveloped sex organs, and a long face with slanted eyes
Prader-Willi syndrome
genetic disorder marked by cerebral and cardiovascular abnormalities; intellectual disability but affinity for music, social skills, and writing; facial characteristics; difficulty with visual, spatial, motor skills
Williams syndrome
inborn error in processing an amino acid in proteins; blonde hair/blue eyes; untreated can lead to severe intellectual and behavioral difficulties (autistic presentation); Guthrie test done at birth; diet as primary means of treatment
phenylketonuria (PKU)
inability to convert milk sugar to glucose; leads to spleen and liver dysfunction; jaundice, vomiting, diarrhea, lethargy, cataracts, systemic infections; avoid milk products and breast milk; untreated can lead to learning difficulty, perceptual problems, tremors, coreoathetosis, and ataxia
Galactosemia
progressive neuromuscular disease that is a result of difficulty metabolizing purines; boys normal for 1st year then regress; intellectual disabilities, neuromotor degeneration, spasticity; nail biting, face-rubbing, compulsions; prevent self-injurious behavior
Lesch-Nyhan syndrome
primarily a condition of motor incoordination; delayed achievement of motor milestones and basic self-care; developmental coordination disorders of speech/language commonly occur
developmental coordination disorder
developmental disorder of motor function
developmental dyspraxia
congenital maladroitness
what model should be used for developmental coordination disorder
CO-OP
infections transmitted from mother to child
STORCH (syphillis, toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes)
infection transmitted during the 3rd trimester of pregnancy or during delivery; requires isolation and penicilin; can lead to hepatitis, failure to. thrive, and neurologic involvement; after treated, osteochondritis, dental abnormalities, and visual and auditory deficits common
congenital syphillis
contracted through handling cat feces or raw meat; still births common; intellectual disabilities, hydrocephalus, and chorioetinitis common for those who live; associated with CP, seizures, cardiac/liver damage, gastrointestinal problems
toxoplasmosis
infection that is very harmful if contracted in the 1st trimester; intellectual disabilities, hearing loss, microcephaly, congenital heart defects, seizures, problems with spleen/liver
rubella
can be transmitter before, during, or after birth; can be dormant (use universal precautions); low birth weight, hearing loss, microcephaly, spleen/liver damage, neurologic deficits
cytomegalovirus (CMV)
contracted during delivery; skin and internal organ lesions; CNS damage; fever, lethargy, poor feeding, vomiting; C-section used to stop transmission
congenital herpes
neoplasm in which the growth resembles the tissue around it
histoid neoplasm
neoplasm that is made up of two layers
mixed neoplasm
neoplasm growth that comes from several distinct cell groups
multicentric neoplasm
neoplasm growth that is similiar to an organ in the body
organoid neoplasm
neoplasm growth that originated from one group of cells
unicentric neoplasm
therapist performs the first several steps of the task and allows the child to complete the last step of the task
backward chaining
child performs the first step of the task and practice it until it is mastered while the therapist completes the rest of the task
forward chaining
developmental framework for visual intervention that is hierarchical with each skill building on the preceding skill
Warren’s Model
the inability of the eye to adjust to different lighting conditions, visual-field problems, accommodations, and other oculomotor functions
refractive errors
poor accommodation for near objects
presbyopia
one eye turned in, out, up, or down as a result of muscle imbalance; results in blurred or double vision
strabismus
tendency for one eye to move slightly in, out, up, or down without overt misalignment
phoria
handwriting development: 10-12 months
scribbles on paper
handwriting development: 2 years
imitates horizontal, vertical, and circular marks
handwriting development: 3 years
copies a vertical line, horizontal line, and circle
handwriting development: 4-5 years
copies a cross, diagonal, and oblique lines; some letters and numbers; can maybe write own name
handwriting development: 5-6 years
copies a triangle, prints own name, copies most letters
positional awareness
proprioception
awareness of movement
kinesthesia
1st grasp progression; whole hand or extended fingers with a pronated forearm used to hold writing utensil; movement comes from shoulder
primitive grip
2nd grasp progression; writing utensil held with flexed fingers, pronated forearm (radial side down) with progression to a supinated forearm position
transitional grip
3rd grasp progression; writing utensil stabilized by distal phalanges of thumb, middle, and index finger (maybe ring finger); wrist in slight extension with supinated forearm on table; should be encourage by _______
mature grip; 2nd grade
functional handwriting grip where the pencil rests against distal phalanx of the radial side of the middle finger; thumb opposed to index finger
dynamic tripod
