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621 Quiz #4 > Week 15: Cog. and Mental Health > Flashcards

Week 15: Cog. and Mental Health Flashcards

1
Q

What is the role of OT in supporting social skills and behavior?

A

Environmental access; teaching new behaviors and social skills; remediation or compensatory; nonverbal skills are explicitly taught; play; parent training;

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2
Q

What is the impact of early social experiences on child development?

A

Temperament, goodness of fit, attachment

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3
Q

Temperament includes…

A

Activity Level, Rhythmicity, Response to Novelty, Emotional intensity, Sensory Threshold, Mood, Adaptability, Distractibility, Persistence.

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4
Q

Goodness of fit includes…

A

Is the child’s temperament compatible with parental expectations?
Easy Child, Difficult Child, Slow-to-Warm-Up Child.

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5
Q

Attachment

A
  • A healthy term infant is biologically prepared for interactions with a competent caregiver.
  • Attachment occurs when an infant is confident that his/her needs will be met.
  • Quality early attachment may predict later relationships.
  • “The quality of early relationships is far more significant on early learning than are educational toys, preschool curriculum or Mozart CDs”.
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6
Q

The impact of the environment on social and behavioral development

A
  • Long-term social stress may negatively impact child development and social participation
  • Poverty (17% of children live in poverty)
  • Social discrimination
  • Severe family dysfunction
  • Impacts ability to gain resources; attitudinal environment; decreases opportunities; different family routines and habits that may not seem normative
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7
Q

What defines mental health?

A
  • Behaviors and beliefs are subjective.
  • Expectations of “normal development” vary between cultures.
  • Majority of mental health diagnosis are made based on behavior.
  • Perception of an “increase in mental health diagnosis” in society.
  • Stigma associated with mental health diagnosis.
  • Surgeon General: “Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity.”
  • How does poverty impact mental health: motivation, exposure, basic needs not met– so how to deal with mental health; barriers to resources; constant anxiety and living unsure; kids are expected to take on more adult roles; stigma how peers view them;
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8
Q

Social-emotional and cognitive development are influenced by executive functioning skills

A
  • Goal, plan, do, check
  • Simplified version for children
  • One step can look different for everyone, and for people with mental or cognitive deficits
  • “child is to execute plan”– what does this mean, specifically? In that sequence? unable
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9
Q

Development of Executive Functioning Skills

A
  • Brain’s ability to identify problems, analyze relevant data, make a decision, execute a plan and self-reflect for efficiency.
  • Requires complex analysis from many regions of the brain, but managed by the frontal cortex.
  • First seen in infants as their ability to transition smoothly between sleep/awake states and maintain quiet, alert state. (initiation, implementation, executing a task)
  • In kids: development, lack of insight, progression of executive functioning skills
  • 25 years to fully develop!
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10
Q

Response inhibition

A

the ability to control impulses

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11
Q

Working memory

A

purposeful recall of data to develop a current response (pneumonic devices; writing things down; habits and routines; pictures)

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12
Q

Self regulation of affect

A

emotional control and expression

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13
Q

sustained attention

A

: continuous attention despite internal and external distractions (positive reinforcement; increase motivation; environmental mods; teaching compassionate reciprocity)

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14
Q

task initiation

A

starting a task in a timely manner (breaking up the task into manageable portion; what things do you need to start? Whats the first step?)

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15
Q

planning

A

making decisions through effective prioritization (talking about it outloud; checklist; connection to goal and outcome)

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16
Q

organization

A

ability to arrange by a thoughtful system (material checklist)

17
Q

time management

A

accurately estimate, allocate and meet time constraints (using a timeline they understand; rugrats episodes!;

18
Q

flexibility

A

adapting to changing conditions (some kids need time to transition, some don’t’; give them a schedule (pictures); give kid some control)

19
Q

goal directed persistence

A

to identify and work towards a goal (putting together small steps; have visual of the goal; incorporating idea/goal throughout; grading goals; having them set goals; having consistency)

20
Q

metacognition

A

self-reflection and monitoring, ability to analyze your own thinking and see situations from the perspective of other people (stories; write social story; role-play; how does your engine run?)

21
Q

context-dependent attention

A

the child will attend to a given task if it is novel, interesting, “fun” and immediately rewarding (not using higher level skills; basic; not long term dependent)

22
Q

goal directed persistence

A

the child can attend to a range of tasks and demands as they are able to adapt their attention to a range of ideas and circumstances

23
Q

OT process with executive functioning skills in children

A

As an OT, we analyze the relationship between the child’s abilities and demands of the task and environment and make accommodations or train weaknesses.

