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transtheoretical model of change

1. precontemplation 2. contemplation 3. Preparation 4. Action 5. Maintenance

three key principles underlying free-market economies

1. supply and demand 2.competition 3. free choice

Balanced Budget Act

1997, brought SNFs under protective payment and dramatically changed the reimbursement to facilities. $1500 annual limit per person, or cap, was placed on occupational therapy services provided in outpatient settings or SNFs.

CQI

Continuous Quality Improvement, began in health care in 1980.

Indirect expenses (sometimes called operating expenses):

Costs associated with running an organization that may be spread across departments according to a predetermined rate or formula and that are not influenced by work volume, such as secretarial support, or overhead costs, such as electricity.

Direct expenses:

Costs such as salaries, services, contracts, and equipment directly related to operation of a department.

Medicare Administrative Contractor

MACs fiscal intermediaries process claims for Medicare beneficiaries

Ways that authority differs from power

Nature Flow Organizational charts Level of Management Legitimacy Position and Person

Capital equipment:

Nonconsumable equipment with a cost and life span over an amount set by the organization (e.g., any single piece of equipment costing more than $500 and with a life span of greater than 12 months).

stage of competency

Novice advanced beginner competency proficiency expert

SSA

Social security administration

Full-time equivalent (FTE)

The number of hours paid to a full-time employee during a designated time period, including payment of vacation or other benefit time. For example, payment for a typical 40-hour workweek multiplied by 52 weeks is 2080 hours.

Cost per unit of care:

The ratio of all expenses to total work volume such that the cost to produce one unit of care (e.g., 15-minute work unit, day of care) is represented and can be tracked over time or compared to costs of other programs or organizations.

Mission Statement

Why does the organization exist? What function do we perform? For whom do we perform the function or who are the primary beneficiaries of services? How do we fill this function?

reasons organizations efforts with change fail

allowing too much complacency failing to create a sufficient powerful guiding coalition underestimating the power of vision under communicating the vision permitting obstacles to block the vision failing to create short term wins declaring victory too soon neglecting to anchor changes firmly in the new organizational culture

Do

carry out process of improvement while collecting data. identify all parts of the process connected to the issue being reviewed. Flow charts work well.

types of competencies

equipment related specialized practice advanced practice

Phases of controlling

establish standards, measuring performance, correcting deviations.

business modeling

evaluating who does what and why; might need to reorganize to meet goals.

ecological model of health promotion

explains where to intervene once a particular challenge or health problem is identified.

consultants

external or internal, provide advice, expertise and project management

medicare

federal program for people over 65 years and some individuals with chronic disabilities.

three levels of analysis for organizational culture

first level-observable culture, or the way we do things around here, second level-shared values that link organizational members together... third level-common assumptions or taken-for-granted truths...

maintenance

health behaviors are successfully incorporated into daily routines so the behaviors become habitual

content theory

help managers understand WHAT will or will not motivate an employee; what will this employee value as a reward or as a need satisfier?

common reasons for resistance to change

increased stressed denial self-interest lack of understanding uncertainty motivation different assessments or perceptions Motivation

action

individuals attempt to incorporate health behaviors into their routine

process theory

instead of emphasis on what an employee needs; emphasis is on HOW to motivate employees.

legislative arena

laws influence scope of care

Change agency

leadership management consultants teams

novice stage

learners focus on applying the rules of a particular skill

advanced beginner stage

learners focus on applying the rules of a skill in specific situations that become increasingly dependent on the particular context of the situation.

expert stage

learners integrate mastered skills with their own personal styles.

proficiency stage

learners perceive situations as "wholes" rather than "aspects," and their performance is guided by intuitive behavior.

competency stage

learners see actions in terms of long-range goals or plans and are consciously aware of their skills

Activities grouped under directing

mentoring coaching performance planning supervision

management

middle-level managers

Productivity percentage

minutes billed /minutes worked

Victim behavior

missed work, lower productivity, complaining, missed workdays or sabotage

precontemplation:

persons are unaware or under aware of a health problem or the benefit of performing a health behavior.

