Peds Models & FOR

Question 1

What is Pediatric Practice

Answer 1

Includes occupational therapy with infants, toddlers, children, and youth

Question 2

Primary Philosophies of Pediatric Practice

Answer 2

Child- and family-centered care
Strengths focus
Cultural competence

Question 3

Three primary core beliefs of Child- and Family-Centered Practice

Answer 3

Respect for children and families
Appreciation of the family’s impact on the child’s well-being
Family-professional collaboration

Question 4

Cultural Competence

Answer 4

Critical in this diverse country where practice WILL include provision of services to cultures different than one’s own

•Cultural diversity in the United States

Question 5

A Culturally Competent Therapist:

Answer 5

Demonstrates an interest in understanding the family’s culture
•Accepts and embraces diversity
•Participates in traditions or cultural patterns of the family
•Inquires about family routines, cultural practices, traditions, and priorities
•Integrates intervention recommendations into the family’s cultural practices

Question 6

Influence of cultural practices

Answer 6

Development of occupations and skill development
Choices of occupation
Choices regarding level of independence at specific ages

Question 7

The OT Process in Pediatric

Answer 7

Much the same as with adults and the elderly
•Referral
•Evaluation
•Occupational profile
•Analysis of occupational performance
•Use of variety of methods
•Top down versus bottom up or combined
•Consideration of context
•Intervention using evidence-based approaches, with measurement of outcomes
•Use of theory to guide clinical decision making

Question 8

Occupational therapists improve children’s performance and participation

Answer 8

by providing interventions to enhance performance
•by recommending activity adaptations and environmental modifications
•through consultation, coaching, and education

Question 9

Specific Aspects of Intervention

Answer 9

•Establish a therapeutic relationship
•Focus on inclusion and natural environments
•Use preferred occupations, client engagement, and child-centered care
•Create the just right challenge
•Modify and adapt tasks and environments
•Use evidence-based interventions
•Advocate for and educate others

Question 10

Optimize Child’s Engagement by

Answer 10

●Begin with the child’s interest.
●Invite the child to select and help design the activity.
●Pose a problem to be solved.
●Use meaningful whole tasks rather than repetition of single step tasks.

Question 11

Indirect services

Answer 11

➢Consultation
➢Coaching
➢Support others in creating their own solutions
➢Requires good communication and collaboration

Question 12

Education and advocacy

Answer 12

➢On behalf of specific children with disabilities
•OR
➢Vying for system change on behalf of all children
➢Often interprofessional

Question 13

Types of service delivery

Answer 13

Direct
Indirect
Telehealth

Question 14

Foundational Theories Used in Occupational Therapy

Answer 14

●Developmental theories

●Learning and system theories

Question 15

Developmental Theories

Answer 15

• Adaptation: The child’s ability to adjust to change to fit into the environment
• Schema: How children represent objects, events, and relationships
• Assimilation: Incorporating new knowledge into existing cognitive structures
• Accommodation: New learning, adapting cognitive structure to new information

Question 16

Vygotsky and the Zone of Proximal Development

Answer 16

➢ Cognitive processing is a social process.
➢ Learning is critically dependent on social interaction

Question 17

Zone of proximal development:

Answer 17

The distance between the child’s actual developmental level when acting independently and the level of potential development when supported by an adult.

Question 18

Scaffolding

Answer 18

The process by which therapists support or guide a child’s actions to improve competence.

Question 19

Maslow’s Hierarchy of Basic Needs

Answer 19

• Physiological needs
• Need for safety
• Need for love and belonging
• Need for a sense of self-esteem
• Need for self-actualization

Question 20

Behavioral theories

Answer 20

•Instrumental or operant learning
•Applied behavioral interventions
•Shaping
•Incidental teaching
•Pivotal response

Question 21

Social Cognitive Theories

Answer 21

➢Children can learn by observing the behavior of others.
➢Children determine their own learning by seeking certain experiences.
➢Children learn indirectly by observing how their peers’ behaviors are rewarded or punished.
➢Children learn social skills through group experiences.

Question 22

Self-Efficacy

Answer 22

The influence of motivation and self-efficacy on learning.

Question 23

●Self-efficacy beliefs determine

Answer 23

➢the goals that people set for themselves.
➢how much effort they expend.
➢how long they persevere in the face of difficulties.
➢how they respond to failure.

Question 24

Dynamic Systems Theory

Answer 24

➢Performance depends on
•interactions of the child’s inherent and emerging skills.
•characteristics of the desired tasks or activity.
•the environment.
➢Self-organization is optimal if the task has a goal and outcome.

