Peds 2 2nd exam Flashcards
What are the 6 purposes of an evaluation
- Comprehensive evaluation to develop an intervention plan
- Screening to decide if further evaluation of the child is warranted
- Eligibility or diagnostic testing to decide if the child is eligible for OT services or to assist in the diagnostic process
- Reevaluation to determine if the child’s progress in therapy and determine whether further therapy is warranted
- Research or outcomes testing to evaluate the efficacy of intervention services and therapy outcomes
Describe the steps necessary to evaluate a child 8 steps
Referral Occupational profile- Administration of evaluation Analysis of occupational performance- Develop recommendations and functional outcomes - Document evaluation results - Plan and implement intervention – re-evaluation when necessary
What factors should be considered when selecting evaluation measures and methods
- Reason for referral
- Relevant medical, education and family histories such as need for interpreter, previous test results and precautions
- Consider the caregiver’s priorities regarding the child’s functional skills
- Consider the developmental and chronological age of the child
- Determine the FOR most appropriate for the evaluation
- Consider the purpose of the evaluation and select the most appropriate methods for the eval
- Consider the requirements of the agency for evaluation of children
- Identify available resources such as child’s caregiver, other professionals, instruments and test material/space/time
Define screening, comprehensive evaluation, skilled observations
- Screening- used to determine whether a child warrants a more comprehensive evaluation. The first level is a basic screening of developmental skills (e.g. motor, social, language, personal and adaptive skills). It involves screening of a large number of children to determine which child should receive further testing. Examples of screening tools include Ages & Stages questionnaire, Bayley scales of infant and toddler development-screening test, the Denver and FirstStep. The second-level screening occurs after a health care professional or teacher identifies the child as being at risk for developmental delays or functional limitations. OT administers a more comprehensive screening tool specific to a particular functional area of concern. Assessments used are the short sensory profile or Bruiniks (short form).
- Comprehensive evaluation- allows the OT to establish goals and plan intervention
- Skilled observations- Ability to observe keenly and to record accurately children’s behavior in an objective manner. Dunn proposes that it is one of the essential tools available for OTs
Why do we use standardized tests?
Standardized tools are implemented to ensure that the results of the screening are evaluation are reliable and valid
What’s the difference between standardized and non-standardized tests?
• Standardized tests have uniform procedures for administration and scoring. They are used to assist in determining the medical or educational diagnosis, documenting a child’s developmental and functional status, aid in planning an intervention program and measure variables in research studies
What is the difference between norm-referenced and criterion referenced tests?
- Norm-reference tests determine how the individual child’s performance compares with that of children in the normative sample e.g alberta infant motor scale, bayley scales, bruininks, developmental test of visual perception, sensory profile, Miller, MVPT, sensory integration and praxis tests
- Criterion-referenced measures- these measures provide information about specific skills important to the child’s functional performance in ADLs, play or school-related tasks. Does not compare the child’s performance with that of their peer group but helps to pin point what the child can and cannot do e.g Test of playfulness, SFA, Hawaii early learning profile checklist, GMFM, evaluation of children’s handwriting. Information gained is helpful for evaluation of the child’s functional skills and for planning appropriate intervention activities to enhance those skills
- The Peabody and school function assessment are a mix of both
Know the meaning of normative sample, measures of central tendency, variability, validity, standard score, standard deviation, correlation coefficient and types of reliability
• Normative sample- composed of children who have no developmental delays or condition
• Measures of central tendency-indicates the middle point of the distribution for a particular group, or sample of children. The mean is the most frequently used measure. Also includes median
• Variability- determines how much the performance of the group as a whole deviates from the mean. The two measures of variability are the variance and the standard deviation
• Standard deviation- the square root of the variance
• Validity- the extent to which a test measures what it says it measures
Standard score- Standardized scores include Z-scores (subtracting the mean for the test from the individuals score and dividing it by the standard deviation), T-scores (, deviation intelligence quotient (IQ) scores, developmental index scores, percentile scores (scores that is at or below a particular raw score) and age-equivalent scores
• Correlation coefficient- tells the degree or strength of the relationship between two scores or variables
