Final Exam Adolescent

vestibular exercise: adaptation

-fosters central reprogramming for gaze stabilization

vestibular exercises: habituation

-getting your body to stop responding in noxious ways to a non-noxious stimulus - orbital swings, motion

stage 2:return to learn protocol

-gradual increase in subsymptom threhold for cognitive activities : add back in above activities at a time

stage 1: return to play

-gradual reintroduction to school/home activity : daily activities that do not provoke symptoms

response to intervention process

-identify & define problem - analyze problem 2 hypothesize causes - establish student centered performance goal - establish intervention plan and system monitoring progress -evaluate progress using performance data

marcias 4 stages of identity

-identity diffusion -moratorium -identity foreclosure -identity achievement

IDEA and IEP laws end when a child turns:

22

6 steps taken in interpersonal reasoning

1. anticipate 2. identify and cope 3. determine if mode shift is required 4. choose a response or mode sequence 5. draw on any relevant interpersonal skills associated with modes 6. gather feedback

FAPE (Free Appropriate Public Education)

1. meet the standards of SEA 2. be provided at public expense 3. be under public supervision and direction 4. include appropriate education at all levels (preschool, elementary and secondary) 5. be provided in accordence with childs IEP

goals of IRM

1. use of therapeutic relationship to promote client engagement in occupations 2. use of interpersonal reasoning to cope with challenges 3. develop client-therapist relationship

what three things should client-therapist intervention encompass?

1. value 2.foundations 3. ethics

promotion of positive mental health

1.Competence ( social/emotional, leisure, work skills) 2.Resilience (coping) 3.Social System modifications/supports ( social environments to support mental health) 4.Empowerment ( enhancing childrens' control over their own mental health)

moratorium

1.Early and Middle Adolescence. Active exploration and developing a sense of identity is occurring

identity achievement

1.Late Adolescence. Comes about through the resolution of self exploration and experimentation to create a coherence between a person's self identity and their self expression and behaviors

identity diffusion

1.Seen in Early Adolescence. A poorly defined sense of self identity. I.e unable to establish any type of goals/values

identity foreclosure

1.State where it appears person has achieved self identity, but in reality they have avoided the key ingredients of self exploration and experimentation. I.e doesn't question things and do them as expected by parents or society

puberty girls

8-13 first period usually between 9-13

preadolescence development

9-12 (tweens)

ADHD and excutive dysfunction

90% of children struggle with executive dysfunction

top down motor assessments ex

AMPS, school-AMPS

RESNA certifications

ATP, SMS

Education about social skills is critical for the person who is transitioning, which of the following is appropriate to teach?

Accepting suggestions The difference between public and private locations Using appropriate greeting

Assitive technology def

"Any item, piece of equipment or product system whether acquired commercially off the shelf, modified, or customized that is used to increase or improve functional capabilities of individuals with disabilities."

special ed process

-EI - referral -evaluation -eligibility -IEP: within 30 days IEP put in place -services -annual re eval

role of OT in adolescent work

-Focus on skills and behaviors needed to full fill worker role. -Assist in creating an occupational identity. This looks at interests, values, and abilities of the adolescent, and identifies careers that fit -OT can educate employers regarding disability and possible accommodations that will be needed -Teach skills needed to navigate the work force

stage 5:return to learn protocol

-accomodations decrease as cognitive stamina increases : increase to full day of school

OT intervention SCI education

-caregivers may benefit from general ed on childs SCI - education can include autonomic dysflexia, symptoms may managemd conservatively using removal of precipitating stimulus or positioning and or pharmacology

vestibular exercises: substitution

-compensation for balance by training vision or somatosensory systems - stand on foam, eyes closed etc

otpf 4 social participation

Activities that involves social interaction with others, including family friends, peers and community members and that support social interdependence

assitive technology

Any item, piece of equipment or product system whether acquired commercially off the shelf, modified, or customized that is used to increase or improve functional capabilities of individuals with disabilities

assistive technology services

Any service that directly assists an individual with a disability in the selection, acquisition or use of an assistive technology device. •Intervention, Coaching, Adjusting

self determination examples

Arcs self determination scale, AIR self determination scale, whose life is it anyway curriculim assessment, SCOPE, VQ

tx acute stress d.o

CBT, group therapies, goal setting and achievement, biofeedback, optiism setting,

eye movement test

CISS, NSUCO eye movement test, developmental eye movement test

test for accomodation

CISS, accomodative ampltidue (near point rode)

test for binocular vision

CISS, near point of convergence (near point rod)

adhd cognitive approaches

CO-OP COG-fun CBT

3 cognitive approaches

CO-OP Cog-Fun CBT

cranial nerve 8

CONSISITS of the cochlear nerve and vestibular nerve this is why infections can impact your balance

standardized assessments used

COPM, COSA, PACS

Consideration of which of the following is critical to the treatment planning process:

How student reacts to structure vs. un-structured environments What methods of teaching have been successful Social interaction abilities

behavioral signs: high arousal

Hypervigilant Silly Noisy Intrusive Disruptive Over-reactive Frustrated easily Distractible Poor self control Overactive

high arousal behavioral signs

Hypervigilant Silly Noisy Intrusive Disruptive Over-reactive Frustrated easily Distractible Poor self control Overactive

sensation seeking AASP example

I add spice to my food

low registration AASp example

I dont get jokes as quickly as others

sensation avoiding AASP example

I only eat familiar foods

secondary transition services

IDEA mandates transition plans 16-21, plans are to include students, strengths, interests and preferences, and focus on transitioning students to adult occupations

part b IDEA

IEP must be designed to include special ed services to all students from 3-21

incomplete SCI

INDIcates that the individual maintained soem motor and sensory fnction below the level of injury

tier 3

INTERVENTION -OT evaluation process (OTPF) - observations, interviews, formal assessments in various contexts

conduct d.o

Persistent pattern of behavior with serious violation of the rights of others or rules of conduct:agrression to ppl and animals, destruction of property by fire or other ways, theft, serious violations

OTPF 4 occupation

Personalized and meaningful engagement in daily life events by a specific client

OT role ADHD adls

address perf skills needed to participate in ADLS within various environments, teach back to break tasks down encourage adolescent to express sexual expression and experiment without guilt or shame, encourage adolescents to be open with their partners about their ADJD, teach them how to stay active, regular exercise improve focus and raise levels of dopamine

role of OT ADLS

address perf skills needed to participate in ADLs within various environments, assistive tech/ adaptive equipm, environmental or task mod may be needed, teach adolescence to express sexual expression and experiment without guilt or shame

Infancy and Early Childhood family developmental factors

adequate pre post natal care nuruting r/ship w/ caregiver support for the development of new skills

OT on IEP

adl/iadl daily habits, social interacrion, employability skills, self advocacy

physical development puberty

adolescent gains 50% of their adult weight and 20% of their adult height, bones longer and wider, muscles stronger, 80% adolescences suffer from acne, adolescents have to integrate all these physical and physiological changes in a health self image

no tech and low tech AT

allows the student to function in their environmnet as naturally as possible

referential delusions

also common . Think that certain gestures and words from others are directed at them. Believe that people on television are sending special messages to them is a common referential delusion.

compassion fatigue

aka caregiver burnout, characterized by a state of physical, emotional and mental exhaustation in response to the unending demands of caring for a dependent family member. may experience fatigue, strss anxiety, or irritability.

prism

bens or alters the direction of the ligthentering the eyes. not designed to eliminate the vertical deviation, comepnsatory approach

adaptive measures

beyond identifying a deficit

comphrensive assessment for interoceptive awareness

body states and emotions, gain information about interoceptive awareness by interview, assessment of self regulation and the caregiver questionnaire for interoceptive awareness 3- late adulthood

a point where the client attempts to inquire about therapists personal information or makes physical advances

boundary testing

concussion systems for recovery

cardiovascular threhold and exercise tolerance, oculomotor and vestibular function, behavioral/cognitive, cervical/spinal

systems for recovery:concussion

cardiovascular threshold and exercise tolerance, oculomotor and vestibular function, behavioral/cognitive, cervical/spinal

employment skills emerging evidence intervention

career exploration, least to most prompting

OT intervention TBI education

caregiveres may benefit from general ed on brain injury including how arousal acceptiance of stimulation an dbody movements are impacting their child.

preparation phase

caregivers are taking steps toward change, OT can validate their choice, enoucrage small steps and guide caregivers2 identify barriers

maintenance

caregivers sustaining their changes on a regular basis. OT can congradulate caregivers on their success creating a new routine and support their ability to stay on track

adaptive measure examples

casey life skills assesment, GOALS, REAL

TBI

caused by external force

dyspraxia: developmental coordination disorder DCD

causes difficulty with motor learning, motor planning difficulty

cervical/spinal symptoms concussion

cericogenic dizziness, decreased neck stability, activation of deep neck flexors, suboccipital spasms

cervical/spinal concussion

cervicogenic dizziness, decreased neck stability / activation of deep neck flexors, suboccipital spasms

dx mental d.o common warning signs

change in sleep-more or less than usually needed, change in weight-gain or loss, change in mood or attn, feeling not normal - lab tests- blood, urine, drugs and alcohol, brain imaging CT MRI FMRI SPECt PET

IDEA D working document

changes over time

maladaptive coping

characterized by an external locus of control, worry, magical thinking (wishing problems would just go away), denial, blaming oneself or others, use of escape, and avoidance stratefies (over eating, over driniing smoking or medication).

example of academic emerging evidence interventions

computer assisted instruction

hi tech example

computer, processor, digital based

Hi tech AT

computer/processor/digital based

stratgeic networks action and expression

activate the how network in our heads that allows us to take info and transition it into something meaningful, is it working? different ways students can demonstrate their learning

active networks engagement

activate the why networks in our heads which is the part of our brain that makes us question things, ways of engaging learners by providing both groups and individuals to work throughout a course, design opportunities for enaggement and discussion online and face2face

education

activities involving learning and participating in educational environment, teens life can be full of drama and worry which impacts education

health management

activities related to developing, managing and maintaining health and wellness routines, including self management, with the goal of improving or maintaining health to support participation in other occupations

ADLS

activities that are oriented toward taking care of our own body, they are routine activities people do everyday without assistance

social participation otpf4

activities that involves social interaction with other including family, friends, peers and community members and that support social interdependence

IADLS

activities that support life in the community and within the home -chores, driving/public transportation, health management

HAAT- A

activity, meaning of activity, occupational performance, operational competence, co-occupation

tier 3

actual intervention - strategies ex. -development of individual interests and leisure participation - specific environment modifications by taking into account individual factors including sensory processing, cognition and physical factors - Individualized coping strategies - foster meaningful relationships

sustained atten and working memory

adapt environment, provide opportunities for repeated asynchronous input, annotating, attn to cues, checking in, study buddy or note friend, ensuring optimal arousal

vestibular exercises concussion

adaptation, substitution, habituation

stage 3:return to play

add movement : running, vestibular and oculomotor exercises, may start using weights

HAAT human aspect

lifespan perspective, novice vs expert, roles-obligations, routines, habits and occupations

stage 2: return to play aim

light aerobic activity PT/OT visit 1

avoidance behaviors trauma occ perf

limit occupational participation

inability to continue treatment due to some outside force

limitations of therapy

RANCHO level of cog functioning 3 (III)

localized response demonstrates localized responses to external stimuli may follow some basic commands

head array

look to direction to move

compression, distraction test and alar ligament test

looking for symptom production, resolution

moderate brain injury

loss of conscioueness from 30 mins to 24 hours, glaslow coma scale score 9-12,

severe brain injury

loss of consciouness lasting more than 24 hours, glasgow coma scale btw 3-8 -experience autonomic storming

psychological and emotional challenges

loss of control of basic physical functions, inability to participate in activities that give sense of achievement, disruption of cherished roles, loss of self esteem

psychosocial concerns with physical disability

loss of independence, sense of helplessness, lack of privacy, changes to role and or lifestyle, uncertanity regarding the future, changes in functional ability, changes in body image

RANCHO level of cog functioning 6 (VII

confused, appropritate demonstrates confusion due to memory deficits follows daily routines with supervision or minimal verbal cues exhibits imporved attention to functional tasks, easily distracted by environmental stimuli, emerging insight into physical deficits impulsive with actions and speech

RANCHO level of cog functioning 5 (VI)

confused, inappropriate, nonagitated demonstrates continued confusion needs step by step instructions for completion of self care skills tends to preserverate on certain ideas or actions

RANCHO level of cog functioning 4 (V)

confused,agitated demonstrates confusion and agitation begins to participate in more basic activities of daily living with maximal assitance

netowrk

connect with others implementing transition program, national, state

factors related to positive adaptation

coping, locus control, social support, gaining knowledge and communicating, generativity, resilience

concussion: cardiovascular impact school

decrease cerebrospinal fluid flow to brain and BP regulation after concussion, higher incidience of orthostatic hypotension

When should transition planning begin

middle school

cardiovascular concussion impact school

decreased CSF flow to brain and BP regulation after concussion, higher incidience of orthostatic hypotension

behavioral/cognitive concussion

decreased attention, decreased dual tasking, increased irritability, poor school performance, change in sleep patterns

behavioral/cognitive symptoms concussion

decreased attention, decreased dual tasking, increased irritability, poor school performance, change in sleep patterns

calming sensations

decreases arousal •Familiar •Soothing •Gentle •Simple •Predictable or routine •Warm Slow

calming sensations

decreases arousal •Familiar •Soothing •Gentle •Simple •Predictable or routine •Warm •Slow

deep second degree burn

deep partial thickeness, dermis: deeper reticular region relatively painless, white, leathery, signfific contact withburn agent

mild brain injury

defined as a loss of consciousness for less than 30 minutes, glasgow coma scale of 13-15, post traumatic amnesia that lasts for less than 24 hrs

transtheoretical model

defines 6 stages that can be applied to the process of accepting the sequelae of the traumatic event and becoming ready to change behavior in order to manage the new condition

positive symptoms schizophrenia

delusions and hallucinations

key features present schizophrenia

delusions, hallucinations, disorganized thinking and speech, negative symptoms

model

demonstrate what OT can do, share success

term child with a disability

demonstrates developmental delays as defined by the state and as measured by appropriate diagnostic instruments and procedures in one or more of the following areas: physical, cogntive, communication, social/emotional, adaptive, etc.

who pays for AT

depends on technology, use and user : school systems, private health, rehab and job training programs, employers

who pays for AT

depends on technology, use, user ex: schools, private health insurance, rehab and job training programs, employers

cognitive behavioral strategies to support a safe and social state

mindful techniques: breath and HR monitoring - zones of regulation, how does your engine run, jounraling, art, all work better when theres a level of regulation

psychiatric conditions associated with physical disability

depression, anxiety, PTSD, substance abuse, suicidal ideation

psychological trauma

depression, anxiety, suicide, hallucination

second degree burn

dermins: superficisla particla thickness superfical: papillary region -pain blistering swelling brief contact with burn agent

tier 1 interventions

mindfullness based cognitive therapy to run stress management program to prevent anxiety and promote mentalhealth for all 6th graders while tracking and monitoring progress, educate teachers movement breaks

identify body cues

draw attn to the body part of focus, increase sensory cues, start with easier body paet, practice

sleep symptoms of concussion

drowsiness, sleeping less, sleeping more, trouble falling asleep

GOAL

evaluation of fundamental motor abilities needed for daily living. 7-17 years consists of 7 activities, dynamic functional tasks that are markers for important activities of a child's daily life.

