Combo # 3
Client Centered Splinting
"An approach to service which embraces a philosophy of respect for, and partnership with, people receiving services" (Law et al.)
Build on family strenghts, dreams and hopes. When talking with families ask "___" rather than "___" questions
"How" rather the "Why"
Specific mental functions?
*memory *language *calculation *attention *memory *psychomotor *emotional control *perception *thought *higher cognitive functions mental function of sequencing complex movements
This approach was used on a child who has Cerebral palsy, the goal of the splint was to decrease the amount of tone present
Central nervous system- Sensorimotor approach
Components of IFSP
Child's current level of development Summaries of evaluation reports Family's concerns Desired outcomes (goals) Early intervention service and support necessary to achieve outcomes Frequency of, method for providing, and location of services Payment arrangements (if any) Transition plan
The concept of inclusion means
Children with disabilities are included in regular educational and social routines as much as possible
Pulmonary Pathologies observed with increase aging
Chronic obstructive restrictive pulmonary disease pulmonary edema asthma pneumonia
Canadian Model of Occupational Performance (CMOP)
Client Centered Interview-based valid
DIP Flexion
Client is sitting with feet on the Floor Move Digit through ROM 1. Start- elbow of the testing extremity is resting on the table with the humerus slightly flexed and forearm in neutral. The DIPs are in neutral or extension 2. Fulcrum- dorsal DIP joint being measured 3. Stable arm- dorsal and the midline of the distal phalanx of the joint being measured 4. Claw fingers 5. ROM- 0-90 6. End - client moves the testing extremity through maximum DIP flexion
CMC Flexion
Client is sitting with feet on the Floor Move thumb through ROM 1. Start- testing extremity is resting on the table with humerus abducted, elbow flexed and forearm supinated. Client hand is placed "palm up" with thumb placed in line with the second digit 2. Fulcrum base of the CMC joint 3. Stable arm- midline of the radius 4. Moveable arm- midline of the first metacarpal 5. ROM- 0-20 6. Ending postiion- client moves testing extremity thumb across the palm inot max CMC flexion
The ability to apply knowledge gained over time and by experience and uses judgement to aid in deciding how to respond to a given situation
Crystallized intelligence
Context and Environment
Cultural Personal Physical Social Temporal Virtual
Allow a therapist to systematically view the influence of culture on specific behaviors and characteristics?
Cultural Schemas
Self Schema are ___ ___ and serve to define self in reflection of ___ endorsed attribute
Culturally mediated Culturally
The set of "values, beliefs, attitudes, customs, language and behaviors that are shared by a group of people and are passed down from one generation to the next
Culture
______ tends to dictate the manner in which a partner is chosen and the roles of participating individuals as a relationship develops
Culture
Cultural Context
Customs, Beliefs/values, standards and expectations
This is based on the hypothesis that a childhood history of physical abuse predisposes a person to violence in later years, a notion supported by longitudinal research
Cycle of violence
Adolescent to engage in the use of illegal drugs like cocaine marijuana and inhalants experience significant adjustment problems in regard to
Education have difficulty in adjusting to adult roles and responsibilities and I'll more likely to become involved in deviant behaviors
Material resistance to stretch and its tendency to return to its original shape after stretch
Elasticity
The term ANTECUBITAL FOSSA refers to the following body part?
Elbow Pit
The humeroulnar joint is responsible for the following movement
Elbow flexion and extension
Criterion referenced
-cut off scores -performance against standard -content specific -variability of scores not desired -discriminates -provides information to plan intervention -sensitive to a fax of therapy -depends on task analysis -formative
In adulthood, the level of impairment is influenced by
-degree of interference with daily activities -chronologic age -level of intrinsic and extrinsic resources -societal barriers
ganglion cysts
-develop suddenly or gradually in the tendons or joints of wrists or feet -non-cancerous, fluid filled cysts
Colles' fracture
-distal radial fracture usually from a FOOSH -external or internal fixation
Bottoms up assessment is most appropriate for
-evaluation -designing intervention that targets impairments such as decreased joint range of motion or muscle weakness
Dupuytren's Conctracture
-fascia under the skin of the palm thickens and becomes scarlike -usually in the 4th and 5th digits -not usually painful -occurs more often in men
immediate memory
-first step, also called sensory memory -recall of stimuli within seconds of the event
flexor tendon injuries
-flexor tendons are located on the palmar aspect of the hand. -are less common than extensor flexor injuries -deep cut -sudden jerk -splinting
Monitoring functions (a component of metacognition)
-include mental activities that let us think about what we are doing before, during, and after we do it. Includes intellectual awareness of personal sills, the ability to anticipate task demands or outcomes, the ability to detect errors in our work, and the ability to organize our actions to complete a desired task. -example-adjusting the task as demands change.
By age __ , most infants have achieved many of the motor skills needed for the development of dressing skills
1 year
ADA 3 definitions of disability ( worker must meet 1)
1. A physical or mental impairment that substantially limits one or more major life activities 2. Has a history of having such an impairment 3. Regarding as having such impairment
According to Guidelines for Documentation of Occupational Therapy, the purpose of documentation are to
1. Articulate the rationale for provision of OT services 2. Reflect the OT practitioners's clinical reasoning 3. Communicate information about the client from the OT perspective 4. Create a chronologic record of client status, OT services provided to the client, and client outcomes
Language acquisition stages
1. Babbling and cooing 2.one word stage 3. two word stage
For the first time congress passed a $ 1500 cap on therapy services combined creating a limit of services
BBA
BBA
Balanced Budget Act 1997- a new system of reimbursement was initiated
ADL
Bathing and showering Bowel and Bladder management Toilet hygiene Dressing and Undressing Eating and feeding Functional mobility Personal care device Personal hygiene and grooming Communicative device use Community Mobility Health management/medication routine Meal prep and cleanup
The professional working with families that have children with disabilities should
Be sensitive to the impact of their words or advice Be nonjudgmental Recognize the validity of feelings
T/F The ligaments on the dorsal aspect of the wrist are thick and strong, which provide stability
F- the volar
T/F Gait activities do not change with age
FAlse- Numerous changes in gait occur with age
Determinants of health
Factors that influence overall health and well-being
T/F Hispanic or Latino refers to a race?
False- Hispanic or Latino refers to a cultural group
T/F OSHA does not have any regulations for cleaning and disinfecting toys
False- OSHA requires facilities and agencies must provide workers with policies and procedures for cleaning and disinfecting
T/F The WeeFIM is a tool that can be used for diagnosis
False- WeeFIM is efficient assessment and documentation of progress
T/F The age-related declines in cerbral blood flow, oxygen need and glucose utilization by the brain are significant enough to account for the extent of brain atrophy that accompanies aging
False- are NOT significant enough
T/F when congress passed the Medicare law, it included OT services so AOTA did not need to lobby
False- it did not and AOTA lobbied heavily
T/F the definition of Individuals with disabilities in FHAA is different than the ADA definition
False- same
T/F Gender identity and bilogically female or male can be used interchangeable
False- they are not the smae
_______________ have the most significant environmental influences on a young child's life and development
Families
Morphogenetic family theory (form evolving)
Families do evolve ; that is change they change Examples include gaining or losing a member through marriage, divorce, birth and death, and the shifting roles of members through marriage, school, progression or aging.
systems theory is a core framework for guiding interactions with families.
Family
____ ___ must be considered when home therapy programs are developed; otherwise time-consuming programs that simply cannot be done within the parameters of the daily household routines and time schedule may be prescribed
Family routines
Characteristics that contribute to martial failure
Feelings of powerlessness Passive-aggressive Neuroticism Suspicion Chemical abuse Depression Borderline pathologies Hostility, defensiveness and agression
Activity Limitation
ICF phrase used to replace disability refers to restriction in activities and participation due to limitations in structure, functions, or contextual factors
This law encourages OT practitioners to work with children in their classroom environment (inclusion) and provide support to the regular education teacher (integration)
IDEA ( renamed from EHA)
In 1990 Congress amended the Education for All Handicapped children Act and changed it name to
IDEA- Individuals with Disabilities Act
The ___ team determines the student's eligibility once all evaluations are completed
IEP
what approach is the most widespread and widely used in research and the scientific literature?
IQ
Authoritarianism
Identification of a clear authority and individual freedoms are superseded by decisions made by authority figure
6 splint classifications
Identification of articular or non articular Location Direction Purpose Type Total number of joints
The "Crisis" task associated with adolescence in Erickson's theory is
Identity versus role confusion
Cognitive domain
Involves thought; ability to express one's self through written and spoken language read, think, perform tasks through completion
The embryonic period
Is a time of major susceptibility to teratogens Last through the eighth week after conceptions
Occupation-based splinting
Is an approach that promotes the ability of the individual with hand dysfunction to engage in desired life tasks and occupations.
Leisure
Is an occupation that is intrinsically motivating and not obligatory
neuromaturational theory of motor development
Is based on the assumption that as the central nervous system matures motor development will proceed in a hierarchical fashion
The use of routines to assess behavior is helpful for program planning because
-routines are meaningful to clients parents and caregivers -the use of retains promotes the delineation of functional outcomes and intervention strategies -observation of a client across domains context and environment is most efficiently done in naturally occurring retains
Occupation-based splinting is defined as
Is defined as "attention to the occupational desires and needs of the individual paired with the knowledge of the effects of pathological conditions of the hand, and managed through client centered splint design and provision.
A preterm infant
Is often low birth-weight
The term mental health
Is often used interchangeably with the phrase emotional wellness
Ecological approach
Is on documenting the individual success in participating in activities and routines across domains and environments
visual perception
Is the most studied type of perception and involves both 1. visual identification 2. visual discrimination -is the often the problem with dyslexia
short-term memory
-second step (if after 5 minutes is considered this) -has a duration of minutes and is used to determine immediate actions or reactions. -divided into two reaction task 1. a storage task-appears there is little age-related decline in storage task 2. procession task-does show age related decline
Disability is frequently created not by the person's level of functional impairment, but by
-societal barriers -attitude of others -discrimination in the workplace -lack of access to services, spaces, and places in the community
vestibular perception
-sometimes considered a subtype of tactile perception, is the awareness of movement in terms of speed and direction. -allows us to stand and balance without vision -allows us to walk on uneven surfaces without vision -allows us to walk down darkened stairways without relying on vision.
What factors influence disability?
-support and relationships -life stage
Splinting
..."an orthopedic device for immobilization, restraint, or support of any part of the body". (Mosby's Medical Dictionary
In creating an information collection procedure, it is important to determine if your strategies
...are meeting the guidelines of contemporary service delivery.
The assessment process should identify the clients current competencies and strengths
...as well as the deficits, weaknesses, and impairments.
Assessment should emphasize attention to the
...clients needs, desires, and outcomes.
Assessment of a client's status should occur in the
...context of naturally occurring activities and routines.
The clients relationship and interactions with his or her most trusted caregiver should form the
...cornerstone of an assessment. This is especially relevant for very young children
Assessment is a collaborative process involving
...multiple sources of information and multiple components
An assessment should follow when individualize
...sequencing procedure
The process of assessment is the first step in an
.intervention process...
CMC Abduction
Client is sitting with feet on the Floor Move thumb through ROM 1. Start- testing extremity is resting on the table with the humerus abducted, elbow flexed, and forearm supinated. Client's hand is placed with the ulnar aspact on the table. The thumb is placed in line with the second digit 2.Fulcrum- base of the first and second metacarpals 3. Stable arm- midline of the seond metacarpal, along the radial border 4. Movable arm- midline of the first metacarpal along the radial border. 5. ROM- 0-70 6- End postion- client moves testing extremity thumb into max CMC abduction
Peripheral and central nervous system Pathologies observed with increase aging
CVA Peripheral neuropathies Parkinson's disease dementia Alzheimer
Maturation Stage
Can last up to 2 years Tensile strength increase Scar tissue softens
Piaget identifies egocentrism in thinking. Egocentrism is
Can't relate to the fact that others have different view of the world
Client Centered Assessments
Canadian Occupational Performance Measure (COPM) Disabilities of the Arm, Shoulder, and Hand (DASH) Patient-Rated Wrist Hand Evaluation (PRWHE)
The term carpus refers to the wrist. Provide another term to refer to wrist?
Carpal
A type of connective tissue, is derived from primordial mesenchymal cells and when fully developed is capable of withstanding mechanical stress and compressive loads
Cartilage
Developmental or degenerative opacity of the lens, causing obstruction and scattering of light to the retina
Cataracts
In genernal decline in physiologic functioning as one ages
chronologically
Interventions efforts should begin with a ______ and ____ of the way in which family members perceive their situation and define their priorities, however unfocused their goals may seem
clarification and acknowledgment
Written record should include
clarification of referral initial evaluation results ongoing daily and/or weekly progress notes
Observations begins when a
client enters room
Competent documentation effectively communicates a
client's response to therapy and also educates other health care provider and fiscal intermediaries about the value of OT
Normative Data Collection
collected by Templin (1957). forms the bases for current measures of language development
Personal advocacy would be seen as selfish within
collectivistic cultural group
Bound Morphemes
combined with free morphemes to change meaning.
Dialect variations do not reflect
communication impairment
Palpation
completed after visual inspection -where symptoms are described-especially abnormal area Skin temperature changes
This type for force is a result of forces pressing inwardly on an object
compression
Entries in a medical record should be
concise, clear, accurate,complete, and chronolgically ordered
Control Parameters
conditions in existence at the time the task is to be excuted
OT's responsibilities are
conduct screenings evaluations formulating and carry out daily intervention plan documentation
orientation
conscious awareness of who you are, where you are, and what time it is.
Preventative Strategies for Student with IEP
consistent structure early notification to students when schedules/routines change inclusion of the student in the decision making process encouraging parent participation
OT practitioner working with the family is using the
consultative role
In the ICF, culture is a ____ factor in human function
contextual
This occurs whereby a single occupation is selected from within a category, such as choosing to be a nurse following a period of considering a career in healthcare
crystallization of vocational choices
For this class, illness is not merely the presence of disease but also reflects the social and
cultural interpretation of well-being
The presence or absence of specific skills, traits or characteristics is
culturally influenced
A young African American girls is adopted by Caucasian parents, what would her culture be? What is her race?
culture would be Caucasian Race- African American
The OTA is responsible for informing the OT of changes in the student environment and providing
current data regarding his or her performance
This shape of thermoplastic material is stronger and better able to handle externally applied forces
curved or contoured
This grasp is used to hold soda cans, pan handles
cylindrical grasp
specific language impairment
do not have cognitive, social, sensory, or motor problems that would adversely affect language acquisition. Pragmatics are difficult to master.
