OTR Examination pocket prep

Work hardening program

• Interdisciplinary • Real and/or simulated • productivity, safety, physical tolerance, and worker behaviors in acutal simulated settings • CARF accredited

work conditioning program

• One discipline • Real and/or simulated • Transition between acute care and return to work • Flexibility, strength, movement, and endurance is the FOCUS • Accreditation is not a requirement conditioning is ONLY conditioning

Transitional Services

16 yo All IEP Areas: Instruction Related Services Activities of Daily Loving Functional Vocational Evaluation Development of Employment Community Experiences

junior standard chair has the dimensions of

16" wide 16" deep 18.5" high

rotator cuff tendinitis

an inflammation of the tendons of the rotator cuff Effe

hemianopia

blindness in one-half of the visual field after CVA

physical demands frequencies: frequently

demand is 1/3 -2/3 of the day

tonic-clonic seizure

generalized seizure in which the patient loses consciousness and has jerking movements of paired muscle groups

antidepressant medications

generally work on neurotransmitters such as serotonin, norepinephrine, or dopamine to regulate mood; not commonly used for pediatric population but may be used for adolescents Selective serotonin reuptake inhibitors: flouxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil) and ciralopram (Celexa)

visual acuity

sharpness of vision of both near and far

Anosognosia

A condition in which a person with an illness seems unaware of the existence of his or her illness.

S1-S5 spinal cord injury

"Loss of function in the hips and legs; most of the impact is in the bladder, genitals, and bowels. Braces are often used here based on strength testing, and some patients will be able to walk with support based on the level and severity of injury " "Generally independent with self-catheterizing and bowel regimens for toileting. Will have some sexual dysfunction. Can drive a modified car. There is no impact on upper extremity (UE) use, speaking, or breathing. May use a slide board or nothing at all for transfers."

simple partial seizure

((originate in the motor cortex and result in clonic activity of the face or extremities; the person may experience visual or auditory hallucinations or olfactory sensations))localized, writhing or L UE -e.g. just a part of you is seizing

STORCH

*Syphilis, Toxoplasmosis, Rubella, Cytomegalovirus (use of universal precautions), Herpes simplex* Major causes *HL in fetus/infant* Mother to child transmission

levels of consciousness

- Coma - Vegetative state - Minimally conscious state

Behavioral therapy for ODD

- consistent expectations and consequences - use of same behavior program in the home/school - positive reinforcement system

Infant visual impairment intervention strategy

-> dim lights -> stimulation of other body senses to influence distance sense -> emphasis on the human face -> softer, simpler 3 dimensional forms -> mobiles hung 2 feet above the infant -> toys that reflect light or flash with sound

CMD implications for OT

-> increased mobility and prevent contractures -> use A/E and orthotics -> Maintain (I) mobility

OT implications for depression

-> provid oppruitinites for self expression

Wet AMD

-Characterized by a proliferation of abnormal blood vessels that leak blood and fluid into the macula, causing central vision loss. This type progresses more quickly than dry AMD... -central vision loss

Formal handwriting assessments

-Children's Handwriting Evaluation Scale -Denver Handwriting Analysis -Minnesota Handwriting Assessment -Evaluation Test of Children's Handwriting -Test of Handwriting Skills -Print Tool

education model

-Views the individual with a disability as lacking knowledge or skills -Focus is placed on learning and making the behavioral changes needed to interact successfully in the environment -An individual's skill deficits are determined, and related goals are established, to promote learning to adequately perform within a particular environment -Behaviors are measured in terms of obtaining skills, knowledge, and competency to successfully meet the demands of the environment -OT frames of reference are based on learning theories to facilitate adaptation in the environment (eg. role acquisition, cognitive remediation)

Community Model

-Views the individual with a disability as lacking skills, resources, and supports for community integration -Focus is placed on identifying and developing the skills needed for one's expected environment -If skills cannot be developed, community resources and supports are identified and developed to enable functioning within one's chosen environment -OT frames of reference promote development of performance components and/or performance areas within the individual's performance contexts (eg. life-style performance, occupation adaptation)

House Management Skills (IADLs) for 7-9 yr old

-being responsible for allowance money -using the phone to call a friend -putting clothes away in the closet

Developmental Coordination Disorder for OT implications

-emphasize improving occupational performance across context -implement modifications and accommodations for written language, including keyboarding provide support in physical education promote safe practice of motor skills provide support for development of good self concept and self-esteem perform assessment with cognitive orientation to daily occupational performance(CO-OP)

Splinting

-fabricated with a long base -wrist extension>wrist flexion (for functional use of hand)o - don/doffing schedule -examine the skin to check for redness and skin breakdown DOES NOT PROVIDE CIRCUMFERTIAL Support like cast

Anticontracture position-hand

-metacarpal extension, 70 degrees of flexion, IP extension, thumb abducted and extended

Three intrinsic attributes to MOHO

-performance capacities -habituation -volition

accomodations for workers with aspergers

-provide advance notice of topics to be discussed at meetings -provide the person with work requests in writing rather verbal -provide assignment into smaller tasks -encourage use of timer -> provide a written checklist of assignments - permit structured breaks to provide an opportunity for physical activity -> allow work from home if appropriate to the job description -> provide a private workspace with adequate room to move arounf and with reduced distractions -> establish employer policies that specift no perfumes or use of products

play for kids with spastic quadreplegia

-using a chin on/of button game -Tasks with limited motor ability UTILIZES the child being actively engaged NO PASSIVE TASKS

complex partial seizure

///originate in the temporal lobe and appear as lip smacking, chewing, or buttoning and unbuttoning clothing; characteristics similar to absence seizures

Picking up head position in prone

0-2months first skill a baby learns

Development of releasing skills in infants (birth-9months)

1) unable to release ( 0-1months) 2) involuntary release when the hand opens (1-4 months) 3) two stage transfer between hands ( 5-6 months)- one hand holds object, second hand joins hold, first hand releases 4) one stage transfer between hands (6-7 months) The child holds the object at midline with both hands and pulls it out of one hand and into the other. 5) voluntary release (7-9 months)

palmar supinate grasp

1-1/2 years writing tool held with fisted hand, wrist flexed and supinated -->uses the entire arm

primary visual aging changes

1. Subcutaneous fat around the eye decreases 2. Strength of muscles, tone, and transparency of corneas decrease 3. Sclera and iris show signs of degeneration 4. Pupils become smaller 5. The lens of the eye becomes thicker, more inflexible, and more opaque 6. Eye diseases become more common 7. The corneas become thicker

Reisburg's stages of dementia

1. no signs 2. person c/o forgetting normal age related info 3. beginning signs 4. IADL deficits 5. can't function independently 6. ADL only with cues 7. bedbound

Piaget's stages of cognitive development

1. sensorimotor 18mons-24 mons During the early stages, infants are only aware of what is immediately in front of them. They focus on what they see, what they are doing, and physical interactions with their immediate environment. 2. preoperational 2-7 years During this stage (toddler through age 7), young children are able to think about things symbolically. Their language use becomes more mature. They also develop memory and imagination, which allows them to understand the difference between past and future, and engage in make-believe. 3. concrete operational 7-12 yrs Children's thinking becomes less egocentric and they are increasingly aware of external events. They begin to realize that one's own thoughts and feelings are unique and may not be shared by others or may not even be part of reality. NON ABSTRACT CONCEPTS 4. formal operational 12-adulthood Adolescents who reach this fourth stage of intellectual development -- usually at age 11-plus -- are able to logically use symbols related to abstract concepts, such as algebra and science. They can think about multiple variables in systematic ways, formulate hypotheses, and consider possibilities. They also can ponder abstract relationships and concepts such as justice.

Handwritten readiness development

10-12 mons: scribbles on paper 2 yr: imitates horizontal, vertical, and circular marks 3 yr: copies a vertical line, horizontal line, and circle 4-5 yr:: copies a cross, right oblique line, square, left diagonal line, left oblique cross, some letters and numbers; possibly can write their own name

Anticontracture position-hip

10-15 degrees of abduction, neutral extension

SES among elderly adults

11.4 percent of individuals over 65 live above the poverty line Approximately half of older adults have completed high school Half of all older women are women Older men are twice as likely to be married as older woman

Distance between driver and steering wheel

12 inches

slim adult wheelchair

14" wide x 16" deep x 20" high

patient population with high TBIs

15 to 28 yr old males

Maximum slope of ramp

1:12. Ramp slopes between 1:16 and 1:20 are preferred. Most ambulatory people and most people who use a w/c cannot manage a slope of 1:12 for 30 feet.

digital pronate grasp

2-3 years, tool held with fingers, wrist in neutral with slight ulnar deviation and forearm pronated

Infant Development of Crawling

3-4 months: infant can roll from supine to her side 5-6 months: infant can troll from prone to supine 7 months: can crawl on belly 7-10 months: infant begins reciprocal creeping. 11-12 months: The skill continues to progress until the infant can effectively creep

Cognitive Linguistic Quick Test

5 cognitive domains (attention, memory, executive function, language, visuospatial fields) for adults with neurological impairment. It includes clock drawing test

Boxer fracture

5th metacarpal fracture. Ulnar gutter splint

Mobility development

7 mons: able to bear weight through both LEs; the infant also begins to transition from sitting to kneeling 9 mons: able to stand while holding on to a surface or piece of furniture; the infant also begins to crawl/creeping 10 mons: taking purposeful steps while holding on to an adults hand for (A) 12 mons: begin to walk (I)

angle for outriggers for dynamic splints

90 degrees

Normal Vital Signs

90-120 (avg 110) systolic 60-80 (avg 70) diastolic, 12-18 respirations, 60-100bpm (avg 80), 97-100.8F (avg 98.6).

No Child Left Behind Act

A U.S. law enacted in 2001 that was intended to increase accountability in education by requiring states to qualify for federal educational funding by administering standardized tests to measure school achievement.

full thickness burn (3rd degree burn)

A burn injury involving all layers of skin and underlying tissues skin (i.e dermis, hair follicles, and sweat glands) may be brown or chard and underlying tissues may appear white. 1-3 weeks of healing

Bruininks-Oseretsky Test of Motor Proficiency

A measure of gross motor, upper limb, and fine motor proficiency in children 4.5 to 14.5 years old. A short form is available for brief screening. Standardized

Percentile

A rank of scores to determine what percentage fall above or below a specific number or reported cases

whirlpool bath

A therapeutic bath of heated or cooled water in which all or part of the body is exposed to forceful, massaging currents in the water. USED TO CLEAR DEBRIDEMENT OF WOUNDS

tactile defensiveness

A type of sensory defensiveness in which a person overreacts or avoids touching certain textures. REQUIRES FIRM/DEEP PRESSURE ALWAYS

IEP (Individualized Education Plan)

A written statement that spells out a program specifically tailored to a child with a disability. must include transitional planning to help a student identify desired post school goals and develop a plan for achieving these goals Plan must begin at 14 with transition services implemented at 16

Driving/visual performance deficits

Acuity:client may be slow to recognize signs and show delayed response to the environment CS: corrective lenses contrast sensitivity: client may be slow to recognize road signs CS: avoid area, time of day, and other conditions (i.e. cloudy/rainy days with poor contrast) night vision client deficits may increase in low light conditions or bad weather CS: restrict night driving, drive on roads with reduced speed limits, and increase following distance at night glare recovery: client may have the difficulty adapting to the dark or to bright lights CS: restrict night driving Visual field deficits peripheral field deficits: client may experience inefficient eye movement CS: use prism lenses, and compensate with extra head turns Field cuts or scotomas client may miss street signs, hazards, other road users, vehicles, or stimuli on the affected side CS: use prism lenses, compensate with extra head turns and frequent eye movements, and restrict driving at night or at high speed

Arnadottir OT Neurobehavioral Evaluation (A-ONE)

Adult population with cognitive/perceptual deficits; Structured observations of BADL and mobility skills to detect underlying neurobehavioral dysfunction

Postacute rehabilitation phase of TBI

Afte inpatient, pt wil be prepared to re-enter the community. Post acute treatment options include home based therapy, residential program, day treatment program, outpatient community reentry program 1. Optimize cognitive function 2. Optimize visual and visual-perceptual function 3. Restore competence in self-maintenance roles 4. Restore competence in leisure and social participation 5. Restore competence in work 6. Contribute to behavioral and emotional adaptation

Entry Level OTA can supervise whom?

Aides, techs, volunteers,

Deductible

Amount you must pay before you begin receiving any benefits from your insurance company

right hemisphere functions

Analysis of left visual field, stereognosis (left hand), emotional coloring of language, spatial abilities, rudimentary speech

Physically least taxing method for feeding an infant

BREAST FEEDING with pillow support

Moro reflex

Baby Reflex in which a newborn strectches out the arms and legs and cries in response when the baby's head/neck is quickly extended Onset: 28 weeks Integration: 4-6 months

modifiable risk factors for fall

Balance Environmental hazards limited mobility NOT AGE

Shift (Hand manipulation)

Balanced movement of thumb in opposition (grabbing and turning a page); buttons through a hole; threading a needle; move finger up a pencil 3-3.5 year

Botox injections

Botox lessesn spasticity for 3-6 months of the opposing no spastic muscles For instance, if the person has flexor spasticity you want to focus on the triceps to strengthen that muscle. Weight-bearing on UE would be indicated

Aphasia's

Broca: can't communicate thoughts Global: receptive and expressive language Weirnickes: compression of verbal language

CPR sequence

C-A-B Circulation-Airway-Breathing for unresponsive adults, children, and infants A-B-C Airway-Breathing- Circulation for unresponsive newborn babies

C6 spinal cord injury movement remaining

C6: Breathing is weak but uses the diaphragm. Paralysis in the hands and below the waist. May be able to use tenodesis movement to grasp items. No control over bowel and bladder but can likely transfer with adaptive devices such as a slide board. Can use motorized chair and possibly adaptive driving." Can learn button buttons

Marginal manual wheelchair user

Can propel a manual wheelchair for short distances; tolerates only limited use because of upper extremity overuse injury, upper body weakness, lack of endurance, or respiratory problems, may at times use manual or power wheelchair

Hiring and ADA regulations

Cannot ask questions about disabilities nor accomodations, sexuality, or veiws on sexual orientation. ONLY ONE CAN ASK AN APPLICANT CAN ASK ABOUT HIS/HER ABILITY TO PERFORM ESSENTIAL JOB TASKS If it is a life skills training group, asking about verbal group leadership skills may be the most appropriate question to ask since they will be leading groups

Erb's Palsy

Caused by excessive stretching of the shoulder, tearing of uppermost roots C5 and C6 (sometimes C7 or superior trunk of brachial plexus. Paralyzes deltoid, supraspinatus, biceps brachii and supinator muscles. (arms) BEST SPLINT TO USE IS A ELBOW LOCK SPLINT

contrast bath

Causes vasodilation and vasoconstriction within the tissues Helps increase circulation, reduce swelling and restore ROM Good for edema, CRPS Type I illnesses (i.e. vasomotor dysfunction)

Progressive-relapsing MS

Characterized by progressive disease from onset but without clear, acute relapses that may or may not have some recovery or remission; seen in individuals who develop the disease after the age of 40

Occupational therapy implications for CP

Children with CP have varying tone/motor abilities Maintain AROM and PROM through stretching, exercises, and orthotics USE AE to increase (I) with occupations Instruct in seating/positioning Constraint induced movement therapy may be indicated

Spinal Cord Independence Measure

Completed by the health care team and includes measures of ADL performance,sphincter control, respiration, and mobility.

Self-determination

Concept that ethnicities have the right to govern themselves So dont tell someone your going to use something when they dont want to

confidentiality

Confidentiality is required for all members in the groups(existing and current members) Even if the therapist discussed the possibility of a guest speaker with members and the members verbally agrees to this visit, the therapist could not be certain that all members in complete agreement. THERAPIST ARE RESPONSIBLE FOR KEEPING CONFIDENTIALITY AT ALL TIMES

transportation of great arteries

Congenital cardiac condition characterized by a anatomic abnormality in which the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. symptoms include cyanosis, congestive heart failure, and respiratory distress

conservative intervention approach

Conservative management is an approach to treating back pain, neck pain and related spinal conditions utilizing non-surgical treatment options, such as physical therapy, medication and injections.

Edema Management Interventions

Contrast bath( dipping hand in and out hot/cold water), cold packs, retrograde masage, coban wraps, and desensitization

corticobulbar tract symptoms

Control all voluntary muscles of speech (except respiratory) Decussate at brainstem where CN's III-XII transition from UMN to LMN With the exception of lower muscles of facial expression, all functions of the corticobulbar tract involve inputs from both sides of the brain.

Hawaii Early Learning Profile (HELP)

Curriculum-based assessment (NOT STANDARDIZED) covers cogntion, language, gross motor and fine motor, social emotional skills, and self help for 0-3 yr olds in home setting

Ape Hand

Damage to the distal median nerve; deformity in which people cannot move thumb away from rest of hand.

Malingering

Deliberate faking of a physical or psychological disorder motivated by gain.

Palm to finger translation

Develop by 2 to 2.5 years with simple rotation

Palm to finger translation

Develop by 2 to 2.5 years with simple rotation A linear movement of an object from the palm to the fingers

Vision Diagnoses

Diabetic retinopathy- vision loss caused by diabetes, decrease vision in the center of eye Cataracts- cloudy vision loss and potential of vision loss, spreads from center of vision to peripheral Glaucoma: decrease in peripheral vision because of increase pressure in the eye Macular degeneration: loss of vision in the center of eye . Vision loss may continue if macula (central area of the retina) degenerates with age

tethered cord

Difficulties with bowel, bladder, gait, and/or foot deformities; tail end of the spinal cord when the cord is stretched as a result of compression, being trapped with a fatty mass or scar tissue, developmental abnormality, or an injury.

Gower's sign

Difficulty rising to standing position; has to walk up legs using hands; occurs in Muscular dystrophy

Primary Progressive MS

Disease progression from onset, without plateaus or remissions or with occasional plateaus and tempory minor improvments

OT/Driving licensee

Drivers liscense agency only responsible for administering liscens not penalizing old people who cant drive. MUST CONTACT physician

OT implications for learning disability

Early childhood: sensory integration, play, socialization, and self help School age: sensory integration, perceptual-motor integration, writing skills Early adolescence: (I) living skills, social skills, and the development of compensatory and adaptive techniques

HEP for edema management

Elevation of the limb AROM isotoner gloves Ice pack (NOT HEAT- this increases inflammation)

meningocele spina bifida

Extensive spinal opening with an exposed pouch of cerebrospinal fluid and meninges

Gravitational insecurity

Extreme fear and anxiety that one will fall when one's head position changes or when moving through space, resulting from poor vestibular and proprioceptive processing.

Omnibus Budget Reconciliation Act (OBRA)

Federal law that regulates the education and testing of nursing assistants

Types of osteogenesis imperfecta

Fetal: most severe; fractures occur in utero and uring birth, mortaility is high Infantile: mod severe, many fractures occur in early childhood; severe limb deformities and growth disturbances also occur Juvenile: least severe; fractures begin in late childhood; by puberty, bones often begin to harden and fewer fractures occue.

Kitchen Task Assessment (KTA)

Focus: Measurement of the judgment, planning, and organizational skills used to perform a simple cooking task Scores for 6 categories (initiation, organization, performing all steps, proper sequence, judgment and safety, completion of task) Population: Adults with Alzheimer's and cognitive dysfunction

total active motion

For finger ROM add extension deficits and subtract from flexion measurements (eg. digit #2 [index] MCP = 0-45, PIP = 10-60, DIP = 10-40; TAM = 125 Finger flexion: 145 Extension deficits: - 20 (10 from PIP and 10 from DIP) = 125

Knee Ankle Foot Orthosis (KAFO)

For patients with more extensive paralysis or limb deformity -knee control provides medial-lateral hyperextension restriction while allowing flexion of knee

split thickness skin graft

Full epidermal and partial dermal layer are taken from the donor site. Chance of graft survival is high.

