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OT210 Theory of Pediatrics > Week 5 and 6 study > Flashcards

Week 5 and 6 study Flashcards

1
Q

What Grasp pattern?

A

Dynamic tripod

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2
Q

What are the 4 mature grasp patterns?

A

Dynamic tripod, lateral tripod, dynamic quadrupod, lateral quadrupod

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3
Q

Mature VS immature grasp

How are they “produced”?

How can you improve immature?

A
  • Mature grasp pattern produced by intrinsic mm of hand
  • Immature grasp pattern produced by extrinsic mm of the arm. This leaves the fingers in a static posture
  • Look at intrinsic mm and try to improve mature grasp through targeting muscles in HEP.
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4
Q

4 elements of efficient grasps

A

proximal stability

stability within the hand

mobility within the hand

muscle tone

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5
Q

stability is on the _____ side of hand.

Mobility is on the _____ side.

mm tone provides ___ ___..

How does hyper/hypo tone effect grasp?

what are interventions for each?

A
  • Stability on ulnar side of hands
  • Mobility on radial side (thumb)
  • Increased tone spasticity=decreased mobility and flexibility
    • Stretching exercises, weight bearing, dynamic splinting
  • Decreased tone = decreased joint stability
    • Orthotics! Give them stability they need.
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6
Q

functional wrist postition is

how can we help a child acheive this easily?

A

40-45 degrees wrist extension

15 degrees ulnar deviation

Interventions for child to facilitate wrist extension in a child to help handwriting.

Bouncing ball, playing drums. Use slant board/ write on wall board. Light bright toy.

ALWAYS go GROSS TO FINE MOTOR when doing the

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7
Q

Pinch grasp patterns

How to Document if don’t know?

A

A. Radial cross palmar grasp

B. Palmar supinate grasp

C. digital Pronate grasp

F. Cross thumb grasp

G= Static tripod Grasp

H. Four Finger Grasp

I. Lateral Tripod grasp

J. Dynamic tripod grasp

When documenting write what you see instead of categorizing it. (how many fingers, extension/flexion, forearm and wrist position. Grasps-Gross, tips, pinch

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8
Q

what do the palmar arches do?

A

Support functional position

“cups” hand for cocave surface

accomodates objects

oppose thumb to fingers

move object with hand against palm

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9
Q

The _____ arch splits hands right and left

The ______ arch goes from pinky to thumb

the ________ arch is furthest away

How do we get a defined arch?

what condition presents with underdeveloped oblique arch?

A
  • C. Longitudinal arch splits hands right and left
  • B. Oblique arch from pink to thumb
  • A. Furthest away distal transverse

*Children with down syndrome tend to not have a great oblique arch

*In order to get a defined arch child needs to crawl!!! Weight bearing on hands defines the arches

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10
Q

Dissociation of the two sides of hand AKA _____.

the Ulnar side gives _____ for grip and _____ for hand.

the Radial side provides ____ and is the “____” side.

A

AKA Hand separation

  • Ulnar = power (ring finger and pinky). Provides stability for hand and power for grip.
  • Radial= skilled side (thumb, index and middle fingers) provides mobility
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11
Q

describe the 5 types of in hand manipulation AKA ______.

1.

2.

3.

4.

5.

A
    1. Finger to palm translation
    1. Palm to finger translation in the video
    1. Shift (example of picking up pencil or threading a needle)
    1. Simple rotation- 90 degrees or less
    1. Complex rotation- reposition 180-360 degrees within the palm
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12
Q

Scissor skills involve:

FM coordination AKA ______.

using both hands but for different jobs (Turn/hold paper, cut with scissors etc.) AKA _______.

Also involves ______ coordination.

A
  • Fine-motor coordination (AKA interdigital dexterity)
  • Bilateral coordination
    • When kids hold paper with non dominant hand and don’t turn paper. Arm stays still= Poor bilateral coordination
  • Eye-hand coordination
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13
Q

Prerequisites for scissors

A
  • Use a fork or spoon.
  • Open and close his/her hand.
  • Use his/her hands together in a leader/helper way
  • Isolate the thumb, index, and middle fingers.
  • Stabilize his/her shoulder, forearm, and wrist
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14
Q

Cutting skill progression

1.

2.

3.

4.

5.

A
  1. cutting scrap paper
  2. snipping the edges
  3. cutting straight lines
  4. cutting angles
  5. cutting curves
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15
Q

What are some wrong scissor techniques?