24
Q

context-dependent attention (#2)

A
  • The child with a disability tends to be context-dependent for attention. (too hard to wait; to hard to reach the goal)
  • Their interests tends to fall within a narrow range. (they are good at that; don’t want to fail; less effort; limited access; lack of exposure)
  • In elementary school, children are expected to be “generalists”
  • In higher grades, children can begin self-selecting to their strengths on some level.
25
Q

Goal directed persistence (#2)

A
  • Seen in most typically developing children.
  • The child naturally adapts to new situations, subjects and persons.
  • The child performs with relatively equal skill across subjects with less gap in their best or worst performance.
  • The child can self direct to task performance and meet self-made goals.
26
Q

common diagnoses for executive functioning problems

A 
Autism
Asperger’s Syndrome
Attention Deficit Hyperactivity Disorder
Oppositional Defiant Disorder
Anxiety Disorders
Mood Disorders
Attachment Disorders
Trauma Disorders
(Tie to the Limbic system and frontal lobe)
27
Q

Occupation-based treatment of Executive Functioning Skills in Children

A
  • Many children are referred to OT to address the sensorimotor aspect of these disorders, but we can impact the cognitive aspects as well.
  • Why? Hard to detect cognitive/executive functioning problems in children; SI or sensorimotor issues can have underlying cog./mental deficits
28
Q

Assessments for executive functioning

A
  • Standardized assessments such as the BRIEF or other psychologically-based measures.
  • Interview and observation of the child in multiple environments.
  • Analysis of the child’s interests and activities to look for a strengths/weaknesses profile and meaningful clusters of behaviors.
  • Set up activity to identify strengths and deficits; ability to transition from task to task; planning; kids that get stuck on parts of the activity and can’t continue; cant start or stop activity
29
Q

Common observations in children with EF problems

A
  • messy
  • good at 1 step tasks only
  • easily distracted and frustrated
  • emotional
  • poor peer relations
  • procrastination
30
Q

Intervention options for EF skills

A
  • teach the cognitive skills that are weaker
  • adapt environment
  • developmental expectation
  • adapt task
31
Q

Models of intervention: occupational adaptation

A

Emphasizes natural contexts, client-centeredness, just-right challenge, emotionally rewarding.

32
Q

Models of intervention: operant conditioning

A

Highly structured activities, token systems, effective with promotion of new skills.

33
Q

Models of intervention: rationale intervention

A
  • Emphasizes the assessment and classification of behaviors into green, yellow or red zones.
  • Classification drives the need to provide therapeutic facilitation, correction, or monitoring.
34
Q

Managing challenging behaviors: Be prepared…

A
  • Rule out non-behavioral factors
  • Be consistent and predictable
  • Create a calm environment
  • Catch them being good and provide praise
  • Use positive terms
  • Keep perspective
35
Q

Preventing challenging behaviors: How to…

A
  • Reduce aversive events and experiences.
  • Share decision making and control.
  • The environment should support success.
  • Consider effectiveness of communication.
  • Have specific expectations.
  • Support self-regulation and awareness.
  • Provide the just-right challenge.
36
Q

Support positive behavior

A

-Are sensory needs being met?
-Is the child developing new skills
and strategies to deal with stress?
-Use “First, then” strategies.
-Manage transitions.
-Well-designed token economies
can increase self awareness and positive behaviors.
-Deconstruct challenging behaviors when the child is calm.

37
Q

Behavior support plan:

A
  • Collaborative goal setting and team consensus.
  • Assessment of the targeted behavior to include description of the behavior and contexts of occurrence.
  • Hypothesis development including antecedents/consequences and communicative function of the behavior.
  • Establish comprehensive behavior support plan outlining intervention strategies.
  • Implement plan and systematically measure outcomes and effectiveness.
38
Q

Best practice for EF interventions

A
  • Use a collaborative approach when deciding on reinforcers and behavioral strategies
  • Keep developmental and cultural norms in mind when designing systems
  • Review plans frequently for effectiveness.
  • Systematically collect pre and post intervention data to objectively analyze results and make modifications.
39
Q

Medications for EF

A
  • Parents often will ask your advice about medications for their child.
  • It is important to respect the parents decision and to be objective.
  • Encourage parents to explore the risks and benefits to medicating and withholding medications.
  • Be realistic about how impactful your services can be in changing behavior driven by a medical diagnosis that is not treated.

621 Quiz #4 (4 decks)

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