Allen Cognitive Level 4

Goal Directed/Familiar Activities-->MIN ASSIST Stitches: imitates 3 'whip stitches' Sensory: Responds to Visual Stimuli Tx: Visual cues to complete tasks, matching, several step-tasks, simple crafts (2-3 steps); NO NEW LEARNING/GENERALIZATION, sorting laundry by matching colors Attention Span: Hours 4=1 task plus 3 whip 24 hour supervision

Groups of air pressure cushions

Group 1: non electric means of pressure management Group 2: electric means for pressure management simple Group 3: electric means for pressure management advanced

Haloperidol

Haldol used to decrease chorea during performance of funcitonal activities client requires continuous evals of symptoms

Not effective interventions for PTSD

Having the person reflect on previous thoughts (i.e. writing in journal, writing personal experiences, or engaging in self reflective meditation) in acute phase

PPO (Preferred Provider Organization)

Health insurance that makes it easier/more options to see out-of-network doctors.

Rapid Pace Walk

In this timed clinical test, clients are instructed to walk 10 feet up and 10 feet back as fast as they feel safe and comfortable. This test is used as a measure for postural instability and gait disturbance.

Hybrid cushion

Incorporate a combination of materials, typically foam and gel

Telehealth Model

Incorporates aspects of all models, however delivers services via telecommunication strategies

lateral epicondylitis

Inflammation of the muscle attachment to the lateral epicondyle of the elbow (i.e. tennis elbow) . Often caused by strongly gripping. Commonly called tennis elbow. Pain is present on the lateral side of the elbow

Work-related musculoskeletal disorders

Injuries and disorders of the muscles, tendons, ligaments, joints, and cartilage; they are caused or made worse by the work setting an injury sustained in a fall does not count might be caused of a progression of lifting heavy loads

Five Characteristics of optimal treatment for ODD

Instructions are clear, short and simple Time ins: increase pleasant social contact Time out: decrease pleasant social contact client practices positive behaviors in brief intense social contexts Incidental teaching involves catching the client being compliant and rewarding them to reinforce desired behavior

superficial partial thickness burn (2nd degree)

Involves the epidermis and the upper portion of the dermis. Involved area may be extremely painful and exhibit blisters(i.e iron burn). Healing occurs with minimal to no scarring in 5-21 days.

simple rotation

Involves turning/rolling of an object held 90 degrees at the finger pads with fingers acting as a unit and the thumb in opposition. 2-2.5 years old

capital purchases

Major assets, such as machinery or land, which one purchases with cash. (500-1000 dollars)

MS sign/symptoms

Motor symptoms impaired balance partial/complete paralysis; common in lower limbs Muscle weakenss This is an inflammatory disease so not heat but ice

Anticontracture position-ankle

Neutral to 5 degrees of dorsiflexion

Development of reaching with toys

Newborn: bat at toys 4 mons: reaches for toys with bil arms positioned in IR, abd, pronation. Infant also reaches with open hands 6+9mons: reach for toys with one arm 6 mons: one arm reach shoulder abd, IR 9 mons: one arm reach shoulder abd with ER- can supinate and extend wrist

OTA/ activities program director

OTA is not providing occupational therapy, therefore does not require supervision of an OT

Occupational therapy driver off-road assessment

Occupational therapy practitioners use a battery of assessments to find clients' strengths and weaknesses and pinpoint areas on which to focus during rehabilitation without going on road.

Traction Reflex

Onset age: 28 wks gestation Integration age: 2-5 months Stimulus: Grasp infant's forearms and pull-to-sit. Response: Complete flexion of UE. Relevance: Enhances momentary reflexive grasp.

Landau reflex

Onset age: 3-4 months Integration age: 12-24 months Stimulus: Hold infant in horizontal prone suspension. Response: Complete extension of head, trunk, and extremities. Relevance: Breaks up flexor dominance; facilitates prone extension.

Three Phases of Guillain-Barre Syndrome

Onset and acute inflammatory phase: acute weakness occurs in at least two extremities that advances and reaches its maximum in 2-4 weeks Plateau phase: symptoms are the most disabling, with little or no change over a few days Recovery phase: remyelination and axonal regeneration occurs over a period in time as long as 2 years; recovery starts at the head and neck and travel distally

Bradydactyly

Overly large digitcs Difficulty with ADL's and fine motor Can recieve plastic surgery

Codman's exercise

PROM for post shoulder surgery used initially to manage pain for people limited by pain or impingement Pendulum Exercises. Bend forward at the waist, (back parallel to ground is ideal). Allow involved arm to hang down, perpendicular to the floor. Keep arm and shoulder muscles relaxed. Move arm slowly, increasing the arc as tolerated. (up/down, side/side, clockwise/counterclockwise)

Three Phases of Cardiopoulmonary Rehab

Phase I: (Acute Inpatient Rehab) Phase II: (Outpatient) Build act tolerance, improve IADL, improve ability with occupational roles and work activities Phase III: (Maintenance Community Ex Programs) HEP, less intense, not covered medicare

Allen Cognitive Level 6

Planned Actions absence of disability. can think of hypothetical situations and do mental trial & error problem solving.

Level of Alertness

Sensory cues that employ the auditory, tactile, and vestibular systems will promote increased alertness during treatment sessions Warm weather will promote relaxation- further impairing arousal and attention

Tendon gliding exercises

Series of hand exercises intended to prevent tendon adhesion and preserve tendon excursion, includes the following: straight fist: Composite MCP and IP joint extension hook fist: MCP joint extension with IP joint flexion intrinsic-plus: MCP joint flexion with IP joint extension straight IPs: MCP and PIP joint flexion with DIP joint extension full fist: Composite MCP and IP joint flexion NO HYPEREXTENSION AT MPs

Classification of CP based on quality of tone

Spasticity: increased flexor or extensor tone Athotosis: fluctuation of tone from low to normal with little spasticity Choreoathetosis: constant fluctuation from low to high tone, without co-contractions typically appears as jerky movements Flaccidity: low tone--> usually progress to spasticity Ataxia: tone usually within the normal range but involving LE flexion patterns

Motor-Free Visual Perception Test (MVPT-3)

Standardized, quick, visual perception excluding motor componenets Spatial relations, visual discrimination, figure-ground, visual closure, visual memory Ages 4-95, different items scored

Inpatient Rehabilitation phase of TBI

Starts at Rancho Level V and higher 1. Optimize motor function 2. Optimize visual abilities 3. Optimize visual-perceptual function -> optimize neglect by prompting the person to use neglected side 4. Optimize cognitive function 5. Optimize voice and speech function 6. Restore competence in self-maintenance tasks 7. Contribute to behavioral and emotional adaptation 8. Support family caregivers

Comorbidities with CP

Strabismus- eye alignment deviation related to strolobus: which means whirling around Nystagmus- reflexive back-forth movement of eyes when head moves Dysarthria- difficulty pronouncing or articulating words Aphasia- associated with poor language dev. functionally looks as though the person has difficulty comprehending the meaning of certain words.

Wechsler Digit Symbol Test

Subtest of Wechsler Adult Intelligence Scale measuring visual perception, motor and mental speed, and visual-motor coordination

Forward parachute (protective extension forward)

Suddenly tip infant forward toward supporting surface, while suspended vertically. > UEs extend suddenly, hands open, neck extends. Relevance: Allows accurate placement of UEs in anticipation of supporting surface to prevent a fall. Onset: 6-9 mths_____Integration: Persists

Pallidotomy

Surgical destruction of the globus pallidus of the brain done to treat involuntary movements or muscular rigidity in Parkinson's disease

Hemipelvectomy

Surgical removal of one half of the pelvis and the lower extremity

Writing: reports of numbeness and tingling NEGATIVE NEURO TEST

Tell the person to stretch before completed activity ELEVATION IS DUMB BECAUSE THAT ADDRESSES EDEMA

Barlow test

Test for a hip that is dislocatable or hip dysplasia examine the clicking is present when he child's leg is abducted and pressure is placed on the medial thigh

Touch Inventory for Elementary School-Aged Children

The Touch Inventory for Elementary-School-Aged Children (TIE) is a self-report screening assessment for tactile defensiveness. ... Twenty-nine children, 6 to 12 years of age, were available for the test-retest portion of the study and were assessed with the TIE with a 1-week interval between sessions.T

topographical orientation

The ability to navigate from one place to the next; requires ability to determine current location, goal locations, and problem solving to implement an action.

life expectancy

The average number of years an individual can be expected to live, given current social, economic, and medical conditions. Life expectancy at birth is the average number of years a newborn infant can expect to live.

tolerance for error

The design minimizes hazards and the adverse consequences of accidental or unintended actions. design safety of all users

LI-L5 spinal cord injury

This impacts the hips, thighs, genitals, and feet. Breathing and speech are not affected. Will likely be able to complete most ADLs independently; arm and hand function is normal. Can use a manual wheelchair, drive a modified car, and will have good balance in the torso. May use a slide board to transfer or none at all. Will use a standing frame in therapy. Will have some sexual dysfunction. Still no control of bowel or bladder but is generally independent with self-catheterizing and bowel regimens."

public health model of service delivery/interventions

Tier 1 interventions: includes assisting in school-wide prevention efforts, collaborating with school personnel to create positive environments, and observing all children's behavior Tier 2 interventions: developing and running programs for at-risk students and consulting with teachers to modify learning demands for at-risk students Tier 3 interventions: providing individual or group interventions for students with mental health concerns and collaborating with school based mental health providers

regressive behavior

To return to a former state of being; usually worse behavior, possibly infantile or childlike Usually after a truamatic situaiton- talk to social worker

Rotation (Hand manipulation)

Turning something within the hand using only the single hand (turning around a pencil or coin; winding up a toy 3.5-4

Decoritcate rigidity

UE are in spastic flexed position and IR and ADD, LE are in spastic EXT position, and IR and ADD (feet turned in) BRING ARMS AND FEET TO CORE(COR) of the body) this is a cerebral hemisphere injury

Erb-Duchenne palsy

Upper trunk brachial plexus injury ("waiter's tip") such as extreme shoulder flexion common with breech delieveries palsy is characterized by weakness or wasting of small muscles of the hands and sensory discrimination in the hand and arm Erb-Duchenne palsy is typically unilateral children with Erb-Duchenne palsy often hold their affected arms in characteristics posture: shoulder adduction and IR, elbow ext, forearm pronation, and wrist flexion Recovery depends on the extent of nerve damage that is present, it typically occurs within 3-24 mons

rooting reflex

a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple Onset: 28 weeks Integrates: 3 months

Warren model for assessment

a developmental framework for intervention that is a hierarchical model with each skill building on the preceding skill

thalamotomy

a surgical incision into the thalamus, which contributes to movement to reduce tremors

visual scanning

ability to systematically observe and locate items

acalculia

acquired inability to perform calculations

Suck-swallowing reflex

actual sucking and swallowing of milk reflex is initiated when a nipple, bottle, finger, or other object is place in the mouth Onset:28 weeks gestation and it integrates at 2-5 months

pain triggers

actvities or movements that cause pain

antispasmodic

adj. Tending to prevent or relieve non-inflammatory spasmodic affections. for MS

Splinting and c/o of pain

adjust by heat to address any deviations in ROM set by the splint. Padding can modify the position of the splint, but is not best practices since it does not correctly allow distribution of pressure

decerebrate rigidity

arms stiffly extended, adducted, internally rotated; legs stiffly extended, plantar-flexed -worst posturing spinal cord injury Decerebrate has alot of Es so extremities would be EXT

Best technique for dressing/ROM

as shoulder ROM deacrease it is bes to support elbows on table at chest level to don t shirts over arms

180 turn for ramps/landing?

at least 4'x8' landing

ATNR (asymmetrical tonic neck reflex)

birth to 4-6 mo.Arm and leg on face side extend; arm and leg on skull side flex (or experience increase flexor tone) integrates at 4-6 months

comminuted fracture

bone breaks into many fragments

Spina bifida for OT

bowel and bladder programs clients may have cognitive and learning issues educate the family and client

Stroke impact Scale

brief assessment of physical and social functioning after stroke

myositis ossificans

calcium deposits that result from repeated trauma most common in ELBOW FLEXORS

Churches

can avoid ADA regulations

Altruism

care of others. it is known as selfishness

Child TBIs

caused by falls, MVC, child abuse, sports injuries

upper motor neuron lesion

causes autonomic dysreflexia increased deep tendon reflexes, and clonus

posterior cerebral artery CVA infarct

characterized as having: -IMPAIRED SENSATION (no hemiplegia) --homonymous hemianopsia - ALEXIA

people with spastic CP

common issues with dissociation

Zone of partial preservation

complete injuries that have some innervation of dermatomes below the level of injury

age-related macular degeneration

condition in which the center of the retina gradually loses its ability to discern fine details; leading cause of irreversible visual impairment in older adults

spinal muscle atrophy

condition of progressive degeneration of anterior horn cells leading to decrease ROM and progressive loss of skills starts off as a kid leading them to be W/C bound

Types of hearing loss

conductive: damage to the physical structure of the ear (i.e blunt trauma) sensorineural: hearing loss caused by a disease or environment damage (i.e. loud noise) Prebycusis: hearing loss caused by decline in age mixed

Myclonic seizures

contractions of single muscles or muscle groups

cranial nerves V, VII, X

control both movement and sensory task related to the face and mouth (i.e smiling and chewing gum)

Formal Sensory Integration assessments - Clinical Observations

crossing body at midline, equilibrium reactions, muscle tone, prone extension, supine flexion

Snellen E chart or Tumbling E chart

far visual acuity

Brachialis

flexes forearm with pronation

Colles fracture

fracture of the distal radius at the wrist

medial epicondylitis

golfer's elbow is a repetitive use of injury to the wrist flexion. Pain is present on the medial side of the elbow

Tongue-touch and eye gaze aids

good for people with no upper body function

normal distribution

graph plotting all reported data that highlights the mean, median, and mode. Typically appears as bell curve

Labyrinth/ Optical Righting

hold infant suspended vertically and tilt slowly to side, forward, and backward --> upright positioning of head when moving body Uses the vestibular system NEVER INTERGRATES

ideational apraxia

inability to formulate an initial motor plan (cant perform task spontaneously or upon request) and sequence tasks where the proprioceptive input necessary for movement is impaired verbal prompts and tactile cues are BEST providing a mirror or photographs WOULD NOT HELP

ideational apraxia

inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for movement is impaired canot produce movements either spontaneously or upon request. THEY NEED PHYSICAL PROMPTS/CUES

Akinesia

inability to initiate movement

Anomia

inability to name/name objects

Agraphia

inability to write

chronic bronchitis

inflammation of the bronchi persisting over a long time

spinal shock

initial stages of SCI; may last 24- 6weeks. Reflex activity ceases below the level of the injury, resulting in spasticity

musculocutaneous and radial nerve innervates muscle group

innervates muscles for elbow flexion

median nerve innervates muscle action

innervates the forearm muscles for pronation; including the pronator trees and pronator quadratus Innervates the wrist muscle responsible for wrist flexion,

cardiac rehabilitation programs

inpatient phase 1 outpatient phase 2

task oriented approach

intervention technique used for nueromuscular conditons that focuses on the specific intended task and retraining using functional activities to accomplish the task

Intervention with cerebellar lesions

interventions should always be ADL focused cerebellar lesion interventions should focus on strengthening proximal muscles, improving postural responses, and increasing stability, WEIGHT BEARING (i.e. UE weight bearing during self care tasks at the sink)

dyskinesia

involuntary muscle movements that have no clear pattern and not repetitive

Genetic anomalies

involve one gene

Totally or severely mobility-impaired user

is unable to self-propel a manual wheelchair; is dependent on a power chair or attendant

Prolonged sitting

ischial tuberosity

Very heavy work

level of work requires exerting >100# occasionally, >50# frequently, >20# constantly to move objects

Akinetic seizures

loss of muscle tone for more than 30 minutes

Vigrometer or sphygmomanometer cuff

measure grip strength for arthritis pts

Lithium

medication used to treat the manic stage of manic-depressive illness

Muscles that support upward rotation

middle trapezius

clients with C5 tetraplegia may benefit from...

mobile arm support to assist in supporting weight of arm during activities and universal cuff or C clamps

radial nerve innervates muscle action

muscles for supination and elbow extension

Landing for ramps

must be at least 4' by 4' for sharp 90 degree turns

Open road with fixed route

neighborhood streets and intersections with naturally occurring traffic and other road users; 45-60 minutes in duration allowing for some control over extraneous variables encountered on the roadway

Anticontracture position-neck

neutral to slight extn

Anticontracture position-forearm

neutral to supination

SCI S1-S5

normal resp system (I) with self care Normal UE, partial LE strength can walk with (A) or walk with braces

SCI LI-L5

normal resp system (I) with self care Normal UE, partial LE strength may use standing frame or walk with braces

School Function Assessment (SFA)

o Focus: assess and monitors functional performance in order to promote participation in a school environment • Does not measure academic performance

tertiary prevention goal

occurs after illness/injury has been diagnosed, focus on medically treating and restoring work role

Difficulties with communication (ASD)

often have difficulty with prosody, or using variation in thier pitch, emphasis or rhythm of speech Children with ASD often have difficulty with pragmatics, or the use of language in social situations May benefit from social skills training

tarsal amputation

originates at the ankle

above knee amputation

originates on the femur

Transition rehabilitation phase

outpatient - Maximize strength gains in the first year post-injury - Continue training AE - Support group for community reintegration

patent ductus arteriosus

passageway between the aorta and the pulmonary artery remains open after birth

Krphosis

pelvic rotates posteriorly, resulting in sacral sitting and flexion in the lumbar spine (i..e hunch back)

Ayomyotrophic lateral sclerosis

peripheral nervous system affects the corticospinal tracts and anterior horn cells and can cause difficulty swallowing and difficulty with speech production

othotist

person who specializes in orthotics, such as creating AFOs

indicators for FCE

post offering screening is performed after a worker receives a job offer Fit for duty tests are performed by OM physicians to determine whether the worker the worker can return to work after an injury FCE should not be used with the intent to prove worker fraud FCE assists the physician to generate ideas of impairment or disability rating

back curvature/OT intervention

postoperative strengthening of abdominal muscles ADL adaptations

Turner Syndrome

present with webbing on the neck, congenital edema of the extremities, and cardiac problems Children may be short, may develop obesity, and lack secondary sexual characteristics Typically do not have intellectual disabilities, althougth they may have difficulty with visual perception

ankle foot orthosis

provide control of stability to foot and ankle

minimal supervision

provide only as needed, possibly less than monthly ( good for senior level OTs)

reaction formation

psychoanalytic defense mechanism by which the ego unconsciously switches unacceptable impulses into their opposites. Thus, people may express feelings that are the opposite of their anxiety-arousing unconscious feelings. (i.e. hugging someone you want to punch)

Tics

quick brief involuntary movements . - are repetitive but NOT RHYTHMIC

myoclonus

quick contractions of muscle group

Appropriate ramp size

ramp should privde one foot of slope for every inch ex: 4 steps with 7 inch rise (4 x7) = 28 inch ramp

Fasciculation

rapid continuous twitching of resting muscle without movement of limb

tbi: closed injury

rapid movement of the head in which the brain strikes the skull

Universality

realization that others may be expereincign similiar emotions or events

Pragmatic reasoning

reasoning that assumes the truth of an idea can be validated by its practical outcome (i.e. using water bottle for weights instead of free weights in hospital setting)

TBI intervetnions for children in school

reducing the amount of written work providing notes before a lesson color coding folders picture schedules daily checklist peer models reducing classroom stimuli

Accounts Payable

refers to the amount being owed

operating expenses budget

refers to the regular, expected, and predicted expenses and income a facility plans for

Medium work requirement

requires exerting 20-50 pounds

Rhomboids

retract scapula and downward rotation NOT UPPER ROTATION

Muscles that support downward rotation

rhomboids, levator scapulae, latissimus dorsi

grading bed mobility

scooting up/down--> bed rolling--->bridging--> moving from and to supine --> from and to sitting ---> standing