Down grades for scissor use?

A

Hand pronated

thumb too far in hole (shouldnt be on joint)

using 2 hands (DO NOT ALLOW)

Fingers outside of holes/ in extension (sign of poor hand separation)

hold paper with forearm NOT supinated

wrist extension

poor positioning/ no support

avoiding crossing midline by turning body

Adaptive scissors, keep paper on table for stability, use a line drawn on paper as visual support,

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16
Q

Adaptive scissors

A

A. Wooded block wedge scissors- no fingers, high tone in hand, SCI with limited distal function. Child pushes on scissors and

B. Loop Scissors- squeeze and spring mechanism. Can open and close hand. Don’t have to have isolated control.

C. spring scissors - Spring scissors for really little kids. Better for playdough. Yello piece flips

D. Dual control training scissors- HOH assist

E. regular child sized scissors = Fiskers

17
Q

Intervention ideas for scissor skils?

A
  • Scissor scoop tongs in sensory bin
  • Squirt gun
  • Spray bottle
  • Playdoh cutting
18
Q

4 areas of FM development birth to 5 y/o?

A
  • What are the 4 areas discussed in this video?
  1. Stability & strength
    1. hand, shoulder, and body
  2. Bilateral Coordination (2 types) (when documenting make sure to mention which type)
    1. hands together doing same job (catch ball), each hand doing different job(cutting)
  3. Sensory Processing
  4. Dexterity
    1. Grasp/release, pinch/thumb, finger coordination, wrist movement
19
Q
  • Why do preschool teachers encourage large pencils or triangular pencils promote functional grasps?
  • Why use small pencils for writing?
  • Why use crayons?
A
  • Why do preschool teachers encourage large pencils or triangular pencils promote functional grasps?
    • Easier to grasp onto for weaker hands, puts fingers in more functional grasp
  • Why use small pencils for writing?
    • promote an open web space and better positioning
  • Why use crayons?
    • doesnt rip paper, wax adds resistance for kinesthetic feedback to reader
20
Q

Developmental sequence of aquisition of prewriting skills

1-2 years old

2-3 years old

3-4 years old

4-6 years old

A

1-2 years old: scribble/ circular scribble

2-3 years old: vertical/horizontal strokes, then lines

3-4 years old: circles and intersecting strokes and lines

4-6 years old: diagonal lines and the ability to form shapes by putting prewriting strokes together

21
Q

Types of CP

categorized by body areas affected

categorized by motor type

A

monoplegia, Hemiplegia. Diplegia, Quadriplegia

  • Spastic- Most common
    • mm. stiff and tight due to motor cortex damage (High brain)
  • Athetoid (dyskinetic)
    • Characterized by involuntary movements arises from basal ganglia damage (mid brain)
  • Ataxia
    • Categorized by shaky movements, affects balance and sense of positioning in space. Arises from cerebellum damage (Low brain)
22
Q

CP interventions

A

CP interventions

  • Positioning (handling & equipment)
    • Handling techniques; slow rocking, bouncing, rotation
  • Weight bearing and wt. shifting promotes postural alignment and independent movement
  • Switches & AAC
  • Adaptive equipment
  • Medical management (sx, botox, oral baclofen)
  • Complementary Alternative Medicine CAM (hippotherapy, massage, refer p.327)
  • CIMT Protocol
23
Q

Principles of motor learning

  • ___&_____ ____ foster brain plasticity.
  • ____ ____ ____ stimulate learning.
  • ____ activities are motivating for ______.
  • _____ _____ fosters development.
  • Children learn best through _____ _____ _____.
  • Using ____ objects facilitates more _____ and _____ __ _____.
A
  • Practice & meaningful repetition foster brain plasticity which results in learning
  • Problem solving movements stimulate learning
  • Shaping activities allow children to perform, they are motivating for future repetitions
  • Children are motivated to learn; intrinsic motivation fosters development.
  • Children learn best through positive enjoyable experiences
  • Using authentic objects facilitates more repetition and quality of movement
24
Q

Learning from Neuroplasticity is a result from

  • _____ (after activity), ______ (comes before activity-anticipate or predict what they need to do)
  • _____
  • _____
  • _____
  • _____
A

Learning from Neuroplasticity is a result from

  • Feedback (after activity), feedforward (comes before activity-anticipate or predict what they need to do)
  • practice
  • modeling
  • demo
  • transfer of learning
25
Q

