Week 12 to 14 Flashcards

Question

Important components of sucking

Answer 1

``` Easily initiated Rhythmical Strong Sustained efficient ```

Answer 2

Under 5 months – not appropriate 5-6 months – no controlled bite 9 months – holds cookie between gums without biting through; feeder breaks off 12 months – controlled, sustained bite 24 months – able to grad jaw opening when biting foods of various thickness

Answer 3

Under 5 months – only sucking 6 months – munching – up and down jaw movement 9 months – some rotary jaw movement 15 months – diagonal rotary – jaw moves down and laterally or down and diagonally as food moves from mid tongue to side or side to mid tongue 24 months – circular rotary – circular or semi-circular jaw patterns with food moving across mid line to opposite sides – used for tougher/firmer foods

Answer 4

Under 6 months – sucking 6 months – does not use teeth or gums to clean food from lips 9 months – draws lips in when food on them 12 months – still may lose food when chewing; actively cleans lips 18 months – can chew with lips closed; loses some 24 months – no longer loses food 3 to 4 years – keeps lips closed for appropriate table manners

Answer 5

Insufficient tone allows jaw to slip and shift forward

Answer 6

Jaw tightly clenches when teeth are stimulated, may be difficult to release Caused by – abnormal muscle tone

Answer 7

Movement seen in normal suck pattern, but protrusion is slightly exaggerated (sticks out beyond lips) Caused by – abnormal tone - lack of tongue mobility

Answer 8

Forceful protrusion of tongue; thrusting makes feeding very difficult Caused by – abnormal tone - lack of tongue mobility

Answer 9

Tendency for lips and cheeks to be pulled into tight, retracted position Caused by – high tone

Answer 10

Reduction in strength and skill in cheeks causing spillage, drool, poor articulation and mouth breathing Caused by – low tone - cranial nerve damage

Answer 11

Stronger reaction to specific sensations Caused by – neurological issues - tube feeding

Answer 12

Milder reactions to a specific sensation than would be expected Caused by – neurological issues

Answer 13

Caused by – abnormal tone - teething - inefficient swallow - constant wet face

Answer 14

Do not upset child – may take along time to regain trust May need same person to always feed Establish routines and rituals OT try strategy first then train feeders then OT moves off when possible

Answer 15

Do not elicit gag reflex then it will diminish When in doubt – get swallow study!!! To decrease tube feeds – work with dietician – child must be hungry to eat successfully by mouth Bite reflex – don’t pull away – relax child/neck flexion Always wash hands/wear gloves

Answer 16

Taste/smell – bland food may not be meaningful; add taste if child over stuffs mouth Proprioception – use taste/temperature if child does not know tongue Vestibular – use this sensation to mediate arousal level for feeding and for increased postural control

Answer 17

Start with handling/sensory input to normalize tone Proper positioning – 909090 - hands at ML - maintaining position should not be work - car seat or w/c may work best

Answer 18

Start with handling/positioning External jaw control technique Biting games – “bite and tug” Snack cap

Answer 19

``` Start with handling/positioning Work on Jaw Control Cup drinking Increase lumpiness of food textures to encourage chew Work on quiet mouth as food approaches Place food at molar Stimulate sides of tongue ```

Answer 20

``` Start with handling/position Massage – ears to mouth - nose to mouth Straw drinking Downward pressure on tongue with spoon elicits lip closure ```

Answer 21

``` Start with handling/positioning Calm environment Work on decreasing gag reflex Work on hand to mouth Work on toys to mouth Let child know food is coming Grade food textures Brushing/wash cloth/cosmetic sponges/nuk brush Electric toothbrush Deep pressure to teeth ```

Answer 22

Start with handling and positioning Variety of stimulations – tastes and textures Cue for over stuffing

Answer 23

``` Start with handling and positioning Increase sensory awareness around mouth Work on Jaw and lip control Work on independently wiping mouth Work on Straw drink – Transport – moving liquid from front of mouth to back ```

Answer 24

Play is an end in and of itself Play is spontaneous, voluntary, rewarding and pleasurable Play differs from other behaviors in form or timing – i.e. only in infancy or very exaggerated Play is repeated but flexible Play is not stressful

Answer 25

Sensorimotor play 0-2 years old Exploratory play First year of life; actively explores environment; interested in how things work Shows up again when child is learning new things Constructive play Building and creating; i.e. sandbox, blocks, arts and crafts Symbolic play 2-5 years old; peeks at dramatic play; encourages self-regulation, empathy and civility During middle childhood it evolves into fantasy play such as daydreaming, secret clubs, riddles, mental games Social play By 3 years old, child can engage in complex social games such as role playing using different identities; i.e. parents, characters, etc. Games with rules Teaches turn taking and to initiate, maintain and end social interactions

Answer 26

- Socializing - Television - Sports/hobbies/games Screen time – virtual interaction Sharism – fast-paced sharing of ideas (i.e. Minecraft) Shifting identities – boundaries between mine and yours blurring with video exchanges Border crossing – moving between virtual and physical world more (i.e.. Sky landers_ Literacies beyond print – reading and writing with e-readers and apps Gaming culture – forgiving and responsive world is expected because they can access “undo” button Bricoleur culture – eager to hack, modify, program and recycle

Answer 27