Montreal Cognitive Assessment (MoCA)

screening for mild cognitive dysfunction; asess different cognitive domains like attention, visuconstructional, memory, etc. and scored up to 30 points >26 = normal

partial seizure

seizure involving only limited areas of the brain with localized symptoms

Generalized seizures

seizures that involve the entire brain

Sensory diet

sensory diet is an individualized plan that provides a specific child with the optimal sensory experiences that the child needs to be functional in his or her environment intervention strategy is specific to children with sensory integrative dysfunction b/c children with typical CNS function are though to be able to seek out the sensory input that need they need on their own

benign paraoxysmal positional vertigo

short periods of vertigo due to positional changes

Focus on C5-C8 interventions

should be considered in the areas of UE ROM and strengthening, bed and W/C positioning , and splinting of UE' Compensatory techniques must be used for hand and wrist functions, especially the use of adaptive devices

safe hand washing techniques

should be implemented -before entering the room -after leaving the room -after adjusting the bed -not during patient care (i.e. after performing PROM shoulder flexion then PROM shoulder abduction

Caregiver instructions

should be photos included and not solely rely on the caregivers memory

ramp

should eprovide 1 foot of slope for evry inch to rise (i.e 6 steps with rise of 7 inches = 42 foot ramp) Ramps may also be too long for someone to (I) access. Therefore a landing at the midpoint for restbreak may be optimal. Current ADA landings reccomendations is 5' x 5'

Sheet graft

skin graft that is transferred directly from donor site to the recipient site close to size

rotator cuff tendinitis/positioning

sleep with shoulder extended and adducted

prerequisite for handwriting

small muscle development eye-hand coordination ability to hold writing utensil ability to form basic strokes letter identification print orientation

festinant gait

small rapid steps resulting from a forward tilted head and trunk posture

wrap around arm rests

space savers; reduces overall width of W/C by 1"

Infantile spasms

spasm begins b/w ages 6mons-24 mons development stops or slows considerably some skills may be lost

body neglect

spatial neglect of the client's own body, generally on the contralateral side (i.e not paying to R arm after CVA or TBI)

weightbearing

strenghtens UE not hand dexterity

Proprioceptive Neuromuscular Facilitation (PNF)

stretching techniques that involve combinations of alternating contractions and stretches based on 4 pattens Right hand D1 Flexion (dab) D2 Flexion (sword) D1 Extension D2 Extension D1 (F) D2 (F) --------- _____________ ---------- D2 (E) ______ _____ D1 (E)

Gerontology

study of the aging process

rotator cuff muscles (innervations)

supraspinatus (suprascapular nerve), infraspinatus (suprascapular nerve), teres minor (axiallary nerve) , subscapularis (subscapularis nerve)

Age appropriate dressing tasks (2 year old)

taking a coat off after an adult unzips it taking off loosened shoes Pushing arms through correct holes in Tshirt NOT PUTTING ON SOCKS (develops at three)

Amsler grid

test to assess central vision and to assist in the diagnosis of age-related macular degeneration

lighthouse near visual acuity test

tests near visual acuity

Minnesota Handwriting Assessment

tests overall legibility and speed of manuscript writing

range

the difference between the highest and lowest scores in a distribution also the scope of reported data

life span

the maximum length of life of a species; for humans, the longest that a human has lived

Senescence

the natural physical decline brought about by aging

figure-ground

the organization of the visual field into objects (the figures) that stand out from their surroundings (the ground).

Shrinking residual limb

the outcome of wrapping residual limb

central coherence

the strong tendency of humans to interpret stimuli in a relatively global way that takes the broader context into account

Optic Functional Visual Analyzer

this tool assesses a variety of visual skills by providing a series of illuminated slides addressing areas such as depth perception, acuity, contrast sensitivity, phorias, glare recovery, and color perception and recognition

Types of generalized seizures

tonic clonic, absence, myclonic, akinetic, status epilectus

Ayers Sensory Integration (ASI)

treatment is based on the principles of inner drive and active involvement of the child individualizing the activities used in therapy based on the childs interest

Snellen wall chart

used to test visual acuity

wrist drop

unable to extend the wrist caused by radial nerve damage

RI zones

using color coded zones with corresponding behavior management (i.e red bad, yellow cautios, green good

Goal Attainment Scaling

using objective measures to show that pts are justified in recieving services through documentation that they are meeting they're goals

determining maximum effort

using the five grip dynamometer test

visual field test

visual field is the range of view people can see as they look ahead, without eye or head movement. - can be identified using the Humphrey Field Analyzer

syndactyly

webbed fingers or toes may inovlve splinting and scar reduction

Trendelenburg sign

when hip dysplasia is developed which means that the child's hip drops to the opposite side of the dislocation and the trunk shifts toward the dislocated hip when the child is asked to stand on one foot

anti-deformity position/splint

when prolonged immobilization is necessary. Splint places wrist in neutral, MPs in flexion, IPs in extension, and thumb in abduction and opposition

Meshed graft

when the donor graft is "meshed" and stretched to cover a greater area of the receiving area

common ergonomic risk factors

• Repetitive movement (for high-risk repetition rates for the upper extremity) • Forceful or prolonged exertion of the hands • Frequent or heavy lifting; pushing, pulling, or carrying of heavy objects. • Awkward or static postures, especially for a prolonged period of time • Excessive vibration • Extreme temperatures, especially cold temperatures • Prolonged contact stress • Material handling with faulty body mechanics, especially if lifting or twisting movement is required

heart disease risk factors

- Not controllable: age, sex, family history -controllable: smoking, high lipids, high cholesterol, hypertension, obesity, diabetes, mental stress, lack of exercise

inpatient phase 1 OT intervention (cardio)

-monitoring of EKG, cardiogram and pulse -clinical pathway: checklist of therapy treatments for particular client -progression of ADLs and activity according to MET levels -monitoring for symptoms of activity intolerance -home program for activity guidelines, pacing and simplification, temp precautions, risk factors, symptoms of activity intolerance

Development of head lifting

0-2 months: the infants head is positioned toward one side 3-4 months: infant can maintain their head at midline as well as flatten his back to the floor, hold his legs together, and tuck his chin toward his chest 5-6months: infant can lift his head and reach for his limb or toy 7-8months: transiting from sitting from unsupported and playing with toys

Lithium therapeutic range

0.6-1.2 mEq/L

standard adult wheelchair

18" wide - 16" deep - 20" high

Functional Independence Measure (FIM)

18-item, 7-level scale that assesses severity of disability in performing basic life activities: not specific to SCI

Sensorimotor Development

1st trimester: taste buds develop 2nd trimester: can respond to visual and auditory stimulation 3rd timester: olfactory senses and distinguishing sweet, salty, and bitter develop in the third trimester

transdisciplinary team

a group of professionals (OTs, PTs, SLPs) may plan interventions together, when appropriate

Dysthymia

a low-grade chronic depression with symptoms that are milder than those of severe depression but are present on a majority of days for 2 or more years Pharmological treatmentsL selective serotonin reuptake inhibitors

case study

a narrative description on how an intervention effects on a particular individual or group

purposive sampling

a nonprobability sampling method in which elements are selected for a purpose, usually because of their unique position

Biceps

forearm flexion with supination

vascular dementia

form of dementia caused by a stroke or other restriction of the flow of blood to the brain abrupt disability rather than continuous decline

Smith's fracture

fracture of the distal radius with volar displacement

Appropriate reasons for OT discharge

functional improvement has plateud patient has met his goals for functional improvement patient has returned to the hospital with new diagnosis NOT A REASON: HAVING A FULL CASELOAD

Cognitive Challenges with Autism

children with ASD may have difficulty with empathy or taking other's perspective and hypothesize about what they might do next Children with ASD often have an acute sense for detail, almost to the posint of missing the bigger picture Children with ASD may have cogntive inflexibility and may be easily upset by changes in their routine and to unexpected circumstances

Cri du char syndrome

children with this syndrome have a weak and catlike cry in infancy often present with microcephaly, down slanting eyes, cardiac abnormalities, and failure to thrive also have intellectual disability, hypotonia, feeding, and respiratory problems

Procedural reasoning

consideration and use of intervention routines for identified conditions also scientific reasoning

close supervision

daily, direct contact at the site of work best practice for new graduates to have this supervision

Symbol Digit Modalities Test

dassesses neurocognitive function underlying many substitution tasks, including attention, visual scanning, and motor speed; divided attention

Abnormal muscle tone and spasticity-TBI

decorticate rigidity decerebrate rigidity

Chromosomal anomalies

more than one gene and involves of thousands of genes

Ergonimic programs

engaged by the companies to promote education and reduce the risk of injury from repetive manual stress

epiphyseal fracture

epiphysis separates from the diaphysis along the epiphyseal plate-only happens in kids

Postural adaptation internventions

establish a neutral and active sitting alignment -both feet flat on floor -equal weight on pelvis -neutral/slight anterior pelvic tilt -erect spinal posture -head over shoulders; shoulders over hips Perform reaching tasks while seated perform activities to maintain trunk in midline -W/C adjustments -weight shifting -trunk strengthening - compensation and environmental adaptations to reduce risk for injury

optician

maker and seller of eyeglasses

School Function Assessment (SFA)

o Focus: assess and monitors functional performance in order to promote participation in a school environment • Does not measure academic performance goal for children with behavioral deficits

Arnold-Chiari malformation

occurs in the process of the development and involves the part of the lower portion of the brain slipping or being pushed through the foramen ovale

Driver rehabilitation Interventions

on the road driving evals must become licensed by the state driver rehabilitation requires constant hands on instruction Necessary driving skills must be influences by physical and cognitive factors Driving is an IADL not BADL

TBI affect on motor function

paresis of one side of the body; dependent on the location of the brain injury spasticity Ataxia Dysphagia/difficulty swallowing Vision and hearing changes

When individual treatment would be appropriate

patients desire for privacy, necessary environmental controls, inappropriate behaviors are exhibited

Prospective Payment System

payment amount or reimbursement is known in advance and based on diagnosis related groups paid in hospitals and inpatient facilities

Windswept deformity

pelvis rotates laterally, with the thighs moving to the other side (i.e bow legged) thigh support will be used to keep knees straight

theory of mind

people's ideas about their own and others' mental states—about their feelings, perceptions, and thoughts, and the behaviors these might predict.

Intervention for sensory deprivation

perceptual isolation is the deliberate reduction or removal of stimuli from one or more of the senses.. THE SENSORY SYSTEM SHOULD NOT BE OVERLOADED Activities should include slow linear movements (i.e slow rocking) Other tasks (i.e. fast rocking, bright lights, upbeat music) can lead to sensory overload

chronic obstructive pulmonary disease (COPD)

permanent, destructive pulmonary disorder that is a combination of chronic bronchitis and emphysema damage to the alveolar walls and inflammation of the conducting airways

symbolic play

play in which children make believe that objects and toys are other than what they are. Also called pretend play. characterized by improvements in language as the child begins to play with other children

Pelvic stabilizer

positioned at the front of the pelvis to limit pelvic tilt, rotation, or obliquity

to inhibit a gag reflex

press a spoon down firmly on the CENTER OF TONGUE and distal to proximal

coronary heart disease

primary killers in adults over the age of 65

driving controls

primary: engage when vehicle is in motion, and they affect direction and speed of the vehicle (i.e gas, brake, steering) secondary: must be accessible when the vehicle is in motion but do not affect the speed or direction of the vehicle (i.e turn signals, horn, dimmer, washer wiper tertiary: do not need to be activate when the vehicle is in motion, must be accessible to client (i.e. ignition, gear shift, air conditioner)

Pencil grasp

primitive grip: the whole hand or extended fingers and a pronated forearm are used to hold writing utensil; the writing movement comes from the shoulder

true experimental design

research using an experimental group and a control group, to which test units are randomly assigned greatest level of randomization

pariteal lobe

responsible for sensation houses primary sensory cortex

Right sided CHF

right ventricle has difficulty pumping blood to the lungs - blood builds in vessels causing fluid retention Common Symptoms: edema, weight gain, ascites(fluid accumulution in belly) , cyanosis (blue-ish color of skin)

Anticontracture position-chest and abdomen

trunk extension and shoulder retraction

abscence seizure

type of epileptic seizure that lasts only a few seconds to half a minute, characterized by a loss of awareness ad an absence of activity, also known as a petite mal seizure

closed course assessment

typically performed in an area without traffic and pedestrians, such as vacated or limited-access parking lot. Assessment pertains to knowledge and understanding of vehicle features(i.e mirrors, seatbelts, seat positioning) and of vehvcle controls at low speeds (i.e. steering, braking, acceleration, parking)

Axilla

underarm

Predictive assessment

understanding the client's current needs and predicting future needs

deltoid sling

used for UE muscle weakness

Mental health clubhouse programs

utilize consumer epowerement which leads them to be active members in the decision making process

Caregiver education about burns

stages of burn recovery importance of (I) activity and exercise participation Pain management techniques

DriveABLE

standardized eval to determine driver competence consists of two parts: the computer based DriveABLE cog assessment tool and the DriveABLE on Road Evaluation

initial release and grasp tasks

starting with elbow flexed with neutral degree of pronation/supination

perservation

state of repeatedly performing the same segment of a task or repeatedly saying the same word/phrase without purpose

perservation

state of repeatedly performing the same segment of a task or repeatedly saying the same word/phrase without purpose (i.e pulling up a sock already covering her foot)

cogential club hand

still funcitonal but requires

Stroke for UE impairment

subluxation in the glenohumeral joint caused by the humeral head moving downward from the joint paralyzed muscles generally in place

Rotator Cuff Muscles (SITS)

supraspinatus->shoulder abduction/flexion infraspinatus -> ext rotation teres minor -> ext rotation subscapularis -> int rotation

stages of burn recovery

surgical and postoperative phase rehabilitation phase outpatient/community integration phase

interdisplinary team

teat of PTs, OTs, and SLPs who provide more comprehensive treatment. They share information about their clients but still maintain autonomy

skin breakdown

when lying supine: skin breakdown at heels When laying side-lying: skin breakdown at greater trochanter

depth perception

the ability to see objects in three dimensions although the images that strike the retina are two-dimensional; allows us to judge distance

medical model

the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and, in most cases, cured, often through treatment in a hospital.

Phantom Limb Syndrome

the perception of sensations, including pain, in a limb that has been amputated

Assessment fo rules of the road and sign recognition

the practitioner assesses the areas of recognition, reasoning, and judgement pertaining to driving rules and statutes

gel-filled cushion

these cushion conform to the shape of the buttocks; they are adequate for postural control, heavy, and sensitive to temp

stacking blocks (development)

at 12-15 mons: child investigates the properties of toys at 21-24 mons: child can correctly identify shapes and drop objects at 24-30 mons: child can stack blocks vertically AND HORIZONTALLY at 36-48 mons: can stack 9 blocks

Object/ toy use development

at 3-6 months: a child participation with a toy is characterized by the movement he performs with it (focusing on oneself) at 6-9 months: a child focuses switch to the toy properties (focusing on toy) at 6-9 months: a child movement patterns become more complicated as he begins to complete simple tasks with a toy at 9-12 months: a child's movement pattern become more complicated with tasks and play is developed by developed schemes

EI programs

at risk infants or toddlers who is under the age of three 6 month review assessment fo 5 areas (cogntion, physical, communication, social-emotional, adaptive responses)

Intention tremor

at the end of task oscillating muscle movements with rhymic pattern

Motor coordination/driving

ataxia with operating a vehicle with standard transmission CS: automatic transmission, power brakes, and cruise control

Neurobehavioral organization assessment

autonomic system motor system attention and interaction emotion self regulation

Achondroplasia

autosomal dominant resulting of stunting ephiphyseal plate growth and cartilage formation dwarfism common co-morbidities include lumbar lordosis, coxa vera, and cubitus varas back and leg pain are common in people with this disease and more pronounced in adulthood

naturalistic observation and instrumented vehicles

driving assessment occurs under real world conditions, with data collection occurring through vehicle instrumentation such as video feed of the driver, and the driving environment and vehicle kinematics (i.e speed or steering wheel movement collected via electronics and sensors, for details

ASD challenges

disturbances are common in social interaction, communication behviros Communicaiton abilities may range from being non-verbal and reliant on picture exchange systems and/or augmentative communication devices to children appearing to speak tangentially, being long winded, or not picking up on other's non-verbal cues

flat plantar surface cushions

do not accomodate body shape- appropriate for clients who require no or minimal support

Manipulative behaviors

do not tell a patient this it comes off manipulative- refer them to the primary individual therapist

Anticontracture position-wrist

dorsal wrist: wrist in neutral to 30 degrees extn volar wrist: wrist in 30-45 degrees extn

Immobilize fracture

during the immobilization phase -fracture requires time to heal the only appropriate intervention would be AROM in fingers and elbow to maintain their mobility

secondary prevention goal

early identification of symptom-related risk factors; ultimately, to minimize or reduce the duration, severity, and cost of work-related injuries

Concreteness

the extent to which a stimulus is capable of being imagined reflects concrete thinking which is concerned with the actual properties of thinkgs and the realities of situations, rather than abstract properties

wheelchair access

the minimum of 60 inch diameter or a 60 inch by 60inch T shaped space for a pivoting 180 degree turn to avoid the need for repeated tries and bumping into surrounding objects

visual-perceptual impairment

the process of being able to understand what is being seen Visual receptive functions -> saccades -> acuity ->accommodation -> binocular fusion -> stereopsis

Post-polio syndrome

the recurrence later in life of some polio symptoms in individuals who have had childhood poliomyelitis and have recovered from it Characterized by new weakness and pain caused by degeneration of motor neuron

kinesthesia

the system for sensing the position and movement of individual body parts Screen for it: therapist moves one extremity with the patient's vision occluded and asks the patient to duplicate this motion

Children with visual impairments

the use of tactile stimulation (i.e. 3 dimensional toys) can provide more input to help the child play

In mature OT groups

therapist participates at the level of a member and does not serve as group leader

non-experimental/correlational research

there is no manipulation of independent variable; randomization and researcher control are not possible just to determine of there is a correlation between an intervention and a desired response

volumeter

Assesses hand size in order to determine presence of edema.

C7 spinal cord injury

"May have some elbow extension and finger flexion, but dexterity deficits exist. Normal shoulder movement and can attend to most ADL tasks independently. No control over bowel and bladder but can use devices independently for toileting. May use a manual wheelchair and drive adaptive vehicles."

C5 spinal cord injury movement remaining

"May have the ability to breathe independently and may be able to flex at the shoulder but with some paralysis in the wrist and hands. Considerable amount UE strength Will need moderate assist with ADLs; could likely use a wheelchair with a modified hand control." NO WRIST EXTENSION WITH TENDONESIS

C1-4 spinal cord injury deficits

"Paralysis of all four limbs, may not breathe independently, speaking is impacted, no bowel/bladder control, total assist for ADLs, may be able to use a Sip-N-Puff motorized wheelchair. Hoyer/mechanical lift for transfers. Needs 24/7 assist; there is a high risk for skin breakdown, wounds, and respiratory issues." Excerpt From: NBCOT Exam Secrets Test Prep Team. "NBCOT-OTR Exam Secrets Study Guide." Apple Books. https://books.apple.com/us/book/nbcot-otr-exam-secrets-study-guide/id578652309

C8 Spinal Cord Injury

"Will have some hand movement, can grasp and release items without the use of tenodesis, but will have dexterity and fine motor skill deficits. Normal shoulder movement and can attend to most ADLs independently. No control over bowel and bladder but can use devices independently for toileting. May use a manual wheelchair and drive adaptive vehicles."

Tinel's sign

"pins and needles" sensation felt when an injured nerve site is tapped

MOHO Concepts

* MOHO addresses how occupation is motivated, patterned, and performed. * Humans in this model are conceptualized as being comprised of three interrelated components: volition, habituation, and performance capacity. * Volition refers to the motivation for occupation * Habituation refers to the process by which occupation is organized into patterns or routines * Performance capacity refers to the physical and mental abilities that underlie skilled occupational performance.

