Week 2 Flashcards

1
Q

S (SOAP Notes)

A

-Subjective information that cannot be verified or measured
-Statement is relevant to the clients condition or treatment
-Concise this section should only be a few statements
(Ch 7)
Ex. Claire stated “my hand hurts and just gets tired when writing
Ex. Noahs mothers reported improvement with attention to task when utilizing sensory strategies during tabletop

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2
Q

O (SOAP Notes)

A

-Objective direct observations throughout the session
-Record all relevant objective data
-Always begins with length setting and purpose
-Focus on occupation purpose and function
-Include assist level (no min mod max) will mostly be numbers
-Can be written chronologically or by categories
-Professional concise and specific
(Ch 8)
Ex. Noah was seen for a 45 min ot session in a telehealth setting to address sensory processing skills required for attention and engagement in classroom activities.
Ex. Noah required 3 verbal prompts for redirection from sensory seeking behaviors to complete a 5-min tabletop task

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3
Q

A (SOAP Notes)

A

-Assessment analysis interpretation of your s and o
-Do not add in new info here
-This is where you will demonstrate your clinical reasoning skills
-These statements should be written as problem progress or potential statements
-Should always end with child would benefit from
(Ch 9)
Ex. Noah’s difficulty processing vestibular and proprioceptive input impacts his ability to attend and complete classroom work
Ex. Noah’s ability to maintain attention to a 5 min tabletop task indicated improved sensory regulation skills required for educational participation

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4
Q

P (SOAP Notes)

A

-Plan this is your plan of what happens next
-Includes frequency duration and purpose and specific interventions
-Needs to relate to your o and a
-Frequency and duration will depend on the setting
(Ch 10)
Ex. Noah will continue to be seen 30 min a week until the annual IEP meeting to improve sensory processing skills for increased educational performance. OT sessions to address proprioceptive and vestibular strategies and sensory regulation techniques within the classroom.

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5
Q

What is play

A
  • Spontaneous
  • Fun
  • Intrinsically motivated
  • Internally controlled
  • Emphasis on process rather than product
  • Pretend or as if component
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6
Q

4 characteristics of play

A
  • Framing
  • Relative intrinsic motivation
  • Relative internal control
  • Relative freedom from some constraints of reality
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7
Q

Contexts and interactions are more or less…

A

Playful depending upon the balance between perception of source of control source of motivation and suspension of reality

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8
Q

Framing

A
  • Players give cues to one another that define an activity or interaction as play this is not real
  • Define the boundaries of play with cues
  • Cues are exaggerated and easier to learn/notice
  • Frames last only as long as players cues support it
  • Frames break for negotiation of rules
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9
Q

Relative Internal Control

A
  • Child acts on his intrinsic motivation by deciding who what to play with and how where to play
  • Supports a safe environment to play
  • Child can choose activities that are appealing and provide a just right challenge
  • Not running the show
  • Shared control through negotiation and collaboration
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10
Q

Relative Intrinsic Motivation

A
  • Motivation that comes from inside of an individual
  • Participating in the activity itself provides its own reward
  • How do we know: Intense engagement, Ignoring things that are not of play, Persistence
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11
Q

Relative freedom from constraints of reality

A
  • Ability to pretend and engage in fantasy play

- Reduction or suspension of consequences that might be associated with the activity in real life

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12
Q

TUOS and pediatric therapy: the art therapy

A
  • Establishing trust
  • Setting a playful atmosphere
  • Tapping motivation and inner drive
  • Reading and responding to childs cues and behavior
  • Adjusting the challenge and flow of therapeutic activities and interactions
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13
Q

Settings that support play in OT intervention

A
  • Respects bulbs on childs intrinsic motivation
  • Allows for object exploration/experimentation
  • Supports play through verbal nonvernal messages
  • May include social or imaginative play
  • May use fantasy play
  • May follow the childs lead by structuring or expanding on child initiated ideas
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14
Q

Research related to therapist child relationship in Ped OT

A
  • Task orientation
  • Positive emotional atmosphere
  • Playfulness
  • Joint managemet of challenge
  • Joint decision making
  • these are all around therapeutic relationship*
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15
Q

Playful Use of Self

A
  • The adoption of a playful attitude in interpersonal relating with the child
  • Two questions:
    1. How do we use ourselves therapeutically to communicate a playful backdrop for intervention
    2. How do we playfully and intentionally interact with clients in the establishment and maintenance of a positive therapeutic alliance
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16
Q

TUOS in creation of a playful context for intervention

A
  • Suspend adults assumptions
  • Level power differences
  • Look for impact of adult presence
  • Assume behavior actions are communications
  • Engage together in co-occupations
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17
Q

Communicating Playfulness Non-Verbally

A
  • Eye gaze
  • Facial expressions
  • Body language
  • Voice and vocalization
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18
Q

Communicating playfulness verbally

A
  • Match the childs language
  • Give words to the childs actions and vocalizations
  • Direct instruct playfully: Invite, Use rhythm, Fun sounds effects, Use kid words
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19
Q

Look listen and feel for child feedback

A
  • How do you know your message about play is being received
  • When a playful message comes across to the child the child is usually agreeable to the task
  • Cues to understand the message of play like laughing and smiling
  • Cues that message is not received is withdrawal pushing away ignorin
20
Q

Therapeutic modes

A
  • Advocating
  • Encouraging
  • Instructing
  • Empathizing
  • Collaborating
  • Problem solving
21
Q