functional handwriting grip where the pencil rests against the radial side of the middle finger; thumb rests on middle finger DIP
lateral tripod
functional handwriting grip where the pencil rests against the distal phalanx of the radial side of the ring finger; thumb is opposed to the index finger
dynamic quadruped
functional handwriting grip where the pencil rests against the radial side of the ring finger; thumb rests on the middle finger DIP
lateral quadruped
what is the word legibility formula
total number of readable words divided by total number of words written
acquisitional stage of handwriting where the child begins to understand the demands of handwriting and develops a strategy for the necessary motor movement
cognitive phase
acquisitional stage of handwriting where the child continues to practice and begins to self-monitor; proprioceptive feedback and visual cues are essential
associative phase
acquisitional stage of handwriting where the child can perform handwriting with minimal conscious attention
autonomous phase
what height should the table surface be for handwriting
2 inches above the flexed elbows
paper position for handwriting
slanted and paralell for forearm
proximal senses; dominate early life experience
vestibular, tactile, proprioceptive
distal senses; do not have as large of an impact until later in childhood
vision and hearing
seeking out the sensory input needed to organize ones self and help to achieve goals; leads to changes through neural plasticity
adaptive response
lower level of the CNS where vestibular input is processes
brain stem
lower level of the CNS where somatosensory input is processed
thalamus
if an individual has difficulty with fine motor coordination, grading force, visual-motor tasks, and motor planning they may have ________ and should be taught to compensate by using __________
tactile discrimination; visual guidance
if an individual appears gawky and awkward they may have difficulty with _________ and should be taught ___________- strategies to help compensate
proprioception; cognitive
if an individual has poor bilateral coordination and difficulty sequencing actions (catching a ball) they may be experiencing __________
vestibular-proprioceptive problems
what are the 3 parts of praxis
ideation, planning, and execution
children who have difficulty with motor planning, tactile perception, and discrimination may have
dyspraxia, developmental dyspraxia, somatodyspraxia
can the sensory integration and praxis test be administered by a general practicioner
no; requires specialized training
method of intervention where as any interaction is considered an opportunity for learning, the therapist acts with respect toward the child, and promote decision making; uses color coded zones (green, yellow, red)
rational intervention (RI)
rational intervention response where as the occupational therapist matches his or her response to the child’s behavior
matching
rational intervention response characterized by observing the child and improving environmental supports
facilitation
rational intervention response characterized by observing the child and letting them know the therapist is present; encouraging the child; using guided questions to prompt problem solving
monitoring
rational intervention response characterized by reminding the child of the expectations, modeling appropriate behavior, and re-directing
gentle correction
rational intervention response characterized by giving the child a break by re-directing
moderate correction
rational intervention response characterized by time out and possible use of physical management if safety is an issue
strong correction
dressing development: age 1
assists through cooperation; pulls off shoes and removes socks
dressing development: age 2
able to doff coat (not fasteners), begin pulling down parts, locate armholes in shirt
dressing development: age 2.5
pull down pants (elastic), helps to put on socks, coat, shirt, unbutton large buttons
dressing development: 3
don pullover shirt, put on shoes/socks, zippers once engaged, button large buttons
dressing development: 3.5
distinguish front/back, manage snaps/hooks, unzip, begins buckles, mittens, dress with supervision
dressing development: 4
removes pullover garments, buckles, zippers, may lace shoes
dressing development: 4.5
weave belt through loops
dressing development: 5
tie and untie knots; dress without supervision
dressing development: 6
tie bows, manage fasteners in back of garment
toileting development: 1
discomfort when wet/dirty, regular bowel movement
toileting development: 1.5
sit on toilet with supervision
toileting development: 2
interest in toilet, dry for 2 hours, flush independently, urinate regularly
toileting development: 2.5
informs about need to use bathroom, regular toileting schedule, help with positioning, dry at night, wipes after urinating, washes hands independently
toileting development: 3
uses bathroom independently; assistance wiping/managing clothing
toileting development: 4-5
independent with toileting, washing hands, clothing management
mobility development: 7 months
bear weight through LE’s, transition from sitting to kneeling
mobility development: 9 months
able to stand while holding on to a surface; begins to crawl
mobility development: 10 months