OSA

evaluation tool and an outcome measure tool based on MOHO/ designed to capture clients perception of their occupational competence and of their own occupational competence and of the occupations they consider important.

hyperactivity/impulsivity adhd

fidgets with hands or feet, squirms, exaggerated emotions, hyperfocus, often runs about or climbs, talks a lot, weak impulse control, difficulty awaiting turn interrupts or intrudes on others, executive function deficits

deep second degree burn example

fire, significant contact with scalding water, friction ex contact with moving treadmill

vestibular system

first sensory system to develop en utero,

ways to demonstrate their learning

flexibility in choices, videos, role play, poster boards, in class or pre record presentation, provide opportunities for feedback and revision of coursework thruout clas

seating using pressure relieving

foam, air, gel, combo

AT promote movement

mobility accessibility, seating ex: wheelchair

postulates regarding change: sensory integration

modulation, posture, discrimination, praxis challenges w graded support from therapist provides sensory opportunities specific to child responsivity challenge therapist utilizes principles from sensory integration shares the sensory experience and varies affect, tone and volume based on childs sensory responsivity pattern ongoing postural challenges encourages repeated opportunities

postulates regarding change: sensory integration

modulation, posture, discrimination, praxis challenges, provides sensory opportunities specific to the childs responsivity challenge, therapist utilize principles from sensory integration

role of OT promoting healthy self identity

module use of appropriate first person language, avoid emotional language, assist adolescent to identify their genders, abilities, interests and positive qualitites that should be the primary characteristics of their self identity

HAAT- context

more inclusionary concept than environment, physical, social, cltural, institutional

HAAT context

more inclusionary concept than environment: physical, social, cultural, institutional

motor cycle incident

most common cause of pediatric SCI

convergence insuficiency

most common nonstrabismis binocular vision d.o OT encounter. eyes drift outward when being used for near work such a reading but at far distance they work well

schizophrenia is

most common psychotic d.o

push assist w.c

most common push manual wheechair, turns on and piushes you further, makes easier to proper

persecutory delusions

most common type of delusions Believes being harmed or harassed by another person or group, such as the government. May believe others are stealing from them or mocking them in some way. Friends and family may describe the person who is experiencing this type of delusion as "paranoid."

oculomotor and vestibular symptoms concussion

most commonly results in decrease gaze stabilization, convergence insufficiency, accomodation difficulties, BPPV

ocular motor and vestivular concussion

most commonly results in decrease in gaze stabilization, convergence insufficiency, accommodation difficulties, BPPV

self awareness and insight

name the emotion, understand the trigger, brainstorm alt responsel, zones of regulation

myopia

nearsightedness I cannot see the tv

a client who feels the need to take the session into their own direction is an example of

need for control

role of OT social participation

need to understand the interaction btw teen and their environ,ent, address skills needed to participate in social situation, make accommodations if possible, education teach teens how to handle peer pressure in healthy way

ADHD

neurological d.o that impacts the parts of the brain that help us plan, focus on and execute tasks

executive function skills definition

neuropsychological concept referring to the cognitive processes required to plan and direct activities, including task initiation and follow through, working memory, sustained attention, performance monitoring, inhibition of impulses, and goal-directed persistence

executive functions

neuropsychological concept referring to the cognitive processes required to plan and direct activities, including task initiation and follow through, working memory, sustained attention, performance monitoring, inhibition of impulses, and goal-directed persistence

stage 1:

no activity

RANCHO level of cog functioning 1 (I)

no response demonstrates no response to external stimuli

Universal design 4th AT category

non traditional AT -accessibility features of smartphone -tablet apps -internet of things - google home/alexa/siri

stage 4: return to play aim

non-contact training drills PT/OT visit 3

therapists ability to pick up on what isn't being said

non-verbal cues

stage 6return to play

normal game play

coping inventory

observation instrument used to assess the behavior patterns and skills that are resources a child uses to meet personal needs and to adapt to the demands of the environment. analysis of the child's coping inventory scores provides info about level of effectiveness, general coping style and specific resources and vulnerabilities

how to assess execugtive function skills

observations data gathering work based testing standardized checklists

how to assess executive function (EF) skills

observations, data gathering, work baeed setting, standardized checklist,brief, childrens kitchen task assessment

early adolescence characterist

obsessed with self, emotionally separate from parents, less family participation, less affection to parents, challenge rules, mood/behavior swings, same gender f/ships, abstract thinking, may experiment with drugs and alcohol

students primary object in school

obtain an education

OT tri annual evams

occ profile, analysis of occupational performance, student strengths, preferences and interestsadl/ia

occupational profile contribution

occupationals, values, interests, QOL, strengths

interventions to consider for STP

occupations, activities, AT, education, training, self-advocacy, groups

autonomic storming

occurs in some children with brain injury and presents as cyclic symptoms that occur after a severe insult to the brain

hearing impairments

occurs when you lose part or all of your ability to hear, other terms are used to refer to hearing impairment such as deaf and hard of hearing

persistent avoidance

of triggers trhat elicit a flashback

commercial

off the shelf

commercial AT

off the shelf

engagement

offer choices to improve interest and autonomy, encourage risk taking

diverse ways ot presenting info to students

offer text, visual, aural info, reading videos, visual inforgraphs,

role of OT work adolescence

focus on skills and behaviors needed to fullfill worker role, assist in creating an occupational identity, interests, values, and abilities of the adolescent and identifies careers that fit, educate employeers regarding disability and possible accomodations that will be needed, teach skills needed to navigate the work force

scooter tiller controlled power w.c

outdoor commonly mobility, seen in walmart, need to have functional ability UE, no posutral support, long wheelbase cannot navigate thru small spaces

OT focus intervention physical abilities

personal strengths and capitalizing on their personal qualities nd life experience in ways beyond ones compromised physica abilities

transition interventions: occupations

participation in a community activiity

social pre (tween)adolescent development

peer groups talking joking physical appearance expresses themself shares less video games cooperative less impuslve able to regulate

social aspect tweens

peer groups predominates this age groups social information, talking and joking, express themselves thru clothes in name brand clothing, shafre less and less of themselves with adults, video games and social media

MD no tech low tech devices

pencil grips, book holders, slant boards, modified feeding utensils, lap trays, page fluffers

CP low tech devices

pencil grips, slant boards, teacher handouts, modified utensils, lap trays, book holders

low technology example

pencil grips, slanted writing surface, calculator with large switches, wheelchair tray, adapted paper, seating systems

accomodation exercises

pencil jumps, one eye patched, holding one image up close, one at short distance wait at each distance for image to refoce, spot the differenc epictures

cerebral palsy CP

peramenent damage to the brain which disrupts the brains ability to control mvmt and maintain posture and balance

locus of control

perception that one has a degree of control regarding a certain life situation (internal locus of control) and an acgtive, flexible, problem focused form of cognitive and behavioral coping style is thought to have a positive impact on rehabilitation outcome, self care, caregiver coping, psychosocial and emotional adaptation and self esteem

adolescence development

period btw 13 and 19

occupation

personalized and meaningful engagement in daily life events by a specific client

health management role of OT

focus on skills and behaviors needed to maintain healthy and wellness routine, assist with medication management, communicate with dr, obtain needs and administer correctly, educate adolescents on their disability and ways to manage symptoms, teach skills needed to maintain a physical, mental and social wellness

role of OT education

focus on teens strengths to design and implement programs to improve performance in various areas, educate educators and other disciplines, design learning, teach teens to advocate for themselvea

IDEA A results (outcome) oriented proecess

focused on improving the academic and functional achievement of the child with a disability to facilitate the childs movement from school to post school activities, measurable goals

decisional conflict

focuses on decision making process while under stress. examines the inner conflict that can occur based on the dynamic stressors and resources available to address the problem

meaning and purpose in

focusing on positive, retaining itnerests, values, skill, acquiring new roles, making new friends etc

ultra light weight w.c

fold wheel pop off, commonly seen in SCI, spinal cord injuries- propels efficiently strong upper extremeity need back bc power breaks down

standard w/ch

folds, general mobility, heavy to manage, not meant to be permanent, nursing home

activities

form of action that is objective and not related to a specific clients engagement or context

vestibular exercises: adaptation

fosters central reprogramming for gaze stabilization

non commercial

handmade

non-commercial AT

handmade

MD impact on school based performance

handwriting skills, sitting posture, ambulation, transitions, meal time, manipulatives

spinal cord injury SCI

happens when a spinal cord tissue is bruised or torn by traumatic or nontraumatic means

refrative error tx

glasses

binocular vision problems tx

glassess ac/a

accomodative problems tx

glassess bifocal lenses] vision therapy

CO-OP Approach use with adolescents with ADHD:

goal plan do check

txmethods adolescents star for

goal identification, guided sensory exploration, playfulness co regulation, self regulation strategies, advocacy, collab with parents partners friends, sensory lifestyle planner

CO-OP adhd

goal, plan, do, check

stage 5

gradual reintegration to school

stage 2

gradual reintroduction to cognitive activity

ADHD mid-high tech devices

graphic organizers on ppt, google dribe folders and calenders, speech to text software

examples of academic research based interventions

graphic organizers, self management

CP impact on school based performance

graphomotor skills, toileting, feeding, transitions, transfers

muscular dystrophy MD

group of diseases that cause progressive weakness and loss of muscle mass

decisional conflict mode highlights

he emotionally charged inner struggle that many of the caregvers of children who have been traumatically injuried are facing when asked to identify goal ares for children.

physical symptoms of concussion

headache neck pain, nausea, vomitting, balance problems, dizziness, sensitivity to light or noise, numbness, tingling

physical symptoms of concussion

headache neck pain, nausea, vomitting, balance problems, dizziness, sensitivity to light or noise, numbness/tingling

most common symptoms of concussion

headache, neck pain, nausea, dizziness

eye health

health of all compinents of the visual system from th eye to the brain

medical trauma

heart dz, chronic pain, respiratory d.o, cancer, STD

benefience

heloijng others, prevent harm, protect rights of others

3 main components of polyvagal theory (Pvt)

hierarchy, neuroception, coregulation

response to RTI intervention

identify and define problem -analyze establish student centered performance goal - establish an intervention plan and system for monitoring progress -implement plan and monitor progress, evaluate progress using performance data

occupational science OTPF 4

identify as an aspect of context and outcome of intervention -occ justice and injustice -identify, time use, satisfaction, engagement, performance

low registration AASP

identify behaviors such as missing stimuli or slowed responses

interoceptive process

identify body cues, connect emotion, act self regulate

vision rehab

identify problem - fixation, smooth pursuits, saccades, accomodation, convergencw

sensation avoiding AASP

identify responses and behaviors such as deliberate acts to reduce or prevent exposure to sensory stimuli and efforts to make exposure predictable

sensation seeking AASP

identify responses and characteristics such as enjoyment, creativity, and the pursuit

sensory sensitivity AASP

identify responses such as noticing behacviors, districtability, and discomfort with sensory stimuli

marcias 4 stages of identity

identity diffusion moratorium identity foreclosure identity achievement

comphrensive tx is key

if all pillars are not addressed the patient will not get better, typical length of tx for post concussion syndrome 4-12 weeks but high variable dependent on number of systems impacted

concussion: cervical posture impact school

if muscles are in spams-leads to poor posture or headaches leads to decreased focus

cervical posture concussion impact school

if muscles are in spasms leads to poor posutre or headaches leads to decreased focus

strategies for promoting positive mental health

positive emotions making connections nurturing strengths mental health literacy physical activity emotional literacy positive thinking fostering kindness

startegies promote positive mental health

positive emotions, making connections, nuturing strengths, mental health literacy, physical activity, emotional lit, positive thinking, fostering kindness

autonomic nervous system

if vestibular system is overloaded: pale, sweaty, nauseous BP changes- throwing up gives deep proprioception which can reset the systems - step off curb unexpectedly then your feel yourself gasp extend your leg to catch yourself, heart races palm get sweaty

autonomic nervous system

if vestivular is overloaded, pale, sweaty, nauseous, BP changes, throwing up givies deep proprioception which can reset the system

executive functions

impact the ability to focus, organize, use working memory and other executive skills

cerebral cortex

important for memory and learning

best practice OT service provision

in natural school contexts including classroom, recess, cafe, afterschool setting

hearing impairments impact on school based performance

inability to focus (miss important info) take notes at an appropriate speed, social communication

mid tech and high tech

increase in complexity and may require a higher level of student support for care, programming, up-keep and use

primary goals IDEA 2004

increase the focus of educatgion on results, prevention of problems through ealry intervening services and improvement of students acdemic achievement, functional outcomes and post secondary success

IDEA goals

increase the focus of education on results, prevention of problems through EI, functional outcomes,improvement of students academic success, postsecondary education

alerting sensations

increases arousal •New •Complex •Stimulating •Intense •Surprising or unpredictable •Cold Quick

alerting sensations

increases arousal, new, complex, stimulating, intense, surprising or unpredictable, cold, quick

prefrontal lobe

increases development, leads to ability for abstract reasoning, processing, speed, and response inhibition

adolescence fables

indestructible, unrealistic, exaggerate

intervention mental health (

individual

COPM

individualized measure of a clients self perception in occupational performance.

Vineland Adaptive Behavior Scales (VABS)

individuall administered measure of adaptive behavior for ages birth -90.

TVPS

individually administered assessment of two dimensional visual perceptual skills for individuals 5-21. assesses visual percetual abitlities requiring a motor response and is designed for both diagnositc and research purposes

providing education and training as well as feedback on performance

instructing

3 mandation areas IDEA, IEPs

instruction community experiences employment and other post school living objectives

IDEA C includes

instruction, related services, community experiences, the development of employment and other post school adult living objectives and when appropriate, acquistion of daily living skills and functional vocational evaluation

sensory regulation

intakes/snacks/beverages, lighting, seating.posture, movement opportunities

IDEA eligibility

intellectual disability, hearing impairment (deaf), visual impairment, speech/language, orthopedic, autism, TBI, specific learning disability, serious emotional disturbance, deaf-blindness

adolescent period characterized by

intense physical growth, physiologic maturation aka puberty, psychosocial development

tier 3

intensive individual intervention 5% students

RESNA: rehabilitation engineering and assistive technology society of north america

interdisciplinary professional association whose activities focus on AT

RESNA

interdisciplinary professional association whose activities focus on AT ATP-broad based At certification, SMS- seating, positoning, mobility focused

VOMS

internal consistency as well as sensitivity in identifying patients with concussions, and is quick and cheap to administer. It is still a single component of a comprehensive approach to the assessment of concussions

VOMS

internal consistency as well as sensitivity in identifying patients with concussions, and is quick and cheap to administer. It is still a single component of a comprehensive approach to the assessment of concussions.

interoception

internal detection of changes in one's internal organs thru specific sensory receptios (to be aware of, for example hunger thrist digestion state of alertness)

reactive attachment d.o

internalizing behaviors -depression and inhibited social withdrawl (R/O ASD) -high co-occurence of cognitive delays due to neglect

interoception and self regulation

interoception provides the MOTIVATION for purposeful self regulation

interoception assessments

interoceptive awareness assessment, MAIA-2, body perception questionnarie, clinical observations

Tier 3

intervention -OT evaluation process (OTPF) - observations, interviews, formal assessments in various contexts

disclosing personal info

intimate self-disclosure

IEP

legally documents the childs educational needs, also documents the individualized set of supports and services determined to be appropriate by special education team to allow the student to benefit from his or her education and participation in school

role of OT leisure/play

leisure checklist to identify interests and assist in increased leisure participation, community education, identifying resources for teens and families, identify community programs for teens and families, develop teens skills needed for social and leisure participation,

Explain the biological and environmental factors specific to adolescence that impact emotional regulation/dysregulation.

less connectivity btw amygdala and prefrontal cortex

pursuits

lets go fishin, visiontap ipad, v

saccades

letter chart , ann arbor letter and symbol tracking

secondary to adulthood transition

life beyond graduation, college, training programs, alt educational programs, vocational skills focus

physical signs: high arousal

tense, hyperactive, fidgety, shifting gaze, shallow breathing, fast heart rate, increased nrg, sleeplessness, physcial shutdown

BESS balance error scoring scale

test to measure balance

panic d.o

the presence of recurrent and unpredictable panic attacks,which are distinct episodes of intense fear and discomfort associated with a variety of physical

recognition networks

the what part of learning, presentation

affective networks

the why part of learning, engagment

reticular formation

regulates sleep/wake cycles and self regulatory systems

STAR theoretical base

regulation r/ships sensory integration

STAR FOR theoretical base

regulation, RELATIONSHIPS, sensory integration

brainstems reticular formation

regulations sleep/wake cycles and self regulatory system

stress management

relaxation, affirmations, transition rituals

just right arousal

relaxed, happy, content, safe, curious, open

DTVP -adolescent and adult

scale standardized for use with individuals from 4-12 assessing visual perceptual skills in adolescents and adults.