Question 25

A pictorial representation that expresses observations and data about certain portions of a theory.

Answer 25

Models

Question 26

Models of Occupational Therapy Practice

Answer 26

Provide structure to guide the process of clinical reasoning.

Promote the use of occupation centered practice and a broad scope of practice.

Question 27

Models About Human Occupation

Answer 27

Consider the interaction between the person, the environment, and the task/occupation.

•Model of Human Occupation (MOHO)
•Person-environment-occupation-performance (PEOP)
•Canadian Model of Occupational Performance and Engagement (CMOP-E)
•Occupational adaptation

Question 28

Systems approach: Importance of context in assessment and intervention

Answer 28

➢Develop a picture or profile of the child’s performance.
➢Focus on the interaction of person, environment, and occupation.
➢Focus on changing the child, task, or environment.
➢Modify the task or environment to improve the child’s skills.
➢Increase the child’s engagement by using activities that are meaningful.

Question 29

Frames of Reference

Answer 29

Provide occupational therapists with specific strategies and techniques based on theoretical principles.

Question 30

Commonly Used Frames of Reference

Answer 30

•Developmental
•Biomechanical
•Motor learning
•Rehabilitation
•Neurodevelopmental
•Sensory integration
•Behavioral
•Cognitive
•Cognitive-behavioral

Question 31

Developmental

Answer 31

●Based on the ideas and knowledge about the typical progression of developmental skills by age
●Predicts skills will become more complex and more competent over time
●Suggests a temporal sequence during which specific skills should be expected
●Suggests intervention to generate the “next” skill
●Based on older linear vs systems ideas about maturation

Question 32

Developmental trajectories can be

Answer 32

•Typical
•Delayed
•Slowed
•Delayed and slowed
•Nonlinear or
•Initially typical followed by a “falling off”

Question 33

Biomechanical

Answer 33

Based on kinesiology and physics.

Question 34

Motor Control/Learning

Answer 34

●Motor control = directing/regulating movement.
●Motor learning = ways of learning movements.
●Problem-solving method, helping child find the best ways to move to solve a motor problem.
●Analyze movement synergies.
●Consider child’s stage of learning.
●Provide feedback to improve efficiency.
●Provide opportunities for practice.
●Promote independence and generalization.

Question 35

Rehabilitative

Answer 35

Allows a child or youth to engage in desired occupations with compensations and adaptations
•Providing adaptive equipment or modifications
•Providing appropriate assistive technology
•Requires a thorough analysis of the activity

Question 36

Neurodevelopmental (NDT)

Answer 36

Analyze missing or atypical movement patterns.
●Use therapeutic handling to facilitate postural control and movement synergies.
●Inhibit or constrain abnormal movement patterns.
●Focus on changing movement patterns.
●Child is active participant.
●Therapists emphasize quality of movement.

Question 37

Sensory Integration

Answer 37

●Based on neuroscience.
●Children receive, perceive, interpret, and react to sensations, and use sensory information to produce adaptive behaviors in response to environmental demands.
●With sensory integration and experiences of success, development occurs, enhancing neuroplasticity.
●Sensory input can be incorporated into activities systematically to elicit an adaptive response.
●Must be active, child-directed.

Question 38

Behavioral

Answer 38

Based on animal research examining learning
•Learning occurs through repetition of specific behaviors with appropriate reinforcement
•Use reinforcement to modify or alter behavior
•Puts little emphasis on intrinsic motivation, as motivation to perform a skill is generated by external motivation provided by reinforcement
•Requires careful analysis to determine what to reinforce and when

Question 39

Cognitive

Answer 39

●Based on the work on self-efficacy
●Use a problem-solving approach to work toward child-derived goals through careful questioning rather than instructing
●Steps include
➢Task analysis
➢Anticipation of the child’s difficulties
➢Exploration and selection of task-specific strategies
➢Application of a strategy to the task
➢Evaluation of strategies

Question 40

Cognitive

Answer 40

●Steps:
➢Focus on the occupations the child selects.
➢Use a general problem solving framework.
➢Use process questions to increase the child’s awareness of the use of strategies.
➢Plan for transfer and generalization of the strategies.

Question 41

Cognitive Behavioral

Answer 41

Based on the idea that problem behaviors are caused by beliefs or thoughts (cognition)
•Change the thoughts, change the behavior
•Uses positive self-talk and feedback for successes