Typical development infant/toddlers (cont.)

Question 1

Which developmental position promotes neck extension against gravity, trunk extension, shoulder stability, and provides a foundation for visual motor skills?

Answer 1

Prone on elbows (prone propped)

Question 2

Typically an infants’ first transitional movement is:

Answer 2

Rolling

Question 3

Why is rolling essential for motor development?

Answer 3

Rolling promotes use of both sides of the body together, strengthening of core muscles, trunk rotation, and balance reactions.

Question 4

What developmental milestone typically emerges between crawling on hands and knees and cruising and is often achieved with use of a half kneel position?

Answer 4

Pulling to stand

Question 5

This developmental milestone requires weight shift and trunk rotation in an upright position:

Answer 5

Walking

Question 6

A fine motor skill that requires isolation of finger movement, emerges between 6-12 months

Answer 6

Pointing or poking with index finger

Question 7

Precision grasp patterns
Precise opposition of thumb to index (or index and middle fingers) is referred to as:

Answer 7

A pincer grasp
“superior (neat) pincer” (opposition of thumb and index fingertip)
“inferior pincer” (opposition of pads of thumb and index finger)
3 jaw chuck - opposition of thumb with index and middle fingers
Children may alternate these grasp patterns depending on size/shape of items, child’s position, placement of food or other items

Question 8

The typical age range for development and refinement of a pincer grasp:

Answer 8

12-18 months

Question 9

What is the typical progression of using two hands together to play and explore, occurring between 6-12 months:

Answer 9

Play with both hands at midline, transferring a toy hand to hand, grasping a toy in each hand, banging toys together

Question 10

Passing a toy or object from one hand to another at midline, is referred to as:

Answer 10

Transferring hand to hand at midline

Question 11

Transferring toys or objects hand to hand is typically established between:

Answer 11

6-8 months

Question 12

This developmental milestone requires weight shift, trunk rotation, and reciprocal movement in a quadruped position:

Answer 12

Crawling on hands and knees

Question 13

Common crayon grasp for a 2 yr. old, sometimes for a younger 3 yr. old:

Answer 13

palmar supinate

Question 14

A precursor to drawing – may emerge between 12-18 m, continuing through 2-3 yrs.

Answer 14

scribbling with crayons (progression from random strokes to scribbling with symbolic meaning)

Question 15

Cards 15-18 will focus on OT Models for Pediatric Practice

Model of Human Occupation
Key Elements and Guiding Principles

Answer 15

Elements:
Volition, Habituation, Performance Capacity, Environment
Guiding Principles:
Requires repetition of occupational actions, thoughts, and emotions within a supportive environment

Question 16

Person-Environment-Occupation-Performance Model (PEOP)

Answer 16

Key Elements:
Person, Environment, Occupation, Performance
Guiding Principles:
Client centered collaboration between client and therapist
Client needs and preferences drive goal setting and intervention planning

Question 17

Canadian Model of Occupational Performance and Engagement (CMOP-E)

Answer 17

Key Elements:
Person, Environment, Occupation
Guiding Principles:
Client-centered, therapists identify gaps between desired and actual performance, occupational experience and engagement important for life satisfaction, spirituality is core

Question 18

Occupational Adaptation (OA)

Answer 18

Key Elements:
mastery, contexts, participation
Guiding Principles:
An individual’s desire to master their environment through participation in occupations, environment demands mastery from the person, adaptive and non adaptive responses, therapist facilitates participation in occupations to empower client and facilitate mastery

Question 19

Flashcards 19 - 27 will focus on OT Frames of Reference for pediatric practice

Developmental FOR

Answer 19

motor, social emotional, and cognitive skills
Skills practiced in a developmental sequence, engage child in tasks at their developmental level, challenge with activities slightly above developmental level, grade activities to balance challenge w/success, opportunities for repetition

Question 20

Biomechanical FOR

Answer 20

Focus on physical limitations
Foundations in kinesiology
Considers ROM, strength, endurance
Positioning, orthoses, pain reduction, edema management, progressive / resistive exercise

Question 21

Ayres Sensory Integration FOR

Answer 21

Processing, discriminating, modulating, organizing, integrating sensory input to produce an adaptive response
Child actively involved in treatment – making choices, directing play - increased potential for improved neural organization
Set up environment with multi-sensory activities to promote adaptive response, challenge praxis w/novel activities create “just right challenge “

Question 22

Motor Control / Motor Learning FOR
(directing and regulating movement) / learning movement)

Answer 22

Based on dynamic systems theory
Dysfunctional movement patterns = insufficient adaptability to meet task and environmental demands Therapists modify task requirements to promote progress and success
Repetition promotes development of improved neural pathways
Motor learning requires repetition of motor tasks that are motivating and meaningful for children that provide opportunities for problem solving

Question 23

NDT FOR

Answer 23

Focus on helping children (and adults) perform skilled movement more efficiently
Increase function with active use of trunk and extremities
Facilitate new neural pathways through repetition and emphasis on motivation, meaningful activity, and problem solving
Key components - normalize muscle tone before movement, quality of movement, target postural control, weight shift, and balance reactions through key points of control, inhibition and facilitation techniques

Question 24

Rehabilitation FOR

Answer 24

Allows child (adolescent) to engage in preferred or needed occupations with modifications / adaptions (may be used with other FOR such as biomechanical, motor learning, cognitive). Allows return to previous occupations with compensations and adaptation
Top down approach
Focus on strengths
Modification to tasks and environment - new ways to complete daily tasks
Caregiver or family training

Question 25

Behavioral FOR (Includes Applied Behavior Analysis)

Answer 25

Behavior reinforced with reward
Identify reinforcers and rewards
Develop behavioral support plan
Collect data regarding behaviors
Environmental stimulus results in behavioral response

Question 26

Cognitive FOR

Answer 26

Assist child to use cognitive strategies to support occupational performance
Based on Bandura’s theories - self efficacy
Child learns to use and generalize cognitive strategies across settings - learns self evaluation
Task analysis
CO-OP model - cognitive orientation to occupational performance

Question 27

Cognitive Behavioral FOR

Answer 27

Thoughts and feelings influence behavior
Changing cognitive thoughts/beliefs can change behaviors
ID negative thoughts and beliefs - help child reframe to promote motivation and participation