transition interventions: groups

school group addressing time management skills

procurement process

school psychologist open case, entire IEP team involves, parent sign consent prior, AT team member evaluate student must have specialized training from AT team but does not need AT professional, trial period best fit, evaluate if student performance improved or not, issued only if student and team provides obkective feedback of performance enhancement in classroom

stage 4

school re-entry

postulates regarding change: r/ship

therapist attunes to child establishes trust with parent therapist collab with parent therapist supports the childs engagement and re/ship w. significant others follows child lead

postulates regarding change: relationships

therapist attunes to the child, establishes trust with the parent, collab with parent, therapist supports the childs engageemnt and relationship with signfic others, follows childs lead

Ef: planning deficit

these students tend to wait until the LAST MINUTE to complete tasks and then do not know what to do when they go to complete them

dyspraxia impact on school base performance

tying shoe laces, graphomotor skills, organizational difficulty, feeding

late adolescence characteristics

sense of self becomes more stable, able to stick to their opinions values and beliefs, strengthen r.ship with parents, increased interest in future, consider current actions in relation to future, increasd self confidence in regards to body image, develop value system becomes more stabel

symptoms of anxiety

sensivitity of noise, dry mouth, diff swallowing, palpitations, headache, poor concentratin, tremor

thalamus

sensory integration center and dx auditory, visual, tactile and gustaroy info

thalamus

sensory integration center and giagnoses auditory,visual, tactile, and gustatory info

sensory processing and integration assessments

sensory processing 3 dimensions scales, non standardizied admin of SIPT, motor or functional skill assessments GOAL, COMPs, auditory processing screening tools TAPS-4, MVPT, VMI, DVPT, interoceptive awareness assessment, MAIA-2

secondary transition planning transition assessment is

separate from tri annual eligibility

biochemistry risk factor major depressive d.o

serotonin and norepinephrine might play a role

change in occ domain

sexual activity health managment social participation

changes in occupational domain

sexual activity, health management, social participation

social participation

social activities, friendships, and the behaviors and roles needed to participate in these activities and relationships, peer pressure, fit in

OT professional should promote

social connections and partciipation in the community thru family and peer relationships, leisure activities and employment opportunities

oppositional defiant d.o tx

social learning psychotherapeutic efforts CBT, parent training, family therapy, collab problem solving modest success

social participation assessment

social profile: assessment of social participation in children, adolescents, and adults, ACIS, BaFPE

example of employment skills research based interventions

social skills instruction, simulation

balance triad

somatosensory/proprioception, vestibular input, visual input

cornerstones

something of great importance on whic everything else depends, core values and beliefs roots in occupation, knowledge and expertise in therapetuic, professional behaviors and dispotions, TUOS

OTPF cornerstones

something of great importance on which everything else is depends - core values and beliefs rooted in occupation - knowledge and expertise in therapeutic use of self -profess behaviors and dispositions

secondary transition planning SMART goals

specific, measurable, attainable, relevant, time bounde

stage 3: return to play aim

sport specfiic exercises PT/OT visit 2

organizing sensations

stabilizing arousal •Grounding •Focusing •Settling •Interesting •Variable •Long-lasting •Alerting & calming properties

organzing sensations

stabilizing arousal, grounding, focusing, settling, interesting, variable, long lasting, alerting and calming properties

termination

stage of readiness to be considered

transition is a backwards design process

start at the end occupation based intervention plan, use appropriate assesment tools, students vision

create attainable prof goals

start with few students, think holistically for all students, seek out info

identity foreclosure

state where it appears person has achieved self identitiy, but in reality they have avoided the key ingredients of self exploration and experimentation

relaxation strategies psychosocial conerns with physical disabiltiy

stress management- breathing, progressive muscle relaxation, autogenic techniques, and or guided imagery to promote state of calm

nontraumatic brain injuries causes

stroke, anoxia, arteriovenous malformation rupture, brain tumor resection, seizure activity, seizure foci resection, infections such as meningitis or encephalitis, metabolic d.oq

planning, prioritizing and time management

tasks appear farther away than they really are, balancing multiple takss, agendas, planner, calendars, apps, color coded scheduling time blocking, sequencing, backward design planning, break down into smalles, time logs, distraction subtraction

What is ots contribution to helping the mental health community?

teach coping, find meaningful occupations that support positive mental health, using ourselves as a therapeutic tool, we take into consideration the person environment and context

examples of community based instruction CBI

teach discrete skills such as turn taking, teaching students to use emotions as a guide, identify signs of impeding emotional stress

hearing impairments no tech/low tech

teacher handouts, books on tape, graphic organizers, tape recorded instructions, visual cues

examples of strategies for executive function skills

teaching deficient skills minimum support for maximum success incentives be consistent

facilitators for healthy adolescent development

positive supportive family, good role models, supportive well adjusted peer group, supportive educational setting, positive and available adults in their lives, mentors, membership in desirable social group

deficit model

reduces a client to a passive participation, task based and prep focused, confines OT to traditional roles in motor and sensory therapy, fixes student, creates gaps

self advocacy psychosocial concerns with physical disability

reducing stigma and misunderstanding- developing knowledge or rights and skills to advocate for full inclusion

early intervening process prek-12

referral, eval, eligibility, IEP, services, annual review.re-evali

stagnation

refers to ones failure to find a wa to contribute, which may cause a person to feel unproductive, disconnected, or uninvolved with others, their community or society in general

transition intervention: advocacy and self advocacy

teaching students to request reasonable accomodations

person centered planning (PCP)

team concerned with students future in tx planning process, process must be individualized, current placement, resources reqauired for success in LRE, realistic goals, performance in speed and general ed classroom

repair and replacement of device

team is responsible for repair, if lost or stolent IEP must file police report,

major depressive d.o risk factors

temperament, environmnet, genetics, biochemistry

tx of visual processing

vision therapy

eye movement tx

vision therapy tx of choice

visual integrity

visual acuity, refractive error, eye health

visual spatial skills

visual motor sheet aware of l and r of ones own body

visual info processing

visual spatial, visual analysis, visual motor integration

self advocacy and confidence building

volunteering, working at home and receiving payment for chores, participating in IEPs and decision making, including teen in budgeting own money

transition goals drive interventions

wants to work at a bakery, live alone or with a rommate in an apartment, collect monster high dolls

teach students to identify signs of impeding empotions stress

when upset at jobsit student learns to politely excuse themselves for a break to leave a stressful social interaction

contextual self identity component

where and how do I fit in? what allows a person to understand their values, beliefs, interests, and social norms for the roles they are in, such as friend, employee, student, daughter/son

self identitiy: contextual component

where and how do i fit in -What allows person to understand their values, beliefs, interests, and social norms for the roles they are in, such as friend, employee, student, daughter/son.

individualistic self identiy

who am I? this is a person's self concept

self identit individualistic component

who am i this is a persons self concept

recognize Ot role in transition

who transition age youth are in school settings

acquired physical disability

wide range of disabilities that can result from trauma or disease including but not limited to SCI, TBI, stroke, significant musculoskeletal injuries such as limb amputation, multiple trauma, burn injuries

deep second degree burn therapeutic considerations

will likely need grafting or will require heal time 3+weeks - will need PROM, scar massage , pressure orthoses, and reteaching of skills with respect to pain and temp limitations in joint ROM

3rd degree burn considerations

will need grafting, amputatrion or complex surgical intervention - may need PROM scar massage and pressure depening on nature of surgeyr - postoperative orthosis fabrication -reteaching of skills, compensatory strategies and or prothesics

2nd degree therapeutic considerations

will require heal time 1-2 weeks will need scar massage and active range of motion AROM monitor need for PROM pressure therapy and or orthoses

occupations of adolescence

work, IADLs, health management, play and lesiure, social participation, rest and sleep, education, aDLs

accomodation exercises

works best with 1 eye patched, pencil jumps, accomodation pencil push ups

ADHD impact leisure.play

•Difficulty playing or engaging in leisure activities •May have difficulty attending to or organizing a leisure activity with peers •Be constantly in motion or "on the go," or act as if "driven by a motor" •May engage in risky behaviors due to impulsivity and trying to fit in

adhd impact rest and sleep

•Difficulty sleeping and fatigue due to medication side affects •Sleep deprivation •Biological sleep patterns shift toward later times for both sleeping and waking during adolescence Trouble keeping a schedule

identifying body cues

•Draw attention to the body part of focus - increasing sensory cues •Start with easier body parts •Practice • •EX: Hands (1), Lungs (11)

adhd impact health management

•Due to poor working memory, adolescents tend to forget to take their meds, follow up with doctor visits. •Poor medication management, poor decision making about healthy nutrition higher risk of obesity, diabetes •At risk for injuries, fatal car accidents due to impulsivity

stress

•State of tension causing anxiety or worry •Stressor is a stimulus that triggers a stress response •Types of stress: acute, chronic, traumatic •Extensive research on links between trauma, stress, and disease •ACES study

substituion

•Strengthen the other sensory systems involved in balance •Standing on foam •Altering visual input with eyes closed, vision restricted glasses, eye patch, coordination

EF: working memory

•Students with this deficit tend to forget easily. They may forget their homework or books Chromebook at school or at home on a regular basis

working memory example

•Students with this deficit tend to forget easily. They may forget their homework or books Chromebook at school or at home on a regular basis

EF: sustained attention

•Students with this deficit tend to have a hard time getting started on a task. These students will get up often when a task is given. They talk to other students when they shouldn't. Their attention is on everything in the room other than their work

sustained attention example

•Students with this deficit tend to have a hard time getting started on a task. These students will get up often when a task is given. They talk to other students when they shouldn't. Their attention is on everything in the room other than their work

Infancy and Early Childhood school community factors

•Support for early learning and high quality childcare

visual analysis skills

attribute blocks, differences and similarities

client's ability to trust their therapist

capacity for trust

the client's ability to communication what they need

capacity to assert needs

stage 4:return to learn protocol

-re-entry w/accomodations as needed : part of school after being able to tolerate 2 full hrs of hw at school

stage 1:return to learn protocol

-recovery : complete cognitive rest- NO school, hw reading rexting or screen use

indirect strategies when integrating services EXAMPLES

-reframe teachers perspective -improve students skills - adapt task -adapt environment -adapt routine

objectives review

-Students who are moving from one setting to another are in transition. -provide support, client centers, occ based, top down, community based, studetnt centered, self determinatin

STAR R/SHIPS

"Human development occurs in the context of relationships..." Relationships are often disrupted with sensory challenges

relationships

"Human development occurs in the context of relationships..." Relationships are often disrupted with sensory challenges

impact of sensory processing challenging on regulation

"Modulation challenges often result in dysregulation" Sensory Over responsive Sensory under-responsive Sensory cravers

STAR regulation

"Self regulation and co-regulation are circular, causal processes...." "Only in the context of safe, attuned and co-regulated relationships can children fully realize the paradox of feeling together and becoming unique

health management otpf4

'Activities related to developing, managing, and maintaining health and wellness routines, including self-management, with the goal of improving or maintaining health to support participation in other occupations

OT intervention TBI purposeful activities

- OT introduce appropriate sensory simulation in controlled manner to evoke a localized volitional response to the environment . monitoring autonomic nervous systems response to sensory simulation can provide info on clients potential return to consciousness

emotion focused coping

(managing feelings provoked by the crisis) does not attempt to change the situation but rather focuses on changing the way the situation is attended to or altering the subjective appraisal of the situation (positive appraisal or acceptance of circumstance) and use of calming strategies for aspects of the situation that cannot be controlled.

OT burn intervention prep methods

- OT must ensure that burned areas are positioned in extension to promote future function.if bed position cannot be maintained orthoses should be used to maintain tissue length - orthoses used to protect injured or exposed body - tracheotomy- positioning neck in adeuqate extension is essential to prevent contacture and has been shown to reduce need for early reconstruction

ESEA: elementary and secondary education act

- OT: specialized instructional support personnel -Consequence of "war on poverty" designed to ensure all children have an equal opportunity to participate in and receive good education at school

typical causes of TBI

- falls, car accidents, sports related injuries, nonaccidental trauma, gunshot wounds

most common reported symptoms concussion

- headache neck pain - nausea -dizziness

therapeutic considerations 1st degre burn

- heals with few days, generally no intervention requires, monitor need for scar massage

regulations of IDEA define OT as

- improving developing or restoring functions impaired or lost thru illness injury or deprivartion - improving ability to perform task for independent funtioning when functions are imapired or lost - preventing thru early intervention initial or further impairment or loss of function - OT services can promote self help skills, sensoriomotor processing, fine motor performance, psychosocial function, and life skills training

stage 2: return to play

- increase HR : walking or stationary bike-no resistence training

stage 3: return to learn protocol

- increase cog stamina with intervals and planned rest breaks : hw in 20-30 min increments

section 504 civil rights law

- no federal funding, no consent to implement, no labels, evaluations, periodic re-eval, FAPE, 504 plan, placement/ LRE, discipline

OT intervention SCI intensive care prep methods

- pain may limit childs participation making collab with physicans on pain management very important

OT

- provides supervision for OTA and overseeing all aspects of the services provided

those diagnosed with concussion

-ALWAYS slow to get up, 71% gait ataxia, 63% clutched or shook their head, vacant stare

IADLs adolescent role of OT

-Assist Teen with taking more responsibility. -Environmental modification may be needed. -Adaptive equipment may be needed. -Teen/Family education.

middle adolescence" psychosocial development characteristics

-Continue to move toward psychological and social independence from parents -Challenge parents' authority and standards -More involvement in their peer group culture -Influence of peer groups is very powerful -Participate in formal and informal peer group activities: sports, clubs, gangs -Accept their body development -Sexual exploration with a partner: dating increases -Able to reflect their feelings and the feelings of others -Become more realistic about the future and the job/career they may want Increase risk taking behaviors -Increased creative and intellectual abilities -Experiment with drugs, alcohol and jeweling vaping/or cigarettes

health management adolescent role of OT

-Focus on skills and behaviors needed to maintain healthy and wellness routine -Assist with medication management. This looks adolescents' abilities to communicate with physician, obtain meds and administer it correctly, take it in a timely manor, identifies side affects and maintain a health diet -OT can educate adolescents on their disability/disorder and ways to manage symptoms -Teach skills needed to maintain a physical, mental and social wellness

early adolescence 11-13 development body image

-Focused on self -Self evaluate their attractiveness -Compare themselves with peers in regards to their appearance and their body shape and size -Interested in their sexual development and that of their peers -Anxious about their sexual development

dynamic visual acuity

-Functional loss of vestibular system can be assessed by dynamic visual acuity. •Read the eye chart sitting still •VOR at 2 Hz •Normal: being able to read within 2 lines of head still.

middle adolescence (14-17) body image develpment

-Have finished puberty. -Beginning to accept their bodies -Interest shifts from their appearance to grooming and enhancing their attractiveness. -This is the time where eating disorders begin and body image disorders start.

leisure play role of OT adolescent

-Leisure check list to identify interests and assist in increased leisure participation. -Community education. -Identifying recourses for teens and families -Identify community programs for teens and families. -Developing teens skills needed for social and leisure participation. -Encourage teens to join clubs they feel comfortable in

disorganized or abnomral motor behavior schizophrenia

-Movements that seem frantic, nervous, restless, or chaotic -On the opposite end, the person may be catatonic - in a daze, not moving, or speaking for hours even when asked questions

social participation adolescent role of OT

-Need to understand the interaction between the teen and their environment -Address skills needed to participate in social situations within various environments -Make accommodations if possible -Education (teach teens how to handle peer pressure in a healthy way)

psychosocial development characteristics early adolescence

-Obsessed with self -Emotionally separate from parents; less family participation. -Less affection to parents. -Challenge rules -Mood/behavior swings -Have mostly same sex friendships. Peers become paramount. -Abstract thinking -Exploration of sexual feelings -Need privacy -Cannot think beyond what they want right now. Can regulate behavior when they want -May experiment with drugs, alcohol and jeweling/vaping/or cigarettes

late adolescence psychosocial development characteristics

-Sense of self becomes more stable. Able to stick to their opinions, values, and beliefs -Strengthen relationship with parents -Increase their independence in decision making -Increased interest in the future, consider current actions in relation to their future -Increased self confidence in regards to body image -Decreased peer influence and increased confidence in personal values and their sense of self -Preference for one-to-one relationships. Start to have a serious significant other -Establish worker role and financial independence -Develop a value system that becomes more stable

acquired vestivular dysfunction

-cancer survivors, cochlear implant recipients, military blast injuries, concussions, burst ear drum, CP, vancomyocin

health management adolescence

-developing and maintaining routines for healthy physical, mental and social lifestyle promotion, engage in activities that are oriented toward taking care of own body, manage dz independently, make their own appts, understand insurance issues

stage 4return to play

-exercise, coordination increased cognitive demand :passing, trapping, throwing, dual tasking

middle/junior high to high school transition

-expectations continue to grow, teaching shifts to focus on how to approach new content and academic subjects

self identity psychosocial development

-individualistic component - contextual component

FAPE

-meet the standarfs og SEA - be provided at public expense - be under public supervision and direction - include appropriate education at all levwls -be provided in accordance with child's IEP

augmentative and alternative communication AAC

-picture exchange communication systems PECS, board maker,recorded speech, devices stores speech, pre-records speech for each symbol, device generates speech, touch screen, eye gaze, switch

how do we assess vestibular oculomotor systems?

