QUIZ 4 Flashcards
assumptions of the biomechanical FOR
- Provides external supports to aid postural control.
- Sensory feedback enhances movement learning via proprioceptive, vestibular, tactile cues.
- Motor development is sequential, building on stable postural reactions.
- Abnormal tone or CNS issues impact postural control and function.
- Postural reactions are shaped by neurodevelopment, environment, tasks, and motivation.
- OTs assess postural dysfunction, external factors, and adapt treatments.
4 stages of motor development
mobility
stability
mobility superimposed on stability
skill
supine position
tonic labyrinthine reflex
gravity is a force infants cannot overcome
predominant flexor tone
prone position
head to side for breathing- hyperextend his or her neck to raise the head or turn it from side to side
prop on forearms- infants needs to bring both elbows from behind the shoulders to directly beneath the shoulders to assume weight-bearing position
side-lying position
asymmetrical movements can be experienced and executed more easily
weight-bearing side (down side) of the body is extended, in coordination with lateral flexion of the neck and trunk of the mobile side (“upside”) of the body
sitting position
gravity demands increase
ring sitting
lateral weight shifting for use of arms
standing position
requires significant extensor muscle activity, promoting upper body and pelvic stability
erect spine, neutral pelvis, stable knees/ankles aids in proximal stability, essential for skilled movements
function/dysfunction continuum
range of motion
head control
trunk control
control of arm movements
mobility
eating
toileting
accessing switches
4 stages of swallowing
the oral preparatory phase, oral phase, pharyngeal phase, and esophageal phase
the oral preparatory phase
oral manipulation of food using the jaw, lips, tongue, teeth, cheeks, and palate
results in the formation of a food bolus
time spent varies on food texture
oral phase
begins when the tongue elevates against the alveolar ridge of the hard palate, moving the bolus posteriorly, and ends with the onset of the pharyngeal swallow
generally reflexive in young infants and under voluntary control in older children
pharyngeal phase
swallow is triggered when the bolus reaches the anterior faucial arches
hyoid and larynx move upward and anteriorly, the epiglottis retroflexes to cover the opening of the airway, and the vocal cords come together to protect the airway
ends with the opening of the upper esophageal sphincter as the bolus passes the airway and moves toward the esophagus
primarily REFLEXIVE
esophageal phase
starts with relaxation of the tonically contracted cricopharyngeus muscle to open the upper esophageal sphincter and ends with relaxation of the lower esophageal sphincter at the distal end of the esophagus, allowing the bolus to enter the esophagus and travel via peristaltic wave activity to the stomach
REFLEXIVE
steps in evaluating feeding problems
interview and chart review
structured observation
interpretation, summary, reccomendations
Liquid consistency most difficult to control
Thin liquids offered from an open cup
level 3 food texture
Liquidized–thin pureed foods such as stage 2 baby foods or the consistency of honey, which drips slowly or in dollops through the tines of a fork.
level 4 food texture
Puréed—puréed foods that are homogeneous, cohesive, or pudding-like; does not dollop or drip continuously through fork tines.
level 5 food texture
Minced and moist—cohesive, moist, semi-solid foods that may require some chewing; ground or minced meats and fork-mashed soft fruits and vegetables included in this diet level.
level 6 food texture
Soft and bite-sized small pieces of meltable and soft-solid foods that require more chewing ability, such as crackers, breads, cooked vegetables, soft fruits, and meats.
level 7 food texture
Regular—no food restrictions; includes fruits with skins, hard or crunchy vegetables, nuts, tough meats such as beef or pork steak, and foods that are very sticky or dry.
feeding intervention techniques
environmental adaptations
positioning adpatations
adaptive equipment
modifying foods
interventions for dysphagia
modifying liquid consistencies
caregiver training
supportive positioning
interventions for sensory processing disorders
desensitization and deep pressure
tools (vibrating toothbrushes)
gradual food introduction
characteristics of play
self-chosen or at least self-directed
it is intrinsically motivated and done for its own sake, is guided by rules that may be managed creatively,
is imaginative
occurs in a relatively stress-free state but active state of mind
modern play theories
psychoanalytic theory, the arousal modulation theory, metacommunicative theory, and the cognitive theories
psychoanalytic theory of play
Children play to help them cope with and manage their emotions, and develop solutions to developmental tasks.