Parents have the right to ____, that i, voluntary mediation and impartial hearing to resolve differences with the school that cannot be resolved informally
due process
A zone of proximal development refers to:
Task that are in a stage of near-readiness
Refers to the process of instructing and helping others acquire information
Teaching
Stress occurs when forces on an object are applied opposite each other
Tension
Discriminative index
That which distinguishes between individuals or groups on specific dimensions such as the acquisition of developmental milestones
Why is public policy important to health care professionals
The ICF reflects the importance of public policy at local, national and international levels in their discussion of environmental contexts
Evaluation
The OT team attempts to discover the nature of the client's problems
Screening
The OT therapist obtains data to determine the need for evaluation
Who has the overall responsibilities with regard to documentation including evaluations results, the intervention plan, modifications to the intervention plan, outcomes, transitions, and discontinuations
The Occupational Therapist
Conformability
The ability of a thermoplastic material to fit immediately into contoured areas the more conformed a splint to a joint, the better the pressure distribution should be
Negotiability
The ability to access a feature of the environment and use it for its intended purpose in a manner acceptable to the person
Negotiability
The ability to operate switches doors sinks and so forth
Independent/Individualistic
The individual is encouraged to purse self-initiated interest and to be responsible for his or her own behavior. The individual's performance serves as the measure for success or failure in a task. Individual excellence is emphasized
Which is true of the infant in the 3 months
The infant is gravity dependent The infant has the first social smile The infant head lags in pull to sit
In the ATNR pattern
The limbs on the face side extended and the opposite limbs flex
psychomotor functions
The mental functions of control over physical and motor skills.Include: ability to originate (plan), initiate (begin) movements, monitor and adapt or adjust motions in progress, perform learned tasks automatically w/o conscious direction, and pace, limit or end movement based on activity demands. EX: Allow the individual to drive a car while listening to a conversation (all of basic control involved in driving is subconscious)
T/F In a step-down nursery or PICU, and OT is required for supervision
True-. Supervision may not be need in subacute, long term or home care setting- clients in those setting are typically more medically stable
T/F A red wound is a healthy wound
True-presense of granulation tissue and is normal
Intense sustained drive to achieve self-selected but usually poorly defined goals
Type A
Consciously controls anger, optimistic
Type B
Personality greater risk of cancer
Type C
Distressed personality type, negative emotions and to inhibit self-expression
Type D
The natural process of aquiring skills ranging from simple to complex
Typical Development
Williams v Toyota Motor
US supreme court claims limitations as " major life activity of performing manual task, the central inquiry must be whether that claimant is unable to perform that task associated with his/her specific job
echolalia develops
about nine months
Understanding the person schema provides the therapist with the knowledge of what personal traits are
acceptable and culturally supported
The role schema that is based on educational or athletic achievements
achieved status position
This arch of the hand allows the DIP, PIP and MCP joints to flex
Longitudinal arch
Disadvantages of parenting
Loss of freedom Financial strain worries over health, safety, well-being Risk of bringing children into a world plagued by crime, war, and pollution Fear children will turn out badly, through no faulth of one's own
The acquisition of motor skills, it is a set of processes associated with practice or experience leading to relatively permanent changes in the capability for responding
Motor learning
Digit and Thumb Extension
Move Digit or thumb through ROM 1. Start - elbow of testing extremity is resting on table with humerus slightly flexed and forearm in neutral. MCP are in neutral when measuring MCP Flexion when measuring MCP flexion. 2. Fulcrum- dorsal surface of the MCP joint that is being measured 3. Stable arm- midline and dorsal surface of the metacarpal of the digit being measured 4. movable arm- midline and dorsal surface of the proximal phalanx of the digit being measured 5. ROM (negative # decfit) write as 0
Digit and Thumb MCP flexion
Move Digit or thumb through ROM 1. Start - elbow of testing extremity is resting on table with humerus slightly flexed and forearm in neutral. MCP are in neutral when measuring MCP Flexion when measuring MCP flexion. 2. Fulcrum- dorsal surface of the MCP joint that is being measured 3. Stable arm- midline and dorsal surface of the metacarpal of the digit being measured 4. movable arm- midline and dorsal surface of the proximal phalanx of the digit being measured 5. ROM 0-90 6. client moves the testing extremity through maximal MCP flexion
Digit and thumb Hyperextension
Move Digit or thumb through ROM Client is sitting with feet on the floor 1. Starting- elbow of the testing extremity is resting on the table with humerus slighly flexed and forearm in neutral 2. Fulcrum- dorsal surface of the MCP joint that is being measured 3. Stable arm- Midline and dorsal surface of the metacarpal of the digit being measured 4. Movable arm- midline and dorsal surface of the proximal phalanx of the digit being measured. 5. ROM-0-30 6. Ending postion- client moves the testing extremity through max MCP hyperextension
The OTA has complete responsibility for preparing certain reports delegated by the
OT
Who can fabricate a splint?
OT practitoners PT practitioners Certified Orthotist Dentist Pedorthist
The OT is legally responsible for ALL aspects of the
OT process
Medical based OT practitioners are either OT or
OTA.
Activity Demands
Objects used and their properties Space Demands Social demands Sequencing and timing Required actions Required body functions Require body structures
The fundamental principle of OT is to promote optimal performance in each are of
Occupation: -play/leisure -ADL -IADL -social participation -education
Splinting to Facilitate Therapeutic Outcomes
Occupational Performance Client Satisfaction Role Competence Adaptation Health & Wellness Prevention Quality of Life
Memory
Often turns translucent good for serial splints difficult to make small adjustments
Assessment
Often use comprehensive strategies and tools to delineate strengths and needs, develop appropriate intervention plans and strategies, and determine change in individuals
Evaluative assessment strategy
One that measures the magnitude of change on an individual overtime on a specific dimension
The important "first word" typically uttered at about
One year of age
What did Olmstead vs LC ruling mean for therapy
Opened up opportunities for OT and PT practitioners to serve more individuals with disabilities in community based programs as the states scramble to put together Olmstead compliance plans
______ and ______ which are the primary earmarks of an aging skeletal system
Osteopenia and Osteoporosis
Bone loss that exceeds that of "normal" aging is called
Osteoporosis
Musculosketal Pathologies observed with increase aging
Osteoporosis degenerative joint disease/arthritis degenerative disk disease thoracic kyphosis Paget's disease polymyalgia rheumatica hip, wrist and vertebral compression fractures
Three characteristic phases of psycho-social development
Phase 1- early adolescence, middle school years 10-13 Phase 2- middle adolescence, high school- 14-17 Phase 3- late adolescence, college/work- 17-21
allophones
Phones that make up one phoneme ("All the phones")
Referral
Physician or another legally qualified professional requests OT services for the client
A person's ability to adapt to the environment in normal life situations or life crises
Physiologic age
The person's ability to adapt to the environment in normal life situations or life crises
Physiologic age
What are the precision grasps pattern
Pincer Tripod, or Chuck Lateral
A conditions where the blastocyst implants too low in uterus is called
Placenta previa
What is a major type of barrier that prevents employment for the disabled
Policy disincentives and the lack of physical access
Restrained Formal Communication
Public communication style is often quiet and controlled, with limited emotional tone
Express/Overt Communication
Public communication style openly expresses moods and feelings in additions to content
In june of 1997 IDEA was amended and reauthorized and is now known as
Public law 105-17
The ability to think in a manner less contrained by the need to find a single answer has been termed
adaptive cognition
Throughout childhood and across adult life , a person's sense of self continues to evolve, but the process is most intense in
adolescence
Changes in the structure of cartilage appears to begin in the
adolescent years
Despite is many challenges the process of giving birth and becoming a parent is a powerful source of
adult development
De Quervains tenosynovitis
affects APL affects EPB most common diagnosed wrist in athletes
Longer life expectancy will lead to a greater percentage of people experiencing the normal
age-related physiologic changes in musculoskeletal system
Young Adulthood Middle Adulthood Late Adulthood
ages 20-40 ages 40-65 ages 65 and older
Middle Adulthood
ages 40-65
The most commonly used and abused psychoactive substance is
alcohol- particularly in adolescence and young adulthood
Morphostatic Family Theory (Form (form-maintenance)
all family systems are organized with recognizable loops and rules. Verbal or nonverbal .Examples include meals, bedtime, expectations for bathing, greeting or departures, and affectionate naming
With healthy aging, individuals will remain independent in _____
all of the ADLs
Perforations
allow air circulations reduce weight should NOT be stretched Cut pattern OUTSIDE of perforation holes
Dropout splint
allows motion in one direction while BLOCKing motion in another
Tensile strenght
amount of long axis force a muscle or tendon can withstand dictates activities and exercises
Cyanosis
an infant who turns blue because of insufficient oxygen
language acquisition device (LAD)
an innate mechanism that is activated through linguistic input from caregivers.
language impairment
any problem in the comprehension or production of language
Section 504 of the Rehabilitation Act
any recipient of federal aid ( including school) cannot discriminate when offering services to people with disabilities
Transdisciplinary Collaborative style
approach involves collaboration among various disciplines, one team member is usually designated to intervene directly and other team members act as consultants
The term usually refers to the area from shoulder to the elbow, or the hummorous
arm
A role schema assigned to a person according to race, gender, or age
ascribed-status position
In the ____ stage of learning, the learner makes connections to previous experiences
associative
Osteoarthritis and degenerative joint disease are characterized by
atropohy and degeneration of articular cartilage and hypertrophy of the subchondral bone and joint capsule
Assessments are influenced by
attitude pain response coping mechanism locust of control
The transitional years from adulthood mark aperiod of increase
autonomy affiliation with peers risk taking behaviors
Development
the changes in performance that are heavily influenced by maturational processes
psycholinguistic theory-semantic base
the child's cognition is the framework for linguistic development. That is, development of the cognitive domain is an important requisite in development of the linguistic domain.
metacognitive executive functions
the control, or oversight, functions of thought
The results of cross-linking fibers is
the fibers no longer glide easily with respect to each other, contributing to decrease in mobility of these tissues and increased stiffness in the movement of joint structure
Referential meaning
the meaning of the individual words, or the word knowledge we possess.
relational meaning
the meaning of the message is the sum of its parts.
abstraction
the mental function of considering something as a general idea, quality or characteristic.
attention
the process of detection and orienting to important or desired environmental stimuli. -a mental function that allows a persom to focus om something while simultaneously excluding less important information. -is mediated by the CNS
Because documentation is part of the legal record and may be used in court,
the services that the OT practitioner documents must accurately reflect the treatment given
Morphology
the study of word structure, including alterations that change word meaning.
dialect
the usage or vocabulary that is characteristic of a specific group of people
Normative life cycle events
the usual or expected transitional events
Syntax
the word order of our language.
Title III of ADA provided privately owned places of public accommodations must allow access for
their customers with disabilities to the goods, services, facilities and advantages they offer to the public. Ex Theaters Dr's office golf courses hotels retail establishment day-care gas-stations hospitals
OTAs are responsible for providing services within
their established level of competence
41-46 mos
they begin to consider perspective of the listener
Physical maturation and psychocial development shape an adolescent's capacities to
think, relate and act as a future adult
t/F Tenderness/pain/firmness along vein should be documented
true
For Transdisciplinary team to be effective, the team members must
trust and respect each other so that they are comfortable with role realease
A major goal in working with families is establishing a _______ , particularly with key members
trusting relationship
Static progressive splint
type of dynamic splint incorporate the use of inelastic components such as hook and loop tapes, outrigger line, progressive hinges Allows CLIENT to adjust the line of tension
This term refers to the 5th digit
ulnar
Instead of trying to establish some sort of linear cause and effect relationship, instead try to simply
understand the relationships amoung events, peopel and situations
Pediatric medical care system comprises a group of individuals who form a complex and
unfied whole dedicated to caring for children who are ill
When meeting a family for the first time, it is important to be interested in learning about the
unique ways in which the parents have been adapting to their child's disability
FHAA makes it ___ to refuse to allow a person with disabilities to make reasonable modifications to dwelling or a public common area at person own expense
unlawful discrimination
Documentation is used for many purposes including
updating others on client status justifying the necessity for OT services explaining request for supplies and reimbursment
Individual vs group sessions
used to encourage frequent team member collaboration. It allows for informal and impromptu communication between two or three team members
Sensorimotor approach
used to inhibit or facilitate normal motor responses whose central nervous system has been damaged
Bio-mechanical Approach
uses kinetics and forces acting on a body
Reverse mainstreaming
uses with student who have difficult transitioning from one are to another, where the regular education students come into the special education classroom during certain courses
Drapability
varies among material as well as time heated Gravity Difficult for beginners require light, stroking motions low drapability-firm pressure
Gloves should be used by OT practitioners when there is a possibility of coming into contact
with infected material or exposure to body fluids
Bone loss appears to be mediated by gender, for ____, bone loss accelerate after ___ as a result of decreasing levels of ___ within the body
women menopause estrogen
Past events are associated with present events and declines with age
working memory
Is culture a learned behavior?
yes
Skeletal maturity is often reached by
young adulthood
The human body becomes mature in late adolescence and its at peak performance fromthis age through
young adulthood
T/F Medicaid recipients pay premiums for health care benefits
false- do not
T/F Oral motor awareness and exploration almost always involve food
false- do not involve food at all
T/F WeeFIM is the only diagnostic tool needed
false- it is not meant to be the only diagnostic tool
T/F It is not important for therapist to be advocates fot their profession in the state or federal level
false- it is very important
T/F Toys must be sterilized after each child
false- must be properly cleaned
T/F Only an OT practitioner can conceive of all the potential positive outcomes and all the ways to achieve those outcomes (equafinality)
false- no individual can
T/F Crises , which are brought on by overwhelming stress, are always negative
false- not always negative
T/F"Trying harder" is a a great way to get families to adjust their routine
false- rarely works. Changing the process, the goals, and the timeline are reasonable adaptations to current family functioning
A person is likely to express a desire to one day become a teacher, doctor, athlete or superhereo
fantasy period- last age 11 or 12t
Presbyastasis can lead to individuals developing a
fear of falling - FOF
Personal Context
features of the person such as age, gender, socioeconomics status and educational level
Title IV of the ADA requires closed caption for
federally funded public service announcements
Oral motor development refers to
feeding sound play oral exploration
Head, hands and ___ reach their adult size earliest
feet
9 to 12-13 weeks
fetal period begins head continues to grow faster than rest of the body
Though CMS (Center for Medicare and Medicaid) oversees the medicare program, it contracts with ___ to handle the actual claims for benefits
fiscal intermediaries
palmaris longus
flexion *median nerve
flexor carpi radialis
flexion radial deviation *median nerve
flexor carpi ulnaris
flexion ulnar deviation *ulnar never
Rehabilitation approach
focuses on abilities rather than disabilities and facilitates returning person to maximal function using their capabilities
Sociolinguistics Theory (Muma)
focuses on the cultural aspect of language.
The OT practitioner is an agent
for bringing new information into the system
Supervision
for pt who can usually perform the activity w/o assistance by additional personnel but not consistently.