-post rotary nystagmus test -dix hallpike test -BESS test -VOMS -King devick testing -dynamic visual acuity

IDEA

-provides funds to states and locaql school districts to meet special ed costs - every child is entitled to free and appropriate education. LRE - IEP for children 3-21 years of age with disabilities including consideration of AT - included mandated services from birth to 2 years and expanded emphasis on educationally related assitive technologies

AT 3 main categories

-seating and mobility -AAC/ communication -Computer access UD created 4th category

balance triad

-somatosensory/proprioception -vestibular input -visual input

stage 6:return to learn protocol

-you can begin the return to play protocol : resume all school wrok including testing

Every moment counts goals

1- development, implementation and eval of occupation based model programs use of enjoyable occupations to promote positrive emotions and mental health provides the founation for all the model programs and embedded strategies 2- build the capacity of OT pracitioners to strategically address the mental health needas of children and youth 3- dissemination of all of Every moment counts, embedded strategies and research outcomes

prinicples of IDEA

1. Free appropriate public education (FAPE) 2. Least restrictive environment (LRE) 3. Appropriate evaluation 4. Individualized education program 5. Parent and student participation in decision making 6. Procedural safeguards

name the six therapeutic modes

1. advocating 2. collaborating 3. empathizing 4. encouraging 5. instructing 6. problem solving

boy puberty

11-12

early adolescence

11-13 focused on self, self evaluate their attractiveness, compare themselves to peers such as body shape and size, interested in their sexual development and that of their peers, anxious about their sexual development

adolescent development

13-19 pre adolescent 9-12

middle adolescence

14-17 finished puberty, beginning to accept their bodies, interest shifts from their appearance to grooming, and enhancing their attractiveness, this is the time where eating disorders beging and body image disorders start

vestibular system

1st system todevelop in utero 28 weeks gestational age. location encased in bones.

polyvagal theory (Pvt)

2 branches of vagus nerve - ventral vagus -dorsal vagus

period of vulnerability

7-10 days post concussion full rest for no more than 48 hours beyond that increase depression, isolation

Bipolar I disorder

: manic episode with or without major depressive episode

asecret what is it

A process to develop strategies.In the moment way of approaching a sensory processing problems

Assistive Technology is any device or service that is used to:

A. Increase functional capabilities B. Maintain functional capabilities C. Improve functional capabilities

AT promote communication

AAC, augmentative devices

assessments used in adolescence

ACOPE AASP adolescent role assessment brief -a brief b COPM CAPE/ PAC child occ self assessment(COSA) comphrensive asssesment of interoception coping inventory DTVP A executive skills questionnaire GOAL OSA QOLI TVPS transition planning inventory 2 vineland adaptive behavior scales

analysis of occupational performanceq

Age appropriate standardized measures to assess:◦Functional performance of occupations.◦ADL/IADLs ◦Education and work performance◦Sleep◦Leisure◦Social Participation, health

major depressive d.o tx

Among the most treatable of mental disorders Most respond well to treatment and almost all gain some relief from their symptoms ØPsychotherapy ØMedications ØExercise ØNutrition

executive functions

An executive function is a neuropsychological concept referring to the cognitive processes required to plan and direct activities, including task initiation and follow through, working memory, sustained attention, performance monitoring, inhibition of impulses, and goal-directed persistence

personality d.o Cluster B: dramatic, emotional, erratic

Antisocial personality disorder Borderline personality disorder Histrionic personality disorder Narcissistic personality disorder

Which of the following helps to build independence for teenagers?

Attending volunteer internships Participating in IEP meetings after age 14 Participating in paid chores at home

asecret

Attention Sensation Emotion Regulation Culture Relationship Environment Task

personality d.o Cluster C: anxious & fearfulq

Avoidant personality disorder Dependent personality disorder Obsessive compulsive personality disorder

gender identity

Awareness of one's identity (including gender identity), body, and position in the reality of one's environment and of time

persistent depressive d.o (dysthymic d.o)

Chronic or long-lasting type of depression in which person's moods are low for long period of time -medications psychotherapy

acute stress d/o

Client must have been exposed to actual threatened death, serious injury, or sexual violation in one • intrusion • negative mood • dissociation • avoidance • arousal beginning or worsening after the traumatic event(s) occurred. (there are 14 symptoms listed in each category)

behavioral signs: just right arousal

Cooperative Good eye contact Focused Attentive Considerate Functioning well Good frustration tolerance

just right arousal behavioral signs

Cooperative Good eye contact Focused Attentive Considerate Functioning well Good frustration tolerance

test for visual motor

DTVMI

intellectual disabilities diagnosistc criteria

Deficits in intellectual functioning ◦Problem solving, planning, abstract reasoning, academic learning, and other intellectual functioning Test scores of two standard deviations below the mean are considered reflective of intellectual disability

flow

Describes the subjective state of consciousness where one becomes totally immersed in the occupation or task and derives satisfaction and sense of well being

STAR FOR

HEAVILY ON RELATIONSHIPS ASPECT parent centered, relationship focused, coaching, sensory based strategies, snesory integration, focus on interaction rather than activity, process vs product

shift in OT

ESSAs emphasizes on providing schoolwide systems of support and the adaoption of multiered models of service delivery

example of tier 1

EX: recommend an evidence based handwriting curriculum to be adopted by school district

identify OT in transition

Evidence based interventions for secondary transition age youth

Middle/Junior High to High School

Expectations continue to grow.◦Teaching shifts to focus on how to approach new content and academic subjects

PTSD def

Exposure to actual or threatened death, serious injury, or sexual violence by directly experiencing, witnessing the event, learning that the traumatic event happened to a close family member or friend, and experiencing repeated exposure

TBI leading cause

FALLS (elderly pop) second: car accidents

hearing impairments mid high tech

FM unit, hearing aids

stage 5: return to play

FULL CONTACT PRACTICE, rebuilding endurance and restoring confidence, following medical clearance discahrge from pt ot

adolescence work or volunteer

Facilitate the adolescent's interactions with adults on a more equal playing field. -Develops life and social skills. -Gives sense of self efficacy

positive mental health

Feeling well emotionally and doing well in everyday function

stage 3: return to learn protocol

HW AT HOME B4 school work at school, increase cognitive stamina with intervals and planned rest breaks, hw in 20-30 intervals

rstage 5: return to learn protocol

GRADUAL REINTEGRATION TO SCHOOL, accomdations decrease as cognitive stamina increases, increase to full day of school

stage 2: return to learn protocol

GRADUAL reintroduction to cognitive activitty, increase subsymptom threshold for cognitive activities, add back in above activities for 5-15 mins at a time

psychosocial functions

General mental functions, as they develop over the life span, required to understanding and constructively integrate the mental functions that lead to the formation of personal and interpersonal skills needed to establish reciprocal social interactions, in terms of both meaning and purpose

PTSD functional consequence

High levels of social, occupational, and physical disability • Considerable economic costs • Impaired functioning across social, interpersonal, developmental, educational, physical health, and occupational domains • Poor social and family relationships, work absences, lower income, lower educational and occupational success. • High levels of medical utilization

acute stress d.o functional consequences

Impaired functioning in social, interpersonal or occupational, also sleep, energy levels and capacity to attend to tasks. • Avoidance, withdrawal, and nonattendance.

identity achievement

LAte adolescence. comes about thru the resolution of self exploration and experimentation to create a coherence btw a person's self identity and their self expression and behaviors

stage 2: return to play

LIGHT AEROBIC ACTIVITY ot/pt 1, increase HR, walking or stationary bike, no resistence training

Secondary to Adulthood

Life beyond graduation.◦College, training programs, or alternate educational programs.◦Vocational skills focus

mental d.o

Mental Illnesses or Psychiatric Disorders Mental disorders are health conditions that involve changes in emotions, thinking, and/or behavior that have a significant problematic impact on a person's ability to function and engage in one or more desired daily activities.

stage 4: return to play

NON-contact training drills, pt ot 3, exercise, coordination, increased cognitive demand, passing, trapping, throwing, dual tasking

OT intervention SCI purposeful activities and occupation based interventions

OT can prevent childs anxiety about mobilitiy limitations by providing adapted call lights or other modified accessibility strategies for increases independence -adaptive equipment can also be trailed incorporated as tolerated for completion of self care activities in bed like feeding or bed baths

apply UDL principles: action and expression

OT encourages student to demonstrate his understanding of the book he read by acting it out. do a pre-record presentation, a poster/video or class presentation

transition interventions prep methods

OT issued splints, recommend visual supports, design UDL materials

example of tier 2 OT

OT might offer small group interventions during lunch or recess for students struggling with behavior management and social interaction with oeers

apply UDL principles: presentation

OT presents reading info as audio text, visual, oral info to help student undertsnads and process content

TUOS, occupationa based intervention, understanding development, activity analysis, person, task, environent

OTs unique contribution to supporting mental health in adolescence

TIER 2

PREVENTION -Screening of at risk populations -Observations, informal interviews of students and teachers, screening tools

TIER 1

PROMOTION -Systems/institutional level -What is being done? What is the quality of what is being done? -Where are the gaps? -Does the environment support successful participation and positive mental health?

personality d.o Cluster A: odd and eccentric

Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorders

STAR FOR

Parent centered Relationship focused Coaching Sensory based strategies Sensory integration DIR floortime - relationship and engagement Focus on the interaction rather than activity Process vs product Flow as paramount

Pre-School to Kindergarten

Play-based settings to academic focused

examples OT tier 1

Provide professional development training to teachers on how to address the sensory needs of their students to optimize learning and participation The OT can assist the general education team in helping students access and participate in the curriculum by paying careful attention to areas of function within their scope of practice: education, social participation, play and leisure, ADLs, IADLs, and work

stage 1: return to learn protocol

RECOVERY, no activity, complete cognitive rest, no school, hw, reading, texting, screen use

stage 6: return to learn protocol

RESUME FULL COGNITIVE LOAD, you can begin the return to play protocol, resume all school work including testing

stage6 : return to play

RETURN TO FULL COMPETITION, normal game play

stage 4: return to learn protocol

SCHOOL RE-ENTRY , re-entry with accomodations as needed, part day of school after being able to tolerate 2 full hours of hw at home

assessments OT uses for career planning

SIB-R (scales of independent behavior-revised) BRIGANCE TSI (transition skills inventory) AFLS- assessment of functional living skills ABLLS-r- assessment of basic language and learning skills-revised CASEY-life skills assessment Vineland - adaptive behavior scales

stage 3: return to play

SPORTs specific exercises pt ot 2, add movements, running, vestibular oculomotor exercises , may start using weights

stage 1 : return to play

SYMPTOM LIMITED ACTIVITY, gradual reintroduction to school, home activities, daily activities that do NOT provoke symptoms

disordered thinking and speech schizophrenia

Scattered or jumbled thoughts and speech Not thinking clearly and does not sound logical when talking May appear alert and engaged in a conversation but words and sentences are hard or impossible for a listener to follow

Elementary to Secondary

Significant changes in expectations.◦Changes from one primary teacher to one teacher per subject.◦From a smaller environment to a larger one

ASECRET

attention, sensation, emotion regulation, culture, relationship, environment, task

psychosis

Symptoms that make it very hard or impossible for a person to know what is real, to think clearly, to communicate and relate with others, and to feel normal emotions

test for visual analysis

TVPS 4, MFVP

Disruptive, Impulse-control, and Conduct Disorders

The common feature of all conditions in this category is the individual's difficulty or inability to manage hostile or disruptive impulses and behaviors as required for socially acceptable interaction.

sensory integration

The integration of sensory information is foundation to development - learning, behavior and attention

accomodation adn convergence

The most common oculomotor problems following concussion are

why are executive functions important

These skills enable us to plan, focus attention, remember instructions, manage multiple tasks and organize our behavior over time and override immediate demands in favor of longer-term goals

example of flexibility

These students have difficulty in transitions and new situations. These students struggle longer than others at the beginning of each year. They also are thrown off by changes in daily schedules. These students have limited problem solving strategies

working memory

Thinking skill that focuses on memory-in-action: the ability to remember and use relevant information while in the middle of an activity

transition in OT

Transition services for high school students with disabilities provides an opportunity for occupational therapy practitioners to finally use the full scope of practice in the school setting.

behavioral signs: low arousal

Unusually quiet Uninterested Withdrawn Preoccupied Distorted thinking Difficulty functioning Poorly oriented

low arousal behavioral signs

Unusually quiet Uninterested Withdrawn Preoccupied Distorted thinking Difficulty functioning Poorly oriented

•Our body cues tell us about how we are feeling •We have to have a pretty good understanding of our body cues to connect to our feelings

What does interoception have to do with emotions?