Resistance:

persons express frustration or anger and may avoid helping to implement change or work against it • Continue to stress why change is occurring. • Allow opportunities to express concerns in writing and in person by using suggestion boxes or town hall meetings. • Make sure that communications includes details, and that persons are kept informed of steps as they happen. • Stress accomplishments.

Acceptance:

persons understand what change will occur and agree to support it even if it is not how they would act if acting alone • Celebrate accomplishments. • Recognize those instrumental in the change but thank all persons involved in the department or organization for their support. • Plan review of impact of change and to assure that the change is not temporary. • Review what went well and what did not go so well to help prepare for future changes.

Functions of Management

planning organizing and staffing directing controlling

Steps to Strategic planning

planning to plan Environmental assessment and monitoring review of organization mission establish goal business modeling performance audit and gap analysis action planning contingency assessment

factors that contribute to employee retention

potential for promotion part-time options autonomy job security competitive salaries flexible schedules vacation/holiday leave positive staff relations continuing education health benefits educational reimbursement

interpersonal

relationships and interactions with persons such as friends peers and family that influence behavior.

Management

the process of guiding an organization by planning for future work obligations, organizing employees into functional units, directing employees in the process of completing daily tasks, and controlling work process and systems to assure adequate quality of work output.

parallel group

18-24 months. Very little group interactions; leader provides essentially all needs of each member. (Mosey)

Titles XVIII and XIX

1965 established Medicare and Medicaid opened employment in nursing homes, related facilities, and home health agencies.

Section 504 of the rehabilitation Act

1973 Discrimination against people with disabilities when offering services is prohibited.

Complaints and appeals

8 basics of the Patient Bill of Right. You have the right to fair, fast, and objective review of any complaint you have against your health plan, doctors, hospitals, or other health care personnel.

Old Old

85 and older

IQ scores considered within normal limits

85 to 115

Cooperative group

9-12yr. longer-term projects; task accomplishments and socio-emotional needs met mostly by members. (Mosey)

Standard IV Outcomes

A COTA contributes to evaluating the safety and effectiveness of the OT processes and interventions within the practice setting.

Developmental sequence prewriting strokes: 3-4 y.o.

Cross, circles...then make shapes.

Context and environment

Cultural

CPT

Current Procedural Terminology. Revised annually calculated basis of a number of factors. Codes describe outcomes.

George Barton

Founded Consolation House in NY, in 1914, an early pro type of a rehabilitation center. Was a founding member of the National Society for the Promotion of Occupational Therapy. Focused on conditions of the discharged patient, need to return to employment after illness and occupation and education convalescents.

Areas of Occupation

Framework. Areas that are oriented toward taking care of one's own body, care of others. Obtaining restorative rest and sleep.

Performance patterns

Framework. Habits, routines, roles and rituals.

3- Fair minus

Part moves through incomplete ROM (more than 50%) against gravity.

2- Poor minus

Part moves through incomplete ROM with gravity decreased.

Developmental Stage of Mobility

Passenger Explores mobility Community Independence

Level C6

Pattern of weakness: absence of wrist flexion elbow extension, hand movement;total paralysis of trunk and lower extremities. Movement possible: Scapular protraction; some horizontal adduction, forearm supination, radial wrist extension. Moderate to Minimum Assitance

Osteogenesis Imperfecta

Congenital condition in which the bones do not develop correctly and become brittle. Prone to fractures with handling. Comorbidity-osteoporosis results from not weight bearing.

social skills training

improving interactive skills (e.g. communication, conflict negotiation skills)

discussion

information that will explain the main findings in great detail and discuss any methodological problems and flaws that the researchers discovered.

open system

input -throughput-output-feedback

dualism

involvement of both government and private industry in health care system

Teacher

is concerned with the individual's learning. Their expertise and experience in creating environments and activities that promote learning and understanding is essential to the development of children and adults.

resilience

is coping with adversity.

Praxis

motor skills planning

components of executive functioning

multitasking, planning, organizing, decision making

Isotonic active assisted exercise

muscle contraction is used as joint move through partial ROM, and the therapist or a mechanical device completes the range.