The hallmark of psycho-social development is the quest
for self- identity
OTA's responsibilities include
formulating and carry out daily intervention documentation
the IEP provides the
framework for positive behavioral support
Early Childhood
from 18 motnhs through 5 years of age
Middle Childhood
from 6 years of age until the onset of puberty ( 12 years of age for females and 14 years of age for males)
Frequently a hand based thumb immobilation splint is applied to a persons with ____, which involves the ulnar collateral ligament of the thumb MCP joint
gamekeeper's thumb
Functional development of the structures will occur throughout the entire __________ period and even after birth
gestational
Family Systems Theory is a
group of ideas that describe the many ways that individuals in families are connected across time and space, and its implications for the families with who practitioners work are far reaching
Inactivity accounts for _____ of the functional decline that occurs between age 30-70; age associated changes are ascribed to the other half
half
Osteoarthritis of CMC joint of thumb
hand based thumb immobilization splint
Gamekeeper's thumb
hand-based thumb immobilization splint
What lets you reach into your backpack for a pencil without turning your head around to look?
haptic awareness
hearing impairment
has significant impact on language
Therapist must verify client's understanding of precautions
have client repeat instructions Role play with client Verify at each visit
Elastic tension dynamic splint
have self-adjusting or elastic components (wire, rubber bands, or springs)
Culture provides group mmembers a mechanism to
judge behavior construct reality make decisions regarding life issues
What lets you know how to control your legs to sit smoothly?
kinesthetic awareness
Finklestein's test
maneuver often used to test for De Quervain's tenosynovitis
Studies have found that adverse childhood experiences can affect one's ability to develop
mature coping skills and emotional strength necessary for successful and satisfying performance of adult roles and responsibilities
voice disorders
may be due to vocal abuse, a specific medical condition, or psychogenic factors.
Autism
may be non-speaking or have echolalia.
Language impairments in adults
may be the result of CVA or other disruption of the blood supply to the brain. -may have sensory and/or motor deficits, memory problems, poor judgement, etc. -may hav motor speech disorder possible swallowing trouble.
How is gestational age measured?
measured in weeks either from the first day of pregnant woman's last menstural period (LMP) or from the moment of conception.
Screening and evaluations include
medical history general observations gross motor function cognitive function visual and perceptual function fine motor function sensory function ADL function summary and recommendations frequency long term goals short term goals
gustatory perception
mental function involves in distinguishing the diferences in taste, such as sweet, sour, salty, and bitter stimuli, detected by the tounge
The nose and olfactory system has been shown to deteriorate with age in ______adulthood
middle
The period of ___ adulthood is one in which th ephysiologic effect of aging begin to manifest
middle
Different cultures predict different responses to events. This difference in expectations can lead to
misinterpretations of responses during a social exchange or event
The desire outcome of motor learning is permanent change in
motor behavior or skill as a result of practice and experience
Multidisciplinary Collaborative style
multiple professionals evaluated the child and make recommendations. Assessment, goal setting and direct intervention may be carried out by each professional with minimum of integration across disciplines
With practice the rhythm progresses into a
munching pattern, which involves an up and down jaw movement
Between ages of 50 and 70 it is estimated that approx 30 % of _____ will be lost
muscle strength
Normal age related changes begin approximately at the age of 40, with a decrease in ______ vision happening in everyone
near
What happens in Middle Adulthood
normal age related changes in physical functioning begin more sophisticated level of thinking is adopted changes in the family system begin to occur may begin to experience their mortality begin to have asense of panic that they have not met their life goals
AMA adds to the definatin of culture by indicating that cultural experiences and knowledge are
not shared with those outside the group
Non normative life cycle events
not the usual or expected transitional events
Age related decrease in strength is related to
number of skeletal muscle fibers reduction in the number muscle motor units reduction of the cardiovascular system
speech disorders
occur very frequently and the etiology is such is unknown
Goodness of fit
occurs when the individual's temperament supports the demands and expectations of the environment
The medical intervention plan is an outline
of activities and task that are used during treatment sessions
Medicare plays a key role in the provision of OT services a major source of health-care reimbursement for
older adults and individuals with disabilities
Personal traits identified in others and predicts the social interaction between individuals based on expected behaviors
person schema
At 4-5 months the infant demonstrates a reflexive ______ when given a soft cracker
phasic bite-release pattern
Young Adulthood where optimal
physical functioning and intellectual reasoning prevail major decision regarding significant relationships career choices are contemplated keen sense of identity prevails
Contact Guard Assistance (CGA)
pt can usually perform the activity but have significant likelihood of requiring physical assistance for support and balance.
This law mandates services for preschoolers with disabilities and provided the impetus for the development of early intervention services for infants and toddlers from birth to 3 years of age
public law 99-457 EHA
State and local govt example of where the must provide access under ADA
public universities voting parks and recreational programs
Main reason for leaving home?
purse a job attend postsecondary education and training getting married cohabitate
Splint design must be based on
scientific principles
Circular rotary chewing develops between the __ and ___ third year of life and allows toddlers to ea almost all adult food
second and third
It is well accepted that adults are strongest physically during the ____ and ____ decades
second and third
Physiologic changes are compounded by the ____ lifestyle often adopted during this time
sedentary
Dressing includes
selecting clothes and accessories appropriate for the weather putting clothes on sequentially fastening and adjusting clothes and shoes
Refers to the characterisitics and traits a person assigns to self
self schema
One dimension of cognition in the AOTA's practice framework is
self-regulation, the ability to control and monitor one's behavior and emotions relative to the situation and social cues
Oral skills develop concurrently and are closely related to the overall development of
sensorimotor skills
It is beleive that common changes in perceptual function in aging are secondary to changes in the
sensory systems, interfering with accurate sensory registration, difficulties with divided attention and difficulties encoding information in the working memory
Normal development is
sequential and predictable
With a stroke of governmental pen ( changes in policies)- helath care professionals can find an area of practice
severely curtailed or expanded by budget constraints, new systems of reimbursement, regulatory reform, appellate court decisions, and other policy changes
Ethnicity refers to
shared traits customs language religion ancestory
This type of stress happens when parallel forces are applied in an equal and opposite faces of a structure
shear
As skin ages, the epidermis thins and flattens making it more susceptible to
shearing stresses, which can lead to blisters and skin tears
Function of catilage
shock absorber provide surface for sliding and rolling between joints foundation for bone growth and development
Free Morphemes
signal a specific meaning
holophrases
single words and is expected up to about 18 mos
process skills
skills used by the individual in managing and modifying actions en route to the completion of daily life task. Include the ability to maintain an effective rate of performance, use tools, and use goal-directed actions to handle tools effectively to complete the desired task.
Generally , ___ is the tissue that least tolerates pressure
skin
Low stress, high stress and repetitive stress can all cause this injury
skin breakdown
Reaction time, coordination of complex movements and use of feedback to adjust movements dynamically all ___ with normal aging
slow
Protein synthesis, while at its peak in the early years, begins to decline with age, thereby diminishing the ability of muscle mass to be sythesized. This age related decline in muscle mass and thereby muscle strength is referred to as
sarcopenia
psycholinguistic theory-structural base
says that the mental operations of the mind are used in the generation of utterances.
Palpate muscle on _____ for comparison
each extremity/ Promixal and Distal
Because ___ is a critical daily living skill essential to the child's survival, growth, health and well-being, it falls within the OT practitioner's domain of concern
eating
Role schema may be based on accomplishment such as
educational or athletic achievements
For a child to be eligible to receive OT services in the public school setting, the services and goals must be
educationally relevant
These types of bandages have potential to apply high amounts of stress and may lead to constriction of the vascular and lymphatic system
elastic bandages
A developing human is known as an ____ until 8 weeks following conception
embryo
ADA prohibits discriminatory practices in areas related to
employment transportation accessibility telecommunications
Illness
encompasses the particular ways in which a pathology or impairment interferes with everyday function.
Infection control is the responsibility of _____ OT practitioner who must follow universal precautions when working with any client
every
Stress is completely normal and necessary for
evolution (morphogenesis) of the family systems
A feature of form-evolving (morphogentic) aspect of living system is their capacity to
evolve along different paths and yet arrive at a given destination
OT practitioners should also be aware that success with a family is an
evolving process
During middle adulthood, bone loss will begin to _____ bone formation due to the process of remodeling
exceed
The likelihood of families following through with intervention plans depends on the extent to which those plans are constructed to fit within families
existing routines, beliefs, and patterns of family life
The embryonic period
extends into the eighth week after conception -all major body structures are formed -developed human characteristics- fetus
extensor carpi radialis brevis
extension radial deviation *radial nerve
extensor carpi radialis longus
extension radial deviation *radial nerve
extensor carpi ulnaris
extension ulnar deviation *radial nerve
What lets you know when clothing is touching your body?
somatic awareness
By 24 months, children can hold a spoon and bring it to the mouth with the wrist
supinated into the palm-up position
Language is a multifaceted behavior that is under constant change due to
technology, dialects, for example
marked by consideration of one's personal skills, capacities, and values
tentative period- begins age 13/14 - goes to late adolescence
motor planning
the ability of the brain to conceive, organize, and carry out a sequence of unfamiliar actions.
emergence awareness
the ability to analyze and monitor a situation to analyze what the strengths or weaknesses are
cognitive flexibility
the ability to consider alternatives and change strategies to a problem.
problem solving
the ability to interpret information, act on it, and self-correct
initiation
the ability to start a task and is an aspect of temporal organizational in the OT framework
Central Nervous System
the brain and the spinal cord
T/F children are now developing type II diabetes
True
T/F high school seniors who smoke every day are 10 times more likely to use cocaine regularly than our seniors who don't smoke on a regular basis
True
T/F the cessation of smoking after a CVA is widely recommended to reduce the risk of myocardial infarction and the current stroke
True
T/F the screening process should be brief and the test used be easy to administer by variety of people
True
T/F the terms screening evaluation and assessment and examination are commonly used interchangeably
True
T/F unlike ADLs, there are some changes in IADLS in the older adult
True
T/F who have disabilities are more likely than ever to be in regular early childhood and educational programs
True
Max Assist
pt can perform 25-49% of the activity
Mod Assist
pt can perform 50% of the activity
Min Assist
pt can perform 75% of activity
Stand-by
pt can sometimes perform w/o assistance of additional personnel, but not consistently. Needs closer supervision.
Egalitarianism
Decision making is done through negotiation between memebers and individual freedoms are included in the process
Function Assestments
Dellon Modification of Moberg Pick up test COPM AMPS DASH
Deprive (an organ or body part )of a nerve supply , as by surgically removing or cutting a nerve or by blocking a nerve connection with drugs
Denervation
To deprive ( an organ or body part) of a nerve supply, as by surgically removing or cutting a nerve supply, as by surgically removing or cutting a nerve or by blocking a nerve connection with drugs
Denervation
If there are 2 people assisting pt, they are automatically assigned
Dependent (1)
_____ is one of the most widespread causes of activity limitations experienced by the elderly
Depression
Projects that may assist teachers and students in programs for the OT and OTA
Design a fine motor kit for a classroom of 1st graders Develop games associated with spring p. 51 box 4-4
Criterion - referenced tests
Designed to measure performance on specific tasks -most academic tests are criterion referenced
What is the key ingredient for intervention success
Developing a trusting and collaborative relationship
Genpredictable eral Principles of Development
Development is sequential and predictable Maturation and experience affect development Development involves changes in the biologic, psychological and social systems Development occurs in two directions horizontal and vertical Development progresses in order in three basic sequences 1. Cephalad to caudal 2. Proximal to distal 3. Gross to fine
Metabolic/ endocrine Pathologies observed with increase aging
Diabetes hypercholesterolemia obesity kidney failure
What allows cells to become sprecialized, is a its peak in younger individuals but begins to decline in the aging adult
Differentiation
Public Law 93-112, Section 504 of the Rehabilitation act
Discrimination against people with disabilities when offering services is prohibited
The intent of this act was to provide adequate education to all :handicapped children" and assist states with providing these services
Education for All Handicapped children Act of 1975
This law was consider the most important legislation related to children's services at the time
Education for All Handicapped children Act of 1975
The ability to process novel information
Fluid intelligence
Passive Acceptance
Focus on accepting circumstances and situations as part of a natural choice
Active Achievement
Focus on controlling circumstances and situations to benefit the individual
The radius and ulna are included in this upper extremity
Forearm
Adolescence
From Puberty until the onset of adulthood (usually 21)
Infancy
From birth through 18 months of age
Gestation and Birth
From conception to the moment at which the neonate can survive on its own without placental nutrients
The part of ADL, includes movement in bed, transfers or moving the body from one surface to another, wheelchair mobility, and ambulation with or without walking aids
Functional mobility
A person's perception of and identification with being either masculine or feminine
Gender Identity
Periods of Develoopment
Gestation and Birth Infancy Early Childhood Middle Childhood Adolescence
Developmental theory that states that the process of occupational choice follows a developmental progression that begins in childhood and spans into the early adult years
Ginzberg Developmental Therory
___ show an increase in motor performance ealier around age 14
Girls
One of the leading causes of blindness, damage the in optic nerve, most common is the open-angle
Glaucoma
Performance Patterns
Habits Routines Roles Rituals
The individual performing an occupation benefits from patterns such as
Habits, routines, roles and rituals
_____ is the single most important component of infection control
Hand washing
In humans, the ability of cells to divide and replicate is limited to some genetically predeterminjed amount reffered to as the ____, which is approximately 50 replications for individual human cell.
Hayflick limit
Leading health indicators
Health concerns selected to represent the trends in population health in the United States
Developing, Managing and maintaining routines for health and wellness promotion, such as physical fitness, nutrition, decreasing health risk behaviors and medication routines
Health management
______ elders are found to provide more financial and emotional support to their children
Healthy
Personality therory emphazes the notion of "fit" between one's personality and career selection
Hollands's personality type
The decrease sensitivity to taste that occurs in the gustatory system
Hypogeuia- "g- gustatory" {g- that taste awful")
The decreased sensitivity to smell that occurs in the olfactory system
Hyposmia (S- sweet smell)
5 Titles of ADA
I employment II State and local gov, serices and transportation III Public accommodations IV Telecommunication V Misc Provisions
Age related decline in muscle mass and therby muscle strength is
sarcopenia
figurative language
"throw" a party
Reason's Families are important
* A family has a significant environmental influence on a young child's life and development * Interventions with children inevitably affect family * Laws and current service delivery models promote a family centered approach * Professional organizations, including the AOTA, have identified the areas of competency and created recommended guidelines for working families
A developmental theory
* Attempts to explain a series of observation of change over time *Canbe disproven
Documentation guidelines that may be used to ensure meeting the therapist legal and ethical obligations
* Date all entries for accurate sequencing of the treatment *Document length of treatment with times and treatment codes/descriptions * Document missed treatments including a reason why missed *Document at the time of treatment so that the entry will completely and accurately reflect treatment session *Document using specific facts rather than general terms *Include all supportive documentation such as physician treatment orders or consents for release of information *Do not criticize another health care provider in written record *Do not change a legal record after the fact without clarifying the time and anture of the change
Strategies for working with adolescents with cognitive impairments
* Identify how each teen learns best. Ask the teen, family, or teachers * Identify strengths and build from existing skills *Offer specific choices *Select activities that match the teens abilities, needs, and interest. Offer activities that are age related but within performance level *Break down activities into simple steps that are achievable, but a challenge *Keep instruction simple *Present only one instruction or step at a time *Increase instruction only if the client consistently follows current instruction *Present directions systematically * use any methods of instruction (verbal or visual, demonstration, visual cues, step by step diagrams) *Help client develop and learn a new skill in a familiar setting before using the skill in novel setting *Give specific feedback with concrete examples * Be consistent and use repetition * Do not introduce variety without reason
Categorically needy individuals that States must cover
* Low income families w/ children * Individual receiving SSI * Pregnant women, infants and children less than specified % of the federal poverty level * Qualified Medicare beneficiaries
Wrist Extension
* MOVE WRIST IN ROM - before placing * Client sits with both feet on the floor 1. Goniometer- volar surface of the wrist 2. Stable arm parallel to the radius 3. Movable arm parallel to the third metacarpal 4. Place wrist in extension- plam parallel to ceiling 5. ROM 0-70
Wrist Flexion
* MOVE WRIST IN ROM - before placing * Client sits with both feet on the floor 1. Goniometer- dorsal surface of the wrist 2. Stable arm parallel to the radius 3. Movable arm parallel to the third metacarpal 4. place wrist in flexion- (palm parellel to floor) 5. ROM 0-80
Ulnar Deviation
* Move wrist ROM- towards pinky (5th) finger*. testing extremity is resting on table with humerus abducted, elbow flexed, forearm pronated. Forearm is placed on the table with palm flat. Wrist in neurtral 2. Goniometer- fulcrum -base of the third metacarpal, over the capitate bone 3. Stable arm- midlline of the forearm 4. Moveable- midline of the 3 metacarpal 5. Move hand towards pinky (5th) finger 6. ROM 0-30 7. Ending max ulnar deviation
If states provide services for the medically needy, what are the minimum
* Prenatal care and delivery of services for pregnant women *Ambulatory services to individuals undera ge 18 and individuals entitled to institutional services * Home healthcare to individuals entitled to nursing facility
The International Classification of Function is?