Interoception provides the motivation for purposeful self regulation

What does interoception have to do with self regulation?

mental health

a state in which the person is functioning effectively in their daily activities. The individual has: vProductive activities (work, school, caregiving) vHealthy relationships vAbility to adapt to change and cope with adversity

mental illness

a state in which there is a diagnosable mental disorder, separate from a physical disorder, resulting in: vSignificant changes in thinking, emotion and/or behavior vDistress and/or problems functioning in social, work or family activities

OTPF 4 activities

a form of action that is objective and not related to a specific client's engagement or context

concussion is

a type of TBI oftem described as mild TBI

behavior therapy

a type of psychotherapy that aims to help a person change his or her behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events

visual efficiency

accomodation, binocular vision, eye movement

planning

abilitiy to create a roadmap to reach a goal or to complete a task, involves being able to make decisions about whats important to focus on and what not important

visual motor integration

ability to accurately reproduce a visual stimulus

flexibility

ability to adapt to new situations, improvise, and shift strategies to meet diff types of challenges

visual analysis

ability to analyze and interpret visual stimuli

task initiation

ability to begin a task without undue procrastination, in a timely fashion

accomodation

ability to change focus form near to far objects

ADHD impact on ADLS

ability to complete activities as it can be difficult to maintain focus or attention, sexual activity/intimacy, diff paying attn during intimacy, drawn to risky behaviors

visual acuity

ability to see fine detail 20/20

response inhibition

ability to think before acting and thus resisting the urge to act out impulsively

visual spatial

ability to understand right and left on one's own body and to project that awareness into space

binocular vision

ability to use both eyes in coordinated manner

concussion: vestibular impact school

ability to walk from class to class, bend down, pick up books, tie shoes

vestibular concussion impact school

ability to walk from class to class, bend down, pick up books, tie shoes etc

switch mounts AT

ablenet, loc line, rj cooper, daessy

additional interventions to consider

academics, employment skills, life skills

most common oculomotor problems

accomodation and convergence

EF: response inhibition

adolescents with this deficit tend to be impulsive. they have weak control impulses and will say things without thinking about what it is that they are saying

ensuring the client's rights are enforced and resources are secured

advocating

client's ability to convey their emotions

affect

IEP ends at

age 22 school provide SOP (summary of performance)

part b of IDEA

ages 3-21 IEP includes specialized and related services ensured both FAPE and least restrictive environment OT

high arousal regulation

agitated, antsy, frustrated, angry anxious fearful, overexcited, manic, euphoric, panicky, overwhelmed, shut down

emotiona signs of trauma

agitation, irritability, fear, axiety, anger, depression

impact ADHD

attention/concentration memory organizational skills time management skills

cardiovascular concussion

altered BP and HR response to exercise. Drop in diastolic BP. Decreased CSF flow

cardiovascular symptoms concussion

altered BP, HR response to exercises, drop in diastolic BP, decreased CSF flow

low/no tech

analog, mechanical

low/no tech AT

analog/mechanical

teach students to use emotions as a guide

aneger when ur question is answered to the person with u as a vue to rights being ignored

oppositional defiant d.o

angry or orritable mood with argumentative, defiant, or vindictive behavior lasing 6months +

semi circular canals

anterior, posterior and horizontal - bilaterial systems

therapists use of what they know from a client's file and what they've personally observed. they use this information to plan which course of treatment is best

anticipate

pursuits

are smooth eye movements that involve following or tracking a moving target

sensation

arousal regulation, vestibular, connecteness to body , groundedness, safety sense(rollercoaster), emotional regulation, vagel system is interconnected with the vestibular system

organizing

arranging a sequence of steps to meet goals

TBI traumatic brain injury

as a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head

adolescent role assessment (ARA) purpose

assesses past history and present organization of internalized roles by providing a profile of the adolescent's role development within family, peer and social contexts adolescents with psychosocial dysfunction

role of OT IADLS

assist teen with taking more responsibility, environmental modification may be needed, adaptive equipment may be needed, teen/family education

pons and medulla oblongata (brainstem)

assists in vestibular systems role in self regulation and arousal, rotary movements equals arousal, slow linear/rhythmic movement calms down

pons and medulla (brainstem)

assists in vestibular systems role in self regulation and arousal. rotatry movement equals arousal, slow linear/rhythmic movement calsm down.

reactive attachment and disinhibited social engagement d.o

assosicated with inadequate caregiving - lack of comfort -lack of physical or safety needs met -lack of developmentall appropriate stimuli and opportunities -lack of opportunities to form attachment due to living situation (ex: high child/caregiver ratios)

interoception and relationships

attunement, coregulation, empathy, perspective taking

client factors AT

auditory, somatosensory, visual, cognition, motor control, psychosocial

RANCHO level of cog functioning 7 VII

automatic appropriate emerging independence with routine taks, functional activities poor insight into true physical deficits demonstrates inflexibility with thought processes and actions

OT intervention TBI prep methods

autonomic stomring, OT may communicate to med team whether interventions are supporig improved tolerance of therapy interventions -low simulation environmnet may promote brain healing, loud noises, bright lights, and tactile imput may oversimulate child and lead to increase agitation and bp. increased bp is dangerous to healing brain tissues

justice

awareness of law, promote fair access to OT

client's ability to maintain perspective while receiving feedback

capacity to receive feedback

inhibition

capacity to think before you act

vision development

babires born able to move their eyes, may not always be in team, babies born to only be able to see a few inches from their face

gravity

babys first experience outside the womb

life skills emerging evidence interventions

backward chainging, progressive time delay

cerebellum

balance and praxis (visual spatial memory) motor control, motor skills

cerebellum

balance and praxis (visual spatial memory), motor control and motor skills

IDEA B student centered

based on the individuals childs needs, taking into account the childs strengths, preferences and interests

childhood attachment r.ships (trauma)

basis for self regulation, a positive sense of self, the ability to trust, and feelings of being worthy of positive attention - thus supporting healthy relationships as the child grows and into adulthood

Middle childhood individual factors

behavior regulation, positive peer relationships or lack of, resilience, empathy

Nihilistic delusions

belief that a major crisis will happen or that they are doomed, dying, or already dead

grandiose delusions

belief that one has exceptional abilities, wealth, or fame

interoceptive awareness

bridge btw co regulation and self regulation

2nd degree burn example

brief contact with scalding, water or curling iron friction (Road rash)

504 disabilitiy defintion

broader than IDEa that is why individuals who do not classify under IDEA classify under 504 - physical or mental impairment that substantially limits one or more major life activities who has record of such an impairment or is regarded as having such asn impairment

task initiation adhd

build a positive cycle (motivate, schedule, budget, reward), daily planner, reminder apps/alarms, bite size pieces, planned breaks, anticipated rewards, graphic organizes, CO_OP method

custom AT

built to fit single user

tracking

by 1-2 months horizontal, vertical then on an arc

WNL convergence

by 6 months

referral

by a parent or school staff must be implemented. generally school staff can request an informal screening by a therapist. " I would like my child __ to be evaluated for AT services

tracking

by age 1-2 months, horizontal, vertical, then on an arc

binocularity

by age 3-4

acquired vestibular dysfunction

cancer survivors, cochlear implant recipients, military blast injries, concussions, burst ear drum or ear tubes after ear infections, developmental delay, CP (movement drives the development of this system),

client's ability to engage in therapeutic process and feel like a partner

capacity for reciprocity

bizarre delusions

clearly far-fetched, cannot occur in real life, or are not based on beliefs of the person's culture

OTPF

client center empowering, occupation based, expands roles, participation and performance, unoque perspective

COSA

client centered assessment tool and an outcome measure designed to capture youths perceptions regarding their sense of occupational competence and the importance of everyday activities. 8-13

complimentary contributors to cornerstones

client centered, occ based practice, clinical and professional reasoning, cultural humility, ethics, evidence informed practice, leadership, professionalism

AASP

clients 11-65+ designed as a trait measure of sensory processing. to use self questionnaire for evaluating their behavioral responses to everyday sensory experiences. provides standard method to measure and profile the effect of sensory processing on functional performance. i

genetic risk factors major depressive d.o

close blood relative with major depressive disorder has two-to-four times higher risk of also having the disorder

regulation

co regulation, self regulation, circular causal processes

TUOS social emotional trauma

co-regulation starts in sessions, providing opportunities for reciprocal regulation=flow

social emotional (trauma)

co-regulation, safety cues, reciprocal, rhythm of regulation, tUOS

concussion: systems impact school participation

cognition, cervical posture, oculomotor, vestibular, cardiovascular

deficits caused by brain injury

cognition: attn, language processing speed memory sequencing physical: strength, muscle tone, sensation, gross fine motor behavior: emotions, behavioral regulation, social pragmatics and psychological functioning

therapeutic strategies to improve ventral vagal regulation

cognitive behavioral, sensory, social/emotional

ensuring the client has a say in the treatment and autonomy to the greatest extent

collaborating

how client expresses their needs and wants is an example of

communication style

vestibular exercises: substitution

compensation for balance by training vision or somatosensory systems

AIS A

complete SCI, no motor or sensory function in sacral segments S4-S5

OT and flow

complexity of the task (just right challenge), determine what the client found enjoyable in the past

folding tilt w.c

compromise btw fold and tilits BAD OPTION, will break

common intervention approaches for psychosocial and physical disability

connecting to other people- ability to form and maintain r/ships, socialing, helping others, forgiving others, loving others. positive personal qualitity- finding meaning, resilience, humor, express gratitude, creativity. life regulation qualities- self discipline, regular physical exercise, attending to bodily pleasures, persisiting at learning new skills

ESEA of 1965

consequence of war on poverty and designed to ensure that all children have an equal opportunity to participate in and receive a good education at school. changed to no child left behind 2002

strategies for executive function skills

consider devleopmental age, change environment not the child, create routines, sport/recreation, teach deficient skills, minimum support for max success, incentives, be consistent

top down motor assessment

considered primary role of OT, most school based OTs only have access to bottom up deficit model tests and not top down functional perfromance tests

contemplation phase

considering change and wieghing the advantages and disadvantages, which often include acknowleding loss

cranial nerve 8

consists of the cochlear nerve and the vestibular nerve, this is why sinus infections can affect your balance

a change in physical space or in therapists

contextual inconsistencies

middle adolescence characteristics

continue to move toward psychological and social independence from parents, challenge parents authority and standard, more involvement in their peer group cultur, influence of peer groups is very powerful, participate in formal and informal peer group activities: sports, clubs, gangs, accept their body development, realistic about futurw

OTA

contributes to screening or eval process, assisits in developing goals,intervention plans, direct intervention, monitor process, document services

somatic motor neruons

control eye movements

somatic motor neurons

controll eye movements

tweens social behaviors

cooperative, less impulsive, able to regulate behaviors, competitive r/ships form

transition plan

coordinated set of activities that promote movement from school to such post school activities, vocational training, employment, adult services, independent living and community participation -based on the individual needs, taking into account his or her preferences interests

therapeutic writing and other creative media psychosocial concernswith physical disability

coping methods, personal understanding, coming to terms with trauma, use of wrtiing and other media jounral painting dancing to explore losses nd sources of resilience

OTPF 4 modifications include

cornerstones, occ science, increase focus on group and pop clients, occupational/ activities, simplify OTPF-3 context and environment, update table that describes diff types of occupations, client factors, prep method and task > change to interventions, clarity for outcomes, virtual interventions, professional reasoning instead of clinical, addition of tables

mechanism of injury concussion

coup counter coup -shearing forces causing axonal injury -w/concussion the main known areas of injury follow the same pathway as the vestibular system and axiety

mechanism of injury concussion

coup counter coup, shearing forces causing axonal injury, with concussion the main known areas of injury follow the same pathway as the vestibular system abd axiety

student centered planning

create structure for future: reduce social isolation and segregation, develop students competence, provide opportunities for new friendships, promote respect for the students

occurs outside of therapy and effects client's demeanor in treatment

crisis point

strategic networks actions and expression examples

cut letter A, copy letter A, lower A in poster, sing songs with A

traditional AT

designed as AT

traditional at

designed as AT

non traditional

designed as general purpose

non traditional AT

designed as general purpose

ACOPE purpose

designed to be used to record the behaviors adolescents find helpful to them in managing problems or difficult situations which happen to them or members of their families

OT interventions physical disability

designed to increase a persons ability to participate in rewarding occupations, social relationships, physical activity, and functional independence may represent a positive approach to meditating emotional distress and promoting positive adaptation to acquired physical disability

mid-high technology

desktop accessibility options, augmentative communication devices, modified keyboards (standard, dvorak, chubon), on screen keyboards, switch controlled computers)

PAC

determines activity preferences

metacognition

develop insight and awareness, learn about how you learn/create, CO-Op method, talk aloud method, error analysis self correction support, describe and name thinking processes, modeling

cognitive development

develop sense of time and become interested in future, develppment of moral and social reasoning, better able to understand consequences of their actions, able to incorporate values into their decision making

QOLI

developed to provide measurement of positive mental health that could supplement measures of negative affect and psychiatric symptoms in both outcome assessment and tx planning. developed to focus the attn of health providers on a clients source of fulfillment including the real life concerns of work money and physical surrounding. measure life satisfaction

physiological signs of trauma

diff breathing, dizziness, fatigue, pain, headaches, chill, fainting

cognitive impact on occ perf trauma

diff focusing, easily distracted, dissociative symptoms safety awareness decreased occ participation

BESS balance error scoring scaler

different poses balance

generativity

different ways people attempt to leave their mark on the world perhaps by creating or nurturing things that will outlast them, caring for others or contributing to society in a psotivie way

dyslexia

difficulty in learning to read, interpreting words, letter, and other symbols but does not affect intelligence

ADHD

disorder involving a group of key skills known as executive functions

TBI

disruption in the normal function of the brain that can be caused by a bump, blow or jolt to the head, concussion is a type of TBI aka mild TBI

cognitive behavioral approach - psychosocial physical disabilities

distorted beliefs, identified and then challenged by providing evidence to the contray

example of identity foreclosure

doesn't question things and do them as expected by parents or society

moratorium

early and middle adolescence. active exploration and developing a sense of identity is occuring

Tier 1

early identification screening prevention 80% of students universialor core instruction

ASD tx

early intervention, behavior and communication approaches, dietary approaches, medication, alt medicine, Ot, music therapy, fam support & education

role of OT rest and sleep

educate teens and caregivers on sleep misconceptions and expectations, address secondary conditions that may precipitate diminished sleep quality, avoid tv, teach teens calming night activities, naps can help teens pick up and make them work efficientyl if they plan them right

OT and burn client

educating child regarding condition, precaution and proceduring using developmentally appropriate language

dyspraxia no tech/low tech

elastic shoe laces/velcros shoes curly shoelaces, slipon, graph paper/highlighted paper, color coded, folders/notebooks, modified utensils

3rd degree burn example

electrocution, explosions, contact with flammable chemicals, house fire entrapment

behavorial signs of trauma

emotional outbursts, social withdrawal, difficulty sleeping, changes in sexual functioning, increased alcohol or drug abuse, self injurious behaviors, changes in appetite or eating patterns

trauma impact occ perf areas

emotional regulation, self regulation, sensory processing, interpersonal skills, relationships, intimacy

mindfulness meditation psychosocial concerns with disability

emotional well being- a form of meditation that focuses awareness nonjudementally on the present

overwhelming feelings due to a certain situation that could embarrass a client

emotionally charged situations

caused by something the therapist does or doesn't do, say, or recognize that ultimately upsets the client

empathic break

understanding the client's thoughts, feelings, and experiences without judgement

empathizing

tUOS modes

empathizing, collaborating, motivating/encouraging, problem solving, instructing/coaching, advocating

therapeutic modes to use with adolescents

emphasizing problem solving advocacy collaborative encouraging

why are executive functions importatn

enable us to plan, focus attention, remember instructions, manage multiple tasks and organize our behavior over time and override immediate demands in favor of longer-term goals

convey hope, confidence, joyfulness

encouraging

OT and neurocongitive network

engage in just right challenge, represent what they want to learn, action and expression to allow students to show what they know as well as assess the effectiveness of the intervention

sexual activity

engaging in broad possibilities of sexual expression and experiences with self and others

strategies to prevent mental ill health

environmental modifications to enhance participation, coping mechanisms, particiaption in meaningful and enjoyable occupations (support positive emotions) social and lesiure participation, groups

transition intervention education

environmental modifications to support maximal independence

people with acquired physical disabilities experience

episodeic lossses that become apparent thru time as the individual moves thru the rehabilitation process and life stages and attempts to reintegrate back into family, social roles and community

IDEA guarantees

equal access and equal opportunities to individuals with physical and or hidden learning disability that significantly interfere with one or more major life activities

intense emotional reaction

expression of strong emotion

disinhibited social engagement disorder

externalizing behaviors (ADHD) - decrease restrain inhibition with adults, overly familar physically or verbally with adults, willingness to go with an unfamiliar adult without hesitation, lack of or absent check ins after venturing away from an adult

tilt in space w.c

extremely physical disability, cannot propel caregiver assistance needed, pressure relief(tilt) pressure relief, common for physical impairments,

hirschberg test for aligment

eye aligment test

postulates regarding change: regulation

facilitating optimal level of arousal, therapist supports the child experience of joy, acknowledges the childs emotional state builds emotion awareness and grades emotional interactions, graded affect and anticipation, ensures safety

postulating regarding change:regulation

facilitiating an optimal level of arousal therapist supports childs experiences of joy acknowledges childs ewmotional state graded affect and anticipation ensures safety just right success

common TBI causes

falls leading cause, 80% elderly population, next common is car accidents

erotomanic delusions

false belief that another person is in love with them

somatic delusions

false ideas about ones health or bodily functions,. such as ones organs are rotting away

hyperopia

farsighted astigmatic clear vision in distance but blurry vision when concentrate on near tas

agorophobia

fear of places or situations that might cause you to panic and make you feel trapped, helpless