• Types of reliability- Reliability describes the consistency or stability of scores obtained by one individual when tested on two different occasions with different sets of items or under other variable examining conditions
- Test-retest reliability- measurement of the stability of a test over time
- Inter-rater reliability- refers to the ability of two independent raters to obtain the same scores when scoring the same child simultaneously
- Standard error of measurement- used to calculate the expected range of error for the test score of an individual
Interpret scores given mean and standard deviation T scores and Z scores
(17-22) divided by 4= 1.5
score minus mean divided by standard deviation
T=(z)10+50
Case study kobe
OT practice framework
Occupational profile
school-related-school function assessment
performance skills-skilled observation of neuromotor status
developmental test of visual perception
activity demand in dept observation of kobe performing a classroom activity
case study Kobe his difficulties and where they stem from
play, self help, and school related tasks which stem from and neurological deficits his need for adaptation to support participation
Checklist for skilled observation of neuromotor status scoring and nine areas observed
scoring 1= normal 2=mild to moderate 3=severe impairements
- Posture
- Coordination (gross motor)
- Coordination (fine motor)
- muscle tone
- range of motion
- presence of primitive postural reflex
- delayed automatic reactions
- oculomotor abilities
- strength
Selection of appropriate evaluation methods
Reason for referral
- Relevant medical, education and family histories such as need for interpreter, previous test results and precautions
- Consider the caregiver’s priorities regarding the child’s functional skills
- Consider the developmental and chronological age of the child
- Determine the FOR most appropriate for the evaluation
- Consider the purpose of the evaluation and select the most appropriate methods for the eval
- Consider the requirements of the agency for evaluation of children
- Identify available resources such as child’s caregiver, other professionals, instruments and test material/space/time
Summary of selected pediatric standardized assessments
-Bayley scales of infant and toddler development fine motor and gross motor performance 1-42 months/scaled scores composite score percentile ranks
-Peabody developmental motor scales fine motor and gross motor peformance 1-84 months/z-scores, t-scores, and scaled scores
-Miller function and participation scale
2yr and 6mo-7yr and 11 months fine motor, gross motor, visual motor, test observation homework observation and
-Bruinicks 4years-21yr 11 months measures fine manual control, manual coordination, body coordination, strength and agility
-Pediatric evaluation of disability inventory
6mo-7 years-social function, self care, and mobility scales.
-school function assessment- grades k-6, measures measures participation in non academic school task task support and activity performance
-Sensory profile-3-10 years old sensory processing, modulation, and behavioral and emotional responses
-Adlolescent/adult sensory profile-11 years and up measures sensory processing including taste, touch, auditory, smell, visual sensory seeking, sensory sensitivity sensory avoiding, low registration
-Sensory processing measure- 5-12 years social participation, vision, hearing, touch, body awareness, balance and motion
-Assessment of motor and process skills-3 years and up measures the quality of motor process skill in performing IADL’s
-School assessment of motor and process skills 3-11 years old measures quality of occupational performance in writing, drawing and coloring, coloring and pasting, etc
Sensory integration chapter summary and terms
- Sensory Integration- organization of senses for use
- Sensory nourishments- sensory input is nourishment for the brain as food is nourishment for the body
- Adaptive responses- when the child organizes a successful, goal-directed action on the environment. Adaptive responses drive development
- Neural plasticity- when a child makes an adaptive response, change occurs at the neuronal synaptic level. Plasticity is the ability of structure and non-comitant function to be changed gradually by its own ongoing activity
- Sensory modulation- tendency to generate responses that are appropriately graded in relation to incoming sensory stimuli, rather than underreacting or overreacting to them. Hyporesponsitivity - Hyperesponsitivity
- Underresponsiveness- fail to notice sensory stimuli that would elicit the attention of most people or they notice but are slow to respond or seems to crave intense sensory input
- Sensory registration- before sensory information can be used functionally; it must be registered within the CNS. Sensory registration problems refer to the difficulties of the person who frequently fails to attend to or register relevant environmental stimuli. Seen in individuals with autism, safety concerns are an issue
- Sensation seeking- these children seem to seek intense stimulation in the sensory modalities that are affected
- Overresponsiveness- overwhelmed by ordinary sensory input and reacts defensively to it, often with strong negative emotion and activation of the sympathetic nervous system. Usually related to tactile and vestibular systems
- Praxis- the ability to conceptualize, plan and execute a non-habitual motor act
- Dyspraxia- difficulty with planning and executing movement, cannot be explained by a medical diagnosis or developmental disabilities