``` Many purposes of play Develop life skills Expend extra energy Relaxation Achieve optimal arousal Develop ego Develop cognition Develop social abilities Contribute to culture Role development ```

Answer 28

Play meaning – quality of the play experience, person’s state of mind and value of play experience for the individual

Answer 29

– attitude during play ``` Dimensions of play: Physical spontaneity Cognitive spontaneity Social spontaneity Manifest joy Sense of humor ``` Elements of play Intrinsic motivation Internal control Ability to suspend reality

Answer 30

Play obtains meaning through context ``` Factors influencing play Environment/physical setting Family Culture Toys ``` More variety of materials then better quality play Quality of care Less parent supervision then more creativity More responsive the care giver then better quality play Socioeconomic status I.e. higher socioeconomic then more dramatic play

Answer 31

``` Familiar toys, peers, materials Freedom of choice Nonintrusive adults Safety Schedule that avoids fatigue, hunger or stress novelty ```

Answer 32

External constraints Limited choices Too much novelty or challenge Over competition

Answer 33

Play is considered child’s major occupation ``` Developmental Competencies: Four areas -Space management -Material management -Pretense/symbolic – separate reality from make-believe -Participation ``` Play, Playfulness and Play Style: Analyze state of mind during play Look at environment during play Use child self-report and perceived self-competencies Interpreting Play: Assessments Standardized assessment tools may inhibit play Best to observe child in natural environment multiple times across multiple settings

Answer 34

-Children in Romanian orphanages Severe sensory problems Delayed development Difficulty interacting with others ``` -Children hospitalized Confinement, stress and pain effect play Regression to earlier developmental stages Decreased endurance Decreased attention Decreased initiative Decreased curiosity Decreased playfulness Decreased creativity Increased anxiety ```

Answer 35

-Physical disability Problems exploring Fear of movement May show more playfulness ``` -Cognitive impairment Enjoy structured play materials Inflexible play Decreased curiosity Inappropriate use of toys Decreased imagination Decreased language Decreased symbolic play Decreased social interaction ```

Answer 36

``` Delayed motor exploration Difficulty with constructive play Delays in developing complex play routines Decreased imitation Decreased role playing ```

Answer 37

Decreased social interaction Decreased understanding of abstract concepts Restrictive imagination

Answer 38

``` Excessive movement or avoid movement Decreased exploration Decreased gross motor and/or fine motor Increased observation or solitary play Restricted play repertoire Resistance to change Distractibility ```

Answer 39

``` Decreased social interaction Decreased language Stereotypical movements Decreased imagination Lack of variety in play Decreased motor planning Decrease organization ```

Answer 40

Variety of difficulties impacting play Motor Cognitive Decreased social opportunities

Answer 41

In therapy, if OT drives the activity it may no longer be viewed as play by the child – it becomes work Two primary ways to use play in OT : Intervention modalities to improve specific skills As an intervention goal

Answer 42

Playfulness helps with generalization during difficulty situations OT should show playful attitude Novelty Imaginary play Mixed age play – develop leadership skills, creativity and imagination

Answer 43

Novel objects added to play increases playfulness – increased creativity, activity and socializing Adapting toys Children should control placement of toys and objects AAC

Answer 44

``` Parent Education: Barriers to play Limitations by adults Physical and personal limitations of child Environmental barriers Social barriers ``` ``` Supporting parents: Help design play spaces Toy inventories Allow children to do more Model play behavior ```

Answer 45

``` Decreased time for free play Overscheduled Decreased recess Safety concerns – less time outdoors Video game time increasing Obesity Exposure to violent games ```

Answer 46

- The Moro reflex is an infantile reflex - develops between 25–30 weeks of gestation and disappears between 3–6 months of age. - a response to a sudden loss of support and involves three distinct components: spreading out the arms (abduction) pulling the arms in (adduction) **look at visuals if you can it will help**

Answer 47

The asymmetrical tonic neck reflex (ATNR) is a primitive reflex found in newborn humans that normally vanishes around 6-7 months of age. -It is also known as the "fencing reflex" because of the characteristic position of the infant's arms and head, which resembles that of a classically trained fencer. **look at visuals if you can it will help**

Answer 48

Symmetrical Tonic Neck Reflex (STNR) The Symmetrical Tonic Neck Reflex (STNR) provides the separation of body movements between the upper and lower half of the body. -It is developed after the ATNR and allows the infant to defy gravity on their hands and knees, and is a precursor to creeping. **look at visuals if you can it will help**

Answer 49

- The palmar grasp reflex is elicited by placing an object or the examiner's finger in the palm of the infant's hand; - this leads to an involuntary flexion response. - This reflex subsides by 3 to 6 months of age - replaced by voluntary grasping, which is necessary to allow transfer of objects from hand to hand.

Answer 50

- A reflex that is seen in normal newborn babies, who automatically turn the face toward the stimulus and make sucking (rooting) motions with the mouth when the cheek or lip is touched. - The rooting reflex helps to ensure successful breastfeeding.

Answer 51

- It is paired with the rooting reflex, in which a newborn searches for a food source. - When he finds it, the sucking reflex allows him to suck and swallow the milk