IDEA educational law

federal/state funding, consent required, labels of disability, evals, re-eval every 3 years, FAPE, IEP, placement/lre, discipline

cognitive symptoms of concussion

feeling mentally foggy, feeling slowed down, forgetful, confused, slow response time, repeats questions, difficulty concentrating

cognitive symptoms of concussion

feeling mentally foggy, slowed down, forgetful, confused, slow response time, repeats questions, difficulty concentrating

acting to self regulate

feeling okay vs feeling uncomfortable, I can change the wy my body feels, feel good menus

positive mental health

feeling well emotionally and doing well in everyday function

who is at the highest risk for concussion

females > males multisport atheletes, children and older adults, history of previous concussion

highest risk for concussion?

females more multisport atheletes children and older adults previous concussion history

UDL

framework used by teachers to reduce barriers to students face in the classroom and increased access so that all students have gr8er opportunities to success.

goal directed persistence

frustration tolerance, delayed gratification, goal attainment scales (GAS), anticipating rewards, breaking down tasks, error analysis, resources for self correction

stage 5 :return to play aim

full contact practice

3rd degree burn

full thickness, full dermins: or hypodermis: muscle bone insensate charrwd black or gray, prolonged contact with burn agent

dynamic visual acuity

functional loss of vestibular system can be assessed, read eye chart sitting still, VOR 2Hz, normal: being able to read within 2 lines of head still

test for visual spatial

garner reversel frequent test

oculomotor

gaze stabilization

oculomotor system

gaze stabilization

RANCHO level of cog functioning 2 (II)

generalized response demonstrates generalized body responses to external stimulation

flexibility in shifting focu

generation of adaptive response- insight and anticipation -teaching conditioning thinking (if then so then), practice brainstorming around anticipated situations, create decision flow charts, use flexible CO-OP, model eval of actions

AT promote development

get around promote socialization, help improve experiences which people use to develop. ex: depth perception, spatial awareness

vestibular exercises: habituation

getting your body to stop responding in noxious ways to a non noxious stimulus

action and expression

ggive options for learners to present what they know

physical development of adolescents puberty

girls 8-13 (avg age 9-13) boys 11-12 integrate all these physical and physiological changes in a healthy self image

no tech definition

highlighting, color coded, shortened assignments, change text size, spacing - does NOT require any specialized equipment

DYSLEXIA no tech low tech devices

highlighting.reading trackers, graphic organizers, adapted paper/raised line paper, color coded folders, books on tape

coping

his or her locus of control, perception ofsocial support, ability to acquire knowledge and communicate about the disability and generativity

context of adolescence

home, shcool, friends house, church, work environment, community groups, sports team, internet etc.

soft skills

honesty, adaptability, on time, personal energy, motivational skills, ability to be accountable, filling our job application, safety, desire to work and be trained

strategies for developing positive family experience posttrauma

hopeful approach understand familys story sense of self efficacy ask question sto engage and acknowledge the caregiver is expert on child utilize nonnjudgemental and supportive tone tailor goals and intevrentions to each family

HAAT- H

human -lifespan perspective, novice vs. expert, roles-obligations, routines, habits and occupations

HAAT- human activity assistive technolgy model

human (mental, sensory, voide, neuromusculoskeletal functions), activity (meaning of activirty),context (more inclusionary concept than environment

HAAT human activity assitive technology model

human: mental, sensory, voice and neuromusucloskeletal functions. activity: meaning of activity context: more inclusionary concept than environment

stage 3

hw at home b4 school work at school

sensory sensitive trauma impact occ perf

hyper-sensitive) can further impede relationships and occupational participation

cervical screen

hypermobility tests for upper c-spine: shapr purser test, vertebral artery test

Bipolar II disorder:

hypomanic episode with a major depressive episode

sensory sensitivity AASP example

i am afraid of heights

rest and sleep

identified as critical occupation, sleep has significant impact on functional performance in self care work and leisure, 7- 7 1/2 hours of sleep

interoceptive process

identify -body cues connect- emotion act-self regulate

identification of what is happening; therapist keeps their own perspective; cope with the situation professionally

identify and cope

symptom clusters PTSD

intrusion, persistent avoidance, negative changes in cognition and mood, alterations in arousal and reactivitiy

CAPE/PAC assessment together

investigates a childs participation with respect to six dimensions of activity. 6-21

bilateral system

involved in bilateral integration***

social support

involving helping behaviors from a person or group that result in emotional benefits and or practical assistance is an important mechanism thru which individuals adjust to disabtility

MD mid high tech device

ipads/tablets (software), computer accessibility options, power w/c, walkers

emotional symptoms concussion

irritability or emotional lability, sadness, nervousness

emotional symptoms of concussion

irritability or emotional lability, sadness, nervousness

Playfulness

is a personality trait that might mediate positive coping and facilitate reduction of daily stress during adolescence

Cognitive behavioral therapy (CBT)

is a short-term, goal-oriented form of psychotherapy that aims to change negative patterns of thinking and change the way a patient feels about him/herself, his/her abilities, and his/her future. Consider it brain training for ADHD.

specific phobia

is any kind of anxiety disorder that amounts to an unreasonable or irrational fear related to exposure to specific objects

student role performance

is defined by participating in education and extracuriccular activities, self management of behavior and chronic conditions, and learning

time management

is the ability to estimate, allocate, and execute within time constraints

interoceptive awarenes

is the bridge between co-regulation and self regulation"

flow

is the way people describe their state of mind when consciousness is harmoniously ordered, and they want to pursue whatever they are doing for its own sake

playfulness common approach studying adolescent well-being

is to focus on the transactional processes between person/environment that are a function of their interactional relationship

transition planning inventory 2

is to identify students' readiness to transition into a postsecondary setting

problem focused coping

leads individuals to deal directly with a challenging situation either by obtaining more infom acquiring new skills to manage the situation or by altering the siutation or environment

complex rehab PWC,

joystick controlled, significant needs, tilit, recline, support, good postural support, complex electronics

soft technology

knowledge, skill

soft technology AT

knowledge/skill

precontemplation phase

lack of awareness of the need to make a change caregivers of children who may have a difficult time coping with their siutation posttrauma and are not ready to make any changes

inattentive ADHD

lack of focus, fails to give close attention to details, diff sustaining attn to taks, does not seem to listen when spoken to directly, diff organizing tasks, avoid or dislike tasks that require sustained attn, lose things necessary for tasks or activities, easily distracted

physical signs: just right arousa

ladequate energy, good posture, forward gaze, deep, even abdominal breathing, normal heart rate

dyspraxia mid-high tech

laptops, google drive, computer accesibility options

tropia

lazy eye

barriers for adolescent development

low SEC, non-supportive fam environment, poor educational environment, unsafe neighborhood, home, or school, non-accessible resources, not belonging to a peer group/isolation, substance abuse, trauma, depression, delinquency

physical signs: low arousal

low energy slouched posuture, downward gaze, sleepiness, low tone, sedentary, immobile

temperament risk factor major depressive d.o

low self-esteem, problems coping with stress, downbeat attitude more at risk

power w.c joystick controlled

main used, 2 independent motor for wheels forward and back, spin in place useful for indoors/home

executive functioning in workplace

make plans keep them, keep track of time, evaluate ideas, finish work on time, ask for help

risk factors for suicide in disabled population

male gender, depression, anger and aggression, alcohol and other drug use throughout hospitalization, premorbid psychiatric illness, prior suicide attempts, chronic pain, multiple medication problems and frequent hospitalizations, social isolation

risky sports concussions

males: bicylcing, football, rugby, hockey and basketball, females: bicylcing, playground activities, cheerleading, soccer, horseback riding

regulation of affect

managaing emotions and regulating appropriate arousal level

self determination assessments

many MOHO pracitioners have developed assessments addressing volition and habituation 2 areas key to self determination, scope and VQ just 2 examples

body image acquired physical disability

may grieve regarding physical changes and body image concerns, such as loss of a body part, paralysis, spasticity, incoordination, or atrophy.

HAAT activity

meaning of activity: occupational performance, occupational competence, co-occupation

CAPE

measure designed to document how children with or without disabilities participte in everyday activities outside of their mandated school activities

PTSD tx

medications (antidepressants) and psychotherapy exposure therapy, cognitive restructuring

interoceptive awareness challenges

meltdowns, uoset for no reason, forget to eat, over eat, frequent urination, does not notice when sick, poor self awareness, cant identify where pain is

hippocampus

memory

key feature dementia

memory loss, executive dysfunction (problems with high level cognitive processes such as planning, problem solving, and initiating activity) most predictive of functional impairment in_______

cognitive signs of trauma

memory problems, confusion, poor attn, and concentration

section 504 examples

mental illness, specific learning disabilities, ADHD, diabetes, juvenile rheumatoid arthritis, cancer, hearing impairments

at risk for protracted symptoms

on field amnesia, history of migraines, females higher risk, children higher risk than adults, history of adhd, anxiety, learning disabiltiy or other neuropsychological disorders at baseline

secondary transition planning when......

on the IEP no later than age 16

school accomodations

one-on-one instruction, extra time btw classes, for tests and projects, at home instruction, limited screen usage, allowing hat/sunglasses, shortedn days, interval class schedule, lunch in quiet setting, decreased hw, rests

visual efficiency problems tx

only eye movement tx is possibl if there is no optometrist in facility tx should be left to optometrist

refractive error

opticqal characterisitcs of the eye (myopia, hyperopia, astigmatism)

seating

optimal positioning can amplify: postural support, endurance, accessibility/function, pressure relief

factors can lead to a good life following onset of disabilityt

optimisic attitude, healthy behaviors, perceived social support, generatvitity, personal goals, financial stability, self efficacy

does the client want a close relationship or something strictly professional?

orientation to relating

apply UDL principles: engagement

ot teacher engages student in reading byu having a class discussion online or face to face questions him then connect to readinga

mental heALTH promotion

population wide

exercise and other forms of physical activity psychosocial conerns with physical disability

physical conditioning stress reduction- promote engagement in preferred physical activities to increase strength and endurance and reduce stress

hard technology

physical device

hard technology AT

physical device

organization

physical environmentl,portal environment, virtual environment, color coded systems, filing systems, routines that support order, central command center-visibility

section 504

physical or mental impairment that may substantially limit one or more major life activities who has a record of such an impairment, or is regarded asd having such an impairment

pre-school to kindergarten transition

play based settings to academic focused

pursuits example

playing sports moving objects

education for all handicapped children act 1975

policy that specifically addressed the needs of children with disabiltiies

adhd impact on work

poor self regulation to adolescents tend to become upset, may struggle with impuslivity and temper outbursts in the workplace, procrastination, poor memory, time management difficulties, interpersonal social skill issues

tier 1

population overall ex. Whole school, rec center

optimal positioning can amplify

postural support, endurance, accessibility/function, pressure relief

imbalance in therapeutic relationship

power dilemma

mid-high technology example

power wheelchair, word prediction, autitory feedback, speech to text, reading pen, touch screen tablets

transition interventions activities

practice completing appl,iation forms

ex recognition networks presentation

practice letter A in the air, in the shaving cream, on your arm, on my arm, how paw patrol practices, how video etc.

role of OT adhd impact work

practice self regulation techniques, help identify triggers, provide strategies to reduce distractibility, teach time management skills, improve memory, teach social skills needed to navigate work force

teach discrete skills such as turn taking

practice skill at rec center during group game activity

major transitions in school

pre-school to kindergarten, elementary to secondary, middle/junior high to high school, secondary to adulthood

the client's ability to provide feedback regarding their treatment

predisposition to giving feedback

does the client mind being touched and by whom is it ok to touch?

preference for touch

occupational profile contribution to IDEA

preferred occupations, interests, individul strength, needs to move from school to adult occupations

Obsessive compulsive personality d.o

preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood as indicated by 4 or more of the following

rolles to support stages of transition

prep,encounter, adjustment, stabilization

1s stage

preparation, encounter, adjustment, stabilization

representation

present content and info in multiple media with varied supports

Tier 2

prevention -Screening of at risk populations -Observations, informal interviews of students and teachers, screening tools

oculision

primarily to tx children with ambylopia

facilitating pragmatic thinking and solving dilemmas

problem solving

children explore their environment

promote socialization and development, develop neurological skills

OT promote for functional outcomes from physical disability

promoting the development of self efficacy and coping skills in patients by encouraging task persistence, distraction, and positive self-talk

Tier 1

promotion -Systems/institutional level -What is being done? What is the quality of what is being done? -Where are the gaps? -Does the environment support successful participation and positive mental health?

mental health OT 3 tiered frameowrk

promotion tier 1 prevention tier 2 intensive individualized intevrentions tier 3

reduce concussion risk

proper fitting equipment, proper tackling techniques (heads up program), stronger neck reduce riskof concussion. vision training preseason

reducing concussion risk

proper fitting equipment, proper tackling techniques, heads up program, stronger neck can help reduce risk of concussion decreased velocity of impact of head on ground, vision training preseason

safety cues social emotional trauma

prosody, facial expressions, body talks

leisure/play

provide enjoyment to life, discretionary, spontaneous, and or organized activities we choose to do, account for more than 50% of teen waking hours, sports videogames, scouts, clubs, band

multiple domain assessments

provide info across multiple domains for transition planning

occupational science

provides a way of thinking that enables an understanding of occupation, the occupational nature of humans and relationship between occupation and health and wellbeing, and the influences that shapes occupation

occupational science

provides a way of thinking that enables an understanding of occupation, the occupational nature of humans and relationship btw occupation and health and wellbeing, and the influences that shapes occupation

RANCHO level of cog functioning 8 VIII

purposeful and appropriate realizesw the physical and cognitive impact of injury compensates for deficits in independently complete daily tasks demonstrates more appropriate problem solving skills illustrates improved learning abilities

connecting to an emotion

putting body cues tg to connect to an emotion, identify what caused that feeling, the way a person experiences an emotion is specific to them

eye movements

qability to maintain steady fixation on an object (fixation) to look from one object to another (saccades) and follow a moving object (pursuits)

social trauma

r.ships, risk of perpetrating or being at risk for domestic violence

common features concussion

rapid onset, short lived, neurological impairments, more of a functional disturbance than a structure one- rarely will anything show up on stand x rays, ct or mirs, symptoms should resolve in 7-14 days majortiy and up to 3 wks children

common features of concussion

rapid onset, short lived, neurological impairments, •More of a functional disturbance than a structural one - rarely will anything show up on standard X-rays, CT scans, or MRIs. •Symptoms should resolve in 7-14 days in majority of people (85%), and up to 3 weeks in children.