Skier's Thumb

*Tear ligament @ MCP resulting in decreased thumb splint and can impact one's ability to pinch and manipulate items through opposition of thumbthumb splint (for 6 wks), AROM & pinch strength (@ 6 wks), ADLs w/ pinch & opposition. PROM (8 wks) & strength (10 wks) after surgery

lower motor neuron lesion

- Carries motor information to skeletal muscles. causes flaccidity, decreased/absent lack of deep tendon reflexes muscle atrophy

Types of TBI

- Focal brain injury : direct blow to head - Multifocal and diffuse brain injury: sudden deceleration of the body and head, possibly from MVC, bicycle, skateboard accident

full thickness skin graft

- Full thickness of the epidermal and dermal layers plus a percentage of fat layers are taken from the donor site. - Chance of graft survival is less. - The outcome is functionally and cosmetically better if graft adherence occurs.

Limb Girdle Muscular Dystrophy

- Onset between 1st and 3rd decades of life - Proximal muscles of pelvis and shoulder initially affected - Progresses slowly

Four types of symptom magnification

- Refugee (uses symptoms to escape an unresolved conflict) - Symptom misinterpreter (responds to physical changes in body in an extreme manner - Game player consciously attempts to convince - Identified patient assumes the patient role as a lifestyle

Hearing implications for OT interventions

-> use of sensory integrative therapy ->support vestibular function -> Maximize use of residual hearing -> encourage age-appropriate self skills -> enhance fine motor coordination and skills -> maximize oral-motor coordination -> maximize visual processing, integration, and perception -> Encourage socialization and peer interaction -> use backward chaining; complete all the steps then allow them to complete the last step. Grade it down -> use forward chaining, in which the therapist encourages the child to complete the first step of the task, and they practice this step until it is mastered. In the meantime, the therapist completes the rest of the task

Implications for OT interventions are as follows:

->Maximize and prolong (I) in mobility and ADLs for as long as possible -> prevent deformity -> work on strength and ROM -> provide psychosocial and vocational support -> AE may be used

Children with cogenital heart failure treatment implications

->children whose conditions have not been resolved or been treated surgically are likely to have compromised endurance but may develop typically unless a comorbid condition is present -> activities should be appropriately placed -> activities should be selected with care -> the child and family should be educated in general health maintenance

Medicare coverage

->covers patients over the age of 65, ->those with end-stage renal disease, (over two years) -> and those with amyotrophic lateral sclerosis (ALS)

Preschool/kindergarten visual impairment intervention strategy

->multi-sensory approach using different textures and media -> activities that encourage body in space concepts -> emphasis on imitation -> shared storybook reading -

elementary visual impairment intervention strategy

->organize the environment so that it is less visually distracting -> alternate positions for visual-perceptual activities ->modify work to enhance visual attention to attributes of the assignment (i.e bold lines to enhance page margin; reorganizing worksheets) -> reduce other sensory input -> teach strategies, for example, a routine for searching in "Where's Waldo"-type activities; scanning routines -> use of chunking, repetition, and mnemonic devices -> use of color coding -> use directional cues for writing -> games to support visual spatial concepts

Assessment of Motor and Process Skills (AMPS)

-A cognitive/perceptual evaluation -May be administered to persons 3 years of age and older regardless of diagnoses -Examines person's functional competence in two or three familiar and chosen BADL or IADL tasks -Individuals choose activities to perform from a list of over 60 standardized tasks -The therapist observes and documents the motor and process skills that interfere with task performance -Sixteen motor and twenty process skills are scored for each task performed -Skills are scored from 1 = deficit to 4 = competent -Final scores account for task difficulty and the therapist's rater severity -A test of occupational performance that is appropriate for those living with a variety of impairments including cognitive and perceptual impairments

Burn related complications

-Contracture -Hypertrophic scar -Heterotopic ossification -Pain -Heat intolerance --> loss of the abilit to sweat in inovlved area, if loss of sweat glands i -Sun exposure -Pruritis (persistent itching) -Psychosocial adjustment

Good interventions after cognitive patients

-Decrease excessive clutter -Keeping items and belongings in familiar places - Attach labels to cabinets -organize each days events consistently throughout the week

Biomechanical approach

-Focuses on the range of motion, strength, and endurance required to perform an occupation -Most commonly used to treat patients with lower motor neuron deficits and orthopedic problems

Best Interventions in Group Settings

-Generalized exercise program -Basic financial training - desire to interact with others experiencing aphasia NOT COMPLETION OF A DIFFICULT PROBLEM SOLVING TASK (i.e. cooking)--> since it may be difficult to process and maintain attention to the whole group. Difficult tasks that require greater concentration are best completed individually

lordosis

abnormal anterior curvature of the lumbar spine (sway-back condition) LORD OF ASS

NDT Handling

-NO gripping, pinching or pulling. -Open hands and finger tips -Contact over muscle bellies -Movement begins with WEIGHT SHIFTING

Stages of TBI

-PRIMARY: at the moment of impact -Secondary: several days-weeks after injury

outpatient phase 2 OT intervention (cardio)

-OT 3 days/wk for 4-8 wks -exercise and activity tolerance with progression of MET levels -weight training at 2-4 wks -education in risk factor modification -work hardening if indicated -eval and treat or refer for psychosocial issues

Intradisciplinary team

-One or more members of one discipline(i.e. OTS) evaluate, plan, and implement treatment of the individual -Other disciplines are not involved; communication is limited, thereby limiting perspectives on the case -This "team" is at risk due to potential narrowness of perspective -Comprehensive, holistic care can be questionable

Treatment modifications for low vision

-Providing ample time for accurate scanning - use a desk lamp to increase light in room - use worksheets with large print and HIGH contrast between lettering and paper - Stand at the individuals midline when addressing them

What should be included in ramp design

-Ramp should have 5' by 5' landing before a doorway for proper opening and closing of door (2' by 2' is too short)o - Four inches is adequate for curb height - Handrails should be between 29 " and 36" inches high - Ramp should have 12 inches in length for every 1 inch of height

flail arm splint

-Recommended for brachial plexus injury of C5-T1 resulting in whole UE involvement. -Provides needed stability at both shoulder and elbow for functional positioning of the hand

Muscles that contribute to elbow flexion

-brachialis -brachioradialis -biceps brachii -pronator teres NOT ANCONEUS (works with triceps/extension)

community phase 3 OT intervention (cardio)

-physician referral -stress test -continuation of phase 2 and progress as tolerated, community settings

Handwriting Intervention: Neurodevelopmental

-postural and arm preparation -muscle tone -proximal stability and strength Therefore i) activities that modulate muscle tone ii) activities that promote proximal joint stability iii) activities that improve hand function

Topical group characteristics

-purpose is discussion/ verbal communication of specific activities in which members are engaged outside of group (i.e planning for a cookout, identi) -concurrent topical groups are for activities already engaged in outside of group -anticipatory topical groups for activities expected in future -premise is that discussion within group facilitates performance outside of group -verbal discussion, role play, 'homework'

Key markers of CP

-retention of primitive reflexes and automatic reactions -abnormal or variable tone -hyperresponsive tendon reflexes -asymmetrical use of extremities -clonus -poor feeding and tongue control -involuntary movements also people with CP have poor muscle posture because of lack of co-muscle activation and the development of abnormal compensatory movement patterns

Outpatient and community reintegration phase-burn

-scar management --> compression therapy, skin conditioning, splinting/positioning, and ex program -community reentry -->improve skin tolerance for friction and shear from compression garments during activity -psychosocial adjustment --> be award of PTSD symptoms -->adjustment period may be need depending on the level of deformity --> may require counseling/mental health services

OT implications for ASD

-sensory integrative therapy highly structured and specialized education program visual supports (i.e. picuutre checklists, communication boards)

lightweight chairs

-similar to standard chair but lightweight -adjustability is limited

juvenile rheumatoid arthritis/Ot interventions

-splinting may be used -involve AROM/RROM programs -monitor joint functions/prevention of deformity -educate the client in energy conservation and the use of AE to put less stress on the joints

Development of dressing skills

1 year: (a) with dressing by cooperating during tasks; pulls off shoes and remove sock 2 years: can doff coat after fastners been off; can help pull down pants, can locate armholes in shirt 2 1/2 years: able to pull down pants with elastic waistband; helps with putting on socks, coat, and shirt; able to unbutton large buttons 3 years: able to don a pullover shirt with little (A); able to put on own shoes (still needs help with tying) can put on socks independently; able to zip zipper once it is engaged, can button large buttons 3.5-4 years old: child require (A) for many dressing tasks; distinguish between front and back clothes- manage snaps and hooks 4 years: Removes pullover garment (I); can buckle buckles; can zip zipper completely; may lace shoes 4 1/2 years: able to weave belt through belt loop 5 years: can tie and untie knots; can dress without (S) 6 years: can tie bows; can manage fasteners in the back of garments

Assessment tool used with ASD children

1) Adaptive Behavior Assessment System 2) Autism Behavior Checklist 3) Bayley Scales of Infant Development 4) Bruininks-Oseretsky Test of Motor Proficiency

Stages of Parkinson's

1) Unilateral shaking or tremor of one limb 2) Bilateral limb involvement, makes walking and balance difficult 3) Physical movements slow down significantly, affects walking more-impaired balance and postural instability 4) Tremors decrease but akinesia and rigidity make ADLs difficult 5) Ct unable to stand or walk, dependent for all cares, may have dementia

Three types of home assessment

1) by evaluation the environment ->self assessment that can be done by the person or other family members -> increase potential hazards at home ->can recieve general information with minimum professional input 2) by evaluating the person -> assessment of performance skill, patterns, client factors, and clients areas of occupation 3) by evaluating the interaction of the person with the environment for person-environment fir, using a home evaluation checklist -> only down when an onsite eval is feasible ->important areas and environment are those in which the client has activity engagement

Gradation of cutting with knife

1) flattened placed directly on the table 2) flattend on a non-skid plate 3) flattend and placed on plate 4) rolled and placed on the plate of table

concepts in community mobility include the following

1) public transportation includes modes of travel that move people to destinations and are sponsored, at least in part, through taxpayer money

Stages of Motor Learning

1) skill acquisition (cognitive) stage person will make frequent errors and motor performance is inadequate, inconsistent, and inefficient. 2) skill retention (associated) stage individual can successfully retain the motor skill and transfer it to different contexts. May require min vc 3) skill transfer (autonomous) stage individual demonstrates skill in a new context; involves only feedback when errors occur, varied environments, individual demonstrating self evaluation/decision making skills. almost automatic

Acute phase TBI interventions

1. Positioning --> W/C and bed positioning to prevent skin breakdown 2. PROM 3. Splinting and casting -> ma be needed if spasticity impacts functionsl tasks 4. Sensory stimulation -> to improve level of conciousness 5. Management of agitation 6. Family and caregiver education _. starts immediately

Assessment of Preterm Infants' Behavior (APIB)

Assesses infant's pattern of developing behavioral organization in response to increasing sensory and environmental stimuli

systematic sampling

A procedure in which the selected sampling units are spaced regularly throughout the population; that is, every n'th unit is selected.

Relapse-remitting MS

25% of ms patients. There are unpredictable relapes during which new symptoms appear or existing symptoms become more severe. this can last for varying periods and there is partial or total remission. the disease may be inactive for months or years. common amoung younger people with the disease.

Handwriting Intervention: Sensorimotor approach

3.Sensorimotor approach a.Multisensory input is provided to enhance the integration of the sensory systems b.Various sensory experiences, media, and novel instructional materials are incorporated. c.Multiple writing tools, writing surfaces, and positions for writing should be offered. using multiple sensory changes and see what sticks

The resting hand splint maintains the hand in

30-45 degree wrist flexion 20-30 degree wrist extension 0-20 IP flexion

Doorway minimum clear opening

32 inches. The minimum clearance width for a standard adult-sized w/c is 26 inches; minimum clearance for walker is 18 inches

Clinical Dementia Rating

5 point scale categorizes levels of dementia and is based on domains of cognition, functional performance, including memory, orientation,judgement and problem solving, community affairs home and hobbies and personal care. the scale ranges rom normal cognition to severe dementia

SCI T1-T5

I in all areas normal UE strength and ROM little to no bowel/bladder control I on curbs w/wc Participates in wc sports

Group Facilitation Skills

sitting down with participants non assigned seating

Finger to palm translation

A linear movement of an object from the fingers to the palm of the hand e.g. picking up coins 12-15 MONTHS

Parkinson's disease

A disorder of the central nervous system that affects movement, often including tremors. mean onset 55-60 major degenerative changes occur in the basal ganglia (responsible for complex movements) The substanstia nigra becomes depigmented, affecting the production of dopamine, a neurotransmitter that influences the speed and accuracy of motor skills, postural stability, cognition, and affect and expression. The lost of dopamine leads to disabling symptoms Cogntion, sensation, vision and hearing, Bowel/bladder is commonly not affected

Confrontation testing

A gross assessment of visual field; therapist brings in targets from different areas in the field & client indicates when targets are seen and their location.

Duchenne muscular dystrophy

A human genetic disease caused by a sex-linked recessive allele; characterized by progressive weakening and a loss of muscle tissue. INDIVIDUALS HAVE REALLY BAD POSTURAL CONTROL AND FINE MOTOR SKILLS

visual imagery/relaxtion

to minimize pain

ASIA assessment categories/levels

A: complete; no sensory or motor function is preserved in the sacral segment S4-S5 B: incomplete; no motor but sensory functions is preserved below the neurological level and extends through the sacral segment C: incomplete; motor functions is preserved below the neurological level, and the majority of key muscles groups below the neurological level have a muscle grade of less than 3/5 D: incomplete; motor function is preserved below the neurological level, and the majority of key muscles below the neurological level will be greater than 3/5 E: normal; sensory and motor functions are normal

Acute rehabilitation phase in SCI

AKA "active phrase of intervention" Includes providing education and support and helping the client find meaningful activities that restore a sense of self-efficacy and self-esteem. The focus includes: • Education --> initial education should be about being in W/C, maintaining trunk strength for upright sitting tolerance, pressure ulcer awareness and reduction should begin FIRST-training to weight shift every 30-60 mins • Caregiver training • Occupational performance interventions • Selection of and training in the use of necessary equipment for I/ADL performance • Physical interventions specific to lower cervical injuries • Psychosocial adaptation begins immediatley and is most prominent during the acute rehabilitation phase --> group learning is particularly beneficial for people with SCI to allow them to learn from their peers

OT Evaluation/ALS

ALS funcitonal rating scale Purdue Pegboard Test Multidimensional Fatigue Inventory Dysphagia screening and testing Complete re-evals when needed as disease progresses

heterotopic ossification

Abnormal extra-skeletal bone formation/calcium deposits that may occur in or near a joint after burns Circumferential burns (i.e elbows, knees, hips, and shoulder) are most susceptible to this condition. S symptoms include decreased joint excursion/ROM, stiff-hard end feeleee endpoint, and increase pain The best action if seen in clinic is to CALL PHYSICIAN TO DIAGNOSE AND LEAD TO A TREATMENT splinting, heat modalities, aggressive PROM may be contraindicated at this time. begin AROM ex within pain free range to preserve joint movement S

MET levels

Acute/IP Care at level 1-2 (standing, strolling 1 mph, playing cards, sewing) D/C to OP/subacute at 3.5 START OP/SUBACUTE rehab at 4-5 METS (cycling 6-8 mph, cleaning [dishes, windows, make bed], raking, hoeing, calisthenics, walking 3-4 mph) Sex at 5-6 METs 6-7 METS is digging, planting, shoveling, cycle at 11 mph 7-8 METS is jogging, basketball, sawing hard wood 8-9 mets is running, vigorous activities like shoveling and fencing

Jean Piaget's Theory of Cognitive Development constructs

Adaptations: adjusting to changes in the environment Mental schemes: beliefs developed by a child's experiences Operations: the ability to process experiences in order to provide a response Adapted intelligence: cognitive ability to adapt equilibrium: the balance between environmental changes and the child's response Assimiliation: making a change to assimilate to existing schemes Accommodation: making a change to accommodation to new schemes

universal cuff

Adaptive device for persons with NO GRIP POTENTIAL , designed to be secured with an elastic strap around the hand and contains a fixed pocket in which the handle of an eating utensil, toothbrush or other ADL device can be inserted for use

Special Considerations burns

After immobilization period, AROM/PROM should be implemented immediately After immobile period, begin with AROM then resume PROM after graft adhesions contracture management and monitoring deformity and scar is the utmost important and splinting should be change as often as needed avoid applying splint directly on burn sites(i.e. volar hand splint to dorsum of hand) Dorsal hand burns be aware of boutinneire precautions- do not form composite flexion of the fingers during the eval and int For deep burns, pat deep partial thickness burns sensory impairments will be noted. Sensory peripheral testing should be completed after wound closes Electrical burns: gross sensory screening should be completed on the involved limb Edema management in hand: dont use volumeter untill all wounds are closed or permission is obtained from the medical docotr

Complex Regional Pain Syndrome Type 1

Also known as reflex sympathetic dystrophy syndrome, this type occurs after an illness or injury that didn't directly damage the nerves in your affected limb. Stress loading or heavy work or weight bearing activities are best for this diagnosis (i.e. manually washing car since it involves scubbing and carrying buckets of water

Accounts Receivable

Amounts to be received in the future due to the sale of goods or services (i.e. therapy services)

snow ball sampling

Asks current participants to identify other potential participants. Excellent for hard to find populations (e.g. parents of children with ADD)

Unified Huntington's Disease Rating Scale

Assesses changes in: - motor function - cognitive function - functional capacity & behavioral abnormalities

Allen Cognitive Level 1

Automatic Actions/Reflexive--> TOTAL ASSIST Stitches: None attempted Motor Actions: walking, eating, drinking, standing Attention Span: Seconds Tx: Sensory Stimulation

OT vision requirments

Before an OT can conduct a visual perceptual evaluation, they must have the pt be scheduled for a visual acuity test. Optometrist are licensed professionals to do this task.