purposeful steps while holding adults hand
mobility development: 12 months
begins to walk independently
when corner of mouth or upper/lower lip is stroked, there is movement of the tongue/mouth/head toward stimulus; helps locate feeding sources to begin feeding;
onset: _________
integration: _________
rooting reflex (searching reflex)
onset: 28 weeks gestation
integration: 3 months
when finger is placed in mouth, there is strong nutritive sucking
onset: _________
integration: _________
suck-swallow reflex
onset: 28 weeks gestation
integration: 2-5 months
when forearm is grasped and pulled to sit, there is complete flexion of UE’s, reflexive grasp, and head lag (for eventual voluntary grasp)
onset: _________
integration: _________
traction reflex
onset: 28 weeks gestation
integration: 2-5 months
when the head is rapidly dropped backwards, there is initial arm extension/abduction and hand opening and then arm flexion and adduction (protective response to stress)
onset: _________
integration: _________
MORO reflex
onset: 28 weeks gestation
integration: 4-6 months
when pressure is applied to the ball of the foot, there is toe flexion (for foot input and gait) problems can lead to hypersensitivity and gravity insecurity
onset: _________
integration: _________
Plantar grip reflex
onset: 28 weeks gestation
integration: 9 months
when the back is tapped alongside the spine from the shoulder to butt while in prone, there is lateral trunk flexion to stimulated side (for trunk stabilization, creeping/crawling)
onset: _________
integration: _________
galant reflex
onset: 32 weeks gestation
integration: 2 months
when the head is fully rotated in supine, there is extremity extension on face side and flexion on skull side (hand-eye coordination)
onset: _________
integration: _________
asymmetric tonic reflex (ATNR; fencing pose)
onset: 37 weeks gestation
integration: 4-6 months
when there is a finger in the palm, there is finger flexion (voluntary grasp, FMC)
onset: _________
integration: _________
palmar grasp
onset: 37 weeks gestation
integration: 4-6 months
when the infant is in supine, there is increased extensor tone (allows posture to adapt to head)
onset: _________
integration: _________
tonic labyrinthine- supine
onset: >37 weeks gestation
integration: 6 months
when the infant is in prone, there is increased flexor tone (allows posture to adapt to head)
onset: _________
integration: _________
tonic labyrinthine- prone
onset: >37 weeks gestation
integration: 6 months
when held in horizontal prone suspension, there is complete extension of head, trunk, and extremities (regulates tone)
onset: _________
integration: _________
landau reflex (superman pose)
onset: 3-4 months
integration: 12-24 months
when the head is extended in the crawling position, the arms extend and there is hip and knee flexion; when the head is flexed in the crawling position, the arms flex and hip and knees extend (quadruped position)
onset: _________
integration: _________
symmetric tonic neck reflex (STNR)
onset: 4-6 months
integration: 8-12 months
when supine with the head fully turned to one side, there is log rolling of entire body to maintain head alignment (facilitates rolling)
onset: _________
integration: _________
neck righting (on body)
onset: 4-6 months
integration: 5 years
when supine with one hip/knee flexed toward the chest, there is segmental rolling of upper trunk to maintain alignment (facilitate sitting and quadruped)
onset: _________
integration: _________
body righting (on body)
onset: 4-6 months
integration: 5 years
when suspended vertically and tilted to side, forward, and back, there is upright positioning of the head mediated by the visual system
onset: __________
optical righting reflex
onset: birth-2 months
when suspended vertically and tilted to side, forward, and back, there is upright positioning with eyes mediated by the vestibular system
onset: __________
labyrinthine head righting
onset: birth-2 months
when rapidly lowered toward a supporting surface while suspended vertically, there is extension of the lower extremities (preparation for surface contact)
onset: __________
downward parachute
onset: 4 months
when suddenly tipped forward toward supporting surface while vertically suspended, there is sudden extension of UEs, hand opening, and neck extension
onset: __________
forward parachute
onset: 6-9 months
when quickly/firmly tipped off balance to side while sitting, there is arm extension and abduction the side
onset: __________
sideward paracute
onset: 7 months
when quickly/firmly tipped off balance backward, there is backward arm extension or to one side with spinal rotation
onset: __________
backward parachute
onset: 9-10 months
curving of the spine toward a raised surface in prone, supine, quadruped, or standing, there is spine curvature and abduction/extension of arms/legs toward the raised side
prone tilting: 5 months
supine/sitting tilting: 7-8 months
quadruped tilting: 9-12 months
standing tilting: 12-21 months
framework to used to guide assistive technology evaluation and service delivery by allowing for collaboration and communication among educational team members to support good decision making to determine the AT needs of a student.