* Published by the World Health Organization * Designed to provide information and datea on outcomes of rehabilitation * A summary of matrix of factors influencing functional outcome after a disease
Essential communication skills
* Solution focused curiosity and interest * Collaborative goal setting * Acknowledgement * Continuity
Expansion of the OT services now include
*Assessing family interest, priorities, and concerns *Observing and gathering information about the daily routines of children and families in their homes and in the class room * Gathering and sharing information with families about development and intervention strategies * Implementing therapy in collaboration with parents, caregivers, and general educators
Medicaid can optionally cover at State level
*Medically needy aged blind or disabled individuals *Members of families w/ dependent children who have too much income and or resources to be eligible for cas assistance but not enough for medical cost *Aged and disabled persons with income less than 100% of the poverty level *Institutionalized persons with incomes no greater than 300 % of the SSI federal benefit rate
What is true about perception?
*Pereception involves memory *Sensation is possible in the absence of perception * Perception gives meaning to the sensory environment
Global Mental Functions
*Underlie the other mental activities and include consciousness, energy and drive *These functions are crucial to all human activity and are important predictive factors in rehabilitation outcomes
The Fetal period
- extends from the nineth week to birth
Orthosis
-"a force system designed to control, correct, or compensate for a bone deformity, deforming forces, or forces absent from the body" (Mosby's Medical Dictionary
Babbling/Cooing
-At about 3 months of age, the infant begins to "coo." -At about 5 months of age, the infant begins to babble. -Infants all over the world use the same sounds (phonemes) when they babble. -At around nine months of age, babies begin to babble more in the sounds specific to their language. --Will begin to babble only the phonemes of the child's native tongue at about 1 year of age -Babbling seems to be a biologically programmed stage of language development.
Two-word stage
-Around their second birthday, infants begin putting words together to construct simple "sentences." -Two word sentences showing an appreciation of the rules of grammar -Children move beyond the two-word stage at around 2-1/2 years of age. -Language production and comprehension increase dramatically thereafter—children may have a production vocabulary of over 10,000 words by school age.
Skinner believed language was the result of learning through: (behaviorist/nature)
-Association : linking certain sounds with certain people -Imitation -Rewards or punishments
What are some examples of the barriers to employment
-Eligibility requirements for federal disability income benefits -Limited knowledge and or skills of employers to implement job accommodations -attitudinal barriers of employers -lack of skills in self advocacy for individuals with disabilities
One-word stage
-Long before babies become accomplished talkers, they understand much of what is said to them. -Comprehension vocabulary (the words they understand) is much larger than their production vocabulary (the words they can say). -Around their first birthday, infants produce their first real words — usually referring to concrete objects or people that are important to them -Child uses one word to convey a complete thought or idea -During the one-word stage, babies use a single word and vocal intonation to stand for an entire sentence.
Boutonniere Deformity
-PIP is flexed and DIP is hyperextended -forceful blow to the finger -RA -splint
Motherese
-People in every culture use a style of speech called motherese, or infant-directed speech, with babies. -Motherese is characterized by distinct pronunciation, a simplified vocabulary, short sentences, a high pitch, and exaggerated intonation and expression
Norm referenced
-Standard point score -evaluate individual performance against great -may or may not be related to therapeutic or instructional content -normal distribution of scores -requires diagnostic skills -not sensitive to effects of therapy -not concerned with task analysis -summative
perception
-a sensation based mental function. -the brain's ability to recognize and interpret sensory information.
What are barriers to function
-a spouse who is overly protective, which can create a helplessness role or dependent role
facilitators to function are
-a spouse who promotes independence, like in the home when he/she encourages participation in household roles
RA (hand)
-a systemic disease -inflammatory joints -splints
Thought functions
-according to ICF, thought functions are specific functions related to the presence and development of ideas. -the control of thought in terms pace, content, and form.
mallet finger
-also called dropped finger -results from hyperflexion of the extensor digitorium -Stax splint or oval 8 splint
gamekeeper's thumb
-also called skier's thumb -injury to the ulnar collateral ligament -sports injury or falls -splinting -surgery may be considered
A comprehensive procedure will involve one or more of these methods
-chart review -parent/family report -interviews -naturalistic observation -clinical observation -standardized tools
The process of gathering information involves
-chart reviews -interviewing and family members and other primary caregivers teachers and health professionals involved in the care of the child -observing the client in a natural setting -Family reports -direct testing using standardization objective measurement tools or clinical observations
Noam Chomsky argues that
-children have a predisposition to learn language -A person's brain is hard wired to learn vocabulary and the rules of grammar -"universal grammar"—a basic understanding of the common principles of language organization -At birth, infants can distinguish among the speech sounds of all the world's languages. -By 10 months, they distinguish only the speech sounds that are present in the language to which they have been exposed.
TBI
-children with TBI will often go off task and lose focus
swan neck deformity
-chronic inflammation of the PIP joint -DIP is flexed and PIP is hyperextended. -may occur with Parkinson's, RA, CP, CVA
For a person to assume the SICK ROLE and be free from blame for her condition, these four conditions must be met
-indiv is exempt from normal social roles (work) -the sick person cannot be expected to get well by and act of will. -because she cannot will herself well, she will be "taken care of." -the person must be active in expression of and in behaviors supporting her desire to get well -the person must seek and comply with the expectation of technically competent help.
trigger finger
-involves the tendons used to flex the finger -more common in women -in thumb of small children or infants -oval 8 splint
Neglect and Abuse
-lack of maternal interaction has an extremely negative effect on language development. -Pragmatics is often a significant problem. -problems with conversational skills
Noam Chomsky's position (nativist)
-language acquisition device & universal grammar -critical period -overgeneralization
The purposes of an arena assessment are to
-obtain an integrated holistic view of the client -determine the interrelationship of skills across domains -decrease handling of individual by multiple professions -decrease repetitive questioning of the family or client
Therapists must apply knowledge of items when considering a splint
-occupation -pathology -physiology -anatomy -psychology -reimbursement -bio-mechanics -aesthetic
boxer's fracture
-occurs at the metacarpal neck, usually in the little finger -casting -occurs when hitting something hard, ie., wall or another person
extensor tendon injuries
-on the dorsal side of the hand -minor cuts -jamming a finger -splinting
carpal tunnel syndrome (CTS)
-pressure on the medial nerve -numbness in the thumb and digits 1, 2, 3, and 4 -may be associated with diabetes -causes may be from typing or using computer -splinting -rest
The ICF classifies three types of environmental factors
-product and technology -natural environment and human made changes to the environment -support and relationships
Augmentative/Alternate Communication
-provides communication in a form other than expressive speech output. -runs the gamut from simple picture boards to speech synthesizers via computer output -ASL- American Sign Language
Some psychomotor mental functions following brain injury or disease are
-psychomotor retardation -agitation-exess movement without direction -posturing/catalepsy-spontaneous maintenance of postures. -echopraxia/echolalia-mimicking other's speech or movement. -stereotypy-repetitive, non-directed motor activity.
De Quervain's tenosyonvitis
-tendons around the thumb become inflamed. -pain may radiate up the forearm -splint (thumb spica)
Intellectual awareness (a component of metacognition)
-the capacity to monitor "self" in relatively "objective" terms. -includes the knowledge about the strategies we employ in our own thinking and knowledge about how our personal thoughts and feelings influence our performance and affect others. -may be considered insight into self
olfactory perception
-the mental function involved in distinguishing differences in smells. -can result in very strong, long lasting memories that are often emotional in nature.
memory
-the registering and storing of information and retrieving it as needed.
Metacognition
-the use of cognitive skills and provides the basis for transfer and generalization of learned skills to daily functioning. -the mechanism through which we plan, organize, execute, and evaluate our day-to-day activities.
intellectual functions
-those skills required for the individual to understand and constructively integrate information from all types of mental functions -develop and change over time
Age related decrease in strength is attributed to ?
1) decline in total of skeletal muscle fibers 2) reduction in type II muscle (fast-twitch) 3) reduction of muscle motor units 4)reduction in the fuction of cardiovascular system 5) reduction of glycoproteins being transported to the muscles 6) The ability of the body to repair nerve damage
Highlights of IDEA or Law 99-457
1) families are mandated co-leaders on state level advisory boards that make recommendations about the way in which services systems are designed 2) family concern, resources, and priorities guide the development of individual intervention plan 3) families play an important role in children's assessment and evaluations 4) families have certain rights to confidentially, record keeping, notification and other procedures related to programs and agencies that serve children
Self- identity has two components
1)- Individual component-who am I as person 2) Contextual component- where and how do I fit into my world
Adult stutus is th eintergration of chronologic age with
1. Cognitive development 2. Physical development 3. societal experience
Super's Stages of Vocational Self
1. Crystallization- Adolescence- consideration occurs of various vocational ideas consistent with one's self concept 2. Specification- Age 18-21-Ideas about vocational interest become more specified 3. Implementation- Ages 21-24- Process of skills training occurs along with experience needed to pursue chosen career 4. Stabilization- ages 25-35- Individual works within desired profession. May make career changes and return to previous stages
Function of steps Leading to Marriage
1. Dating- 2. Courtship- considering marriage, long term goals 3. Engagement- strengthen relationship, prepares fo rmarried life
Tips for providing Intervention in the classroom
1. Develop a good rapport with teacher before providing intervention in the classroom 2. Discuss with the teacher what you would like to do 3. Working in small groups makes intervention less obvious and intrusive 4. Keeping a regular schedule 5. Walk into the classroom at a non-disruptive time 6. Provide intervention as the child participates in the activities 7. Adjust the activities so that a child is successful in those activities 8. Flexibility 9. It may be wise to schedule breaks 10. Be responsible for developing a weekly lesson for the entire class 11. Communicate clearly with the teacher 12. Ask for and accept feedback
Motor development follows 3 basic rules
1. Development cephalad to caudal ( head to tail) 2. Proximal to distal - children develp control structures close to their body before they develop those farther 3. Gross to fine- children gain control of large body movement before they can perform more refined movement
The OT practitioner is must develop communication skills to help family assimilate this new information. To do so, the OT practitioner is guided by these two basic ideas
1. I must acknowledge and accept current family form and function 2. I must ally myself with the systems capacity for change (support the assimilation of the knowledge I bring).