TBI prevention

Primary: Seat belts, helmets, making living situations safer for elderly and children Seconday: medical interventions-maintaing BP/oxygenation, management of intracranial pressure, nutrition, and seizure prevention

OTA/in-home evaluations

CAN COMPLETE IN HOME EVALUATION under the supervision of OT however, the interpretation and determination of goals is (I) under the responsibility of the occupational therapist

OT implications for ADHD

CBT- challenging automatic thoughts, reducing cognitive distortions, challenging underlying beliefs and assumptions, mental imagery, controlling recurrent thoughts, controlling behaviors Behavior modification Education interventions (safety awareness) Social skills training Modifying classroom environments, especially organization of space and objects Self-management skills Interventions to enhance sensory modulation and support organizational routines

Four categories of CMD

CMD I : does not involve severe intellectual functioning difficulties CMD II : involve muscle and brain abnormalities CMD III : involves muscle, brain, and eye abnormalities CMD IV : involves muscle, brain, and eye abnormalities

congential muscular dystrophy

CMD is heterogeneous group of disorders with onset in utero or during the 1st year of life Brain involvement is apparent, along with neuromuscular functioning CMD is characterized by hypertonia, generalized muscle weakness, and contractors Common co-morbidities include clubfoot, torticollitis, diaphragmatic involvement, and congential heart and spinal defects Diagnosis is confirmed by the presence of high serum levels of creatine kinase, electromyograph, and muscle biopsy clinical presentation includes a floppy child with muscle weakness in the face, neck, trunk, and limbs, decreased muscle mass, and absent deep tendon reflexes

Severity of traumatic brain injuries

Class I injuries: neurapraxia; some degree of paralysis is present, but no peripheral degeneration Class II injuries (axonotmesis): the endometrium is intact, but the axon degenerates distal to the legion Class III (neurotmesis): these injuries are the most serious type, in which both the axon and the endometrium are severed

Three different phases of handwriting acquisiton

Cognitive phase: child is beginning to understand the demands of handwriting and develop a cognitive strategy for the necessary motor movement Associative phase: the child continues to practice and begins to self monitor; proprioceptive feedback and visual cues are essential in this phase Autonomous phase: the child can perform handwriting with minimal conscious attention

corticospinal tract symptoms

are spasticity (which contributes to muscle pain and hyperactive reflexes)

visual motor integration

Coordinating the interaction of information from the eyes with body movement during activity enlarge keyboard would improve accuracy and coordination for key strikes

Handwriting Intervention: Psychosocial approach

Psychosocial approach a.Intervention is focused on improving self-control, coping skills, and social behaviors. b.Emphasis is placed on communicating the importance of good handwriting to the child. c.Opportunities to enhance self-confidence are provided.

fixed expenses

Costs that do not change from month to month (i.e. rent)

developmental milestones of jumping

Creeping(i..e crawling) up steps develop at 15 months child will be able to jump down from a step and will be able to walk up and down stairs, one foot at a time, without support at 2 years child will be able to jump down from a step and will be able to walk up and down stairs, two foot at a time, without support at 3 years Skipping at 5-6 years old

Handwritten documentation

Must provide accurate account of therapy session only abbreviations can be used if appropriate by the facility A sticker with the pt name and DOB should be place on every page. Errors should be crossed out with one line with initial of the therapist + date over the mistake

Temporal lobe

hearing

Three major forms of neural tube

Encephalocele: protusion in the occipital region of the brain Anencephaly: neural development above the level of the brain stem is lacking Spina bifida: most common type of neural tube defect; congential defect of the vertebral arches and spinal column, the mild form of spina bifida is called spina bifida occulta (and it consists of only one or two affected vertebrae with no involvement of the spinal cord. No symptoms may be present

Qualitative Research Types

Ethnographic: comprised of observing , interviewing, and/or reading about a specific culture to improve ones understanding of the culture and what is important to them Phenomenological: involves documentation of an individuals experiences and responses to situations without further analysis by the researcher Heuristic: involves great immersion of research into a particular situation or experience in order to obtain firsthand account (i.e. staying in a prison to get account of occupations in a prison)

OT role in burn acute phase (after 72 hours)

Eval: ADLS, psychosocial aspects, communication, cognition, ROM, MMT, pain Interventions: Splinting and positioning in anti-deformity positions, edema management, early participation in ADLs, and client and caregiver education anti-contracture positioning: positioning is critical because the position of greatest comfort is usually the position of contracture Edema management: -elevation of ext -AROM ex - wrappings with co bands Early participation in ADLS: apply adaptive strategies/AE, allowing succes in early ADL tasks, Gradually discontinue/grade AE to encourage active movement Implement ROM and activtiy as tolerated - NO PASSIVE OR ACTIVE ROM with exposed tendons or recent grafts (wait5-7 day)

Autonomic Dysreflexia

Extreme rise in BP by a noxious stimulus (i.e. catheter bag) Stimuli that initates this includes blocked catheter or sitting on sharp objects Symptoms include pounding headache and profuse sweating (potentially life threatening emergency!) HOB elevate 90 degrees, loosen constrictive clothing, assess for full bladder or bowel impaction, (trigger) administer antihypertensives (may cause stroke, MI, seizure)

4 types of playing with kids/Development

Exploratory play (0-2 yrs) Symbolic play (2-4 yrs) Creative play (4-7 yrs) Isolative: dressing paper dolls, coloring in color books, playing card games, cutting and pasting onto cards Game-based play (7-11 yrs) card / competitive games , if the kid is developmentally ready for this this is the best for social interaction skills, especially in a hospital which can be extremely lonely

Glasglow Coma Scale grading

Eye Opening Response • Spontaneous--open with blinking at baseline 4 points • To verbal stimuli, command, speech 3 points • To pain only (not applied to face) 2 points • No response 1 point Verbal Response • Oriented 5 points • Confused conversation, but able to answer questions 4 points • Inappropriate words 3 points • Incomprehensible speech 2 points • No response 1 point Motor Response • Obeys commands for movement 6 points • Purposeful movement to painful stimulus 5 points • Withdraws in response to pain 4 points • Flexion in response to pain (decorticate posturing) 3 points • Extension response in response to pain (decerebrate posturing) 2 points • No response 1 point

Sensory Testing

FIRST STEP: demonstrate test with clients vision not occluded, then SECOND STEP to occluded SCI: sensory testing should be proximal - distal PERIPHERAL NERVE INJURY: distal-proximal

Dupuytren's Disease

Fascia of palm and/or digits becomes thick and contracted. -Surgical release is required. -OT intervention: 1. Wound care (dressing changes and whirlpool if infection suspected) 2. Edema control (elevation above heart) 3. Extension splint 4. A/PROM and progress to strengthening 5. Scar management (massage, scar pad, compression garment) 6. Functional tasks that emphasize grasp and release

SCI t6-t12

I in all areas UE strength there may use standing frame or walk with braces

HEP exercise program/ pain

If patient reports pain this is likely due to the intensity of the program. therfore, reduce the program by 50% and reassess for pain Ending the workout all together can leas to muscle/joint stiffness THIS IS NOT NECCESSARY

Rancho Los Amigos Scale

I. No Response: Patient appears to be in a deep sleep and is unresponsive to stimuli. (no response) II. Generalized Response: Patient reacts inconsistently and nonpurposefully to stimuli in a nonspecific manner. Reflexes are limited and often the same, regardless of stimuli presented. III. Localized Response: Patient responses are specific but inconsistent, and are directly related to the type of stimulus presented, such as turning head toward a sound or focusing on a presented object. He may follow simple commands in an inconsistent and delayed manner. IV. Confused-Agitated: Pt in heightened state of activity and severely confused, disoriented, and unaware of present events. Behavior frequently bizarre and inappropriate to immediate environment. Unable to perform self-care. If not physically disabled, may perform automatic motor activities such as sitting, reaching and walking as part of agitated state, but not necessarily as a purposeful act. V. Confused-Inappropriate, Non-Agitated: Pt appears alert and responds to simple commands. More complex commands, however, produce responses that are non-purposeful and random. Pt may show some agitated behavior in response to external stimuli rather than internal confusion. Pt is highly distractible and generally has difficulty in learning new information. Can manage self-care activities with assistance. Memory is impaired and verbalization is often inappropriate. VI. Confused-Appropriate: Pt shows goal-directed behavior, but relies on cueing for direction. Can relearn old skills such as activities of daily living, but memory problems interfere with new learning. Has beginning awareness of self and others. VII. Automatic-Appropriate: Pt goes through daily routine automatically, but is robot-like with appropriate behavior and minimal confusion. Has shallow recall of activities, and superficial awareness of, but lack of insight to, condition. Requires at least minimal supervision because judgment, problem solving, and planning skills are impaired. VIII. Purposeful-Appropriate: Pt alert and oriented, and is able to recall and integrate past and recent events. Can learn new activities and continue in home and living skills, though deficits in stress tolerance, judgment, abstract reasoning, social, emotional, and intellectual capacities may persist.

Allen Cognitive Level 5

Independent learning/Exploratory --> self control/inclusive reasoning stitches: imitates 'simple cordovan stitch' using trial and error X 3 stitches Alters actions with overt trial and error; poor organization, planning, and socialization-mild impulsivity Tx: Concrete tasks; NEW LEARNING AND GENERALIZATION

Kitchen Task Assessment (KTA)

Judgment, planning, and organizational skills to perform simple cooking task for adults with dementia/Alzeheimers Pre-test-washing hands, observes cooking pudding from mix, can provide assistance 0-independent, 1-verbal, 2-physical, 3-incapable initiation, organization, performing all steps, proper sequence, judgment and safety, completion of task scored0-18 adults and elders with dementia, also for cognitive dysfunction

Routine Task Inventory

Level of impairment based on Allen's model Grooming, dressing, bathing, walking, feeding and toileting Housekeeping, preparing food, spending money, taking meds, doing laundry, shopping, telephoning, and traveling Observation, self-report, report of caregiver Rated based on Allen's cognitive levels 1-6 Adults and elders with cognitive impairments

Parkinson's disease medications

Levodopa (L dopa) can decrease symptoms by increasing amounts of dopamine in the brain. Side effects are nausea and dyskinesia Other meds are dopamine replacements medications the person with PD may be a surgical candidate

Cranial nerves XI, XII

MOTOR Neurons Accessory nerve (CN XI) Motor nerve • trapezius & sternocleidomastoid • controls swallowing movements • Neck & back • Pharynx & larynx (motor) Hypoglossal nerve (CN XII) Motor • Tongue movements (motor)

Functional classifcation of CP

Manual Ability Classification System Gross Motor Function Classification System

Splinting for nerve injuries

Median nerve injury: pt may benefit from an opponens splint (since the the pt will have issues with decreased thumb opposition, abduction, and flexion)- therefore positioning of the thumb is crucial Ulnar nerve injury: Splints that maintain MCP flexion Brachial plexus injury: flail arm splint involving shoulder/entire arm Radial nerve palsy: outrigger EXTENSION splint (aka radial nerve splint)

rehabilitation phase

Medical treatment continues with skin grafts and reconstruction surgery as needed for movement and function.

Level of Intellectual Disability

Mild: IQ between 55-70; ability to learn academic skills at the 3rd-7th grade level; able to work with minimal support Moderate: 40-55; ability to learn academic skills at least to 2nd grade levels and able to perform unskilled as well as some skilled work tasks Severe: 25-40 IQ; able to communicate and perform basic ADLs and health habits, often require support to complete routines Profound IQ below 25; requires caregiver (A) for basic tasks; also generally has neuromuscular, orthopedic, or behavioral deficits

National Institutes of Health stroke scale

Multidisciplinary team assessment that addresses several client factors for strokes. -informal observation or standardized assessments and should measure the following areas 1. postural adaptation through functional tasks 2.UE: sensory, ROM, joint alignment, muscle tone, pain, motor control, strength/endurance, functional performance Assessments include: Functional test for the Hemiplegic/Paretic UE, Arm Motor Ability Test, Wold Motor Function Test 3. Motor learning ability: clients abilities to solve challenges of movement and UE use, is critical for recovery of stroking

Erhardt Developmental Prehension for grasping blocks

Neonate: visual attention and reflexive grasp 3 mon: swipes at cube and may attempt to grasp - if cube is touched but uses ulnar side of hand (no thumbs, at this would be radial side of hand) 4 mons: primitive squeeze grasp 5 mons: palmar grasp 6 mons: radial-palmar grasp 7 mons: radial palmar grasp with neutral wrist 8 mons: radial digital graps 9 mons: radial grasp with wrist ext

children handwriting evaluation scale

Norm-referenced tool that assesses cursive writing of children in grades 3 through 8. Task consists of near-point copying of short paragraphs. Similar features of CHES-M.

OT implications for osteogenesis imperfecta

OI can be expected to develop progressive deformities Activity patterns are affected by caution and time spent in casts Maternal education in handling and positioning is essential Monitoring activtiy that promotes weight bearing should be encouraged

Justice

OT code of ethics: an advocate for a patient as well as an advocate for the field of OT

SCI Acute Phase

OT short session limited to 15 mins i: provide family education ii: allowing environmental controls for pt (i.e. nurse call button or bed controls) iii: maintain UE ROM, which can be done through ROM ex and positioning; including splinting ---> emphasis on the following movements: scapular rotation, shoulder scaption, shoulder ER, elbow ext, and forearm PROr Total body positioning evaluation should include hand splinting needs -UE should be positioned at 80 degrees shoulder abduction, ER with scapular depression, and full elbow extension. The forearm should be in pronation to avoid risk for supination contracture

Secondary Progressive MS

One of the four recognized forms of Multiple Sclerosis named for gradual advance of the disease; superimposed relapses (new or resurfacing symptoms) and remissions (periods of recovery) may occur, but they tend to tail off over time.

Standing Tilting Reflex

Onset: 12-21 months Integration: Persists Stimulus: After positioning in standing, slowly raise one side of supporting surface Response: Curving of spine toward raised side (opposite to pull of gravity); ABD/extension of arms and legs Relevance: Maintain equilibrium without arm support; facilitate postural adjustments in all positions

primary open angle glaucoma

Primary open angled galucoma: 90% of cases. Outflow of aqueous humor is decreased in trabecular meshwork, becomes clogged like a sink Develops slowly and without symptoms, no pain or pressure, pt usually doesn't notice until peripheral vision is compromised

Allen Cognitive Level 2

Postural Actions/Gross Body Movement-->MAX ASSIST Stitches: Unable to imitate/complete 'running stitch' Motor Actions: Approximate imitations, Pacing, bending, stretches Attention Span: Minutes Tx: gross motor games, dance, imitating body possture

Handwriting Intervention: Acquisitional

Practice Repetition Feedback Reinforcement should be individualized to the child handwriting should be over-learned and used in a functional way

Honeycomb-shaped plastic cushion

Provide uneven pressure relief and are lightweight

Medicare Part A (aka Hospital Insurance or HI)

Provides hospital insurance automatically @ age 65 (if FICA qualified) @ no fee but may have deductible & co-pay. covers inpatient stays in hospitals, short term stays at skilled nursing facilities, and some home health services

Joint Protection

Pulling stresses the joint more than pushing an object Using larger muscle groups to carry items may reduce strain placed on smaller muscle groups Maintaining neutral wrist position when carrying an item is also recommended to reduce strain and pain Lifting with the legs when picking up heavier items is a common recommendation to prevent injury to ones back

Burn- rehabilitation phase

SKIN CONDITIONING -to prevent shearing/dry skin from splint several times a day -skin massage to desensitize the hypersensitive grafted sites of immature or problematic skin SCAR MANAGEMENT -Initiate compression therapy for both edema control and scar compression -> elastic bandages -> Cobans -> elastic tubular support -> thigh high thromboembolism deterrent hose -> spandex bicycle pants ->Isotonic gloves THER EX/ACT -Ex progressively graded to regain strength and act tolerance -Educate client on skin lubrication and massage SPLINT -> Continue anti-contracture positioning -> dynamic splints or serial casting to reverse disability ADLS -Use AE/AD as needed CLIENT EDU -> skin care protocol -> wound healing process -> compression therapy -> Ex/Act program to preserve ADL activity

Motor Learning Theory

Random practice, several motor tasks in random order to encourage reformulation of the solution to the presented motor problem; importance of practice and repetition; transfer of learning is promoted (ex: practice with unaffected hand first before using the affected hand to transfer skills); guided imagery has been shown to increase motor learning USING BOTH HAND SIMUTANEOUSLY MAY BE TOO HARD TO INITALLY START OFF WITH

Downward parachute (protective extension downward)

Rapidly lower infant toward supporting surface while suspended vertically. > LEs/UE extend. Relevance: Allows accurate placement of LEs in anticipation of supporting surface to prevent fall. Onset: 4 mths_____Integration: Persists

Interventions for Car driving

Reduced effort steering 9 (i.e. altering the wheel position) - makes driving easier for people with UE ROM, pain, endurance deficits Hand controls/pedal extension: used for people with LE deficits Steering Ring: used for people with UE prothesis

Sensorimotor period (birth- 2 years old) cognitive development

Reflexive stage (1 month)- Schemes (beliefs in response to experiences) are formed following the infants performance of reflexive movements (i.e. touch a stove won't touch again) Primary circular reactions (2-4 months) - Reflexes are performed in circular motion as the infant learns what he/she will gain from his performance Secondary circular reactions ( 5-8 months) - Infant transitions to performing voluntary movements in a circular fashion and gains greater understanding of the effect of his actions Coordination of secondary schemata (9-12 months) - infants voluntary movement becomes more complex as he/she begins to understand abstract concepts (i.e object permanence)

Allen Cognitive Level 3

Repetitive Actions-->MOD ASSIST Stitches: Imitates 3 'running stitches' Motor Actions: manipulation of familiar objects, react spontaneously to tactile stimulation Attention: 30 minutes; no written directions;increased distractability Tx: performs familiar/repetitive ADL's tasks (face washing, etc), sanding wooden bookends 3=3 running

Co-insurance

Requires the insured individual to pay a fixed percentage of the loss after the deductible has been paid Money the beneficiary must pay after receiving services

Left sided congestive heart failure

Results from ventricular muscle damage or overloading. As muscle deteriorates, cardiac output (i.e. pumping blood outward towards body) falls. Common Symptoms: dyspnea, dry cough, hypotension, tachycardia, fatique

Tendon gliding exercises

Series of hand exercises intended to prevent tendon adhesion and preserve tendon excursion, includes the following: straight fist: Composite MCP and IP joint extension hook fist: MCP joint extension with IP joint flexion intrinsic-plus: MCP joint flexion with IP joint extension straight IPs: MCP and PIP joint flexion with DIP joint extension full fist: Composite MCP and IP joint flexion from d/c of therapy: OT should be focused on active motions

facilitating tendonesis with patients with SCI

Splints should be used in the dorsal aspect of hand and support the wrist in ext, and thumb in opposition (preserving the web space) allowing for MCP and PIP joints to flex properly

Capitation

System of payment used by managed care plans in which physicians and hospitals are paid a fixed, per capita amount for each patient enrolled over a stated period regardless of the type and number of services provided; reimbursement to the hospital on a per-member/per-month basis to cover costs for the members of the plan.

Table height/OT

Table height varies depending on the task 21-28 inches: seated and typing and computer 28-31 inches: Extensive writing 31-37 inches: seated precision work (Easier the task the lower the table)

Clock Drawing Test

The client is asked to reproduce the face of a clock set to a specific time. This test may detect difficulties with visuospatial skills, visual perception, selective attention, memory, abstract thinking, and executive functioning.

Driving Habits Questionnaire

This instrument captures information about avoidance behaviors that are often identified as compensatory strategies in older drivers

Dynamic tripod grasp

The pencil rests against the distal phalanx of the radial side of the middle finger while the pads of the thumb and index finger control it 4.5+

Activity synthesis

The process of identifying gaps in performance and bridging those gaps by grading or adapting the activity or the environment in order to provide the "just right challenge" for the client

Complex rotation

The rotation of an object 360 degrees, e.g. turning a pencil over to erase 6-7 YEARS

Letter-number cancellation

These assessments test visual scanning and selective attention as a client scans a grouping of letters and has to select and draw a line through the targeted letter.

alternating pressure cushion

These cushions provide scheduled pressure relief through alternating levels of inflation and deflation; they also reduce postural stability.

Finger-to-nose and toe-tap tests

These timed motor coordination tests for the upper and lower extremities detect dysmetria and coordination problems.

Fitness-to-Drive Screening Measure

This 54-item measure enables occupational therapy practitioners and family members, caregivers, and significant others of older drivers to screen at-risk older drivers

Assessment of Driving Related Skills

This assessment battery developed by the American Medical Association addresses domains required for driver fitness: vision, cognition, and motor function.

Short Blessed Test

This brief 6-item assessment is used to identify cognitive function related to dementia. The test assesses the domains of memory , orientation, and concentration.

Driving Health Inventory

This computer-based assessment battery assesses the domains of vision, cognition, and motor function as they pertain to increased crash risk.

Emergent Phase

This phase is also known as the Fluid Resuscitation Stage. It occurs w/in the first 0-3 days post burn. The patient will present with a decreased cardiac output, and a decrease in fluid volume. (FVD) Here, the patient is in a state of dehydration and shock. Things important: 1) sustaining life risk fo dehydration hypo/hyperthermia fluid resuscitation cardiopulmonary stability escharotomy/fasciotomy 2) controlling infection through wound protection/wrapping. Ant open wounds can lead to infection/bacteria growth -> wound dressing include toppical ointments and grafts (xenograft- pig skin, allograft - human cadaver skin 3) managing pain pharmalogicial -narcotics pain management for associated injuries (i.e. fractures and organ damage)

Glare recovery

This test assesses vision impairment and how quickly a person recovers vision after exposure to a bright light source.

SAFER Driving

This workbook helps clients look at their driving knowledge and skill in relation to their health conditions and medications.