SETT (student, environment, task, tools)
standard deviation of ________ away from the mean on standardized assessments indicates the need for OT services
1.5
1st sensory system to develop and most mature at birth
tactile
1st line of defense against falling _____
2nd line of defense against falling ____
equilibrium reactions; protective reactions
according to Erhardt Prehension Developmental levels, at what age is fine pincer grasp achieved
12 months
at what age is voluntary release present
7-9 months
at what age is bilateral hand use available for different functions
12-18 months
linear object movement on finger surfaces to reposition objects such as separating paper and rolling clay into a ball; present from 3-6 years
shift
rotating an object 360 degrees such as turning a pencil to erase; present from 6-7
complex rotation
at what age does a child begin to show an interest in scissors and can do controlled opening and closing
2-3 years
at what age can a child cut laterally and simple geometric shapes
3-4 years
at what age can a child cut simple figure shapes
4-6 years
at what age can a child cut complex figure shapes
6-7 years
psychosocial development stage proposed by Erikson characterized by an understanding that survival and comfort will be met and hope is integrated
age: _______
basic trust vs mistrust
0-18 months
psychosocial development stage proposed by Erikson characterized by an understanding that bodily functions cannot be controlled; self-controlled will integrated
age: _________
autonomy vs doubt/shame
2-4 years
psychosocial development stage proposed by Erikson characterized by gaining social skills and gender role identity; sense of purpose integrated
age: _______
initiative vs guilt
pre-school
psychosocial development stage proposed by Erikson characterized by a sense of security through peers and mastery over activities of their age group; feelings of competency integrated into personality
age: ________
industry vs inferiority
elementary school age
psychosocial development stage proposed by Erikson characterized by making choices about adult roles with resolution of identity crisis and a sense of fidelity or membership with society
age: ________
self-identity vs role confusion
teenage years
psychosocial development stage proposed by Erikson characterized by establishing intimate relationships with partner/family; capacity to love is achieved
age: ________
intimacy vs solidarity
young adulthood
psychosocial development stage proposed by Erikson characterized by finding security in contribution of chosen personal/professional role; capacity to care is achieved
age: ________
generativity vs self-absorption
middle adulthood
psychosocial development stage proposed by Erikson characterized by reflecting on own values and sharing knowledge gained with younger generations; wisdom acquired
age: ________
integrity vs despair
maturity/older adulthood
stage of moral development that occurs until age 8 characterized by punishment and obedience and instrumental relativism (making choices based on benefit to self and others)
pre-conventional morality
stage of moral development that occurs between ages 9-10 characterized by social conformity and law and order (rules internalized)
conventional morality
stage of moral development where there is social awareness and awareness of legal implications of decisions/actions (social contract); age varies and not always achieved
post conventional morality
Maslow’s hierarchy of needs (5)
physiologic safety love and belonging self-esteem self-actualization
can enhance or weaken intrinsic motivation, self-regulation, and well-being; key elements are competence, autonomy, and relatedness
self-determination theory
period of hierarchical cognitive development characterized by reflexes, voluntary movement, improved gross and fine motor function, and purposeful use
age: ________
sensorimotor period
0-2 years
period of hierarchical cognitive development characterized by categorizing objects, relating objects to one another (seriation), recognition of similarities in objects (conservation)
age: ________
preoperational period
2-7 years
period of hierarchical cognitive development characterized by spatial awareness (reversibility), rules, inductive thinking, and logical thinking
age: __________
concrete operations
7-11 years
period of hierarchical cognitive development chracterized by hypothetical deductive reasoning, and use of logic to hypothesize problem solving