5 components of postural mechanism

muscle tone, postural control and stability, righting responses, equilibrium reactions and protective extension reactions.

developmental dyspraxia

neurologic disorder of motor coordination manifested by difficulty thinking out, planning out, and executing planned movements; difficulty with motor planning that is a result of sensory processing problems.

entry level

new graduate or an individual new to the practice setting

closed brain injury

non-penerating; trauma to the head by force. Brain tissue tear apart in skull

basic research type

objective is to discover new knowledge and to find out how things work or what they are made of, i.e: cellular structure of scar tissue.

asymmetrical patterns

paired extremities perform movements toward one side of the body at the same time.

Myocardial Infarction (MI) - What happens during an MI?

part of the heart muscle dies

Pt.

patient

0-6mo.

period of the most rapid physical growth.

reality orientation

person/place/time. Can be done in groups or one on one.

Pursed-lip breathing

prevent tightness in the airway by providing resistance to expiration

monopolist

probably the most common challenge is the person who dominates

price fixing

process of agreeing with another service provider to set costs together at a determined level

Planning

process of deciding what to do by setting performance objectives and identifying the activities needed to accomplish these tasks

life skills group

process of learning to satisfy one's needs in responsible ways. Organized around 3 content areas, values clarification, competency training and information classes.

the 4 p's of marketing

product price place promotion

institutional

programs and policies within an organization that influences behavior (weight loss program incentives) Smoking cessation.

step 1 in the 4 step intervention process

Problem; identify the specific issues in the group.Who is involved, what are the behaviors, and how is it affecting other group members and the group process?

Principle 5

Procedural Justice - OT personnel shall comply with laws and Association policies guiding the profession of OT.

3 types of clinical reasoning OT's use

Procedural reasoning

Grading

Process of performance being viewed step by step, from simple to complex. Builds upon what has already been accomplished. Example would be to add weights.

Activity Demands

Required body functions

Activity Demands

Required body structures

BOT (Bruininks-Oseretsky)

Testing of manual dexterity (stringing blocks), bilateral coordination (pivot thumbs and index fingers...itsy bitsy spider), upper-limb coordination (catching a ball or dribbling a ball).

Discrimination

The ability to detect a difference or distinction between one item or picture and another, for example, the ability to identify which picture is not like the others.

When is OT indicated for the treatment of patients with gout?

When resting splints are required, with decreased hand function and joint mobility, and when AE may be helpful.

Conditional reasoning

Where OP's place the Pt. in past, present and future social worlds to guide treatment decisions.

Mildred Schwagmeyer

Worked in Tuberculosis hospitals until recruited as assistant director of education at the AOTA national office in 1958. Became the most knowledgeable person on the subject of OTA's at the National Office in the United States.

Stage 3 Parkinson's Disease

Worsening of symptoms, impaired righting reactions, disability related to ADL, balance changes, may still maintain independence with interventions.

functional position

Wrist: neutral or 20 to 30 degrees of extension depending on person's tolerance, 15 to 20 degrees of metacarpophalangeal (MCP) flexion, and 5 to 10 degrees of ulnar deviation. Thumb: position of comfort in between radial and palmar abduction.

How could you modify activities to protect joints.

You could use splints, adaptive equipment/devices, give client rest breaks during the activity

Anemia

a pathological deficiency in the oxygen carrying component of the blood (red).

health

a state of complete physical, mental and social well being.

Lead pipe rigidity

a state of stiffness and inflexibility that remains uniform throughout the range of passive movement, associated with diseases of the basal ganglia.

Seizures

a sudden attack, spasm or convulsion; and intense, involuntary muscle contraction.