Static tripod grasp

Thumb and first two fingers A little wrist motion 3+ years

Play Assessment Tools

Transdiscplinary Play-Based Assessment (TBA)- uses observations from therapist, teachers, nurses, and OTHER RELEVANT PEDIATRIC DISCIPLINES to determine development in cognition, social emotional, language, and sensorimotor (up to 6 yrs) Revised Knox Preschool Play Scale childs ability to play INSIDE AND OUTSIDE environments. Assess space management, material management, pretense/symbolic, and participation (0-6 yrs) Childhood Autism Rating Scale- observation of behavior to rate severity of autism (i.e no, mild-moderate, or severe) [2 yrs and up] Early Coping Inventory-measures coping abilities in regard to sensorimotor organization, reactive behavior, and self initiated behavior, Determine if therapy is appropriate doe a specificities child in regards to identifying coping strategies for success (4-36 months)

Secondary causes of SCI

Tumors Myelomeningocele: birth defects caused when the backbone and spinal canal do not close before birth Syringomtelia: growth of a cyst in the spinal cord Multiple sclerosis: nervous system disease affecting the brain and spinal cord Cancer: Amyotrophic lateral sclerosis: disease attacking neurons in the brain and spinal cord

Maintaining UE ROM

UE should be positoned at 80 degrees shoulder abduction with scapular depression, and full elbow extension. The forearm should be in pronation to avoid risk for supination contractures

Benbow's developmental classification of factors that are the basis of skilled hand use

UE support Wrist and hand development visual control bilateral integration spatial analysis kinesthesia

Claw hand deformity/burn

Ulnar nerve laceration (i.e curling of 4th and 5th digits) , MCP flexion block splint BURN DORSAL ASPEC OF HAND

Ergonomics of Seating

Wrist should be in a neutral position (NOT 20 degree extension) Legs above the knee are parallel to the floor Legs below the knee are perpendicular to the floor Feet are flat on the floor

Most affective approach to treating schizopherinia

Written documentation with a structures, expected outcome, best to reinforce reality and to provide concrete feedback

AT for Visual Impairments

Use alternative sensory pathways -> tactile stimulation (i.e. bump dot, braille) -> auditory substitution (i.e. book tape, text to speech, talking devices and appliances) Reading aids ->optical aids (i.e. handheld magnifier, field panders, telescopes) ->non optical aids (i.e enlarged print, reverse reading, white print on a black background ->electronic aid(CC tv, electronic magnifier, table computers) ADL aids -> kitchen aids (boil alert, liquid level indicator, talking kitchen scale) ->medication management (i.e talking medication box, magnifying pill cutter, jumbo pillow box) -> miscellaneous (lighted magnifying makeup mirror, large universal remote control for television, talking watch or clock) Mobility aids -> cane with warning device (ultra cane with ultrasound beams and sensors) -> wheelchair mounted mobility (i.e. clear path indicator) -> Navigation aids

AT for Auditory Impairments

Use of an alternative sensory pathway -> Tactile substitution (random method-tactile lipreading by putting the thumb on the speakers lip and fingers along the speakers jawline; vibration) -> Visual substitution (flashing lights, speech-to-text, captioning) Hearing aid -> air conduction -> bone conduction -> cochlear implants Telephone access -> teletype device -> captioning service

steamer basket/steamer/crock pot

Used for steaming food, especially vegetables. Inserted into a pot or pan to hold food above boiling water. Could be used for energy conservation for home management techniques

Good positioning for posterior total hip replacement

Using hip abductor pillow between legs sitting in tall chairs lying supine NOT ROLLING TOWARD THE NON_OPERATIONAL SIDE (promotes hip adduction and IR)

Contextual Memory Test

Which test is designed to objectively measure awareness and strategy use in adults with memory impairments and /or screen clients for memory impairment that may require further testing? GOOD FOR PEOPLE WITH RANCHO LEVELS

electroconvulsive therapy (ECT)

a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient six hours after ECT, the patient can complete/engage in structured tasks temporary memory may be lossed after an ECT so asking the person to complete history questionnaire may not be favorable

Scaphoid fracture

a break in the scaphoid bone in the thumb

myasthenia gravis

a chronic autoimmune disease that affects the neuromuscular junction (i.e acetylcholine receptors) and produces serious weakness of voluntary muscles in facial and proximal muscles Difficulty in swallowing and speech production

standard deviation

a computed measure of how much scores vary above and below the mean score

heat stroke

a condition marked by fever and often by unconsciousness, caused by failure of the body's temperature-regulating mechanism when exposed to excessively high temperatures. MUST CALL ((911

Developmental group

a continuum of groups consisting of parallel, project, egocentric cooperative, cooperative, and mature groups. Purpose to teach and develop members' group interaction skills

Nardil

a type of antidepressant, used to treat symptoms of depression that may include feelings of sadness, fear, anxiety, or worry about physical health serious side effects of Nardil including: fainting, mental/mood changes (e.g., agitation, confusion), muscle stiffness, shaking (tremor),' can increase BP which can lead to stroke.Heart palpations can be a serious sign or indicator of problems

stratified sampling

a variation of random sampling; the population is divided into subgroups and weighted based on demographic characteristics of the national population (i.e chosen by a certain trait)

Occupational therapy evaluation/intervention-phases of recovery

a) acute phase b) rehabiitation phase c) community phase

Executive Function Performance Test (EFPT)

a. Assesses executive function deficits during performance of real-world tasks b. Tasks include cooking oatmeal, making a phone call, managing medications and paying a bill c. Structured cueing and scoring d. PRECURSOR to the EFPT is the Kitchen Task Assessment

predictive validity

ability of an assessment to predict scores of a similar evaluation

Shoulder Adhesive Capsulitis

aka frozen shoulder EXTERNAL ROTATION IS THE MOST AFFECTED BY THIS CONDITION Treatment PROM, inflammation reducing modalities, and functional act to increase use of arm

Four degree burns

all layers of tissue (the epidermis, dermis, fat, muscle, and bone)

Light or modified duty programming

allows a worker to temporarily perform job duties with less physical demand

Hip disarticulation

amputation through hip joint; pelvis intact

Wrapping residual limb

applying an elastic bandage to the residual limb in a figure 8 pattern will reduce the volume of residual limb

PNF

approach is based on the premise that stronger parts of the body are utilized to stimulate and strengthen the weaker parts. development will follow normal sequence thru a component of motor learning. PNF places great emphasis on manual contacts and correct handling. movement patterns follow diagonals or spirals (DI,D2 flexion/extension) that each possess a flexion, extension, and rotary component and are directed toward or away from midline.

Rood Approach

appropriate sensory (i.e tapping muscle belly) stimulation can elicit specific motor responses

Thematic Group

assist members in acquiring knowledge, skills, and/or attitudes needed to perform a specific activity Assumptions: improvement of ability to engage in activity outside of group can result from teaching of these activities within group; learning is facilitated by practicing and experiencing needed behavior with reinforcement of appropriate behaviors given

Guidance

assistance and advice received from others

Cutting Skills Development

at 1.5-2 yrs-> kids can hold scissors; often with both hands at 2-2.5: can open close scissors at 3--> able to make snips at 3-3.5--> non dominate hand to hold paper while cutting At 4 yrs-> kids can cut out circles ,curved lines At 6-7 yrs-> kids can cut complex shapes (i.e. stars

Child Development of Toileting

at 12 months: indicate discomfort with urination 1 1/2 years: can sit on toilet with (S) 2 yrs: shows interest in potty training; can stay dry for 2 hour or more; can flush toilet (I); urinates regularly at 2.5- child expresses toileting need but requires assistance with positioning, hygiene, and clothing management; can wipe self after urinating/wash hands (I) at 3- goes to bathroom (I); may need assistance wiping, particularly after bowel movements; may need (A) fastening or managing some clothing items at 4 and 5- the child can complete hygiene, clothing management, and hand washing (I)

Ability to crawl

at 7months (commando style army crawl reciprocal creeping 7-10 monthsin quadriped positon

Neurobehavioral subsystems

based Als' Synactive Theory of Development Pertains to control of behaviors by the nervous system that one can basically control THERE ARE 5 (SAAME) Autonomic response- physical regulation of the body Motor System: factors affecting movement and ability to move Emotional state: level of arousal Attention-interaction: ability to respond to stimulation and the environment Self regulation: ability to maintain stability between all subsystems SYMPATHETIC SYSTEM IS NOT INVOLVED-ITS NOT EVEN A THING

Mini Mental State Exam

cConcentrates only on cognitive functioning, not on mood or thought processes Standard set of 11 questions, requires only 5 to 10 minutes to administer Useful for both initial and serial measurement, so worsening or improvement of cognition over time and with treatment can be assessed Good screening tool to detect dementia and delirium and to differentiate these from psychiatric mental illness Normal mental status average 27; scores between 24 and 30 indicate no cognitive impairment

sensory integration dysfunction

cluster of symptoms that reflect central nervous system dysfunction Not primary sensory deficit Leads to disorganized and maladaptive interactions with people and objects Produces distorted internal sensory feedback

Most important thing to assess with PWC

cognitive level

Thromboangiitis obliterans (Buerger disease)

complete compromise (obliteration) of the circulation within arteries and veins in the legs; symptoms are aggravated by exercise and relieved by rest. RESULTS IN DIMINISHED TEMP SENSATIONS, PARATHESIS, AND COLD EXTREMITIES

House Management Skills (IADLs) for 13-14 yr old

completing washing, drying, and putting away clothes tasks

physical demands frequencies: occasionally

demand is 1/3 of the day

physical demands frequencies: constantly

demand is 2/3 of the day is full day

SCI Prognosis for Recovery

depends if its a complete or incomplete injury. If sensory/motor functions do not return to body after 24 hours, then it is less likely that they will return Recovery at least 3 months, recovery continues for 18 months or longer although the rate of recovery declines Strengthening muscles in the zone of partial preservation for complete injuries may dramatically improve functional abilities

Trustworthiness of qualitative research

depends on: credibility, study's ability to provide accurate overview of information received, regardless of whether it supports the theory or purpose of study dependability, assurance that all relevant infromation is documented and included in study's findings confirmability, accuracy of the findings in relation to the information received through the study transferability, 'ability for the study results to correlate with related studies . would one be able to transfer the findings to a different but related study and authenticity

Developmental Coordination Disorder

disorder involving deficits in the ability to walk, run, or hold on to objects -dyspraxia, congenital maladroitness is primarily a condition of motor incoordination, and other developmental delays Early symptoms include delayed achievement of motor milestones and basic self care skills developmental disorders are likely to have visual impairments

Neoplastic disorders

disorders involve new or abnormal tissue growth or tumor

Arnold-Chiari syndrome

elongation medulla/cerebellar tonsils through foramen magnum

OT role in emergent phase (0-72 hours)

eval: observation of joints affected, gathering information about prior functional status Intervention: spinting in anti-deformity splint -> hands: instrinsic plus for hands -> opposite clients posture -> neck, elbows, knees: generally in extension -> shoulder: abduction -> hip: extension -> anti-frog leg and anti-foot drop for lower extremity

heavy work

exerting 50# occasionally, 25-50# frequently, 10-20# constantly to move objects

sedentary work

exerting as much as 10# of force occasionally, using negligible amount of force frequently to move objects, and involves sitting most of time

light work

exerting as much as 20# of force occasionally, 10# frequently, or negligible amount constantly to move objects; may require walking/standing to significant degree or maintaining a production rate pace

deep breathing

expanding the diaphragm to increase one's intake of air to assist with relaxation and enhance vocal delivery Can be EFFECTIVE WITH PAIN MANAGEMENT AND CONCENTRATION

innapropriate acts of transfer for volunteers

explain to the DOR why thats a bad idea

Catharsis

expression of emotion

status epilectus

extended seizures; prompt medical intervention needed to maintain body functions and hydration

Anticontracture position-elbow

extension

Aconeus

extension of elbow

Anticontracture position-knee

extension, with anterior burn, slight flexion

OT interventions to support handwriting readiness skills

fine motor control isolated finger movements pre-writing lines and shapes as mentioned earlier left-right discrimination print orientation letter discrimination early exposure to technology for children with more significant cognitive or physical disabiilites

PPS (Prospective Payment System)

fixed payment scale/schedule based o your DRG, effected Medicare Part A, resulted in shorter hospital stays

Brachioradialis

flexes forearm with wrist neutral

Boutonniere deformity

flexion of PIP joint and hyperextension of DIP joint Interventions: may use silver ring splints to help with functional grasps

Innervated by the median nerve

flexor carpi radialis palmaris longus flexor digitorium profundus

Innervated by the ulnar nerve

flexor carpi ulnaris

secondary progressive with relapses MS

fluctuation with relapses and deterioration between relapses

foam cushion

foam is of variable density. Foam that is soft and pliable will mold itself around the buttocks. If it is too soft, the client may totally compress it, making it useless for pressure management. From cushions are lightweight and low cost

lower neuron symptoms

focal and multifocal weakness, muscle atrophy (prox--> distal) , and cramping and twitching of muscles

muscular dystrophy

group of hereditary diseases characterized by degeneration of muscle and weakness

Hypertrophic scar development

happens at 6-8 weeks after burn. Looks like a raised red line Can be minimized with compression garments once wound as full healed.

standard contoured surfaces

have contours based on typical body sizes. They provide more support than flat surfaces, distribute pressure across their surface, and are less expensive than custom-made surfaces.

HMO (Health Maintenance Organization)

health care agency provide basic health and trx to voluntary enrollees who prepay a fee for in or out patient on a agreed on package. SMALLER GROUP OF PROVIDERS

four main components of executive functioning skills

higher level cog functions volition, planning, purposeful action, and effective performance

Most appropriate way to use prothesis with eating

hold a regular fork with terminal device knife with hand Dont use hands to stabilize plate because this isnt a typical social behavior

Community reentry implications for TBI OT

home and community visits to assess activity demands and to problem solve strategies on the basis of the client's occupational performance in these settings Home/school modifications and introduction of AE Collaboration with school personnel, family, and rehabilitation team

veracity

honesty in depicting the services and the purpose of OT

Frontal lobe

houses -prefrontal cortex (cog and executive functions) -premotor cortex ( organizes and sequences motor movements -Broca's Area (aphasia) -motor movement for speech

acceptance criteria for early intervention

impaired development of 33% in one area or 25% in two areas

TBI Primitive reflexes

impaired righting reflexes observed with midbrain damage absence of equilibrium reactions and protective extension with basal ganglia damage

presbyopia

impaired vision as a result of aging

Mobilization phase of a fracture

improve strength, decrease swelling or decrease pain through modalities

Visual/child impairments of OT indications

in infancy, caregivers may need support to respond to their baby's cues and to establish sleep routines, and the infant may not display typical attachment behaviors Play exploration may need to be supported to promote development in all areas learning may not affected because cognition may b intact; however, accommodations and modification may need to be made to tasks and the environment -> children to learn to use their other senses -> use sensory integrative therapy -> support social participation -> support development of self care skills -> develop tactile and proprioceptive abilities -> improve fine motor manipulation skills -> Maximize functional use of vision

ataxia

inability to perform coordinated movements common in tbi To treat: used weighted utensils

Apraxia

inability to perform particular purposive actions, as a result of brain damage. common in tbi Int: using hand over hand techniques to repair damaged neural pathways. Compensation may also be included to follow steps by using pictures or writting on cards

Alexia

inability to read/understand written words

visual agnosia

inability to recognize objects/body parts (i.e not recognizing an apple when presented) Visual functions itself is not impacted, but perception

Akathisia

inability to sit still, restlessness

ASI treatment/expected outcomes

increased in the frequency or duration of adaptive responses development of increasingly more complex adaptive responses improvement in gross and fine motor skills improvement in cognition, language, and academic performance increase in self confidence and self-esteem enhancement of occupational engagement and social participation enhancement of family life

photosensitivity

increased reaction of the skin to exposure to sunlight maybe a side effect of a psych drug when your outside

axillary burn

increases tighness in the arm, resulting in the decreased ability to abduct the arm. To reduce abduction contructure the arm should be positioned 120 degrees with EXTERNAL ROTATION

osteogenesis imperfecta

inherited condition of deformed and abnormally brittle bones Fracture prevention is key to interventions which can lead to social isolation, low self efficacy and depression Exploring game opportunities, which doesn't require physical activity would be optimal)

Denial

insurance company denies payment

Paratonia

involuntary resistance to passive movement of the extremities

coprolalia

involuntary utterance of obscenities or inappropriate remarks

Exploratory play

involves the child exploring characteristics of toys, people, and their surroundings, and the response to toys, people, and surroundings of child actions

deep partial thickness burn (2nd degree burn)

involves the epidermis and dermis

cubital tunnel syndrome

irritation, compression, and entrapment of the ulnar nerve in the forearm Sensory changes in the ulnar nerve path in the elbow and forearm- decrease in grip strength positive tinel sign at elbow

Print Tool

is a commercially available and standardized way of measuring a child's ability to produce handwriting

scolosis

lateral curvature of the spine

thoracic/lateral supports

lateral to the trunk below the armpit to facilitate trunk stability

emotional lability

laughing or crying without any reason or when it is inappropriate

Air filled cushions

lightweight cushions, they provide even pressure relief but have to be properly inflated to perform well. Reduce postural stability

Superficial burn (1st degree)

limited to the epidermis (i.e. sunburn) heals 3-7 days Slightly painful, minimal swelling

Forequarter amputation

loss of clavicle, scapula, and entire UE

Anterior cord syndrome

loss of movement as well as odd of pain and temp sensation below the injury, however the person still has light touch and proprioception sensation

shifting

manipulation an item linearly and relocate the fingers to a different position , such as inching the fingers from a pencil eraser downward to the tip of the pencil

Difficulties with motor skills (ASD)

may have dysprxia or poor motor planning dyspraxia can be seen with fine and gross motor activities underlying sensory integrative functions are often addressed as a way to remediate this dysfunction

clients with C6-C7 tetraplegia may benefit from...

may have fully innervated shoulder girdles allowing for greater force for rolling in bed and crossing midline with arms Grasping objects with tendonesis the wrist drive- wrist hand orthosis (or tendodesis splint) is useful for maximizing pinch strength

Intensity of pain

measured by a pain scale (i.e. 0-10)

Duchenne muscular dystrophy

most common form of muscular dystrophy; absence of dystrophin Boys with DMD develop typically after birth and begin to demonstrate symptoms b/w ages 2-6 Enlarged muscles and a positive Gower's sign are present parents commonly report that children with DMD have challenges with going up and down stairs and getting up from lying down Disease progresses quickly and child need to use a w/c by age 9 people with this usually die in their 20s b/c of respiratory/cardiovascular challenges

phantom limb pain

pain in a limb (or extremity) that has been amputated

complex regional pain syndrome

pain that occurs after an injury to an arm or a leg, a heart attack, stroke, or other medical problem

Neuroma (amputation)

painful nerve endings in the scar tissue of a residual limb

Effects of medication exaserterbatevd inside

orthostatic hypotension' akathsia tremors

Proprioception

our sense of body position Screen for it: therapist positions one extremity with the patient's vision occluded and asks the patient to duplicate this motion

Common causes of intellectual disabilities

problem acquired in childhood through trauma, toxins, or infections problem with fetal development/birth chromosomal problems CNS malformations Congenital anormalities Metabolic, neurocutaneous, and endorcrine disorders

5 P's of Marketing

product, price, place, promotion, people NOT PLAN

Rett Syndrome

progressive neurological developmental disorder featuring constant hand-wringing, intellectual disability, and impaired motor skills ASD symptoms appear briefly Development appears normal for first 6 mon of age Childs head growth begins to slow; the child loses hand skills and demonstrates poor coordinated trunk and gait coordination Initally, a loss of social skills occur, but social skills reemerge later Common comorbidites: microcephaly, spasticity, and seizures

bronchopulmonary dysplasia

prolonged use of mechanical ventilation and other traumatic interventions to treat acute respiratory problems result in the airway thickening the formation of excess mucus, and restricted alveolar growth children with bronchopulmonary dysplasia are at a greater risk of respiratory infections and problems

Tonic Labyrinthine Reflex

prone position- assume fetal position integrates at 6 months

rehabilitation workshop

provide individuals the opportunity to participate in a paid work environment and develop work skills. These programs may be used as intermediate job positon or long term placement

the change process (intervention management)

provide people with opportunities to change their actions in order to facilitate a functional improvement and/or (I) Therefore, strengthening an affected arm would facilitate functional improvements and (I) for dressing

air-fluidized bed

provides the highest LEVEL of pressure relief for ulcers

benediction sign

proximal Median Nerve damage, digits 4 and 5 can still flex because of the intact ulnar nerve. CANNOT FLEX digits 2 and 3.(they looked curled)

Ayers Sensory Integration

proximal senses are emphasized:vestibular, tactile, proprioceptive Senses are thought to dominate a child early's life experience Distal senses are not thought to have as large an impact until later in childhood -> vision, hearing, sensory input at critical points in development because it is thought to result in learning or behavioral disorders adaptive responses are important for change

Displacement

psychoanalytic defense mechanism that shifts sexual or aggressive impulses toward a more acceptable or less threatening object or person, as when redirecting anger toward a safer outlet (i.e. anger over progression of disease causing the breaking of AE

Transporter chairs

pushed by attendant/caregiver; used for short distances or temporary use

transfer of training approach

remedial/restorative approach that focuses on restoration of components to increase skill. Deficit specific and utilizes tabletop and computer activities as treatment modalities. client education to remediate defictis table top activities to practive remediation strategies computer games to devlop performance component skills

4 types of attending skills

selective attention (able to maintain focus on tasks when environmental distractions are present) Sustained attention ( able to focus on task for a long time) Divided attention ( able to focus on multiple tasks at the same time) [playing cards and on the phone] Attentional switching (ability to transfer attention between unrelated tasks in order to complete them efficiently and correctly) [answering the phone, then playing cards, then going back to the phone]

manual chairs

self-propelled or pushed. Must have enough room to move the wheelchair between rooms in the home in order to be eligible.