According to the ASHT classification - 6 splints
1. Identification of articular or nonarticular 2. Location 3. Direction 4. Purpose 5. Type 6. total number of joints
# stages of wound healing
1. Inflammatory 2. Proliferative 3. Maturation
Tips for working with parents
1. Listen to parents 2. Present information in layman's term 3. Parents attending IEP meeting may be nervous, but them at ease 4. IEP- begin your report with child's strengths 5. Try to speak to parents before your evaluation 6. Be clear of what has and has not worked inthe classroom 7. Order the list of problems in way that is most important and will not frustrate parents 8.Ask the parents what works and does not work at home 9. Provide suggestions and/or strategies for helping function with in the classroom 10. Follow-up with parents
Three components of successful aging
1. Low probability of disease 2. High cognitive and physical function capacity 3. active engagement with life
Family Systems Theory Concepts
1. Morphostaic 2. Morphogenetic 3. Equifinality
Tips for working with Teachers
1. Most important remember OT in school's setting is to help the child function in the classroom 2.Spend time in the classroom w/o making suggestion or judging the teacher 3. Ask the teacher what he or she see as the problem areas for the child 4.Prioritize strategies for the teacher 5. Provide the teacher with short written strategies and follow-up 6. Respect the teacher's time 7. Emails and short notes are effective means of communication with teachers 8. Help determine good child teacher fits 9. Present yourself to teachers as a resource 10. Help teachers out by using OT resources 11. Provide solutions to teachers concerning children with special needs 12. Use layman's term
Characteristics of ADulthood Process
1. Moving out of the adolescent world whole questioning it and one's place int it.- a process involving sepration, ending, and transformation 2. Exploring the possibilites in the adult world, testing living choices, and consolidating and initial adult identity 3. Forming a dream with a place in the life structure 4. Forming a mentor relationship lasting an average of 2-3 years 5. Choosing an occupation and forming love relationship leading to marriage and family
The Rules of Language have 5 parameters
1. Phonology 2. Morphology 3.Semantics 4. Pragmatics 5. Syntax
Steps of Stages in the OT process
1. Referral 2. Screening 3.Evaluation 4. Treatment planning or intervention planning 5. Treatment implementation 6. Reevaluation 7. Discharge planning
CMC Flexion-MMT
1. Start- Client is sitting with the forearm in supination and digits 2-5 in extension 2. CMC thumb is in extension 3. Motion-client moves the thumb CMC in the direction of flexion 4. Stabilize at the wrist 5. Resistance is applied at the metacarpal for CMC flexion in the direction of extension 6. No resistance is applied when testing fair strenth 7. Poor grading is not completed for this test
PIP/DIP Flexion-MMT
1. Start- Client is sitting with the testing extremity in forearm supination and digit extension 2.motion- Client moves the testing extremity in the direction of PIP/DIP flexion while keeping the MCPs in extension 3. Stabilize at the MCP joints to avoid compensation of hyperextension 4. Resistance is applied with the middle and distal phalanges in the direction of PIP/DIP extension 5. No resistance is applied when testing in the gravity eliminated postion
Digit and thumb oppostion
1. Start- client is sittin with the testing extremity in forearm supination and digits extended 2. Motion0 clients moves in the direction of hand thumb opposition of first and fifth digit 3.Stabilize at wrist 4. Resistance is applied at both the fifth and first digit away from opposition when testing normal or good strengh. 5. poor grading is not completed for this test
MCP Abduction-MMT
1. Start- client is sitting with testing extremity in forearm pronation and digit extension 2. Digits are adducted 3. Motion- client moves the digits in the direction of MCP abduction 4. Stabilize at the metacarpals 5. Resistance is applied to each finger for MCP abduction in the direction of adduction 6, Third digit is tested on both sides 7, No resistance is applied when testing fair strenght
Wrist Flexion-MMT
1. Start- client is sitting with testing extremity on a table in forarm supination, 2. Wrist over the edge of the table in sight extension- Stablize at distal forearm to avoid compensation 3. Resistance is applied to the palm of the hand in the direction of wrist extension 4. No resistance is applid when testing Fair strengths 5. Motion- client moves testing extremity in the direction of wrist flexion 6. Write Grade
Wrist ulnar deviation-MMT
1. Start- client is sitting with testing extremity placed on a table 2. Forearm is in pronation 3. Motion- client moves the testing extremity in the direction of wrist ulnar deviation (pinky side) 4. Stablize at the distal forearm to avoid compensation. 5. Resistance is applied at the 5th metacarpal in the direction of wrist radial deviation. 6. No resistance is applied when testing Fair Strenght
IP Extension-MMT
1. Start- client is sitting with the forearm in supination 2. Thumb IP extension , the joint is flexed 3. Motion -Client moves thumb in direction of extension 4. Stablize at thumb proximal phalange 5. Resistance is applied for IP extension is the direction of flexion6. No resistance is applied when testing fair strength 7. Poor grading is not completed for this test
IP Flexion-MMT
1. Start- client is sitting with the forearm in supination 2. Thumb IP flexion the joint is extended 3. Motion- Client moves thumb IP in directin of flexion 4. Stabilize at the thumb proximal phalange 5. Resistance is applied for IP flexion in the direction of extension 6. No resistance is applied when testing fair strength 7. Poor grading is not completed for this test
MCP Adduction-MMT
1. Start- client is sitting withtesting extremity in forearm pronation and digit extension 2.MCP adduction the digits are abducted 3. motion Adduction 4.Stabilize at the metacarpals 5. Resistance is applied to each finger for MCP in the direction of abduction 6. No resistance is applied when testing fair strenght 7. Poor grading is not completed for this test
CMC Adduction-MMT
1. Start- client is sitting withthe forearm in supination and digits 2-5 extended 2. CMC adduction thumb is abducted 3.Motion- client moves thumb CMc in direction of adduction 4. Stabilize at the wrist 5.Resistances is applied in the direction of abduction6. No resistance is applied when testing fair strenght 7. Poor grading is not completed for this test
CMC Abduction-MMT
1. Start- client is sitting withthe forearm in supination and digits 2-5 extended 2. Thumb CMC abduction- the thumb is adducted 3. Motion- client moves thumb CMC in the direction of abduction 4. Stabilize at the wrist 5. Resistance is applied at the first metacarpal for CMC abduction in the direction of adduction 6. No resistance is applied when testing fair strenght 7. Poor grading is not completed for this test
Wrist radial deviation-MMT
1. Start-Client is sitting with testing extremity placed on a table 2. Forearm is in pronation 3. motion- client moves the testing extremity in the direction of wrist radial (thumb side) deviation 4. Stabilize at the distal forearm to avoid compensation. 5. Resistance is applied at the second metacarpal in the direction of ulnar deviation 6. No resistance is applied when testing fair strenths 7.. Grade
MCP extension-MMT
1. Start-client is sitting with the testing extremity in forearm pronation and digit flexion 2. Motion-Client moves the testing extremity in the direction of MCP 3. Stabilize proximal to the MCP joints at the metacarpal to avoid compensation 4. Resistance is applied at the proximal, middle and distal phalanges in the direction of MCP 5. No resistance is applied whe testing in the gravity -eliminated postion
MCP flexion-MMT
1. Starting -client is sitting with the testing extremity in forearm supination and digits 2-5 extended 2. Thumb MCP flexion -thumb is in extension 3. Motion - client moves the thumb MCP in direction of flexion 4. Stabilize at the thumb metacarpal 5. Resisitance is applied at the proximal phalange for MCP flexion in the direction of extension 6. No resistance is applied when testing fair strenght 7. Poor grading is not completed for this test
MCP Extension-MMT
1. Starting -client is sitting with the testing extremity in forearm supination and digits 2-5 extended. 2. Thumb in MCP flexion 3.Motion -client moves the thumb MCP in the direction of extension 4. Stabilize at the thumb metacarpal. 5. Resistance is applied at the proximal phalange f 6, MCP extension in the direction of flexion 7. No resistance is applied when testing fair strength 8. Poor grading is not completed for this test
CMC Extension-MMT
1. Starting-client is sitting with the forearm in supination and digists 2-5 in extension 2. CMC extension- thumb is in flexion 3. motion- client moves the thumb in the direction of extension 4. Stabilize at wrist 5. Resisitance is applied at the metacarpal for CMC extension in the directionof flexion6. No resistance is applied when testing fair strenth 7. Poor grading is not completed for this test
Cycle of Violence
1. Tension building-breakdown of communication, batter becomes irritable, victim changes behavior to "keep peace" 2. Explosion- Tension becomes unbearable and uncontrollably discharged 3.Calm-Batter apologetic, promises it will never happern again, no abuse takes place
Human learning occurs at the level of the
1. body including innate abilities 2. person, including interpersonal contacts and experiences 3. society
What are the five models used to gather information?
1. bottoms up assessment 2. top-down assessment 3. reaching-based assessment 4. Arena assessment 5. judgment based assessment
The three prenatal periods
1. germinal or preembryonic 2. embryonic 3. fetal
The 4 purposes of splints
1. mobilization 2. immobilization 3. restrictions 4. torque transmission
Cultural Schemas are divided into 4 areas
1. person 2. self 3. role 4. event
Planning information - gathering strategies
1. why do you need to collect the information? 2. what information do you need to collect? 3. how should you collect the information? 4. what does it mean?
Three main types of tactile perception
1. somatic awareness- information about the state of the body (touch, pressure, temperature, pain, etc. 2. kinesthetic awareness-is about movement within the body and changes in limb position. 3. haptic awareness- involved in distinguishing tactile differences in texture, shape, size, and weight.
Splint Fabrication Process
1.Referral- 2.Evaluation- use assestment, COPM, DASH, PRWHE 3.Consider Treatment Options-Biology, cause, course, traditonal treatment 4. Analyze Assessment Findings-pathology and protocols Determine Splint Design 5. Design-desired activities, functions within splint
Wrist Extension-MMT
1.Start- Client is sitting in testing extremity on a table with forearm in pronation 2. Wrist over the edge of the table in slight flexion 3. Stabilize at the distal forearm to avoid compensation 4. Resistance is applied on the dorsum of the hand in the direction of the wrist flexion when testing 5. No resistance is applied when testing fair strengths 6.. Motion- Client moves the testing in the direction of wrist extension 7. Grade
Garnder's 7 learning styles reflecting multiple intelligences
1.linguistic 2. logical/math 3. spatial 4. musical 5. bodily/kinisthetically 6. interpersonal 7. intrapersonal
Adolescence ages
10-19
Strength increases ___ months after and adolescent height and and weight have peaked
12
Boys the typical time of peak growth is
13 years
By ____ some diagonal jaw movements are added to the munching pattern
7-8 months
Between ____ , the infant begins to independently eat with a spoon
15-18
Transition to adulthood normally considred as between the ages of
16-24
Adulthood spans the spectrum from what society designates as the beginning of maturity at the age of ____ to the end of life
18
two-word utterances
18-24 mos.
Between the ages of ______ individuals typically reach the optimal speed of reaction time and attain adult growth of the skeletal, respiratory and cardiovascular system
19-26
Transition to adulthood
20-24
Young Adulthood
20-40 years
Solutions-focused curiosity and interest and collaborative goal setting are skills that are grounded in the central communicative tool known as
Acknowledgment
In ___________ Medicare coverage was extended to younger individuals with disabilities and individuals with permanent kidney failure requiring dialysis or transplant
1972
FHAA
1988 Fair Housing Act of Amendments- added individuals with disabilities to the list of people protected from housing discrimination under existing law
Girls usually reach full height ___ years after they begin menstruating
2
Most adults are strongest between
2 and 3 decade
At age _, children eat independently, consuming most meats and raw vegetables
2 years
By age __ refined balance and equilibrium reactions provide children with necessary motor skills to raise their arms to pull shirts over their heads
2 years
Proliferative stage
2-3 day after injury last 2-6 weeks Epithelial Cells migrate to the wound
The forearm through of a splint should measure approx ___ of the forearm
2/3
Hearing is usually optimal in adult at age
20
By ___ , toddle can also efficiently drink from cups
24
By __ , the foundations has been established for all adult eating patterns
24 months
By age __ years, children are more aware of details and can find arm and leg holes easily
3 years
Skeletal muscle mass and function decline slowly between the ages of ___ and ___
25 and 70
What would be the total number of joint for this splint-Elbow flexion immobilization splint type 2 (3)
3 joints as indicated by (3)
Between the ages of 50 and 70 it is estimated that approximately ___ percent of muscle strength will be lost
30
Baby boomers represent
30 % of the populations
A ___% in cell density between the ages of 30 and 100
30- especially in the hip
At ____ children experiment with forks to stab food
30-36 months
By ____ children try to serve themselves liquids and family style serving of food
30-36 months
Peak muscle strength occurs
30ies
Anticipatory Control
Alteration or adjustment of the motor program even before any interaction with the envionment occurs
Finch and Tanzi demonstrate that twins reared apart share less than ___% inherit ability of lifespan
35
ADA
American with disabilities act- promotes civil rights of individuals with disabilities in the mainstream of society in employment, state ad local government services, places of public accommodation, transportation amd telecommunication
As th eidividual enters adulthood, they are typically independent in
IADLs ( clothing care, meal prep,mange money)
Individuals reach peak maturity in their ___ decade, at about their early __
3rd decade early 20 p. 265
The goal of splint wearing is to tolerate stress to the end range of the joint comfortably for
4 hours
Beginning at ____ months a "true sucking pattern ( up and down tongue movement) develops as head and jaw stability appears
4 months
Average growth period last about
4 years
By age they can recognize correct and incorrect sides , use buckles, zippers and laces
4 years
The development of independent dressing skills typically occurs at age____
4-5 years
Energy requirements for aging adults begin to decline after age
40
Tear secreation decrease by up to ____ in older individuals
40
At __ months , the infant has complete head control and more jaw ability
6months
The loss of sensitivity to pain stimuli begins to occur approximately at the age of
50
Adolescents gain approx ____ of their adult weight and ___ of their adult height
50 % weight 20% height
______ is necessary for a person to function independently during occupational performance task
Motor Control
Most people over age ___ are eligible for Part A w/o need to pay premium
65
Late Adulthood?
65 and older
The disintegration of cells into membrane-bound particles that are then eliminated by phagocytosis or by shedding
Apoptosis
in 200 the average life span is
74.1 male 79.5 female
There are __ carpal bones arranged in 2 rows
8
The fastest growing segment of the population is those over the age
85
Contemporary Task-Oriented Approach
?
Model of Human Occupation and Adaptation
?
Hand preference is typically established by what age
?4? ?2 years?
Interdisciplinary Collaborative style
Approach to treatment is cooperative and interactive Team comprising professionals from several disciplines have frequent direct involvement with the child
What type of play is characteristic opf the preschool child
Associated play Parallel Play Fantasy Play
The developing organism begins to look like human
At the beginning of the fetal period
Complaints of memory impairment with everyday activities and is a very modest loss of memory function in healthy persons aged 50 and older
AAMI- Age-associated memory impairment
A student with disabilities who is not eligible for special education services but requires reasonable accommodations in his or her regular educational program may be eligible to receive related services under this law
ADA
Overweight
A body mass index of 25 - 29 -
Obese
A body mass index of 30 or higher
Client centered means
A collaborative relationship with individuals in the clients environment to assist the client to obtain the skills and make modifications to remove barriers
The concept of disablememnt means?
A disease is not prescriptive of the individual's function in society
Cardiopulmonary system
A key physiologic system in mediating behavior, particularly motor behavior; support characteristically of motor performance such as endurance
Autism is
A kind of pervasive developmental disorder Associated with mental impairment usually diagnosed in early childhood
Physiatrist
A physician who specializes in physical medicine
A student with disability who is not eligible for special education services but requires reasonable accommodations in his or her regular educational program may be eligible to receive related services under
ADA or section 504 Rehab Act
Areas of Occupations
ADL IADL Rest and Sleep Education Work Play Leisure Social Participation
To achieve adult status the individual must have effective strategies for manging
ADL andIADAL task
Sexual activity is ADL or IADAL
ADL- that results in sexual satisfaction
Routines--based assessment
A routines based assessment judges the capabilities of the individual with an everyday routines and activities -assesses participation and environmental factors -identifies those factors that interfere with or promote the performance of a specific functional task within a specific routine
Family-centered intervention is
A standard of care in working in early intervention Designed so family concerns and priorites drive the intervention plan Characterized by family input into assessment of child performance
An intrinsic, non-purposeful pattern that repeats itself is called
A stereotype
disablement model
A theoretical attempt to categorize activity limitations in terms of an individual social and cultural environment
A frame of reference is defined as
A theoretical perspective that organizes approach to client management
Norm referenced tests
A type of standardized test that has been given to a large number of individuals that serve as a normative sample
The first words emerge at about 12 mos in most children
A very important linguistic milestone
Structure involves (chart p. 74)
A. Phonology-sound system B. Morphology-word structure C. Syntax-word order
Pragmatics involves
A. Pragmatics-the rules and conventions for talking
Meaning involves
A. Semantics-the meaning component of language
The TriAlliance of Health and Rehabilitation Professions consists of
AOTA American Physical Therapy Association American Speech and Hearing Association
ADL
Activities of Daily living
Focuses on the problem by attempting to solve the problem, master the situation, or expand resources to deal with the situation
Adaptive, coping (problem-focused)
Systems
Administrative control and organizational mechanisms and are established by governments at the local regional national and international levels
Example of Cognitive learning
Adult learning to dance; older person who had a stroke learning to brush his teeth again Person with LE amputation learning to move around the house
Examples of associative learning
Adult remembering similar movement in previous dance routine; Older person picking up familiar toothbrush Person with LE amputation noticing how nice it feels to be back home
Self advocacy
Advocating for one's needs and rights and the disability rights movement has championed the development of the skilled individuals with disabilities
Inflammatory Stage
After trauma last 3-6 days Vasoconstriction begins during 5-10 mins
PMH
Age Date of injury Hand Dominance Avocation interest Subjective complaints Vocation How injury occurred Functional ability Family/social history treatment received to date Prior injuries habits
Patient's History includes
Age Gender Diagnosis PMH (Past Medical History)
Universal design can be used to create homes that allow people to
Age in place
Public Law 94-142 Education for all handicapped children act (EHA-Education of the handicapped act)
All children have the right to free and appropriate public education
In order to support positive youth development, adults should
Allow increase autonomy with limits
Standardized test
An evaluation instrument that has uniform procedures for administration and scoring
Proposed that language acquisition was a learned behavior under operant control. (operant learning theory) The developing youngster produces various language forms which are selectively reinforced by his caregivers.