BRIEF 2/A

rating scale completed by parents and teachers of school-age children 5-18 and by adolescents 11-18 that asseses everyday behaviors associated with executive functions in home and school environmnets. designed for wide range of children for whom there may be concerns about self regulation such as ASD, learning disability, TBI, depression, other developmental, neurological, psychiatric and medication conditions

intrusion

re experiencing trauma such as flashbacks, dissocation

concussion: oculomotor school impact

reading abilitiy and screen time, light sensitivity

oculomotor concussion impact school

reading ability and screen time, light sensitivity

saccades example

reading and copying a board non moving objects such as book or board

dyslexia mid/high tech devices

reading pens, ipads/tabletsm speech to text, text to speech software, scantype, math apps

dyslexia impact on school based performance

reading, graphomotor skills, math, organization skills

saccades and smooth pursuit

reading, word searches, wheres waldo, spot the difference pics, spot it game, watvhing a bird figh

stage 5 return to play

rebuilidng endurance and restoring confidence, following medical clearance/discharge from PT OT

examples OT tier 1 supports

reccomend evidence based handwriting curriculum to be adopted by school district identify universial screening methods for handwriting, socio-emotional skills., presence of subjective well being

role of OT in secondary transition

recognize, explain, identify, select

CP high tech devices

recorders, ipads/tablets (scan type, notability, cowritier, speech to text, words prediction), computer accesibility options, power w/c, transfer lifts

sports spasticity w.c

recreational activity specifically

universal design learning

reduce barriers students face in the classroom and increased access so that all students have greater opportunities to success

udl principles

representation, engagement, action and expression

504

requires schools receiving FEDERAL funds to provide access to public education to students with documented disabilities. ADA ensures that the educational program is accessible to individuals with disabilities and may include providng specific accomodations.

least restrictive environment LRE

requires that students with disabilities receive their educational program, including all their academic and realted services, with children who are not disabled to the maximum extent appropriate

the client's ability to adapt to changes

response to change/challenge

tx double vision

restore eye alignment using glasses, prism or vision therapy, occulisoon 100% effective

stage 6

resume full cognitive load

stage 6 return to play aim

return to full competition

examine OT departmental practices

review secondary eligibility criteria, identifyi primary school interventions that support transition needs

autonomy

right of self determination, collab w/students

explain OT role transition

role of OT in secondary transition servies

low arousal regulation

sad bored, flat spacy, foggy, hopeless, numb,closed off, discouraged, suicidal

common emotional reactions to physical disability

sadness, despair, guilt, fear of losing control, disbelief, panic, confusion, denial, apathy, withdrawal

evaluation

schools have designated AT team to complete evals (OT/PT) formal or informal - ongoing process linked with education and or therapeutic planning -by team within natural setting where child needs to engage in occupations - with trials using potential AT devices - with meaningful follow through involving all team members (psychologist, OT,teachers)

tier 2

screening at risk populations

AT 3 main categories

seating and mobility. AAC communication, computer access

ADHD no tech/low tech

seating systems, lap belts, headphones for isolating attn/books on tape, graphic organizers, timers, color coded

Infancy and Early Childhood indidivudal developmental factors

secure attachment self regulation

Infancy and Early Childhood individual factors

secure attachment, self regulation

hallucinations

seeing (visual), smelling (olfactory), feeling (tactile), hearing (auditory) things that are not there

identity diffusion

seen in EARLY adolescence, a poorly defined sense of self identity,

select OT transition

select age appropriate standardized assessments for outcome monitoring

behavioral trauma

sexual promiscuity, illicit drug use and teen pregnancy

visual figure ground

shape counting, figuring patterns, character searching

cervical screen

sharp purser test, alar ligament test, vertebral artery test

flexibility

shifting of attention, seeing problems thru different viewpoints changing cognition, behavior as needed

concussion: cognitive impact school

short term memory - working memory - may need to make lists, have a friend take notes, get at home instruction, go back to school in idff schedule, one class on one off

cognition concussion school impact

short term memory/working memory, may need to make lists, have friend take notes, get at home instruction, go back to school in a different schedule, one class period on, one off

elementary to secondary transition

significant changes in expectations, changes from one primary teacher to one teacher per subject, smaller environment to larger one

switches AT

simple, microlite (light touch), string (pull) switch, squeeze switch, wobble switch

reciprocal social emotional trauma

so not just picking up safety cues but also giving them- becomes a large part of social connecteness

top 4 evidence based practices

student centered planning, community based instruction, self determination, inclusion in school and work

self advocacy

students must learn how to advocate for himself, calling universities and programs, keep written records, learn rules of the game, identify weakness and strengths

educate stakeholders

students, parents, teachers, administrators

empathic listening

summary statements offer best means of understanding a clients thoughts or thinking

example 1st degree burn

sunburn

burn depth 1st degree

superificial, epidermis pain redness, itching

Infancy and Early Childhood school and communit developmental factors

support for early learning and high quality childcare

UDL focuses on

supporting success for ALL students with diverse learning and life needs, equals learning opportunities for all

play/playfulness trauma

supports: developmentally appropriate-not too stressful, sensory enrichs-support regulattion, recriprocal- co-regulation safety cues

stage 1:return to play aim

symtpom limited activity

the IEP must

take into account youths individual strengths an preferred occupations including:-post secondary education, vocational ed, integrated employment, adult services, independent living, community participation

tier 2

targeted interventions 15% students problem solving team small group interventions, multisensory startegy 4 team, spelling words, targeted intervention

mental health prevention

targeted populations at risk

vertebral artery test

tests for patency of the vertebrobasilar artery, looking for 5 D's- dysarthria, dizziness, diplopia, drop attack, diaphoresis

sharp purser test

tests transver ligament

strategic networks

the HOW part of learning: action and expression: frontal lobe: executive function

recognition networks

the WHAT part of learning presentation: auditory system

affective networks

the WHY part of learning: engagement limbic

resilience

the ability of adults who are facing a severe and potentially disabling physical injury to maintain relatively stable, healthy levels of psychological and social fucntioning and to maintain positive emotions and positive perception of self and the future

resilience

the ability to recover and even thrive in the face of trauma, stress, or adversity

strategic networks

the how part of learning, action and expression

interoception definition OTPF 4

the internal detection of changes in one's internal organs through specific sensory receptors (to be aware of, for example hunger, thirst, digestion, state of alertness)"

executive skills questionnaire

to assess executive skills

executive skills enable us to

to plan , focus attn, remember instructions manage mult taks, organize our behavior over time and override immediate demands in favor of longer term goals

interoception challenges

too big, too small, distorted, modulation

look for in assessments

top down, pop appropriate, standardized

complete SCI

total loss of motor and sensory connection below level of injury

OT roles to support stages

transition assessment, transition planning, direct services, education and training, environmental modification, functional outcomes

multiple domains assessments examples

transition p;anning inventory 2. transition behavior scale 2, DASH-3, brigance transition skills inventory, Ohio employability/life skills assessment

IDEA requires

transition services for all children with disabilities and ensures that education is designed to meet each students unique needs and to prepare them for employment and independentl living

ot presentation

u: OT/teacher presents reading information as audio-text, visual, oral information to help student understands and process content

OT action and expression

uOT/teacher encourages student to demonstrate his understanding of the book he read by acting it out, do a pre-record presentation, a poster/video or class presentation

ot engagement

uOT/teacher engages student in reading by having a class discussion on-line or face to face to answer students' questions and help him make connections to reading

non traditional AT

udl 4th category AT- accessibility features of smartphone, tablet apps, internet of thing, google home, alexa

example of identity diffusion

unable to establish any type of values or goals

recognition networks presentation

understands and processes content. by presenting info in more than 1 way can help students build deeper and a more omplete conceptual understands, diverse ways of presenting info to students

ways to engage learners

uprovide both groups and individual work throughout a course udesign opportunities for engagement and discussion on-line and face to face uallow learners to choose topic within assignment's define parameters based on their own interests

tier 2 interventions

use executive function training program for 3 students who have excutive function deficits, using bystanders into allies program teach small group concrete skills and strategies 2 stop bullying

interoception vs mindfulness

use visual supports, makes mindfullness interactive and playful, opportunities for daily practice, systemically builds skill, breaks down into small steps

light weight folding w/c

very commonly seen in 5-15 year old with CP!!!! - folds and put supportive seating on top frm based, pressure relief, cushion on top

container baby syndrome

vestibular dysfunction in children is likely on the rise due to the concern with container baby syndrome. Basically when you are pregnant and register for baby gifts....the internet will tell you that you need 45 different containers to put your baby in to make them happy.

example of life skills interventions research based

video modeling, task chaining

tier 3 interventions

zones of regulation program to teach student strategies to regulate and control his emotions, video modeling social skills

risk factors generalized anxiety d.o (GAD)

§Family members with an anxiety disorder §Increase in stress §Exposure to physical or emotional trauma §Unemployment, poverty §Drug abuse

conduct d.o tx

§Preventive interventions attempted but not notably successful §Parent training §Behavioral interventions reinforcing prosocial behavior

adaptive skills assessments related sensory processing and integration

·Adaptive behavior/life skill rating scales (e.g., ABAS-3, Vineland-3) · ·Sensory checklists (e.g., Adult/Adolescent Sensory Profile®; Spiral Adolescent Sensory Questionnaire ·Behavioral assessments (e.g., BASC-3) · ·Executive function/attention rating scales (e.g., BRIEF-2, Quality of life- QOLI ·Social Participation ·COMPS

clinical observations of assessing sensory processing and integration

·Arousal state changes in response to sensations ·State of alertness ·Attention ·Balance, strength, and endurance ·Visual tracking and ocular motor screening ·Imitating complex novel movements ·Repetitive motor patterns · ·Environmental awareness

common impact ares of sensory processing and integration

·Client Factors, Performance Patterns & Skills ·Emotional maturity and self-regulation skills ·Self-concept and sense of self ·Sense of agency and confidence ·Mental health & well-being ·ADLs & IADLs ·Self care and adaptive behavior ·Responsibility and independence ·Rest & Sleep leisure school, work , play social participation

tx methods adolescents

·Goal Identification ·TUOS/partnership/safety ·Client Education/Problem solving · ·Guided Sensory Exploration ·Playfulness ·Co-regulation ·Sensory Integration Activities · ·Self-Regulation Strategies - identification and practice · ·Sensory Lifestyle Planning ·Physical Activity · ·Advocacy for Accommodations and Adaptations · ·Collaboration with Parents, partners, friends

sensory processing in adolescence

·Research has shown that sensory processing and integration challenges: ·Persist across the lifespan (Kinnealey, et al., 2011; Cousins & Smyth, 2003) ·Continue to benefit from sensory-based intervention in adulthood (Wallis, et al., 2018)

delusions

Øfalse beliefs that do not change even with proof that the beliefs are not true, no matter what others may say.

environment risk factors major depressive d.o

Østressful childhood, violent life events, neglect, abuse, low income

strategies for executive function skills

• •Always consider the developmental age of the child •Start by changing the environment NOT the child > picture agendas, wall calendars, bins for organization, quiet workspace, picture of completed task to visualize what is expected • •Create routines/schedules > provides predictability and sense of security •Match the task to work capacity > if attention is 5 min. than task is 5 min. - with success then work to increase this •Sports/recreation that maximize planning, sequence attention > yoga, karate, swimming, guitar, piano (team sports have less individual progress)

dorsal vagus

•Connections below the diaphragm- gut, heart, lungs- basic physiologic functions •Homeostasis •Health •Protection •Survival •Non-mylenated

dorsal vagal immobilized

•Shut down •Flat affect •Blank stare •Withdrawal •Decreased arousal •Under aroused •Depression • •Appears under aroused

social risk factors

•Social isolation •Abuse or neglect •Peer rejection •Separation or loss

social risk factors mental health

•Social isolation •Abuse or neglect •Peer rejection •Separation or loss

Aces defines as

•Childhood physical social or emotional abuse •Emotional and physical neglect •Domestic violence in home •Alcohol abuse in home •Mentally ill household members •Parental discord •Crime in the home ( potentially leading to imprisonment)

cognitive approaches ADHD

•Cognitive orientation to daily occupational performance (Co-op) approach •Cognitive-Functional (Cog-Fun) •Cognitive Behavioral Therapy (CBT)

ventral vagus

•Connections above the diaphragm- head and neck •Social Engagement System •Developed later in response to human development •Human experience •Connectedness to others •Mylenated •Self Regulation •Life satisfaction

cog fun

• is a manualized program that develops executive strategies and self-efficacy in occupational performance through fun and enjoyable activities that are entwined into the child's everyday context and language use

flexibility

• the ability to adapt to new situations, improvise, and shift strategies to meet different types of challenges

risk for protracted symptoms

•A greater number, severity, and duration of symptoms after a concussion •On field amnesia •History of migraines •Females at higher risk than males •Children at higher risk than adults •History of ADHD, anxiety, learning disability or other neuropsychological disorders at baseline

personality d.o

•A heterogeneous group of disorders defined by longstanding, pervasive, inflexible pattern of behavior and inner experiences that deviate from the expectations of their culture, manifested in two or more of the following areas: cognition, emotion, relationship, impulse control.

habituation

•A reduction in the pathological response to a specific movement, by repeated exposure to that stimuli. •These will make the patient nauseous...so they need to buy in. -Motion Sensitivity -Puma Exercises -POV videos -Orbital Swings -Rotary Chairs/Boards

trauma

•A single event or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual's physical, social, emotional or spiritual well-being •Experience Individual -Perception - Response •Families, organizations, communities, inter-generational trauma

ADLs adolescent role of OT

•Address performance skills needed to participate in ADLs within various environments (ie- take a shower in gym class, apply deodorant or style hair independently) •Assistive Technology may be needed to teach ADLs •Adolescents with neuromuscular disorders are likely to have trouble with ADLs because of their motor and associated movement difficulties, disturbances of sensations, lack of visual perceptions, cognition and communication that are associated with these disorders. The nature of the neuromuscular disorders affect adolescents' ADL performance differently compared with other developmental disabilities such as autism or Down syndrome •Adaptive equipment may be needed •Environmental or task modification may be needed •Teach adolescent to express sexual expression and experiment without guilt or shame

Infancy and Early Childhood family factors

•Adequate pre/post natal care •Nurturing relationship with caregiver •Support for the development of new skills

inhibition example

•Adolescents with this deficit tend to be impulsive. They have weak control impulses and will say things without thinking about what it is that they are saying

trauma informed care

•Advocates for understanding that individuals experiencing trauma-related sequela are Doing the best that they can -resilience, attempts to cope no longer adaptive or supportive of health

school accomodations:concussion

•Allowing hat/sunglasses •Shortened days / interval class schedule •Lunch in a quiet setting •Decreased homework •RESTS - should not push through cognitive fatigue following a concussion.

role of OT ADHD IALDs

•Assist Teen with taking more responsibility •Teach adolescent money management skills •Educate Teen/Family on impulse control

interoception and r/ships

•Attunement •Co-regulation •Empathy •Perspective taking

interoceptive awareness challenges

•Autism •ADHD •OCD •Eating disorders •Sensory Processing Disorder •Trauma •PTSD •Anxiety •Panic Disorder •Depression •Addiction •Chronic Pain •Suicide

interoceptive awareness challenges dx

•Autism •ADHD •OCD •Eating disorders •Sensory Processing Disorder •Trauma •PTSD •Anxiety •Panic Disorder •Depression •Addiction •Chronic Pain •Suicide

middle chilhood individual developmental factors

•Behavioral regulation •Positive peer relationships or lack of •Resilience •Empathy

social protective factors

•Caring and supportive parents •Positive early attachment •Sense of social belonging •Supportive relationships •Community participation

social protective factors mental health

•Caring and supportive parents •Positive early attachment •Sense of social belonging •Supportive relationships •Community participation

adhd impact education

•Due to poor working memory, students tend to forget easily. They may forget their homework, books Chromebook at school or home on a regular basis. •Overlook or miss details, make careless mistakes in schoolwork or during other activities •Have problems sustaining attention in tasks or play, including conversations, lectures, or lengthy reading •Difficulty with mental problem, problem solving due poor working memory Can not do mental manipulation such as math

role of OT adhd rest and sleep

•Educate teens and caregivers on sleep misconceptions and expectations •Address secondary conditions that may precipitate diminished sleep quality (e.i pain, fear, depression, anxiety) •Modify the environment •Avoid TV, computer/ipad, cellphone in the hour before bed and stick to quiet, calm activities •Establish a routine sleep schedule •Teach teens calming night activities to counteract their already heightened alertness •Naps can help pick teens up and make them work more efficiently

Middle childhood family factors

•Emotionally responsive interactions with caregivers •Consistent discipline •Parental coping

middle childhood family developmental factors

•Emotionally responsive interactions with caregivers •Consistent discipline •Parental coping