5 Principles of motor control

  1. ____ ____ approach - motor control _____ and is ____ by on an interaction from ____ ____.
  2. ___ ____: One system will influence another
  3. One task involves reactions from ____ _____.
  4. one must have _____ __ ____, which is guided by a _____ ____ informed by _____ that encourages one to _____ in the task
  5. _____ and _____ occur because of ________.
A

5 Principles of motor control

  1. Dynamic Systems approach DST- motor control develops and is refined by on an interaction from multiple systems.
  2. Must recognize the “Ripple effect” for successful intervention
    1. One system will influence another
  3. One task involves reactions from numerous systems which will require adaption based on bodies reactions
    1. Visual, proprioceptive, kinesthetic, neuromuscular, and tactile systems
  4. To engage in a task one must have intent to move, which is guided by a cognitive process informed by motivation that encourages one to engage in the task
  5. Changes and learning occur because of neuroplasticity
26
Q

Pillars of motor control:

  • _______
    • Has to be motivating
    • Target child’s volition (think MOHO)
  • ______
    • Dressing “play dress-up”
  • _______
    • Oral care, dressing, (home environment)
A

Pillars of motor control:

  • Meaningful
    • Has to be motivating
    • Target child’s volition (think MOHO)
  • Mimic child’s Occupations
    • Dressing “play dress-up”
  • Natural Context
    • Oral care, dressing, (home environment)
27
Q

Transfer of learning a skill is also called _________

Anticipating where an object is going to be compared to you _____ _____ _____.

A

Generalization Transfer of learning a skill.

Projected action sequence- Anticipating where an object is going to be compared to you

28
Q
  1. Dynamic Systems approach DST is what?
  2. what does it include?
    • _______
    • ______
    • ________
    • _____/____
    • ____ ____
A
  1. Dynamic Systems approach DST- motor control develops and is refined by on an interaction from multiple systems.
    • fine dance of all of these aspects you need to look at if doing any motor control
      • Includes neurological
      • Musculoskeletal
      • Psychosocial
      • Context/environment
      • Task requirements- (activity analysis, needs to be thorough)
29
Q

considerations of feedback with Motor Learning:

  • After activity
  • Before activity
  • from yourself
  • from outside yourself
  • timing (4)
  • frequency (2)
A
  • Feedback (after activity),
  • feedforward (comes before activity-anticipate or predict what they need to do),
  • Intrinsic feedback (internal),
  • Extrinsic feed back (external),
  • timing of feedback (concurrent, immediate, terminal, delayed),
  • frequency of feedback (consistent, sporadically)
30
Q

Therapeutic Handling NDT Principles

A
  • Repetition
  • neuroplasticity
  • Key points of control
  • “feel normal” mvmt
  • Symmetry
  • Emphasis on quality of mvmt.
31
Q

NDT Points of control

A

Points of control

  • Proximal Key points (We do most of the work, Mod-max assist)
    • Shoulders
    • hips
    • trunk
    • pelvis
  • Child spastic CP dependent getting in and out of almost all positions
    • Need to start with proximal support.

Distal Key Points

(child generally doing 60-70% of the work and only need a tiny amount of work)

  • Hand
  • Feet
  • head
32
Q

Inhibition Techniques

  • Used to _____ stimuli/tone
  • Is this sustainable? Will it last?_______
  • Ideas to decrease?
A

Inhibition techniques

  • Used to decrease stimuli
  • Is this sustainable? Will it last? No short lived
    • Only lasts momentarily. Botox, Baclofen pump etc.
  • of consistency

Ideas to decrease

  • Sustained pressure on tendon
  • Generally, get that through sustained weight bearing
  • Slow stroking spine
  • If slow enough can limit some tone
  • Rotation
  • Slow rocking / rolling
  • Heavy joint compression- weightbearing
  • Sustained wt. bearing
  • Calm music, dim lights
33
Q

Facilitation techniques

Used to ______ stimuli/tone

  • Child presents with _____
  • Decreased _____ __ _____

Ideas to increase:

A

Facilitation techniques

  • Used to increase stimuli
  • to increase mm tone
  • Child presents with flat affect
  • Decreased reactivity to touch

Ideas to increase:

  • Light touch
  • Tapping, sweeping mm belly
  • Fast vestibular input
  • Joint compression
  • Wt. shifting
  • Quick, variable movements
  • Upbeat music, bright lights.
34
Q
A

OT210 Theory of Pediatrics (3 decks)

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