B. F. Skinner
Typical Characteristics of Psycho-social Development- Early Adolescence
Being engrossed with self Emotional Separation from parents Decrease in compliance with parents rules or limits Challenging the authority of others Questioning adults opinions Changing mood and behaviors Mostly same-sex friendships with strong feelings toward these peers Demonstration of abstract thinking Idealistic fantasizing about careers Importance of privacy Interest in experiences related to personal sexual development and exploring sexual feelings Self-consciousness display of modesty, blushing, awkwardness about self and body Ability to self-regulate emotional expression Experimenting with drugs
A term associated with healthy individuals who experience brief transitory episodes of cognitive decline
Benign senescent forgetfulness (BSF)
This approach helped a person who had a tendon repair that resulted in flexor contractures of the MCP joint regain full range of motion
Bio-mechanical Approach
Common Myths about parenting
Birth of child will save a failing marriage Children will take care of parents in old age PArents canexpect respect and obedience from their children Having a child gives the parents another chance to achieve what they should have achieved in life Mothers are naturally better parents than fathers Havinga child means that the parents will always ave
Public Law 99-457 Part H
Birth to Three services should be equal in all states and counties
Life Cycle
Birth, Infancy, puberty, adulthood and old age
5 to 8-9 weeks
Bones and muscles begin to give contour to body face and neck appear-human resemblance begins
In the ___ approach, the therapist focuses on identifying problems with specfic performance skills
Bottom-down
This condition is common after a carpal tunnel release, or when the flexor reinaculum is absent
Bowstringing
The embryonic germ layer of mesoderm forms all of the following tissues
Brain
8 weeks
Brain grows faster than the body forehead becomes prominent as a result of proliferation of brain tissue limb buds elongate muscles and cartilage develop sex organs begin to form embryo grows to 30-50 mm in length embryo becomes a fetus
Cardiovascular Pathologies observed with increase aging
CAD HTN Valvular heart disease Left ventricular dysfunction and failure CHF dysrhythmias aortic stenosis aneurysms peripheral vascular disease
The joint of the first digit
CMC, MP, IP
Hand oppostion of first and 5th digits
Client is sitting with feet on the Floor Thumb touches Pinky (1 touches 5) 1. Start- testing extremity is resting on table with humerus abducted to 90 degress, elbow flexed and forearm is supination. 2. ruler measuremetn-located on arm of the gonimeter are used for oppostition 3. measurement is taken from tip of 5 to tip of first 4. measurement recorded in centimeters of opposition (negative)
Other Splint Considerations
Client motivation Clients ability to follow directions Client may require more than one splint
PIP Extension
Client sitting with feet on the Floor Move Digit through ROM 1. Elbow of the testing extemity is resting on the table with humerus slightly flexed and forearm in neutral. The PIPs are in neutral or extension 2. Fingers in "claw" 3. Fulcrum- dorsal surface of the PIP joint is being measured 4. Stable arm- dorsal and the midline of the proximal phalanx of the digit being measured 5. Moveable- dorsal and the midline of the middle phalanx of the digit being measured 5. Write as 0 or negative if defict
Name natural environment barriers
Climate Earthquakes and floods and volcanoes Terrain Rural areas
Measure all wounds in
Cm
During the beginning stages of learning, individuals rely on ___ to guide movement
Cognition
_____ informs occupational performance
Cognition
Disruptions in functional performance due to bereavement
Cognition memory orientation sleep leisure
________ between OT practitioners is essential and is facilitated by the OTA's knowledge of the occupational responsibilities
Collaboration
Collaborating with the family to clarify and develop a common set of goals helps practitioners efficiently and effectively manage the treatment process
Collaborative goal setting
Top-down assessment
Collect information on the icy areas of activity and participation and environment -desired outcomes guide the assessment process -these are statements that describe what the team would like to see happen and individual -can be general or specific statements
Document Skin
Color Temp Texture Muscle atrophy Scarring Edema Skin Thickness Allergies Wounds/sutures
This part of the IADL includes all aspect of sending and receiving information, specifically the ability to use tools to write, and to operate a personal computer, read, type, text, or use a telephone, tape recorder, or special communication device
Communication management
This part of IADL refers to the skills used to move around the neighborhood or community
Community Mobility
7
Complete Independence
Addiction
Compulsive physiological and psychological need for habit forming substance
Virtual Context
Computer or airways, simulators, chat rooms
DASH
Condition specific Measures client's perception of how current disability of upper extremity has impacted function Measures client's functional abilities 30 set questions about function within performance areas Clients rate on 1 to 5 scale current ability level Should be coupled with interview Re-administration post splint fabrication measures client change in functional abilities
PRWHE
Condition specific tool Clients rate pain/function in 15 preselected areas Obtains info about client's functional abilities Broader functional areas than DASH Closed ended questions Should use interview to ID details of function/context
Family members are the ____ in most children's lives
Constant
Policies
Constituted by rules regulations conventions and standards established by government at the local regional national and international levels or by other recognized authorities
Is the background into which something is interwoven
Context
The ____ component is one's understanding of one's relationship to other and the world
Contextual
Typical Characteristics of Psycho-social Development- Middle Adolescence
Continuation of movement towards psychological and social independence from parents Increased involvement in peer group culture, displayed in adopting peer value system, codes of behavior, style of dress and appearance Involvement in formal and informal peer groups such as sport teams, clubs or gangs Acceptance of developing body; sexual expression and experimentation Exploring and reflecting on the expression of own feelings and those of other people Increased creative and intellectual ability Risk taking behaviors underscored by feelings of omnipotence ( sense of being powerful) Experimenting with drugs
What is a biological based problem or condition in which a person's functional abilities have been disrupted?
Disease or disorder
This crease is the landmark for the distal edge of the palmar portion of splint intended to immobilize the wrist while allowing motion of the MCPS
Distal palmar Crease
BM I is calculated by
Dividing weight by the square of height in meters
Determining the need for OT therapy in the school
Does the child have and exceptional education need Does the evaluation indicate the need for OT Does the child demonstrate a significant delay in motor, sensory or perceptual, psycho-social or self-help skills Is OT a related service that may be required for the child to benefit from and participate in an educational program Does the child require the specialized skills of the OT practitioner
Questions a Therapist should ask client
Does the splint feel secure do the straps irritate you anywhere does you skin feel hot What activities will you be doing When you move do you experience pain Does the splint feel comfortable after 20-30 minutes
This term refers to the back or the posterior aspect of the hand and forearm in relationship to the anatomical postiiton
Dorsal
Identifying a situation that is worse than your own
Downward comparison
The degree of ease with which a material conforms to the underlying shape without manual assistance
Drapability
Which splint employs elastics, springs, and wire, as well as multipart splints
Dynamic splints
According to the ____, schools are required to provide special, or related, services as necessary for the student to benefit from the educational program
EHA- Education for All Handicapped Children's act
Due to the thin, supple nature of the skin on the dorsal surface of the hand, it is often the location for this common ailment
Edema
When present, friction is increased, joint motion is limited, and tissue has less ability to elongate and compress. Significant exposure to this diagnosis can result in permanent deformity
Edema
T/F The perceived or actual prsence of developmental delays warrents the provision of OT and other rehabilitative services
True
4 weeks
Embryo cells divides into 3 layers Special layer of cells begin to grow into uterine wall where the placenta will form special cells grow and form the amnion ( water sac) heart tube forms blood begins to circulate through embryonic disc tubes toward the end Development of neural systems begins, and neural groove appears Intestinal tract, lungs, liver and kidneys begin to develop Small buds appear on the sides of the body- beginning of limbs by the end of 4 weeks embryo is 4-6mm long, head is forming, body is curled
Psychological Development in Adolescents
Emotional Separation from parents Expolaration of interest, ideas and roles Expermentation related to interest and preferences Formation of personal idenity Identification with a peer group Exploration of romatic relationships Development of a sense of one's ssexuality Developing sexual orientation Establishing occupational for future workers role
Judgment based assessment
Enables therapist to obtain task specific information about an individual from those who see him perform on a regular basis -asking parents and caregivers to fill out the form or answer a series of questions regarding the child's behavior would yield information
The mental process of assigning meaning to the sensory input and characterized by active rehearsal of the information
Encoding
Virtual environment
Environment in which communication occurs by means of computers and absence of physical contact
__ implies that no single past even predicts a systems current form, nor does a specific current event specifically predict a future form
Equifinality
Assistive technology
Equipment or devices designed to help persons with disabilities increase functional capacities or meet the requirements of daily living
____ ____was the first development theorist to propose that acquiring a sense of identity was the foremost psycho-social task of adolescent development
Erik Erikson
What term is used to reflect the influence of race and culture on behavior?
Ethnicity
The evaluation process
Evaluations are used to help make a diagnosis identify atypical development or determine eligibility for services
Organize sequences of well-known situations
Event schemas
Abstract reasoning, inductive and deductive reasoning and cognitive flexibility to devise alternative solutions to a problem
Executive functions
Contains knowledge about world and facts and figures that can be detailed verbally
Explicit memory
0 to 4- 5 weeks
Fertilized eggs decends from fallopian tube to uterus Early cell division occurs with formation of embryonic disc zygote becomes and embryo developing embryo attaches to uterine wall
A Thermoplastic material with high degree of ___- can take stresses repeatedly
Flexibility
____- allows a circumferential splint to open and close without breaking
Flexibility
The thumb can perform the following movements
Flexion extension abduction adduction opposition
"Dog" is a free morpheme that imparts a specific meaning.
If an "s" is added we understand that it means more than one.
What would be the total number of joint for this splint-index-small-finger MP flexion mobilization splint, type 2
If no secondary joints are included in splint design, the joint level is type 0
What is the negative changes in a person's well-being and social position within a cultural group?
Illness
Primary care model
Immunizations, vaccinations, regularly scheduled check-ups, and on-going monitoring of chronic conditions.
Incorporates skills that are practiced and automatic and that primarily involve cognitive or motor components
Implicit memory
American with Disabilities Education Act
In areas of public services, discriminatory practices against individuals with disabilities by employers are prohibited EHA is renamed individuals with Disabilities Education Act- IDEA
Contextual Factors
In the ICF- those factors that influence how a person is able to respond to a given condition these factors are intrinsic (internal) or extrinsic ( environmental)
Disability
Inability to pursue life tasks and roles because of physical or mental impairment
Relationships
Include immediate family extended family friends and acquaintances peers colleagues neighbors
Physical environment
Includes both the natural and man-made features of the space the person occupies
Natural environment
Includes physical features of the outdoor environment such as landforms distances between resources to rain plants animals and bodies of water
_____ cross-linking of collegen fibers is seen with aging or inactivity
Increase
T/F The pulmonary system hasa large ventilatory reserve capacity that can compensate for the structural and physiologic effects of aging
True
Adolescent Cognitive Development
Increase capacity for abstract thinking-logical thinking Advance reasoning- hypothetical deductive reasoning Development of impulse control-emotional self regulation Increased ability to assess risk and consequences vs. reward Increased problem solving skills Improved used and manuipulation of working memory Improved language skills, especially girls Future-oriented plannign and goal setting Increased capacity to cognitively regulate emotional states Emergence of morla reasoning-conventional level of morlaity Greater ability to perceive other's perspectives Focus on role obligations and how one is percieved by others Questioning values of parents and institutions
Self-care skills in preschool child usually develop to the point of
Independence in most self-care ADLS Emerging independence in IADL's
IEP
Individual Education Plan
IEP
Individual educational program
IFSP
Individual family service plan
Mental functions
Innate to humans and include both: 1.) Global functions like consciousness 2.) Specific functions like self-control
In order to receive federal funds for Medicaid the state must provide categorically need individuals with the following minimal services
Inpatient hospital services Outpatient hospital services Rural health clinic services Laboratory and X-Ray services Nursing facility services Home healthcare for Individuals age 21 and older Family planning services Early and periodic screening, diagnosis and treatment for individuals under age 21 Certified midwife services and physician services Certified pediatric and family nurse practitioner service Federally qualified ambulatory services and health center services
A family subsystem
Interacting component parts of members of the family
Which group has a strong connection between members within cultural group and understanding that individual's behavior has an impact on others
Interdependent cultural group
COPM
Interview based Identifies problems in performance areas Identifies a client's perception of their ability to perform in a performance area Identifies a client's satisfaction with their current abilities Can be used with all ages/disabilities Caregivers or family members can answer questions for client if needed Provides objective documentation of splinting effects by pre-post scores
This grasp is helpful in holding flat objects such as books or snadwichers, is NOt present with median and ulnar nerve injuries
Intrinsic plus grip
Affective Domain
Involves feelings, including happiness, sadness, anger, etc, which are all part of the human experience
A yellowish cast to the newborn skin is
Jaundice and an indications of high bilirubin levels
Often used to describe women who demonstrate stronger family bonds and most involved in providing care for their family members
Kin keeper
metalinguistics
Knowledge about the form and structure of language
Takes place within the learner and can be defined as the acquisition of skills or information that changes a person's behavior, attitudes , insights, or perceptions
Learning
Splint Compliance
Listen when client makes suggestion determine if splint is not correct for goal Does it look worn Does it smell Dirty spots Strap looks old or new
De Quervains tenosynovitis
Long forearm-based or radial gutter splint
T/F There is a high correlation between increasing age, decreasing physical activity and increasing disability
True
The primary function of this muscle group is to flex the MCP joints
Lumbricals
Joints of Digits 2-5
MCP PIP DIP
Therapist should fabricate this splint only on hands that have a healthy
MP joint
Third major source of visual disability and is more serious than cataracts or glaucoma because it is least treatable
Macular degeneration
Successful interactions with infants are facilitated
Matching actions to the infants signals ( synchorny)
2
Max Assistance (pt can perform 25-49% of task)
Siblings of infants with disabilities
May get less attention from parents and others
Which following statements about transition
May involve changing roles May be associated with rituals of transition
Sources of data
Medical chart Physician referral Patient Patient's caregiver
The property that describes a materials ability to return to its preheated (original shape)
Memory
4
Minimal Contact Assistance (pt performs 75% or more of task)
Splints and Orthoses are not only to immobilize but to
Mobilize position protect a joint project a specific body part
3
Moderate Assistance (pt performs 50-74% of task)
6
Modified Independence
Typical Characteristics of Psycho-social Development- Late Adolescence
More stable sense of self Strengthened relationship with parents Increased independence in decision making and ability to express ideas and opinions Increase interest in the future, consideration of consequences of current actions Resolution of earlier angst at puberty about physical appearance and attractiveness Diminished peer influences; increased confidence in personal values and sense of self Preference for one to one relationship; starting to select intimate partner Becoming realistic in vocational choice or employment Definition of an increasingly stable value system
The reflex that results when the head is dropped back rapidly is called
Moro response
Research about peer relationship in adolescence shows that
Most peer influences encourage pro-social behavior
The ability to regulate or direct movement
Motor Control
PIP Flexion
Move Digit through ROM Client is sitting with feet on the floor 1. Elbow of the testing extemity is resting on the table with humerus slightly flexed and forearm in neutral. The PIPs are in neutral or extension 2. Fingers in "claw" 3. Fulcrum- dorsal surface of the PIP joint is being measured 4. Stable arm- dorsal and the midline of the proximal phalanx of the digit being measured 5. Moveable- dorsal and the midline of the middle phalanx of the digit being measured 6. ROM- 0-100 7. Ending postion- client move sthe testing extremity through max PIP flexion
One of the most notable physical changes that occur with aging
Muscle atrophy
Agonist
Muscle considered to be the prime mover of a motion
effector system of motor control
Musculoskeletal system; key in executing motor behavior
This law was enacted in 2001 in order to improve teaching standards and the student's learning results
No Child left Behind (NCLB)
0
No activity occurs
Physical Context
Nonhuman aspects of the environment
Wellness
Not only is the absence of illness that includes the motivation to be involved in life to have a sense of control over one's actions and to desire interaction and connection with other individuals and perhaps most prominently wellness enhances our sense of self-esteem and self-worth
Summarize safe guards for children with disabilities provided by IDEA-R