ADHD impact social participation

•Engaging in social interaction with others within their community successfully may be impacted •Communication can also be problematic as it requires emotional regulation and the ability to attend to, focus on, and listen and respond to others •Difficulty getting along with others, unable to form and maintain childhood friendships or having close friends •Peer group activities, intimate partner and peer relationships are impacted

trauma stress and health

•Extensive research on links between trauma, stress, and disease •ACES study

role of OT health management adhd

•Focus on skills and behaviors needed to maintain healthy and wellness routine •Assist with medication management. Promote adolescents' abilities to communicate with physician, obtain meds and administer it correctly, take it in a timely manor, identifies side affects and maintain a health diet •OT can educate adolescents on their disability/disorder and ways to manage symptoms •Teach skills needed to maintain a physical, mental and social wellness

role of OT education adhd

•Focus on the teens' strengths to design and implement programs to improve performance in educational area •Educate educators and other disciplines on how this disability impact teens educational performance and help implement Universal Design Learning •Teach them how to break task down teach them time management skills •Teach teens how to advocate for themselves

risky sports: concussion

•For Males: bicycling, football, rugby, hockey, and basketball. •For Females: bicycling, playground activities, cheerleading, soccer, and horseback riding.

ventral vagal (safe and social)

•Happy •Content •Attuned to others •Connected to others •At ease •Playful •Self- Aware •Productive

comprehensive tx is key

•If all pillars are not addressed, the patient will NOT get better. •Typical length of treatment for Post Concussion Syndrome takes 4-12 weeks, but highly variable dependent on number of systems impacted

adjustment d.o

•Individual experiences severe stress related symptoms that occur within 3 months of exposure to a trauma (discrete or chronic) •Degree of distress is clinically significant and negatively impacts functioning •Those with fewer protective factors and more risk factors are at risk of developing this

interoception

•Information that we get from the internal organs • body cues •8th Sense

interoception definition

•Information that we get from the internal organs • body cues •8th Sense

adHD impact IADLs

•Instrumental activities of daily living are also likely impacted in adolescents with ADHD •Financial management -requires an individual to plan and self-regulate which is hard for an adolescent with ADHD to do •Meal preparation and shopping can also be difficult as they require attention, focus, organizing and planning •Difficulty with Chore completion •Difficulty with driving/Public transportation as it requires adolescent to maintain focus attention • Regulate emotion/ impulse

metacognition

•It is the ability to problem solve which includes self-monitoring and self-evaluative skills

metacognition def

•It is the ability to problem solve which includes self-monitoring and self-evaluative skills

skills suported by interoceptive awareness

•Language •Communication •Heath management •"Reading the context of life" •Forming and keeping Relationships •Happiness

skills supported by interoceptive awareness

•Language •Communication •Heath management •"Reading the context of life" •Forming and keeping Relationships •Happiness

role of OT Adhd impact leisure/play

•Leisure check list to identify interests and assist in increased leisure participation •Identifying recourses for teens and families •Identify community programs for teens and families. •Developing teens skills needed for social and leisure participation •Help teens identify safe and healthy leisure activities • Encourage teens to join clubs they feel comfortable in

barriers for adolescent development

•Low Socioeconomic Status •Non-Supportive Family environment •Poor educational environment •Unsafe neighborhood, home, or school •Non accessible resources •Not belonging to a peer group/Isolation •Substance Abuse •Trauma •Depression •Delinquency/School dropout

individiual risk factors

•Low self esteem •Chronic illness or disability •Poor social skills •Insecure attachment to family •Poor coping skills •Trauma

individual mental health risk factors

•Low self esteem •Chronic illness or disability •Poor social skills •Insecure attachment to family •Poor coping skills •Trauma

pathophysilogy of conccusion

•Metabolic Cascade -Damage to the brain cells results in chemical changes /metabolic dysfunction. -Massive release of neurotransmitters that interferes with the cell communication •The brain is more vulnerable in this state. -Decreased cerebral blood flow during this period due to the depleted oxygen, build up of lactic acid, and depletion of glucose -Typically lasts 7-10 days but can last up to 1 month or more in some people.

role of OT promoting healthy self identity

•Model use of appropriate first person language. Instead of saying "Beth with CP", identify Beth with another positive characteristic. "Beth with Brown Curly Hair" •Avoid emotional language Don't say "Chris who SUFFERS from Down Syndrome. Don't say "John who is a girl now" •Assist Adolescent to identify their genders, abilities, interests, and positive qualities that should be the primary characteristics of their self identity

systems risk factors

•Neighborhood violence and crime •Poverty •Homelessness •School failure •Lack of health and other support services

systems risk factors mental health

•Neighborhood violence and crime •Poverty •Homelessness •School failure •Lack of health and other support services

sympathetic mobilized state (Trauma

•On edge •Limited eye contact •Hyper-vigalent •Limited attention (auditory) •On the go •Can't sit still •Anxiety •Stress • •Threshold for sensation decreased/affected

interoception have to do with emotions

•Our body cues tell us about how we are feeling •We have to have a pretty good understanding of our body cues to connect to our feelings

paranoid personality d.o

•Pervasive distrust and suspiciousness of others , beginning early adulthood, as indicated by 4 or more of the following: •Suspects, without sufficient basis, that others are exploiting, harming, or deceiving them.

antisocial personality d.o

•Pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by 3 or more of the following: •Failure to conform to social norms with respect to lawful behaviors. Deceitfulness (repeated lying)

adolescence individual developmentalfactors

•Physical Health •Intellectual ability •Emotional development •Social development •Connectedness to peers and family

adolescence individual factors

•Physical Health •Intellectual ability •Emotional development •Social development •Connectedness to peers and family

adolescence school community factors

•Physical and psychological safety •Rules and limitations •Supportive relationships •Opportunities to belong

adolescence family developmental factors

•Physical and psychological safety •Rules and limitations at home •Supportive family relationships •Opportunities to belong

adolescence family factors

•Physical and psychological safety •Rules and limitations at home •Supportive family relationships •Opportunities to belong

properties of executive function skills planning

•Planning is the ability to create a roadmap to reach a goal or to complete a task. It also involves being able to make decisions about what's important to focus on and what's not important

resilience protective factors

•Positive qualities and skills - individual - positive emotions, self-efficacy, flexibility •Perceived supports - environment - supportive relationships, safe living environments

individual protective factors

•Positive sense if self ' •Good physical health •Good social skills •Close relationship to family •Good coping skills

individual protective factors mental health

•Positive sense if self ' •Good physical health •Good social skills •Close relationship to family •Good coping skills

cognitive development

•Prefrontal lobe increases development. This leads to increased ability for abstract reasoning, processing speed, and response inhibition. sense of time development moral social reasoning •Piaget: Called this stage "Formal Operations" logical thinking. -Symbolic thought. -Hypothetical-deductive reasoning.

vision rehaB

•Prescribe exercises to address the problem •Vary the context •Make it difficult -patch an eye -incorporate movement -compliant surface -make it fun •Take breaks! - eye muscles are small and fatigue easily. Sore muscles = headache.

vision rehab

•Prescribe exercises to address the problem •Vary the context •Make it difficult -patch an eye -incorporate movement -compliant surface -make it fun •Take breaks! - eye muscles are small and fatigue easily. Sore muscles = headache.

Connecting to An emotion

•Putting body cues together to connect to an emotion •Identifying what caused that feeling •The way a person experiences an emotion is specific to them

saccades and smooth pursuit interventions

•Reading! •Word Searches •Mazes •Where's Waldo •Spot the difference Pictures •Spot It game •Watching a bird in flight

systems protective factors

•Safe living environment •Economic security •Positive educational experience •Access to health and other supports

systems protective factors mental health

•Safe living environment •Economic security •Positive educational experience •Access to health and other supports

principles of trauma informed care

•Safety #1 •Trustworthiness •Peer support •Collaboration •Empowerment •Cultural, historic or gender issue competence

importance of meaningful occupation

•Shift of the global view of health from absence of disease to satisfaction, quality of life, and pursuit of health •Following injury/illness people talk about a new sense of purpose, discovering new sources of meaning Finding meaning in everyday occupations is important occupations contribite to ones sense of identity

rest and sleep adolescent role of OT

•Teach teens calming night activities to counteract their already heightened alertness •Naps can help pick teens up and make them work more efficiently, if they plan them right. Naps that are too long or too close to bedtime can interfere with regular sleep •Educate teens and caregivers on sleep misconceptions and expectations •Address secondary conditions that may precipitate diminished sleep quality (e.i pain, fear, depression, anxiety) Modify the environment (including

Middle childhood school community factors

•Teacher support •Positive family and school relationship •School policies to reduce bullying and support kindness

middle childhood school and community developmental factors

•Teacher support •Positive family and school relationship •School policies to reduce bullying and support kindness

adolescence school and community developmental factors

•Teacher support •Positive family and school relationship •School policies to reduce bullying and support kindness •Physical and psychological safety •Rules and limitations •Supportive relationships •Opportunities to belong •

vertebral artery test

•Tests for patency of the vertebrobasilar artery •Looking for the 5 D's: Dysarthria, Dizziness, Diplopia, Drop attack, diaphoresis

task initiation

•The ability to begin a task without undue procrastination, in a timely fashion

neuroception

•The ability to sense safety and danger •Unconscious •Risk assessment sense •Gut feeling •Picking up on cues •Interoception vs neuroception?

EF: time management

•These children procrastinate and get work done at the last minute and frequently ask for assignment extensions. They do not know how to accurately estimate time for task completion

example of time management

•These children procrastinate and get work done at the last minute and frequently ask for assignment extensions. They do not know how to accurately estimate time for task completion

EF: goal directed persistence

•These students can create goals for themselves but are not able to achieve them. They are not able to understand the necessary steps to reach a goal and often become distracted with outside stimuli which negatively impacting their task completion

example of goal directed persistence

•These students can create goals for themselves but are not able to achieve them. They are not able to understand the necessary steps to reach a goal and often become distracted with outside stimuli which negatively impacting their task completion

EF: flexibility

•These students have difficulty in transitions and new situations. These students struggle longer than others at the beginning of each year. They also are thrown off by changes in daily schedules. These students have limited problem solving strategies

EF: metacognition

•These students make careless mistakes frequently. They also will complete one step then stop instead of finishing the series of steps. For example, these students may divide instead of multiply repeatedly while failing to review their work and realizing their mistake. Also, these students will do one step of long division and then stop, not reflecting on the whole process needed to complete the task

example of metacognition

•These students make careless mistakes frequently. They also will complete one step then stop instead of finishing the series of steps. For example, these students may divide instead of multiply repeatedly while failing to review their work and realizing their mistake. Also, these students will do one step of long division and then stop, not reflecting on the whole process needed to complete the task

EF: self regulation of affect

•These students tend to become upset quickly with situations, unable to control their emotions. These students tend to have outbursts that disrupt daily functioning

self regulation of affect example

•These students tend to become upset quickly with situations, unable to control their emotions. These students tend to have outbursts that disrupt daily functioning

ef: organization

•These students tend to have messy desks or cubbies. They lose papers often and frequently shove papers instead of placing them in appropriate spots

example of organization

•These students tend to have messy desks or cubbies. They lose papers often and frequently shove papers instead of placing them in appropriate spots

EF: task initiation

•These students tend to put off doing work that they need to complete. They lack the processes to start the task

task initiation example

•These students tend to put off doing work that they need to complete. They lack the processes to start the task

example of planning

•These students tend to wait until the last minute to complete tasks and then not know what to do when they go to complete them.

working memory

•Thinking skill that focuses on memory-in-action: the ability to remember and use relevant information while in the middle of an activity.

inhibition

•This is the capacity to think before you act

adolescent development is characterized by

•This period generally encompasses the ages between 13 and 19. Pre-Adolescence is between 9 and 12 (tweens) •This period is characterized by: -Intense physical growth -Physiologic maturation (puberty) -Psychosocial Development

time managment

•Time Management is the ability to estimate, allocate, and execute within time constraints

interoception challenges

•Too big •Too small •Distorted •Modulation

hirschberg test for alignment

•Tropia: a misalignment of one of the eyes when both eyes are uncovered uCan they see clearly? uEye chart for acuity

role of OT social participation ADHD

•Understand the interaction between the teen and their environment, teach them skills to safely engage in their community (volunteer work, local churches/synagogue, fire dept, food pantry) •Address skills needed to participate in social situations within various environments Therapists may also teach teen social skills (learning to read facial expressions and the tone of voice in others, and how to respond appropriately) •Education (teach teens how to handle peer pressure in a healthy way) teach skills to form and maintain healthy relationships

interoception different from mindfulness

•Use visual supports - less abstract •Makes mindfulness interactive and playful •Opportunities for daily practice during everyday activities •Systematically builds skill •Breaks it down into small steps

PTSD

•When the symptoms of experiencing trauma continue to worsen over time rather than resolve

organization

•ability to arrange or place things according to a system

organization def

•ability to arrange or place things according to a system

self regulation of affect

•ability to manage emotions in order to achieve goals, accomplish tasks, or control and direct behavior

dependent personality d.o

•excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and as indicated by 5 or more of the following: •1. has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.

social and emotion impact occ performance trauma

•fear/fight/flight- which can impede social participation and other occupations

educations adolescent role for OT

•focus on the teens' strengths to design and implement programs to improve performance in various areas •Educate educators and other disciplines on how physical disabilities impact teens educational performance and help implement Universal •Design Learning •Teach teens how to advocate for themselves

narcissitic personality d.o

•grandiosity, need for admiration, and lack of empathy, beginning by early adulthood as indicated by 5 or more of the following: •Has grandiose sense of self-importance (e.g., exaggerates achievements and talents).

amygdala (anxiety)

•integrates information from multiple sensory areas to assess for threats with consideration of input regarding the context of presenting stimulus. • Once a threat has been detected by the amygdala a rapid response is coordinated.

generalized anxiety d.o

•persistent, excessive, unrealistic worry associated with muscle tension, impaired concentration and insomnia.

borderline personality d.o

•pervasive pattern of instability of interpersonal relationships, self-image, affects, and marked impulsivity beginning by early adulthood as indicated by 5 or more of the following:

Cognitive behavioral therapy CBT adhd

•short-term, goal-oriented form of psychotherapy that aims to change negative patterns of thinking and change the way a patient feels about him/herself, his/her abilities, and his/her future. Consider it brain training for ADHD.

anxiety

•subjective sense of unease ,dread or foreboding can indicate a primary psychiatric condition

sharp purser test

•tests the transverse ligament Alar Ligament Test Compression / Distraction Test Ø All are looking for symptom production / resolution

COG fUN (cognitive functional) adhd

•that develops executive strategies and self-efficacy in occupational performance through fun and enjoyable activities that are entwined into the child's everyday context and language use •It emphasizes the use of parent-child treatment and environmental supports to enhance motivation of executive strategy acquisition.

goal directed persistence

•the capacity to have a goal, follow through to the completion of the goal, and not be put off by or distracted by competing interests

goal directed persistence def

•the capacity to have a goal, follow through to the completion of the goal, and not be put off by or distracted by competing interests

sustained attn

•the capacity to maintain attention to a situation or task until the task is complete despite of distractability, fatigue, or boredom

sustained attention

•the capacity to maintain attention to a situation or task until the task is complete despite of distractibility, fatigue, or boredom

behavioral therapy

•type of psychotherapy that aims to help a person change his or her behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events. Behavioral therapy also teaches a person how to: •Monitor his or her own behavior. •Give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting.

tier 3 strategies for individualized intervention

■Development of individual interests and leisure participation ■Specific environmental modifications taking into consideration individual factors - sensory processing, cognition, physical ability ■Individualized coping strategies ■Foster meaningful relationships

strategies to prevent mental Ill health

■Environmental modifications to enhance participation ■Coping mechanisms ■Participation in meaningful and enjoyable occupations ( that support positive emotions) ■Leisure participation ■Social participation ■Groups

interventions principles for mental ill health

■Systems of care - wraparound services ■Youth Empowerment -Voices are heard and that they take an active role in their own mental health and treatment process ■Promotion of subjective well being -Identifying and developing ones strengths

OT unique support mental health adolescence

■Therapeutic use of self - central to intervention ■Occupation based intervention - doing ■Understanding of development - psychological, social emotional etc.. ■Activity analysis ■ Person, task and environment