Arousal Modulation theory of play
A child plays because his or her nervous system either has too much or needs more stimulation.
metacommunicative theory of play
Children use communication about play to identify that it IS play; through play children learn to perform on two levels at once, in reality and the make believe.
cognitive play theory
Play’s purpose is to foster cognitive development and abstract thinking, Piaget proposed play stages, Vgotsky introduced the at once, in reality developmentake believesitive emotions, and enables a state of balance that leaves us poised to p, and development may be enhanced by play with peers.
Bruner considered the varied types of play and their differing impact on development. Play is one method of problem-solving, reducing risks and consequences, and increasing flexibility.
stages of play
exploration, competency, and achievement
exploratory play behavior
seen most in early childhood and is fueled by intrinsic motivation
competency
fueled by effectance motivation- inborn urge toward competence
characterized by experimentation and practice to achieve mastery
achievement
linked to goal expectancies and is fueled by a desire to achieve excellence
adapations for grasp
pencil grips
lined and unlined paper
different mediums to “write in”
hand skill development
stability and strength
precision, speed, dexterity
compensatory approach to handwriting
improve a student’s participation in school with accommodations, adaptations, and modifications for certain tasks, routines, and settings
remedial approach to handwriting
used to improve or establish a student’s functional skills in a specific area
interoception
ability to perceive and process the internal state of one’s body, including internal visceral and emotional signals such as body tension, tight stomach, rapid breathing, elevated pulse, voice intonation, blushing, smiling, crying, and laughing
Challenges can limit social participation
partial participation
occurs when a child performs some steps of the task and a caregiver completes the remaining steps; this allows the child to practice and often improves performance of the ADL task.
prepping a low-tone child for handwriting
bouncing “popcorn ride”
calisthenics
scissor skills at 2 yr
snips
scissor skills at 2.5 yr
Cuts across a 6-inch piece of paper
scissor skills 3-3.5
cuts along a 6 in line
scissor skills 3.5-4
cuts out a circle
scissor skills 4-5
cuts out a square
scissor skills 6-7
cuts out a variety of shapes
Friendships result in…
higher play levels, higher language levels, better conflict resolution skills, and more positive affect
key elements of social skills groups
collaboration on goals (participant, parent, therapist)
consistent and predictable format
posted rules for behavior
intensive parent training
daily feedback and homework
sensory and social
level of sensory responsivity may impact social skills
pull-up garments
Large size
Stretchy material
Loops sewn into waistband
Elastic waistbands, but not too tight
Pressure-sensitive tape
Zipper pulls
Dressing sticks
pull-over garments
Large, easy opening for head
Flexible knit fabric
Large armholes and sleeve openings; raglan sleeves
Elastic cuffs and waistbands
front-opening garments
Loose style
Fullness in back of garment
On shirt or jacket, collar of different color from main garment
Short-sleeve garments first, proceeding to long-sleeve garments
Raglan sleeves
Garment with no closures or one or two buttons (e.g., sweater, jacket)
buttons
large
high contrast
zippers
nylon easier than metal
pulls
longer
socks
soft, stretchy
large
loops sewn in
shoes
loose
wide
slip on
hook and tab closures
tabs at heels
toileting interventions
adapted toilet
modified clothing for donning and doffing
decreasing seat opening
safety rails
menstruation education
dressing interventions
changing clothing type
adaptive aids
bathing interventions
modeling
modifying tools
sexual activity interventions
education on appropriate behaviors
education on positioning
support groups
sleep interventions
sleep hygiene (routine)
modifying physical environment
education