AKA

above the knee amputations

parts of research project

abstract introduction discussion methods results conclusion

Therapeutic activities

activities like knitting

anoxia

an absence of oxygen

symes amputation

ankle disarticulation

contextual inconsistencies

any aspect of a client's interpersonal or physical environment changes during the course of therapy. Interpersonal event that occur during group process.

help seeker

appears needy; seeks pity

primitive reflexes

are observed in the infant and are involuntary, helps to elongate muscle groups in preparation for voluntary control.

norms

are the established guidelines and expectations for behaviors

defense mechanisms

are unconscious and are used by the ego to control impulses and organize actions in a way that leads to compromise among the id, superego and the demands or reality.

specificity

art of stating things simply, directly and concretely

coordinator

assembles/organizes ideas

performing

at this point the gout members work together and begin to realize group and individual goals.

harmonizer

attempts to mediate differences of opinions

precautions and complications of spinal cord injury

autonomic dysreflexia,orthostatic hypotension, respiratory impairment, hypothermia/hyperthermia, sensory loss.

brain stem

breathing, heart rate, arousal & unconsciousness, sleep and wake cycles, attention and concentration

RLA V

confused, inappropriate, non-agitated. Appears alert and response to simple commands more consistently. Cognitive activities, group sessions, emphasize importance of ADLs.

Choreoathetosis (athetoid)

constant fluctuations from high to low and jerky movements.

introduction

contains information about the author's interest in the research, why they choses the topic, and their hypothesis

id

contains the drive to self-preservation and pleasure-present at birth-operates unconsciously.

superego

contains the standards for behavior based upon learned rules-operates unconsciously. It is our conscience-tells us right from wrong.

midlife 40-65

continued chronic problems, adjustment disorders, early onset dementia

normal muscle tone

continuous state of mild contraction or a state of readiness of a specific muscle.

Soft tissue injury

damage to muscle, nerves, skin, and/or connective tissues. Contusion, crush wound or injury, dislocation, sprain.

qualitative date

data that is represented in non-numerical forms, such as written descriptions, pictures, etc.

quantitative data

data that is represented in numerical form

eschar

dead epidermis and necrotic dermis that remains attached to the wound bed.

neglect

decreased awareness and attention of the affected side

anemia

decreased hemoglobin/oxygen in system, effecting activity tolerance

hypotonicity

decreased muscle tone. Floppy posture with difficulty performing movements against gravity and fatigues quickly.

warm water

decreases muscle tone

brazelton behavioral states

deep sleep; light sleep; drowsy or semi dozing;alert, actively awake; fussy; and crying.

hypoxia

deficiency in the amount of oxygen reaching the tissue

Aspergers

deficit in social interaction without a significant delaying communication skills. Has age-appropriate cognitive and self-help skills.

dyscalculia

deficit in the ability to perform calculations

abstract thinking

enable a person to see relationships between objects, events or ideas. To discriminate relevant from irrelevant detail. Recognize absurdities.

rehabilitation act

enacted in 1973. requires affirmative action hiring policies for federal agencies, nondiscrimination in hiring people with disabilities when the employer receives federal funding, and access to government buildings and services

omnibus budget reconciliation act

enacted in 1987. Sets requirements to improve and monitor the quality of life of residents in long-term care centers. Requires that long-term care facilities assist residents in maintaining independence, living as full a life as possible, and being free from restraints whenever possible.

american with disabilities act

enacted in 1990. provides for equal access for people with disabilities in employment, public transportation, private business, government services, and telecommunications

health insurance portability and accountability act

enacted in 1996. Privacy rules require written consent before disclosing information and put restrictions on electronic data transmission

individuals with disabilities education act

enacted in 1997, provides for free and appropriate education for children with disabilities in the least restrictive environment. Includes requirements for the states to develop early intervention programs

Duchenne's Muscular Dystrophy

pseudohypertrophic muscular dystrophy. Muscle mass replaced by fat and scar tissue. Progressive disease which ultimately affects the cardiopulmonary system, which can result in death. Comorbidity of scoliosis is common.

postural tone

refers to muscle tension in the neck, trunk, and limbs.

pull-out

remove the child for therapy outside of the classroom

indirect selection devices

requires intermediate steps in order to indicate a response. Maybe accomplished in one of two ways: scanning or encoding.

standard setter

sets expectations and ideals for the group

delirium

short term impairment of STM & LTM

NDT key points of control

shoulders, hips, elbows, knees, head, ankles, hand

dominator

shows inappropriate authority by monopolizing others

Phalen's test

sign is present if a person feels similar symptoms when resting elbows on the table while flexing the wrists for 1 minute

3 basic categories of learning #2

skills, actions or behaviors that are learned, the "doing" part of the activity

Pressure sores - Stage 2

skin broken; remove all pressure until skin heals

epidermis

skin growth cells are located here

sociocultural arena

societal values and beliefs about what is acceptable and expected are constantly shifting

technology arena

sophisticated new products are constantly introduced

inductive reasoning

starts with specific observations and uses them as a basis for generalizations or constructing theories.