ASI treatment/interventions

sensory input can be used systematically to elicit adaptive responses registration of sensory input is necessary before an adaptive response can be made therapy is guided by the child- therapist find the just right challenge

cranial nerve I,II, VIII

sensory nerves associated with smell, vision, hearing and the vestibular system

OT implications in acute TBI

sensory stimulation can promote awareness ROM can help maintain joint mobility Positioning can help prevent skin breakdown and promote distal function Splinting can help maximize hand functions

Additional impairments to SCI

skin breakdown due to loss of sensations decreased vital capacity leading to decreased breathing orthostatic hypotension- positioning the client in supine with feet elevated about the heart. Be careful with sup/sit transfers- allow time for transfer by going slow to allow for optimal change in blood pressure autonomic dysreflexia: standing the client up, loosening restrictive clothing , and checking the catheter for obstruction spasticity can impact ADLS--> can also lead to contractors Heterotropic ossification: may be controlled through proper positioning in bed and the W/C and maintenance of the client's joint ROM regularly important to identify heterotrophic ossification deep vein thrombosis: vital skin inspection at LE for assemetry, color, size, or temp bowel and bladder function: at or above s2-s5 level Temp changes Pay may be noicieptive Sexual function: sexual drive is not altered in men: erections and ejaculation are often affected, potentially compromising fertility In women: menstration usually ceases but no changes occur in fertility

quadriplegic index of function

specific for clients with tetraplegia

ASD

spectrum of conditions that reflect a range of deficits ASD is characterized by severe and complex, impairments in social interactions and communication skills and by the presence of stereotypical behaviors, interests, and activities Onset is typically before age 3 Increased diagnosis may be related to increased awareness Boys are more likely than girls to get diagnosed ASD a neurobehavioral disroder

Melbourne Low Vision ADL Index

this tool assesses the impact of visual impairment on ADL/IADL

Michon's Hierarchy of Driving Behavior

three levels the strategic level: involves higher level decision making to determine trip goals, mode of travel, and navigating or mapping routes the tactical level: involves decision made during the driving maneuvers including making turns or slowing to pass a vehicle operational level: involves decisions made to control the vehicle safely by executing the necessary visual-motor or coordination skills

useful field of view

three part computer based cog assessment used to determine crash risk. it assesses a) central vision loss/cognitive processing speed b) divided attention c) selective attention After completing the three tests, clients are categorized according to a 5 point scale ranging from very low crash rate to very high crash rate

steropsis

three-dimensional vision/jusdign distance CS: learn to use environmental cues

Instrumental group

to help members function at their highest possible level for as long as possible and meet mental health needs assumes mental health members have reached highest potential and have not made progress in tx

primary prevention goal

to identify and reduce risk factors early before injuries occur and to promote healthy work habits and lifestyle

ODD interventions/social skills

videotape modeling and role plays of conflict situations reading and discussion of stories about children who encounter and deal with social problems child centered intervention, in which the child initiates and directs the activities and the therapist supports the child formation of groups of clients with similar interests to help them cope and practice social interaction Socratic questioning to encourage the child to articulate a rationale for his or her decisions Behavior Management techniques such as recording progress on charts, time outs, n

occipital lobe

vision

Tetralogy of Fallot

which is characterized by pulmonary valve or artery stenosis, a ventricular septal deficits, right ventrical hypertrophy, and ovverid of the ventricular septum. Symptoms include central cyanosis, coagulation defects, clubbing of fingers and toes, feeding difficulties, failure to thrive, and dyspnea Defects with mixed pulmonary

ideal doorway width for W/C

with the minimum being 32 INCHES , anything past that is acceptable W/C are usually 25-26 inches wide

Prosthestist

works to fit an individual to appropriate prothesis and makes adjustments as necessary

Feeding Development

•before 33 weeks no oral motor strength - feeding through G tube appropriate option •33 weeks gestation and after: jaw and tongue movement strong enough to feed •40 weeks: reflexes •4-5 months: munching occurs •6 months: strong up and down movement of tongue •7-8 months: mastication of soft and mashed foods with diagonal jaw movements •9 months: lateral tongue movements, able to drink from a cup •12 months: rotary chewing •24 months: able to chew most meats and raw vegetables

Anomic Aphasia

can speak normally and understand speech, but cannot identify written words or pictures

Anticontracture position-axilla

shdr abduction to 90, external rotation

Cauda Equina Syndrome

lumbar level spinal cord injury resulting in the loos of movement . Many affects bladder and bowel control

constraint-induced therapy

used to rewire the brain by restraining the fully functioning limb and forcing the patient to use the "bad" one

Marginal ambulatory user

can walk short distances; may need a wheelchair on occasion, especially outdoors; can benefit from intermittent use of a power mobility device such as a scooter

anterior cerebral artery CVA infarct

characterized as having: -contralateral hemiplegia -INCOTINENCE -CONFUSION -INABILITY TO SPEAK

Left middle cerebral artery CVA infarct

characterized as having: -contralateral hemiplegia -homonymous hemianopsia -loss of sensation in involved limb - APRAXIA -APAHASIA

Right middle cerebral artery CVA infarct

characterized as having: -contralateral hemiplegia -homonymous hemianopsia -loss of sensation in involved limb - NEGLECT -IMPAIRED SPATIAL AWARENESS

Creative play

characterized at the child being able to play in groups as he begins to improve social, motor, sensory, and cognitive processing skills

ataxic celebral palsy

characterized by HYPOTONIA and ataxia and is caused by a cerebellar lesion

RI response: strong correction

characterized by a time out, that is, time away from the activity until the child is calm; possible use of physical management if safety is an issue

RI response: gentle correction

characterized by altering the environment, reminding the child of the expectations, modeling appropriate behavior, and redirecting the child to another location or activity

Dyskinetic Cerebral Palsy

characterized by dystonia (fluctuations of tone) and caused by basal ganglia lesion

RI response: moderate correction

characterized by giving the child a break by redirecting the child

RI response: facilitation

characterized by observing the child and improving the child's environmental supports

RI response: monitoring

characterized by observing the child and letting the child know the OT practioner is present; encouraging the child; and using guiding questions to prompt the child to problem solve

Heart Diagnoses

-Myocardial infarction -Coronary artery disease medical treatment: open heart surgery, cononary artery bypass graft, valve replacement repair -Congestive heart failure -Cardiomyopathies medical treatment: angioplasty, stent with drug coating, artherectomy

MOHO-based assessments

1. *Short Child Occupational Profile:* occupation-focused assessment that determines whether volition, habituation, skills, and environment *facilitate or restrict occupational participation* 2. *Child Occupational Self-Assessment:* client-directed assessment that covers everyday activities including self-care, school tasks, social activities, family-related activities 3. *Pediatric Interest Profiles:* self-report survey of play and leisure interests 4. *Pediatric Volitional Questionnaire:* observational assessment to understand volition 5. *School Setting Interview:* collaborative interview that describes student-environment fit in multiple school settings

Rood: Motor Patterns

1. *Supine withdrawal* (total flexion while supine to gain trunk stability) 2. *Rollover* (arm/leg on same side flex as trunk rotates, to elicit lateral trunk responses) 3. *Prone extension* (prone w/upper trunk/head in extension) 4. *Neck co-contraction* (prone, lift head into extension, to develop head control) -FIRST STABILITY PATTERN 5. *Prone on elbows* (inhibit tonic neck reflexes, provide trunk and proximal limb stability) -SECOND STABILITY PATTERN 6. *Quadruped* (on all fours, to develop limb and trunk cocontraction) -THIRD STABILITY PATTERN 7. *Standing* (first static then active weight shifting) 8. *Walking* (gait patterns integrated into functional activities)

standard adult narrow wheelchair

16" wide - 16" deep - 20" high

Age Discrimination in Employment Act

1967 law that prohibits discrimination of employees 40 years and up.

Handwriting Intervention: Biomechanical approach

4. Biomechanical approach (STRONG FOCUS ON BODY POSITONING) a.Intervention is focused on the ergonomic factors that influence writing production. i.Sitting posture: =Children should be seated with feet on the floor, thus providing support for weight shifting and postural adjustments. =The table surface should be 2 inches above the flexed elbows when the child is seated in the chair; this position allows for motor synergy and symmetry. ii.Paper position =The paper should be slanted on the desktop so that it is parallel to the forearm of the writing hand when the child's forearm is resting on the desk. =Left-handed students with a supinated grip should have their papers slanted to the left iii.Pencil grip and adjustment of the writing tool =Adaptive equipment to support a functional grip includes pencil grips, triangular grips, moldable grips, wider-barreled pencils, and rubber band slings. =A mature grip should be encouraged in young children; as early as second grade, changing a child's pencil grip may be stressful. iv.Paper modifications

Self-feeding development

5-7mons: begins to eat baby food from a spoon 6-8mons: begins to grasp bottle 9-12 mons: infants begins to feed himself finger foods 12-14 mons: attempts to use spoon (I) but often spills as he tends to turn he spoon Straw use: 18 months

Huntington's chorea

A rare genetic disease in which the central nervous system degenerates and the individual loses control over voluntary movements, with the symptoms often appearing between ages 30 and 50.

Standard Precautions

A strict form of infection control that is based on the assumption that all blood and other body fluids are infectious. Washing hands before and after group session at all times. IF a person has HIV or not, just wash hands

routine supervision

direct contact at least every 2 weeks with interim supervision as needed (good for intermediate level OTs) advances to general when they're more experienced but not advanced

Droplet precautions

Must be followed for a patient known or suspected to be infected with pathogens transmitted by large-particle droplets expelled during coughing, sneezing, talking, or laughing. Includes: Rubella influenza pertusis

acute phase

Also known as the Inflammation Phase Includes 72 hours after an injury or until the wound is closed (may be days or months) Treatment focuses on infection control and grafts (removal of dead tissue and replacement of skin or substitute over the wound); biological dressing may also be used to cover the wound. Physiological support and team communication are important Infection control can be non surgical or surgical cardiopulmonary stability is maintained

Anti deformity postion for splints

Always the opposite of the anatomical motion of the action of the involved limb i..e: burn on anterior neck= anti deformity/splint position in extension

Tachydysrhythmia

An abnormally rapid heart rhythm. common in children can lead to congestive heart failure marked by irritability, poor eating habits, and pallor

quasi-experimental design

An experiment (i.e control and experimental group) that does not require random assignment to conditions.

Denver Developmental Screening Test

An instrument used to assess the development of children between birth and 6 years of age. age appropriate tasks to identify any potential development delays in areas of personal social skills, fine motor skills, gross motor skills, and language

Hypoglycemia

abnormally low blood sugar usually resulting from excessive insulin or a poor diet.. Usually paired with excessive sweating and nausea. Treatment: have the patient sit down and take a orange tablet or orange juice

Bradydysrhythmias

abnormally slow heart rate Artioventricular block is the most common type Medical intervention may include a pacemaker

adjusted age

adjustment made in age of child if born prematurely Subtract the number of weeks premature from the chronological age (this is your baby's adjusted age): 20 weeks minus 6 weeks equal 14 weeks

Neurobehavioral Cognitive Status Examination

This examination is available in paper- and computer-based formats. It is a brief neurocognitive assessment that includes the domains of consciousness, orientation, attention span, language, constructional ability, memory, calculation, and reasoning and judgment.

Common sensory processing deficits for evaluation

sequencing motor tasks Initiation of tasks ocular pursuits NOT FINE MOTOR SKILLS

left hemisphere functions

sequential processing, analytic thought, logic, LANGUAGE, science and math

task-oriented group

Increase awareness of needs, values, ideas, and feelings. psychological or physical trauma. TASK is to TELL and ASK (i.e writing a song) good for self expression VETERAN CARDS ARE NOT ACCEPTABLE SINCE YOU CANT GO INTO YOUR FEELINGS

ALS six stages

I: person can walk, (I) with ADLS, and has some weakness II: the person can walk and has moderate weakness III: person can walk but has severe weakness IV: requires W/C for mobility, need (A) for ADLs, and has severe weakness in the legs V: the person requires W/C for mobility and severe weakness in arms and legs VI: confined to bed and (D) for ADLs and most self care tasks

burn-surgical post operative phase

IMMOBILIZATION is important after skin graft to allow for graft adhesion (generally takes 3-10 days) Immobilization for at least 2-3 days walking is not reassumed until 5-7 days after grafting in LE POSITIONING - may be anti contracture positioning EXERCISE/ACTIVITY -uninvolved lims - gentle ROM in involved limb after graft adhesion

documenting homebound status

If person did not answer the door document that " no one answered the door instead of no one was home. this can jeopardize someone eligibility for home health under medicare A

Development of precision of fingertips

Natal: no voluntary grasp 3 months: no attempt to grasp but visually attends to object 6 months: raking and contacting object 7 months: inferior scissors grasp 8 months: scissors grasp 9 months: inferior pincer grasp 10 months: pincer grasp 12 months: fine pincer grasp

Erhardt Developmental Prehension Development

Natal: no voluntary grasp or visual attention 3 mon: no attept to grasp, but visually attends to objects 6 mons: raking and contacting object 7 mons: inferior-scissors grasp 8 mons: scissors grasp 9 mons: inferior pincer grasp 10 mons: pincer grasp 12 mons: fine pincer grasp

Activities based on Rancho Levels

TOTAL ASSIST I: No response- Appears to be sleep II: Generalized Response:- gross motor response to pain (DECORTICATE/DECEBRATE POSITION WHEN RESPONDING TO PAIN). no eye tracking III: Localized Response: sensory stimulation activity- blink to pain, and directly respond or track objects. CONFUSED -NOT PURPOSEFUL-MAX ASSIST IV: Confused-Agitated: not oriented to whats going on/place/time impacting them to involved in treatement planning (i.e. often causing them pulling lines or trying to get out of bed) Very simple ADL (i.e. donning socks) MAX ASSIST no attending V: Confused - Inappropriate : give them a toothbrush and they brush their hair. Bad safety awareness. very simple ADL MAXA no attending VI: Confused - Appropriate: Repetitive self care tasks (i.e. brushing teeth) MOD A attend to familiar tasks for 30 mins orientation is still off AUTOMATIC/PURPOSEFUL VII: Automatic - Appropriate: rentering the community New learning occurs!. Unrealistic with planning for future and acceptable interpersonal skills MINA VIII: Purposeful - Appropriate reentering the community- some MEMORY challenges can complete tasks up to an hour with distractions SBA

Evaluation Test of Children's Handwriting

a criterion-referenced tool designed to evaluate manuscript and cursive handwriting skills of children in Grades 1 through 6. Its focus is to assess a student's legibility and speed of handwriting tasks similar to those required of students in the classroom.

Facioscapulohumeral muscular dystrophy

affects the face, upper arms, and scapular region. a. Onset usually occurs in adolescence. b. This type of dystrophy is characterized by sloped shoulders and limited ability to raise arms above head. c. Decreased mobility in the facial muscles results in a "masklike" appearance.

cystic fibrosis

a degenerative disorder cause by an inherited autosomal recessive disorder related to gene on the chromosome 7 CF affects multiple systems and is characterized by the muscle producing glands malfunctioning and producing secretions that are thick, viscous, and lacking in water, these secretions block the pancreatic duct, the bronchial tree, and the digestive tract -> early symptoms of CF found inf the infants is the blockage of the small intestine, resulting in abdominal distention -salt tasting skin -grease foul smelling stools chronic pulmonary disease is the most serous complication and is characterized by a chronic cough, wheezing, and lower respiratory infections

Oppositional Defiant Disorder (ODD)

a disorder characterized by age-inappropriate and persistent displays of angry, defiant, and irritable behaviors

Professional review organization

a group the reviews documentation of services within a specific profession in order to determine if the services are justified

Total Quality Management (TQM)

a management philosophy that focuses on satisfying customers through empowering employees to be an active part of continuous quality improvement

sheltered workshop (aka vocational rehabilitation wokrshop)

a protected and supervised workplace that offers job opportunities and training at a pace and level tailored to people with various psychological/developmental disabilities If indivdual wants housing a group home with daily on-site supervision would be the most appropriate

diaphragmatic breathing

a relaxation technique used to relieve anxiety also lean forward on thighs to decrease anxiety and panic and SOB

random sampling

a sample that fairly represents a population because each member has an equal chance of inclusion

multidisciplinary team

a team of PTs OTs SLPs all providing care to a patient (I) of each other. No collaboration on patient care nor outcomes

pursed lip breathing

a technique of exhaling against pursed lips to prolong exhalation, preventing bronchiolar collapse and air trapping; done to increase expiratory airway pressure, improve oxygenation of the blood, and help prevent early airway closure.

Emphesyma

abnormal condition of the lungs marked by decreased respiratory function; resulting from smoking Lung lose elasticity

C7-C8 spinal cord injury movement remaining

all triceps to elbow extension, finger extension , good grasp with some decreased strength and POOR FINGER DEXTERITY, decreased respriatory reserve - rehab potential- ability to transfer self to wheelchair, roll over and sit in bed, push self on most surfaces, perform most self care, independent use of wheelchair, attendend 0-6 hrs a day

Freedom to Work Act

allows social security beneficiaries to work without losing their social sercurity income (65 years+)

break-even analysis

amount of income required so that the accounts receivable equals the accounts payable (i.e to break even)

juvenile rheumatoid arthritis

an autoimmune disorder that affects children aged 16 years or less with symptoms that include stiffness, pain, joint swelling, skin rash, fever, slowed growth, and fatigue

escharotomy

an incision made into the necrotic tissue resulting from a severe burn Cutting this tissue can relieve pressure to prevent compartment syndrome(i.e feelings of parathesia, coldness, and descreased or absent pulse in extrimity)

Functional Capacity Evaluation (FCE)

an objective assessment of a person's ability to perform work-related tasks and is the core of all return to work programs. Assessment can be performed by a multitude of disciplines, and a wide variety of FCEs used in practice typical FCE include: ->medical records -> interview ->musculoskeletal screening -> evaluation of physical performance, -> formation of recommendations, and report generatione

Custom-contoured surfaces

are shaped to the clients body more expensive. Provide the most support

diagnositc related groups (DRGs)

are the diagnosis groups determined by medicare/medicaid by which quantity of payment of services is determined

gullian-barre syndrome

ascending paralysis(i.e starting from feet and going up). watch for respiratory problems. Common sensory changes therefore intervention that educate the patient about sensory deficits and related adaptive strategies

quality of pain

asking the person to describe the pain

Test of Handwriting Skills

assesses a child's neurosensory integration skills in both manuscript and cursive writing -- skills that are often disrupted in students with learning difficulties.