age: _______
formal operations
11-teen years
age at which a child acts on objects with a variety of schemes
12 months
age at which a child links schemes in simple combinations (baby in carriage and push)
12-15 months
age at which a child links multi scheme combinations in sequence
24-36 months
2-3 years
age at which a child links schemes into complex script
36-42 months
3-4 years
category of play involving object properties and effects of actions on objects and people
age: _______
exploratory play
0-2 years
category of play that involves manageable objects in terms of symbolization, control, and mastery; parallel play
age: ______
symbolic play
2-4 years
category of plays that involves exploring combinations of actions on multiple objects; cooperative peer groups
age: ________
creative play
4-7 years
category of play that involves rules, competition, social interaction, and skill development; friends validate performance
age: _______
games
7-12 years
at which age is munching, phasic bite and release present; takes food from spoon
4-5 months
at which age is there strong up and down movement of the tongue
6 months
at which age does mastication of soft foods, drinking from a cup, and diagonal jaw movement occur
7-8 months
at which age does lateral tongue movement and finger feeding occur
9 months
at which age is the jaw firm and rotary chewing occur; dips spoon in food but spills
12 months
at which age is a child able to chew most meats and raw vegetables; interest in using fork and proficient at spoon use; can use a straw
24 months/2 years
how to facilitate swallow
also used in presence of tonic bite reflex
downward pressure of spoon on middle of tongue
assessment of appearance, pulse, grimace, activity, and respiration measured 1, 5, and 10 minutes after birth to indicate new born well being
apgar score
assesses patterns of developing behavior organization in response to increasing sensory and environmental stimuli; includes a neonatal behavioral assessment and a behavior checklist; scores reflect degree of facilitation; includes eye movement and asymmetry
assessment of preterm infants behavior (APIB)
rating scale of brief neurological examination incorporated into routine assessment used for newborns in an incubator/ventilator in handling tolerance
neurological assessment of preterm and full term newborn infant (NAPFI)
standardized performance/observation screening tool for earl identification of children at risk for developmental delays in areas of personal-social, fine motor, language, and gross motor; 125 items assessed sequentially until child fails 3; parent questionnaire; 1 month-6 years at risk for developmental delay
Denver Developmental Screening Test II
standardized rating scale for development to attain a baseline in domains of cognition, language, motor, social-emotional, and adaptive behavior; parent questionnaire; 1 month-43 months
Bayley Scales of Infant Development- 3rd Edition (BSID-III)
identifies students at risk and whom need further evaluation for 5 areas identified under IDEA (cognition, communication, physical, social-emotional, adaptive function; 2.9-6.2 years
FirstSTEP Screening Test for Evaluating Preschoolers
standardized task performance screen for sensory-motor, cognition, and combined abilities; results help develop a plan for assessing school development problems; 2.9-5.8 years
Miller Assessment for Preschoolers (MAP)
non-standardized scale of developmental levels for education curriculum referenced areas administered in the natural environment, family context, and during typical routines; includes warm up, structured plat. and snack time; 0-3 years with developmental delay/at risk; pre school version 3-8
Hawaii Early Learning Profile Revised (HELP)
standardized behavior checklist to assess functional capabilities to detect functional deficits, determine developmental level, and monitor progress in areas of self-care, mobility, and social skills; includes a modifications and caregiver assistance scale; 6 months-7 1/2 years
Pediatric Evaluation of Disability Inventory (PEDI)
standardized rating of gross/fine motor skills (reflex, sustained control, locomotion, object manipulation, grasp, visual motor integration); discontinued with 3 consecutive 0 scores; 0-6 years with disorders; norm referenced assessment/training tool
Peabody Developmental Motor Scales (2nd edition) (PMDS-II)
school based assessment of visual-motor, fine motor, gross motor, and participation; very engaging assessment; 2.6-7.11 years