Empathizing mode

A
  • Tone of voice
  • Mirroring emotions and actions of the child
  • Personify objects to mirror the child emotions
  • Give voice to the childs feelings and reactions
  • Play with the child as a partner or in parallel
  • Communicate empathy through touch as appropriate
  • Share control
22
Q

Collaborating Mode

A
  • Offer choice in activities play schemes sequence
  • Join childs play schemes
  • Share control
  • Look to teh childs behavior to communicate feedback about interest comfort level and enjoyment of play activities
  • Follow the childs directions
23
Q

Grading collaboration

A
  • Overuse of the mode may communicate a lack of understanding
  • For some asking to take lead may feel unsafe if they need direction
  • Grading communicates understanding respect whil allowing some self direction
24
Q

Instructing mode

A
  • Provide directions in playful ways (Song, Personification of toys and body parts)
  • Demonstration (Talking through, Taking turns with the child)
  • Playful and firm limits (Ooops this way is closed you need to find another way)
25
Q

Encouraging Mode

A
  • Accurate feedback is important (Good job vs you climbed the slide without holding on vs you are great at climbing slides)
  • Does not always have to be verbal can be through facial expressions
26
Q

Encouraging Mode and Childs Arousal

A
  • Consideration of the childs thresholds must be taken into account when providing encouragement
  • The amount and type of encouragement must be carefully considered to allow the child to maintain an arousal state that allows them to continue engagement in play activities
27
Q

Problem-Solving Mode

A
  • Playing dumb (Put child in position of expert as if you are stuck on problem)
  • Personifying objects
  • What exactly is the problem
28
Q

Assessing Play in OT

A
  • Social participation
  • Imagination
  • Independence
  • Coping
  • Enviornment
  • Performance skills and patterns
  • Most often evaluated in natural environments for a real-life perspective
29
Q

Challenges to Assessing Play

A
  • Human and physical factors in environment can have influence
  • In standardized situations play is altered or limited
  • Difficult to assess the meaning of play
  • Time and timing of observation may not be sufficient to determine if behavior is typical
30
Q

5 aspects of play

A

-Players approach to play-test of playfulness
-Preferred play activities-play profiles play history
-Skills the player uses in play-revised knoxPPS
-Source of motivation for play
environmental -test of environmental supportive

31
Q

Choices

A
  • Most cover one aspect of play
  • Choice will depend on age time ability to conduct observation and what we want to knoe
  • Skills players use in play is most commonly assessed (Easy to observe, Often developmentally relevant to the evaluation)
32
Q

Takata Play History

A
  • Semi-structured qualitative open-ended interview
  • With play observation
  • Examines history of play skills and choices made for play
  • Epochs is how scored
  • Therapist interpret results using taxonomy of play epochs
  • Some evidence of reliability and validity
33
Q

Epochs

A

How Takata Play is Scored

  • Sensory motor
  • Symbolic
  • Dramatic and complex
  • Games
  • Recreational
34
Q

Takata Play Limitations

A
  • Not standardized
  • Interview format
  • Interviewer competence
35
Q

Takata Play Strengths

A
  • Environmental focus

- Gathers historical data as well as present

36
Q

Pediatric interest profiles

A
  • Addresses preferred activities aspect of play
  • 3 age appropriate profiles rating play leisure interests and participation
  • Paper and pencil self report
  • Provides starting point for identification of play related issues
  • Appropriate for kids and teens
  • Quick and useful when observation is not possible
  • No training and free
  • Retest reliability
  • Describes perception of play preferences. It is not able to identify patterns of play preference nor to determine whether ot not certain patterns put children at risk
37
Q

Pediatric Interest Profiles Age Ranges

A

The kid play profile- 6-9
Preteen play profile 9-12
Adolescent leisure interest profile 12-21

38
Q

Test of Playfulness

A

-Assesse s playfulness 6 months to 18 years
-Scored after unobtrusive free play for 15 min
-Take place inside and outside with playmate
-3 primary constructs of playfulness
-29 items describe observable behaviprs
Observer rates the extent to which they display and carry out behavior

39
Q

3 Primary Constructs of Playfulness

A
  • Intrinsic motivation
  • Internal control
  • Freedom from constraints of reality
40
Q

Test of environmental supportiveness for play TOES

A
  • Developed as companionto test of playfulness

- Allows OT to examine the effect of caregivers playmates and the play space on play

41
Q

3 Steps of TOES (Test of environmental supportiveness for play)

A
  1. What is motivating the child, what does the child get out of experience, why does he she choose certain activities over others
  2. How well does the environment help the child engage in those activities- toys playmates space
  3. Is there anything you would like to change to help child play better
42
Q

Revised Knox Preschool Play Scale

A
  • Observational assessment
  • Assesses play skills
  • Gives developmental descri[tion of typical play behavior
  • 6 month increments 0-3
  • Viewed in 4 dimensions
  • Admin in and outside for 2 30 min observations in natural environment
  • Scoring is mark above each description with overall for each dimensions
  • Does not require toys equipment used in natural setting
  • Large age ranges needs additional standardization and validity
43
Q

Know Preschool Play Scale is Viewed in 4 dimensions including:

A
  • Space management
  • Material management
  • Symbolic
  • Participation
44
Q

Transdisciplinary play based assessment TPBA-2

A
  • Ages birth -6 years
  • 4 key developmental domains: Sensorimotor, Emotional social, Language, Cognition
  • 60-90 min to complete
  • Conducted at home or in natural environment
45
Q

Questions to Consider

A
  • What is fun and why
  • Child characteristics
  • Activity characteristics
  • Match
  • Relational characteristics