Glasgow Coma Scale

assesses eyes, verbal, motor NOT AUDITORY determine severity of coma Max- 15 pts, below 8= coma sever: 3-8 Moderate: 9-12 Minor: 13-15

Performance assessment and improvement (PAI)

assessing the current effectiveness of a program and determining strategies to improve quality/performance

face validity

assessment appears to meet stated purpose

Marfan Syndrome

autosomal dominant trait characterized by excessive growth at the ephipyseal plates children with marfan syndrom present with long and slender fingers, skull asymmertries, and tall statue Noted differences in their joints, eyes, and heart Associated with lax and hypermobile joints and poorly striated muscles Common co-morbidities include dislocation of the lenses, scolosis, coxa vara, depressed sternum, stooped shoulders, and fragility of the blood vessels

Unilateral below elbow amputation

can achieve funtional (I) with using intact UE for ADLs while using their residual limb as a stabilizer A prothesis can readily become unnecessary as a person devlops unilateral skills so the best intervention is focusing on developing unilateral skills for completing meaningful tasks.

handybar

balance during transfers in/out of car

Klinefelter syndrome

boys with this syndrome have learning disabilities and emotional and behavioral problems; they are tall, slim, and small genitalia, and are unable to father children

direct expenses

can be directly attributed to a department, a function, or a specific activity. This is mainly OT salaries and benefits

ventricular septal deficits

characterized by one or more openings in the muscular or membranous portions of the ventricular septum. More than 50% of cases self-correct by age 5; otherwise, surgery is warranted. They could result in Eisenmenger's complex or pulmonary vascular obstruction owing to prolonged exposure to increased blood flow and high pressure; symptoms include feeding difficulties, shortness of breath, increased perspiration, increased respiratory infections, fatigue with increased activity, and delayed growth.

infant's backward parachute reflex

characterized by shoulder and elbow extension of one arm as well as trunk rotation by tilting head backwards

Spastic Cerebral Palsy

characterized by spasticity and HYPERTONIA and caused by a motor cortex lesion

RI response: matching

characterized by the OT practitioner matching his or her response to the child's behavior

Brown-Sequard Syndrome

characterized by the loss of movement, light touch sensation, and proprioception on the same side as injury as well as loss of pain in the opposite side of injury

Game based play

characterized continued participation in games with other children - improvement s in participation in both cooperative and competitive environments

scleroderma

chronic progressive disease of the skin and internal organs with hardening and shrinking of connective tissue Leads to increase to contractures (NEED SPLINTS) INJURY/BREAKDOWN OF SKIN ( warranting skin protection education)

to increase gag reflex

circular/lateral motions

Motor flexibility/Driving

client may have difficulty entering or exiting a vehicle CS:install swivel seats, use a transfer device, or install an eight way adjustable seat

Motor strength/Driving

client may have difficulty managing controls (i.e. emergency brakes) CS: review vehicle design considerations (i.e foot vs hand operated parking brake)

Visual Information Processing

client may have difficulty recognizing signs, negotiating intersections CS: limit driving to familiar areas and to roads with reduced speeds, and avoid traffic hours or complicated intersections

Fading

client skills improve, so the OT draws back help

Symptom minimizer

client who keeps symptoms hidden so he or she can return to normal activity or avoid appearing weak

TBI recovery (D) on these factors

clients age preinjury capabilities severity of injury quality of intervention

Motor endurance/driving

clients may have difficulty driving for long periods of time CS: automatic transmission, power brakes, and cruise control, plan the route in advance and take ample rest breaks

Congential clubfoot

clinical features include unilateral and bilateral foregoot adduction and supination, heel varus

Contracture (amputation)

complication that can occur in the joint proximal to the amputation- resulting in decrease ROM in the proximal joint `

carpal tunnel syndrome

compression of the median nerve as it passes between the ligament and the bones and tendons of the wrist (sensory changes in 1-4 digits); caused by excessive wrist flexion

pronator teres syndrome

compression of the median nerve in the forearm near pronator trees (sensory changes in 1-4 digits plus forearm pain) positive tinel sign at forearm

Guyon's canal

compression of ulnar nerve in the wrist. sensory changes in the hand along ulnar pathway (pinky and ring)

cognitive behavioral driver's inventory

computer-based neurocognitive battery is validated for people with TBI and is designed to assess the cognitive and behavioral skills required for driving.

developmental dysplasia of hip

condition often occurs bilaterally and is more common in girls than boys are genetic/environmental hip laxity may be heriditary or the result of hormonal secretions in utero Increased uterine pressure/poor presenting position may play a role dislocation in utero also be caused by sudden passive extension or positioning that keeps the legs extended and adducted early diagnosis is a critical delay can lead to a serious long term disability treatment with bracing, casting, or splinting is done within the first few steps of life, children typically have good developmental outcomes

Homebound status criteria

confinement, based on necessity of adaptive equipment for mobility, need for assistance from others, or "considerable and taxing effort" to leave home. -requires caregiver assist for transfers -physically very difficult to get outside the home -person cannot drive May leave home for medical appt and non-medical infrequent appts (hair, church, etc)

De Quervain's Tenosynovitis

contributes to pain in the thumb and wrist and can be caused by repetitive use or injury; causes inflammation at the radial styloid

Cranial nerve III,IV, VI

control motor movement of eyes

indirect expenses

costs that are incurred for the joint benefit of more than one department and cannot be readily traced to only one department. can be variable i.e. rent

Denver Handwriting Analysis

cursive handwriting scale designed for evaluating the writing of students in grades three through eight. This kit contains the test booklet, the scoring profiles for grading, and a wall chart as well as the explanatory manual.

amyotrophic lateral sclerosis

degenerative disorder that impacts the corticospinal tracts and anterior horn cells. characterized as progressive weakness initially starting with distal muscles. Weakness can also cause difficulty with swallowing/speech production Decreases in fine motor control need for ADL/IADL tasks in the spinal cord and brainstem

Early indicators of IDD

delays in in meeting motor and speech milestones unreponsive to handling and physical contact Reduced alertness Limited reactions to play Feeding difficulties Neurologic soft signs Poor balance Motor assymetry Decreased perceptual moto skills Decreased fine motor skills

Acting out

describes behaviors that violate societal norms (i.e. sexually provocative behaviors

Preprosthetic treatment

desensitize the residual limb complete AROM as available in residual limb Wrapping should be completed DISTAL to PROXIMAL Reduce tension in wrappings toward the proximal limb

Location of pain

determined by the patient by having them describe or point to the pain

spatial relations

determining the position of objects relative to each other

Sitting upward with arms propped forward

developed at 5-6 mons If this appears later (i.e. 8 mons) or ANY OTHER DELAYS then a sensorimotor skills evaluation must be implemented before you complete anything else

Development of oral motor

diagonal jaw movements 7-8mons effective mastication: 9 mons Cup drinking/rotary chewing: 12 mons

Dysarthria

difficulty forming words 2/2 of paralysis of speech muscles

Most common form of sensory integration dysfunction

difficulty with tactile discrimination and perception characterized by difficulty making sense of interpreting tactile input Fine motor manipulation skills may be delayed children may have difficulty grading force or pressure being able to feel objects and use them efficiently is an important part of child development - when children have difficulty interpreting when they are feeling, they may experience delays may have difficulty with visual-motor tasks and motor planning in general Compensate for motor skills by using visual guidance

IDD OT implications

early years: support to meet development milestones, enriching the environment; supporting parents School age: support development of functional skills, collaboration with special educators and other related service personnel, acquisition of student role Adolescence: supporting the development of vocational interests and skills, social skills, sex education, and community mobility skills General adaptations of the environment -> use of AT with a specific strategy for implementation -> switches or communication devices -> mobility devices (i.e scooters and walkers)

OT intervention implications are as follows for cystic fibrosis

educate the client about the disease progression instruct the client and his/her family in energy conservation teach techniques to promote effective breathing

occupational therapy implications for asthmas

educate the client regarding the reduction of exposures to irritants teach the client self management strategies, including pacing and stress management encourages structured peer group to reduce the likelihood of social isolation educate the client regarding breathing exercises, stretching, and controlled breathing to manage attacks

Cognitive Orientation to daily Occupational Performance (CO-OP)

employing top down strategies to encourage problem solving when difficulties are encountered to improve overall task performance

Evaluation Group

enable client and therapist to asses client's skills, assets, limitations regarding group interaction Role of OT: select and orient clients to group purpose, select activities that require collaboration and interaction, OT not to intervene only observe

Cooperative Group

enable members to engage in group activity which facilitates the free expression of ideas and feelings, develop sense of trust, love, belonging, cohesion

Parallel group

enable members to perform individual tasks in presence of others minimal interaction

egocentric cooperative group

enable members to select and implement long-range activity which requires group interaction, enable members to identify and meet needs of selves and others (ex: safety and self esteem)

OT Implications of klumpke palsy

fabrication os a sling that fits proximally around the humurs to ensure alignment and prvent subluxation from gravity PROM and AROM ex Resistive exercises and weightbearing if strength improves Tactile stimulation to increase awarenss engagement in activities that bilateral in nature to increase body scheme (i.e. patty cake, peek-a-boo) Retrograde massage for edema Surgical intervention if spontaneous improvement in not noted between ages 3 and 6 mons

pt home hospice services

focus on activtiies the patient wants to do rather than focus on medical treatment Joint protection/energy conservation strategies may be helpful but the person will still need (A) so exploring options are better

ODD/OT treatment

focus on functional outcomes for the client within contexts -> following classroom rules -> taking direction from other people -> following societal rules ->Ameliorating skill deficits (most pronounced during times of stress -> using coping strategies to successfully engage in daily tasks -> Using self management strategies such as relaxation techniques or visualization techniques

bottom up approach for OT

focuses on an individuals current skills and abilities, not necessarily what they need to be able to do (occupations)

top-down approach for OT

focuses on current occupations and prospective occupations a person want to do INTERVENTIONS SHOULD FOLLOW THIS PROGRESSION

Interactive Reasoning

focuses on the interaction between disease/ disability and the individual, caregiver, and the clincian, Type of reasoning is client centered and involves the clinician identifying motivational factors to encourage performance

Splint wearing schedule/protocol for the first 72 hours post-surgery

for burn victims and skin grating, the splint should be worn at all times besides dressing changes Immobilization reported as 5-10 days

Figure of Eight Splint

for combined median and ulnar nerve injury to prevent MCP hyper extension

lateral pinch testing

forearm in neutral and pinch meter on middle phallanx

semi-reclined with neck is neutral

help with children with CP spasticity

hemophillia

hemophillia is a blood disorder that commonly affects males; 60% of cases are hereditary characterized by the absence or reduction of one of the clotting blood proteins Hemophillia results in longer bleeding time or bleeding episodes three types of hemophillia: mild, moderate, severe

concurrent validity

how well scores and data match on two separate but similar assessment administered in close proximity

content validity

how well the assessment encompasses and accounts for all possible responses

fidelity

how you approach a person: atributes of compassion respect good judgement and honesty

Asomatognosia

inability to recognize parts of one's own body (i.e this is not my left arm)

fascitomy

incision into fascia

Human Activity Assistive Technology Model

includes interactions and balance among four major elements: 1. Activity 2. Context 3. Human skills 4. Assistive technologies

Arthrogyposis/OT implications

increase and maintain clients ROM and manual muscle strength with daily stretching programs, splinting, and serial casting increased functional participation with ADLs, IADLs, education, and play though the use of AE

task-oriented group

increase client's awareness of their needs, values, ideas, feelings, and behaviors as they engage in a group task.

erthrocytosis

increase in the number of red blood cells and elevated white blood cells; referred to transient leukemia experienced in 1 in 150 children with down syndrome will experience this

Most effective healthcare team

interdisciplinary and transdisciplinary

shunt malformation

intermittent headaches, shortened attention span, increased paralysis, decreased upper extremity strength, decrease in school performance, increase irritability

Klumpke's palsy

lower brachial plexus injury resulting in claw hand deformity; usually improves between 3-6 months characterized by paralysis in the hand/wrist muscles (i.e. most likely claw hand deformity) Severe klumpke palsy severe enough can lead to full paralysis in UE

Adaptive strategis for visual impairments

items such as large print books or magazines, walking clocks computer adaptations (magnification and screen reading programs use of contrast (bold lined paper and bold tipped pens use of contrast colors and decrease use in patterned backgrounds reduce clutter

neural tube defects

malformations of the brain, spinal cord, or both during embryonic development that often result in lifelong disability or death rate of neural tube defects is decreasing, possibly because of increased awareness of the importance of folic acid for women in their child-bearing years

ishihara color test

measure of color perception tests for red or green color deficiencies

Pelli-Robson Contrast Sensitivity Chart

measures contrast sensitivity

break reaction timer

measures the time required to move the foot from the acceleration to the brakes in response to a stimulus such as a red light Options are available to expand to complex or choice reaction times in responding to multiple stimuli requiring choice of response

mild spastic diplegic cerebral palsy

mild lower extremity involvement and minimal to no upper extremity involvement good interventions: a foot propelled bicycle with hand brakes Hand bike not goof for LE stregnthening, which is the deficit

PLISSIT model

model used for sexual expression and sexual activity P - Permission LI - Limited Information SS - Specific Suggestions IT - Intensive Therapy

Adapted tricycle with foot brakes

more suitable for children with more involvement and lees control of lower and upper extremities

Dry AMD

most common type of AMD; causes deposits of yellow-colored extracellular material within the macula of the eye, causing possible atrophy of the retina and a gradual loss of central vision

myclomeningocele spina bifida

most severe form of spina bifida. In addition to an excessive spinal opening with an exposed pouch of cerebrospinal fluid and meninges, the nerve roots are also exposed -> children with this have sensorimotor problems at or below the level of lesion -> LE paralysis and loss of sensation is common -> Some children also have hip, spinal or foot deformities -> Complications include hydrocephalus and Arnold-Chiari syndrome

Neurological Assessment of Pre-term and Full-term New-born Infant (NAPFI)

neurological eval and scale that assess habituation, movement and tone, reflexes, and neurobehavioral responses (i.e. level of arousal, alertness, auditory/visual orientation, irritability, consalabiity , and cry Involves assessing on infants response to items presented in three stages: quiet or sleep state, items not influenced by state, and during the infants awake state

Neonatal/vestibular

not fully developed at birth, so it has little significance early in life

Handwriting Evaluation

occupational profile Interviews -> child -> teacher -> parent Analysis of performance -> work samples -> file review -> direct observations (writing tasks that the most difficult for the child, what behaviors are evident when the child is required to write, lOA or cueing (if any) the child needs to complete the writing tasks) Measuring handwriting performance -> writing the uppercase and lowercase alphabet -> copying letters, words, and numbers in manuscript and cursive Factors restricting handwriting performance

Mixed seizure disorder

occurs when a person experiences both generalized and partial seizures

pelvic obliquity

one side of the pelvis is lower than the other side, which can lead to scoliotic posture and pressure ulcers on the ischial tuberosity

optometrist

one who measures vision

beneficary

one who receives benefits (i.e the patient)

Requires full arm movement for writing

palmar supinate (gross grasp around the pencil and full arm movement) and digital pronate grasp (gross grasp with begining use of digits around the pencil and full arm movement)

Trail Making Test

paper and pencil assessment measuring cognitive flexibility, motor control, perceptual complexity, visual scanning and executive function. Frontal lobe of brain

Porteus Maze Test

paper and pencil tracing activity is correlated with on-road driving performance. Not timed

Arthrogyposis multiplex congental

reduced anterior horn cells in the spinal cord; however, exact cause is unknown characterized by an incomplete contracture of many or all of the clients joints, which is present at birth UE/LEs involved clients often present with stiff and spindly exts and the appearance of thickened knee and elbow joints. Their muscles may be underdeveloped, and in some cases, they may experience paralysis b/c of spinal cord involvement

reflexive bite

reflexive, sustained jaw closure, accompanied by increased abnormal tone in the jaw muscles, in response to stimulation of the teeth or gums. It is difficult to release, and its force can damage the teeth or an object placed in the mouth." It is a swift, involuntary biting action that may be triggered by stimulation of the oral cavity. The bite can be difficult to release in some cases, such as when a spoon or tongue depressor is placed in a patient's mouth. A reflex is a movement that is triggered by the nervous system but does not require conscious thought. Use a narrow, shallow, coated spoon that will help the food slide off for feeding.

top loading washer/dryer

requires more work than a front loading machine

TBI impact on cognition

short and long term memory high level executive functios, such as impulse control, sequencing, insight judgement, and long term planning decreased insight perceptual difficulties, possible impairment of receptive and expressive language depression during recovery Mood Swings

clients with C8 tetraplegia may benefit from...

should focus on grasping objects with MCP joint ext and proximal and DIP flexion

three factors leading to intellectual disability

significant impairments in intellectual abilities, as measured by a psychoeducational assessment. A child is considered to have an intellectual disability if they scored more than 2 standard deviation below the normative range for a child's age Onset before the age of 18 Impairment of adaptive abilities necessary for ADLs and IADLs

Inpatient Acute physicatric Rehab/interventions

simple concrete safe tasks that can be done in one session--> since these individuals may not stay long to continue project

Common comorbidities of IDD

speech problem ambulation problems Seizures Visual problems Chronic conditions

Central Cord Syndrome

spinal cord injury characterized by greater UE weakness than lower extremity weakness

Bayley Scales of infant Development

stanadadized evaluation for ages 1-42 months that is used to determine a child's baseline abilities as well as continued progress through treatment Parents complete two questionnaire to determine scoring in five developmental areas: cogniton, language,motor skills, social-emotional, and adaptive behavior skills

Get up and go and times up and go (TUG)

the TUG involves timed performance of getting up from a chair , walking 10 feet, turning around, and walking back to sire down again: Indicator of fall risk. GUG is observational rating for fall risk suing a a score ranging from 1-5

contrast sensitivity

the ability to detect differences in light and dark areas in a visual pattern--> poorly defined edges or low contrast objects that may be only slightly brighter or darker than their surrounding, which is important in night driving

figure-ground perception

the ability/challenges to discriminate properly between a figure and its background good interventions: using different colored/solid folders to hold materials for each class subject NEED CONTRAST and NON CLUTTEr

sympathetic nervous system

the division of the autonomic nervous system that arouses the body, mobilizing its energy in stressful situations (i.e fight or flight) increase BP/HR, restricts peristalsis

parasympathetic nervous system

the division of the autonomic nervous system that calms the body, conserving its energy - lower BP/HR, increasing peristalsis (involuntary constriction and relaxation of muscles in the intestines), increase flow of saliva

neurophysiological approach to therapy

use a technique (PNF, ROOD, NDT handling techniques ) to facilitate rotation during functional tasks MAKE SURE ANSWER INCLUDES FUNCTIONAL TASKS BECAUSE THIS WILL BE THE BEST CHOICE>

Airborne precautions

used for patients known or suspected to be infected with pathogens transmitted by airborne droplet nuclei includes: Measles, Severe Acute Respiratory Syndrome (SARS), Varicella (chickenpox), and Mycobacterium tuberculosis

percussion/massage residual limb

used to desensitize residual limb

pressure mapping

used to determine comparative effectiveness of different cushions for relieving pressure on the seating surface, pressure mapping is done by inserting a pressure sensitive mat between the client and the seating surface

Narrative reasoning

used to make sense of people's particular circumstances focuses on collecting functional performance history and personal goals for improving participation in desired activities

Meniere's disease

vertigo and pressure within ears

scaffolding

when the OTs assist with the client with parts of the tasks that are too difficult, but the client finishes the task him/herself help motivate the person that he or she can complete a task

tbi: open injury

when the object enters the brain

ALS medications

◯ Riluzole (Rilutek) is a glutamate antagonist that can slow the deterioration of motor neurons by decreasing the release of glutamic acid. It must be taken early in disease process, and will add approximately 2 to 3 months of life to the client's overall lifespan. antispasmodics, non anti-inflammatory medication), and antibiotics may be prescribed Medications do not alter the fatality of disease but help manage the symptoms