Notifying parents of all proposed actins Obtaining consent to evaluate allowing parents to attend IEP team meetings providing the right to an independent evaluation the right to appeal school decisions in front of an impartial hearing officer
OTAs must be trained in medical-based pediatric therapy to provide services in the
PICU Subacute long-term home care setting
____ and ___ corpuscles, the skin receptors responsible for the sensation of pressure and light touch, show a decline in number with aging
Pacini's and Meissner
The main objective is to feel better through management of emotional response to a stressful situation in order to free oneself of the psychologicl or physical impact
Palliative, copin ( emotion-focused)
These terms are used interchangeably to refer to the front or anterior aspect of the hand and forearm in relation to the anatomical positiion
Palmar or Volar
What are some typical barriers encountered by persons using a wheelchair
Parking, approach, entrance, room layout, lecture areas, campus
Medicare consists of 2 types of insurances
Part A- which covers hospital insurance, skilled nursing Part B- which covers medical benefits, including OT and PT, labs, home health, outpatient
Ignoring a problem and hoping it will go away
Passive appraisal
Perceptual Coping Strategies
Passive appraisal Re-framing Downward comparison Use of spiritual beliefs
Movement involves
Perception motor planning motor execution feedback bio-mechanics
The ability to base one's moral judgement on one's own moral values and moral standards
Post-conventional (Kohlberg)
Physiological loss of accommodation or ability to focus on near objects
Prebyopia( I can not focus on a "p" ia)
Infants born to mothers who drink alcohol during pregnancy have an increased risk of
Prematurity lower birthweight irritability and poor skills for attachment
Sensory Vestibular-Pathologies observed with increase aging
Presbyastasis disequilibrium
When complaints of balance problems and dizziness are common and when no other pathologies are noted _______ is the termed used to describe this disequalilbruim
Presbyastasis ( Trouble with my "stasis")
Sensory ear Pathologies observed with increase aging
Presbycusis
This age related impairment that initially causes an inability to hear high-pitched sounds, begins to manifest prior to the age of 25
Presbycusis
Auditory acuity and most common cause of hearing loss in adults
Presbycusis ( can not hear "cu")
Most common visual problem in older adults; loss of accommodation or ability to focus on near objects
Presbyopia
Sensory eye Pathologies observed with increase aging
Presbyopia cataracts glaucoma macular degeneration
Arena assessment
Primarily used an early intervention -the simultaneous observation of a child by various disciplines
Assets
Products or objects of economic exchange such as money goods property and other valuables which individual owns or to which he or she has rights of use
Quality of Life
Promotes fullfillment both basic and complex needs, leading to life satisfaction
PPS
Prospective Pay Systems- ( part of BBA)- amount of reimbursement for a particular service is predetermined, irrespective of actual cost
One of the most important things a caregivier can do in infant interaction
Provide consistency and predictability
One of the most important things a caregiver can do infant interaction
Provide consistency and predictabilty
This arch is fixed and consists of the distal row of carpal bones
Proximal transverse arch
Radial Deviation
ROM- Move hand toward thumb 1. testing extremity is resting on table with humerus abducted, elbow flexed, forearm pronated. Forearm is placed on the table with palm flat. Wrist in neurtral 2. Goniometer- fulcrum -base of the third metacarpal, over the capitate bone 3. Stable arm- midlline of the forearm 4. Moveable- midline of the 3 metacarpal 5. Move hand towards thumb- meadure 6. ROM 0-20
The distinct biologic attriburtes possed by a group of people
Race
This term indicates the thumb side of the palmar surface
Radial
Client centered care
Reflects recognition concern for the influence of power and relationships
Mortality
Reflects the death rate in a given population
Redefining a situation in ways that make it more manageable
Reframing
Refers to the point where the sensory input is received
Registration
Often cited because it contains language indicating that individuals with disabilities cannot be discriminated against in any program
Rehab Act or Rehabilitation Act of 1973
This approach allowed a person who had a stroke to grasp the walker by using splints that were adapted to assist with grasp
Rehabilitation approach
Attitudinal environment
Relates to observable consequences of customs practices ideologies values norms factual beliefs and religious beliefs
Motor development i the first year of life
Relatively uninfuence by environment as long as environment is supportive
Accessibility
Removing barriers that prevent people with activity limitations from the use of services products and information available in that environment
Examples of Public Policy
Requirements for immunizations school lunches wheelchair accessibility
The process of locating and producing for use,encoded information
Retrieval
_____ material is used for joint stabilization
Rigidity
Relinguishing certain professional duties to other team members
Role release
A person's social position within a culture and the expected behaviors of a person in that position
Role schema
Which of the following family characteristics would facilitate coping behaviors
Routines and roles that somewhat flexible
_____ based materials are the quickest to become brittle
Rubber
SOAP notes
S-Subjective-general statement O- objective- what is done A-Assessment- effect of interventions P- Plan- what will be done
The term coined to describe the role of middle-aged adults who are sandwich between older and younger cohorts in the population
Sandwich Generation
The factor that seems to have the greatest influence on self-esteem in adolescents is
Satisfaction with physical appearance
Advantages of Prefab Splints
Save time an effort Immediate feedback variety of material choices prefer sports brace appearance no waste
What are ways of organizing complex information to help guide thinking?
Schemas
The educational rights of children with disabilities are protected by two additional laws (other than EHA), they are
Section 504 of the Rehabilitation Act ADA- Americans with Disabilities Act
The ability to subconsciously screen out extraneous information while focusing on important cues is well developed
Selective attention
Changing one's physical apperence to express individuality is an example of
Self-concept
Process of self-evaluation related to other abilities to competencies in physical activities
Self-concept
The person's conviction that he can organize and implement effective strategies to deal with any potential situation that may be novel or unpredictable and have stressful components
Self-efficiacy
____ and ____ governments paly a primary role in the development of public policy, which is expressed through laws and funding mechanisms
State and Federal
Performance Skills
Sensory perceptual skills Motor and praxis skills Emotional regulation skills Cognitive skills Communications and social skills
Healthy people 2020
Serves as a mechanism to identify the health of the US population set goals for the nation's health and provide mechanisms to measure progress
Services
Services that provide benefits structured programs and operations in various sectors of society in various sectors meet the needs of individuals
Set up
Set up
This refers to a person's preference pattern of physical and emotional arousal, and sexual attraction toward others of either opposite sex or same sex/gender
Sexual Orientation
Paul functions of the family
Sexual relations Economic cooperation and protection Legitimate procreation Socialization of offspring Enculturalization of citizens Social control
Which of the following type of memory is dividied into storage and processing
Short-term
Which of the following summaries best descibe the current research on having a sibling with a disability
Siblings feel they have to "grow up " too fast
Social Context
Significant others and larger social group
Adolescent Physical Development
Skeletal growth Growth in muscle mass and strength Growth and maturation of reproductive organs Growth of secondary sex characteristics; pubic and body hair Advance motor coordination skills Boys- Significant increase in muscle mass, onset of sperm production and ejaculation Girls- Development of female body shape, including breast development, menarche
Often reached by young adulthood and is illustrated by the attainmment of maximal or peak, bone mass between the ages of 25 and 35
Skeletal maturity
This is illuustrated by the attainment of maximal or peak, bone mass between the ages of 25 and 35
Skeletal maturity
Reimbursement for PT and OT under Medicare part A
Skilled nursing home health
Race includes the following attributes
Skin color hair type bone structure
____ plays an extremely important roles in families and individual well-being
Social support
Disablement
Sociological concept commonly used to describe the impact of disease or disability on human function
The focus should be on strengths, achievements, and desires rather than the traditional problems and deficits
Solution focused curiosity and interest
emotional functions
Specific mental functions related to feeling and affective reactions, appropriate degree of emotional response within context of environment and society.
Except for ____, these service are available only to special education student
Speech Therapy
Temporal Context
Stage of life, time of day, and time of year
ST is a______ service, which means that a student who does not receive special education services may receive ST
Stand-alone
SAE
Standard American English
Components of IEP
Statement of Child's present level of educational performance Statement of measurable annual goals Description of special education and related services Description of program modifications or support Explanation of the extent to which the child will not participate in regular classroom and IEP activities Projected date for beginning services and educational modifications Transition services Statement of the way that progress toward annual goals are measured Descriptions of methods regularly inform parents of their child's progress
What was the Olmstead vs LC ruling
States could not force segregation of individuals with disabilities into state institution in order to receive services States must provide range of services in the community so society does not prevent individuals with disabilities from participating within the community
Which splints place tissues in a stress-free position to enhance healing and to minimize friction
Static splints
Gateway drugs
Substances that seem to open the entrance to harder drug use
specific mental functions
Such as memory, language and calculation are more esaily quantified than the global functions and are more often a focus of intervention following brain injury. ex: attention, memory, psychomotor control, emotional control, perception, thought, higher cognitive functions, the mental function of sequencing complex movements
The therory that views the process of a career choice as developmental in nature
Super's self-concept therory
The most mature of the fine motor patters is
Superior pincer grasp
5
Supervision or Setup
The following muscles comprise the rotator cuff
Supraspinatus Infraspinatus Teres Minor Subscapularis
The 4th embryonic week
The beginning of organogenesis A critical time for the development of the nervous system A time when serious developmental defects can occurs
What is true about play in middle childhood
The child begins to engage in sports Play does not have to be structured Cooperative play emerges
Universal design
The design of products and environments to be usable by all people to the greatest extent possible without the need for a gas station or specialized design
What period is most senstive or susceptible to the effects of toxic substances or abnormal conditions?
The embryonic period
Which period has structural and physiologic refinement of tissue, organs, and systems.
The fetal period
Which prenatal period is the longest and involves the most growth?
The fetal period
Interdependent/Collectivistic
The group members hare responsibility for behavior, and the purit of interest is strongly influenced by group needs. The group performance serves as the measure for success or failure. Group cohesiveness is emphasized
Substance abuse
The overindulgence in and dependent on an addictive substance
Products and technology
The physical items that people come in contact with walk completing their daily activities
normalization
The process represents the successful integration of activity limitations into daily occupations in a manner that enhances function
Morbidity
The rate of incidence of the disease
dynamical systems
Theory has roots in human physics refers to self organization of complex particles states that behavior at any given time is the result of variable interactions of a number of complex ssytems and that behavior is emergent
Union Schools vs Smith 1994
The school did not provide the parents with proper information about alternatives or available resources for their autistic child. The court state that these aspects of IDEA should be enforced
Extending the splint borders beyond the crease will inhibit thumb opposition and palmar abduction
Thenar Crease
Gag-reflex
This reflex protects the infant from swallowing anyhting that may block the airway
This type of prehension is that in which the thumb pad makes contact with pads of the middle and index finger
Three jaw chuck or tripod
Autonomic nervous system
Tied to parts of the central nervous system and peripheral nervous system directed by special parts of teh brain and peripheral nervous system
In the ____ approach, the therapist focuses on the client's occupational history and interest
Top- down
1
Total Assistance/Dependent (pt performs less than 25% of task.
Bottoms up assessment
Traditionally therapist have relied on a bottom up assessment -typically measures body level structure and function -leads to a program designed to remediate those deficits
T/F There is a postive correlation between increased participation in recreational activities and higher psychological well-being or more successful aging
True
T/F There is significant neuronal loss subcortical regions of the brain such as the thalamus, forebrain, and hippocampus
True
T/F adolescents who drink heavily or who binge drink are more likely to use drugs than are nondrinkers or moderate drinkers
True
T/F alcohol and tobacco are usually the first drugs that young people try
True
Adolescents who engage in drinking have a higher likelihood of
Transitioning to heavier alcohol abuse and the use of other drugs
T/F A person schema will develop and change as one grows, ages and matures in life
True
T/F Although age-related changes do not necessarily have been associated with disease process, the incidence of chronic disease does increase with age
True
T/F Apoptosis is not readily accomplished in late adulthood
True
T/F By the time infants are born, they will have developed all the body structures they will ever have?
True
T/F Exercise training and physical activity can delay and even reverse some of the effects of disuse and aging
True
T/F Family adaptation is affected by the interaction of family resources ( time, money, friends) and perceptions ( they way events are defined)
True
T/F For a transdisciplinary team to be effective, the team members must trust and respect each others so that they are comfortable with role release
True
T/F Greater Cultural diversity further complicates our defining the stage given that cultures and societeies differ in terms of explaining the appropritae age for leaving school, leaving the home or orgin, beginning a full time job, getting married, and becoming a parent
True
T/F It is normal to see veins on the dorsum of the hand
True
T/F Low probability of disease not only denotes the absence of disease but also recognizes the absence, presence or severity of risk factors
True
T/F Medicare means therapist must write thorough documentation to justify treatment so it can withstand any audits the fiscal intermediaries may undertake
True
T/F Middle age is often characterized as a period of crisis , as the aging adult faces a series of lifestyle changes and demands
True
T/F Movement is essential for activities of daily living, as well as work, educational, and leisure activities
True
T/F Nearly 1/2 of the children in the US under the age 5 years are racial or ethnic minorities
True
T/F No standard or single method for documentating OT intervention exist within the profession
True
T/F OSHA standard regarding blood-borne pathogens requires employers to offer a free three injection hep B vaccination series to all employees who are exposed to blood or any other potentially infectious material during routine duties
True
T/F OT practitioners must have extensive knowledge of medical terminology when working in medical system
True
T/F OTAs must be trained in medical-based pediatric therapy to provide services in the PICU, sub-acute,,long-term,or home care setting
True
T/F Orthosis and Splints are used interchangeably
True
T/F Splints must address all muscles involved in motion
True
T/F Splints that focus on client factors alone do not always treat the functional deficits
True
T/F The Occupational Therapy assistant must ensure that patients remain safe within the health care setting
True
T/F The aging brain remains plastic in that individuals can puurposely continue to gain or retain complex skills
True
T/F The aging process is universal, irreversible, and progressively cumulative throughout the lifespan
True
T/F The normal developmental progression can be negatively affected by atypical experiences and events such as prolonged hospitalization
True
Disadvantages of Prefab Splints
Unique fit is compromised Little control over therapeutic positing of joints Expensive Prefab made for a few specific targets made need to be order time frame
Using a philosophical or spiritual beliefs to make sense of and find meaning in a situation
Use of spiritual beliefs
Client Factors
Values Beliefs Spirituality Body functions Body Structures
Edema is caused by
Venous Thrombosis Subcutaneous fibrosis Lymphatic obstruction
Development progresses in two directions
Vertical and Horizontal
Stage of change
Views four variables -current behavior -the number of quit attempts -the intention to change -the amount of time elapsed since quitting smoking
The ability to maintain attention on a task for a sustained period
Vigilance
Scaphoid fracture
Volar forearm thumb immobilization splint
The functional assessment that is used to describe a child's performance during essential activities; it is used to measure those activities that children can actually carry out and not may merely be capable of doing
WeeFIM
Questions to successfully answer transition to adulthood
What are my goals Who am I Whom should I marry Should I have children What career should I pursue What are my priorities Wat do I value
Grasp reflex
When a finger is pressed into the infant's palm, he/she grasps the finger
Phasic bite-release reflex
When the infants gums are stimulated, he/she may respond with a rhythmic up and down movement of the jaw
Suck-swallow reflex
When the infants lips are touched, the mouth opens and sucking movements begin
Rooting Reflex
When the infants' cheek or lips are stroked, they turn toward the stimulus
Padding placed in a splint to reduce pressure areas should be incorporated during this phase of the splint process
When the splint is being formed
The degree to which individuals commitment to their work-role influences their desire remain a member of the workforce
Work-role attachement
Hand Splinting became important aspect of physical rehab during
World War II
Color classification of wounds
Yellow, Red Black
Fertilization also called conceptionis believed to be complete when the sperm and the ovum fuse into a single cell called the
Zygote
language
a complex and dynamic system of conventional symbols that is used in various modes for thought and communication.