Miller Function and Participation Scale (M-FUN)
standardized test to provide index of overall motor proficiency (speed, duration, accuracy, hand/foot preference); 4-21 years
Bruininks-Oseretsky Test of Motor Proficiency (2nd Edition) (BOT-2)
observation checklist based on performance of involuntary arm-hand patterns, voluntary movement of approach, and pre writing skills; for all ages
Erhardy Developmental Prehension Assessment (EDPA)
assessment of quality of movement for mobility, stability, motor organization, social/emotional ability, and functional performance; cutoff score indicate motor delay; 0-3.6 months
Toddler and Infant Motor Evaluation (TIME)
assessment of copying 24 geometric forms sequenced according to difficulty; discontinued after 3 done incorrectly; measure quality of forms; norm references; ages 2-100; culture free/non-verbal
Beery-Buktenica Developmental Test of Visual-Motor Integration- VMI, 6th Edition
assessment of visual perception and visual motor integration to design interventions and monitor progress (eye-hand coordination, copying, spatial relations, visual motor speed, position in space, figure-ground, visual closure, form constancy) ; for adults and adolescents
Developmental Test of Visual Perception (2nd edition) (DTVP-II)
assessment of visuomotor development, involuntary visual patterns, and voluntary visual patterns; determines developmental level; 0-6 months
Erhardt Developmental Vision Assessment (EDVA)
standardized, norm referenced, assessment of visual motor integration and visual perceptual skills (perception in space, awareness of spatial relations, color and space discrimination, matching, reproducing what is seen); 2 performance subtests and. 2 behavior checklists; 3 1/2- 51/2 years old
Preschool Visual Motor Integration Assessment (PVMIA)
standardized, norm-referenced quick evaluation for visual perception (spatial relations, visual discrimination, figure-ground, visual closure, visual memory); 4-95 years
Motor-Free Visual Perception Test (MVPT-4)
evaluation of spatial deficits due to hemi-field visual neglect or abnormal saccades; children/adults with visual cutes of without visual impairment
Motor-Free Visual Perception Test, Vertical (MVPT-V)
visual perceptual skills assessed separately from motor dysfunction; MC format with increased complexity; discontinue after 3 errors; 4-19 years
Test of Visual Perceptual Skills (4th edition) (TVPS-4)
assessment of reactions to daily sensory experiences; can be caregiver judgement and observation; cut off scores indicate problems; includes:
Infant-toddler: 0-36 months
Adolescent/Adult: 11-65
Sensory Profile (SP)
assessment of sensory integration and processing; takes 2 hours to administer and requires extensive training; 4-8.11 years
sensory integration and praxis test (SIPT)
assessment to determine the severity of autism and distinguishes autism from developmental delays without autism through observation and rating of behavior; children over 2
childhood autism rating scale (CARS)
assessment of coping habits, skills, and behaviors administered as a questionnaire (productive, active, flexible); 15 years; 4-36 months)
Coping Inventory and Early Coping Inventory
assessment of play behavior and play opportunity with information provided by main caregiver; general information, previous play experience, actual play over 3 days; 9 areas of play; children and adolescents
Play History
observation of play skills to differentiate developmental play abilities, strengths/weaknesses, and areas of interest; administer in natural environment; 0-6 years
Revised Knox Preschool Play Scale (RKPPS)
observation of playfulness on 4 aspects (intrinsic motivation, internal control, disengagement, framing); 15 months-10 years
Test of Playfulness (ToP)
non-standardized observational assessment of development, learning style, interaction patterns, and behaviors; team observation in 6 phases with program plan developed; infancy-6 years
Transdisciplinary Play-Based Assessment (TPBA)
questionnaire assessment that measures restrictions in social participation related to community mobility, access to work, recreation, and social interactions; 15+ years with physical disability
Participation Scale (P Scale)
assessment to monitor functional performance for participation at school; criterion references questionnaire to address 9 items of participation; kindergaren- 6th grade
School Function Assessment (SFA)