Pluripotent
a complex multicellualr organism capable of producing all organs and tissues in the body -Primoridal cells that may still differerntiate into various specialized types of tissue elements
This dramatic increase in height, weight and changes in body portion occur as a result of
a complex regulatory process, involving pituitary gland initiation of the release of growth and sex-related hormones from thyroid, adrenal gland, and ovaries and testes
According to Chomsky
a grammatical utterance is first a mental operation
Bradycardia
a heart rate of less than a 100 beats per minute
Malingering
a person who enjoys exemption from work and social demands and either exaggerates his disability or fails to follow through on intervention strategies aimed at returning him to the workforce.
consciousness
a state of awareness and alertness; the ability to remain awake and alert. -without consciousness, the individual remains passive and dependent on others for survival.
Occupational Disruption-
a temporary and less severe condition in which a client is unable to engage in meaningful occupation due to unexpected factors
The munching pattern is effective for eating
baby food or other dis-solvable foods
27-30 mos
beginning to produce phrases. Inflections also occur. (alterations to words that change meaning)
habits
behaviors so ingrained in activity and context that they are done without conscious thought.
isolation systems are designed to protect a person or object from
being contaminated or infected by transmissible pathogens
Physical development is the result of significant
biological changes
Prelinguistic period
birth to 12 mos
In the ICF, communication is listed as a
body function and is broadly defined under activities and participation as general and specific features of communication by language, signs and symbols, carrying on conversations and using devices and techniques
Disability status is influenced by the nature of the condition creating impairments in the ICF category of
body structure and function
communication
broad term that encompasses our sharing of thoughts and ideas with others.
Performance Skills are the
building blocks of performance in occupation
A condition where the lens of the eye become opaque, will add to the decrease in light sensitivity
cataracts
Providing OT services in an educational setting requires a shift in thinking and a
change in philosophy from clinical (medical) model.
The size of the spoon's and bowl should match the size of the
child's mouth
1/3 to 1/2 of OT practitioners work with _____; public school system are the _____ largest employers
children 2nd
Total body water content _____ with age which is exhibited intracellular as either dehydration of the cell or decrease in cell mass when hydration is adequate
decrease
Ask families to ____ rather than ____ a situation
descibe rather than explain
The second step in building a trusting relationship is
developing strategies for accomplishing the family's agreed-upon goals
31-34 mos
development of syntax.
This type of tissue can be negativity affected by mechanical stress, has decreased tensile strength and can be change the width of a scar based upon stress placed upon it
healing tissue
Long-term memory
holds past events for indefinite periods of time
Obtaining and maintaining personal and household possessions
home establishment and mangement
This grasp uses only the fingers, and the thumb is often NOt used
hook grasp
What should you be observing
how they carry UE reciprocal arm swing Guarding postures Involuntary movemnt (tics or tremors) pt. answer a question pt follow direction pt have postural asymmetry skin color/texture changes joints -deformity/deviation
The ability to adjust to changing temperatures is compromised within aging individuals as the ______ is altered
hypothalamus
This process of thinking about possibilities without the use of concrete examples is referred to as ____ and is essential for problem solving and arguing
hypothetical deductive reasoning
phenemes
individual sounds and exist only in our minds., basic building blocks of language, unique sounds that can be joined to create words
One of the first steps trusting relationships with key member is to
identify the outcomes family members desire
Outwardly, a person's ____ is visible in his or her values, beliefs, interest, and commitments to work, and the social role he or she assumes such as daughter or parent
identity
anticipatory awareness
ie, anticipating a loud crash.
Pediatric primary model
immunizations, vaccinations, regular schedule check-up, and on-going monitoring of chronic illness
perceptional functions
include the mental processes of matching sensations with meaning, using the individual's sensory environment.
maintained abilities
includes cultural and academic knowledge
The LRE guidelines provided the impetus for development of mainstreaming and
inclusion models ( models in which children with disabilities are able to spend time in a regular classroom)
Medicaid enacted in 1965 a state /federal program that provides basic care
indigent individuals based on low income or their qualifications for public assistance
OT practitioners need the knowledge and skill to work as a member of interdisciplinary teams, which requires
interpersonal, communicative, and collaborative skills
The OTA may assist in the preparation of the
intervention plan document progress report any necessary revisions in the intervention plan based on reevaluation complete the discharge summary in collaboration with the OT
Pain is assessd by
interview questions body diagram rating scale questionnaires
Change is possible only through the _____ and ____ of new information into the system, such as gaining or losing a member
introduction and assimilation
Second-level medical care model
involves follow-up that occurs one a child becomes ill
procedural memory
involves primarily motor skills and is less resistant to deterioration.
second-level medical care
involves the follow-up that occurs once the child has become ill
Third level medical care model
involves the need for hospitalization
Temperament
is genetically driven and has been found to be fairly stable within an individual beyond infancy, but can change.
Sterilization
is used to destroy all forms of microbial life including highly resistant bacterial spores
The screening process
is used to detect whether a child's behavior or skill development is at a level that places him at risk for development of problem concerns or delay
According to Erikson, a person failing to achieve intimacy in young adulthood experience
isolation
Germinal or preembryonic period
last approx 2 weeks from conception untill unicellular zygote period has implanted in the uterus and has become an embryo
Realistic career exploration happens during
late adolescence
Studies show that marriage is most satisfactory in
later lefe
This the strongest pinch pattern is the contact between the thumb pad and the lateral aspect of the index finger
lateral prehension
Pediatric OT services are mandated by
law
Children the right to be educated in the
least restrictive environment and receive other services that may be required for them to benefit from their educational program
The medical record is a
legal document
Very Low Birth Weight (VLBW)
less than 1500 g
Low Birth Weight (LBW)
less than 2500g
Extremely low birth weight (ELBW)
less than 750 g
OT are responsible for
providing the overall framework for medical based services.
Critical stages of the family life cycle are those involving
life transitions; birth, marriage, leaving home, death
Oral motor control relates to the child's ability to use
lips cheeks jaw tongue palate
RA
long forearm based thumb immobilizationn splint
Where will OT find themselves working under Medicare
long-term care facilities home health care programs inpatient or outpatient hospitals free-standing clinics rehabilitation centers private practices
Torque transmission splints may create motion of primary joints situated
longitudinally transversely p. 8 figure 1-2
Successful-aging individuals are consider
low-risk and high functioning
Static Splint-
maintain a position to hold anatomical structures at the END of available ROM, thus exterting a mobilizing effect on a joint
Herzog nonpaid productive activities
maintenance of one's home and possessions volunteer work housework child-care informal assistance to relatives and friends care provided to impaired others
Acne is more common in males or females
males because of testosterone
The privileges and exemptions of the sick role may become objects of a secondary gain that the patient is positively motivated to secure or retain. this is called
malingering.
Documentation is a continuous process that begins immediately
on receipt of the initial referral
barrier free design
one universal standard that remains accessible to all.
Expectations in adulthood are heavily influenced by
one's culture
Thumb immobilization splint prevents motion of
one, two or all thumbs
Any abnormality in the structural development of an infant must have occured during the period of ?
organogenesis (organ formation), in the early stage s of development
Bone loss that exceeds that of normal aging is called
osteoporosis
Reimbursement for PT and OT under Medicare part B
outpatient in hospitals and outpatient clinics outpatient services in home health
Activity demands take into account all of the
parameters of a specific activity
As an environmental context, culture influences all areas of human activity and
participation
Cultures that endorse a stnace of living in harmony with nature or being subjugated to nature represents a
passive acceptance viewpoint
OTA's can assist
pediatric medical based screening contribute to pediatric medical based evaluation
Ovulation typically starts about 12 to 18 months after menche and at the
peek of physical growth
tactile perception
perception of touch
Perceptional functions provide clues to
performance skills.
35-40 mos
period of sentence embedding.
What happens in Late Adulthood?
physical functioning may be a concern physiology are possbibly compounded by chronic illness and disease physchosocial issue may become increasing paramount as the nuclear family nuclear family may not be intact and one must contend with loss of close friends and loved ones. One ponder their life accopmplishments move into retirement devote more timme to leisure activities
Decontamination is a
physical or chemical process of removing or inactivating pathogens on a surface or item to the point where they will not transmit infectious particles
In the school system, the practitioner evaluates the student's performance in the classroom to determine if
physical, emotional, or behavioral aspects interfere witht he student's ability to perform task that are required to be performed by all students
Pediatric medical based OT practitioners use
plau activities to facilitate the acquistion of age appropriate developmental skills
As a result of PPS, the amount of therapy service in long term care-
plummeted and thousands of OT and PT and assistants were laid off
lability
poor regulation of emotion and flattening of affect. -Associated with depression and other mood disorders -May be temporary or persistant
Truth means ( according to the OT code of ethics and ethics standards)
practitioners provide both verbally and in writing is accurate
Havinghurst believes a major difference between adolescence and young adulthood is the removal of
preestablished life goals
Emergence of the zygote marks the beginning of the first 3 ____ periods
prenatal
OT practitioner working directly with a child is using the
prescriptive role
T/F Individual stressful life events such as loss of a job or relationship breakup can trigger a recurrence of
previously unresolved task demands and immature coping patterns
ADA- Americans with Disabilities Act
prohibits discriminatory practices in areas related to employment, transportation, accessibility, and telecommunications
Documentation of treatment is necessary to
provide a record and to justify the therapy
Total
pt can perform 25% or less of the activity
Maturation and experience influence the
rate and direction of normal development
The absence of illness is
refers to Health
When osteoblastt and osteoclast work together to produce new bone
remodeling
How is cultured learned?
repeated exposure to acquire
Serial Static Splinting
requires the remolding of static splint holds the joint or series of joints at the limit of tolerable range-thus promoting tissue remolding
Educators and OT practitioners are required to consider ____ when selecting instructional or interventional practices
research
Elasticity
resistance to stretch is helpful when working with high tone or multiple areas too little elasticity can stretch too easily and become too thin
episodic memory
retrieving and acquiring information that occurred in the past at one particular point in time. -example is prospective memory-remembering to do something in the future. -example is source memory-remembering whether an event actually occurred externally or if it derived from an internal source.
Material that have a high degree___ of are strong and resistant to repeated stress
rigidity
The clear separation of responsibilities between the registered OT and COTA
role delineations
Phonology
rules that govern combinations of phonemes producing meaningful words. Constitutes the struture of language.
Developmental Disability
speech and language delay
This grasp requires an object rest against the palm of the hand and abducted five digits flex around the object
spherical grasp
Promoting good postural alignment is important in the treatment and prevention of
spinal deformities
Direction classification are applicable to articular
splints only
Volar thumb immobilization splint
sprains joint dislocations ligament injuries scaphoid fractures
The hand based immobilization splints provide _____ for the thumb while allowing for wrist mobility
stabilization
The critical task of adolescence is achieving
stable, multidimensional self-identity
Occupational Deprivation-
state in which a client is unable to engage in meaningful occupation due to factors OUTSIDE his or her control.
The most important point about the phases of the life cycle is the fact that moving from one phase to another causes
stress and requires the family to adapt
A ____ ____ base of prenatal deelopment is crucial to understanding many of the diseases, impairments, and developmnetal differencences in children, as well as the behavioral patterns of premature infants
strong knowledge
Normal development of oral motor skills related to eating and feeding involves
sucking from a nipple coordinating suck-swallow-breath sequence, drinking from a cup munching and chewing solid food
Although OTAs assist with developing goals and may attend meeting (IEP). Although OTAs do not not interpret the findings or negotiate changes in levels of service or goals, they may
suggest changes or reevaluations
medical model
this model establishes physicians as the gatekeepers to the label of disability and empowers the to certiy who is eligible for social support services like worker's comp.
vulnerable abilities
those likely to decrease or diminish
Hypertonicity
thumb loop splint or figure 8 wrap splint
No matter the type of documentation, all OT practitioners are responsible for documenting within
time frames formats standard established by practice facility federal law state law payer source various other regulation programs
FAPE- free appropriate public education
to all children from 5-21 years of age
Services included in EHA
transportation PT OT Speech Therapy (ST) assistive technology services psychological services school health services parent counseling and training
Types of records and reports to be written and determined by the
treatment facilities and funding agencies
The olfactory nerve and ophthalmic and maxillary division of the ____ nerve mediate quality of order detection and somatosensory nuances
trigeminal
T/ F If problem solvng skills and decision-making ability are influenced by life experience, then transitioning to adulthood can be conceptualized as a period when major life decisions are made w/o much life experience upon to base them
true
T/ F Research indicates that despite understanding what constitutes healthy behavior, college students believe that they personally would probably never have a drinking problem or have heart attack regardless of how much they exercise, smoke, or eat high cholesterol food
true
T/F A child leaving home is typically a stressful stage of a family transition, requiring a redifining of family roles and rituals
true
T/F Adolescents and young adults have fewer colds and respiratory problems than children do, and are faced with fewer chronic health problems that can occur at later stages of the life cycle
true
T/F Adults self-care demands are most extensive of those at any point in the lifespan
true
T/F Development is dynamic and continuously changing process
true
T/F High homemmaking commitment and high career commitment coexist for men
true
T/F Intimate relationships is virtually impossible for individuals preoccupied with fears of being hurt or rejected
true
T/F The fact they can bounce back from considerable stress and exertion may lead many young people to push their bodies too far
true
Splint Instructions
verbal and written phone in case of emergencies cleaning instructions precautions directions on how to handle pressure point/pain ask about wear at each visit
Dynamical systems theory
views the development of motor skills as emerging from the interactions of many subsystems within a specific task
Veracity, which is based on the
virtues of truthfulness candor honesty
The self-concept as it relates to participation in a particular occupation and evolves through adolescences and young adulthood is termed
vocational self-concept
Factors influencing the retirement experience
voluntary or forced personal satisfaction -health, income, attitudes, and preparedness
Apoptosis is actualy a process of
waste removal
When is an embroyo considered a fetus?
when it developes human characteristics