SWOT

strengths weakness opportunities threats

sample

subjects, participants, units of study

Decerebrate posturing

sustained contraction and posturing of trunk and extremities in extension.

paraneoplastic syndrome

symptoms caused by the presence of the cancer cells in the bloodstream; often the first clinical sign of cancer.

procedural technician

takes on various duties and jobs

rehabilitative or educational technology

technology is only one aspect of rehabilitation or educational program (software program for teaching ABCs)

high technology

technology that is difficult to obtain and use (electric feeding machine)

components of IRM #1

the client

theory

the general principles or ideas that relate to a particular subject- it provides a way of understanding what is necessary for practice.

Programmed aging theory

the genetic "clock". Cells may lose the ability to replicate. Segments of DNA become depleted with advancing age. One of the genetic theories.

effects of disabilities and environment on children with disabilities

the impact of different family styles and environments on an infant, toddler, child, or youth with disabilities.

self-understanding

the insight one has into one's problems and the understanding of how one's behavior positively or negatively influences the problems

group dynamics

the interacting forces within a small human group.

components of IRM #3

the interpersonal events that occur

components of IRM #4

the occupation

Phenotype

the physical expression of the gene. A person's characteristics

immediacy

the practice of giving feedback right after the event to which it relates.

Sample

the subjects of the study.

isotonic concentric contraction

there is joint motion and the muscle shortens. May be done with or without resistance. Motion is done against gravity. Elbow flexing to bring food to mouth.

concrete thinking

thinking in a literal, manner, mental inflexibility, difficulty with problem-solving

Obsessive-Compulsive disorders

this category of disorder involves obsessive thoughts and compulsive behaviors that are uncontrollable and the client feels compelled to perform them.

transtheoretical model of change

this model suggest that behavioral changes occurs in a series of stages.

way to achieve service competency

through CEU courses

adapting activity

to accommodate residual abilities

Ataxia

uncoordinated movements is due to a muscle control problems that cause an inability to coordinate movements. It leads to a jerky, unsteady, to-and-fro motion of the middle of the body (trunk) and an unsteady gait (walking style) It can also affect the limbs.

Somatic mutation theory

unexpected chromosomal changes occur and result in replication mistakes. Mistakes result in progressive loss of function. One of the genetic theories.

codependency

unhealthy involvement of non-substance abuser in controlling the substance abuser

nystagmus

unintentional jittering of one or both eyes.

activity theory

unless contained by poor health or disability, elders have the same psychological and social needs as middle-aged persons.

electrotherapy

use of electric current to stimulate muscle contraction.

perception of vestibular input

what tells us what direction we are moving in, the speed of our movement, our head position, and the position of our body in space

Performance patterns

Habits

FIM score -4

Minimal Assist: Patient participates 75% -90% of the time

Mod@x2

Moderate assist with 2 persons

Intervention review

Monitoring progress towards outcomes.

Performance skills

Motor and praxis skills

Occupation based

Occupations have meaning and have a functional goal. (ADL's, IADL's, etc..)

Abnormal Hard End Feel

Occurs sooner in the ROM than is typical or in a joint that normally has a soft or firm end feel. A bony grating or bony block is felt.

Abnormal Soft End Feel

Occurs sooner in the ROM than is typical, or in a joint that normally has a firm or hard end feel. Feels boggy.

2 Poor

Part move through complete ROM with gravity decreased.

dyscalculia

disabilities involving math

Neoplasm

abnormal new growth of tissue

Progression of Parkinson's can lead to

drooling, dyspagia, monotone speech, disorders in bowel and bladder control.

self-regulation and interest in the world

during the first few months after birth, the infant is focused on organizing the internal and external worlds, and the job of the primary caregiver(s) is to help them regulate these influences.

NDT approach

dynamic techniques that guide movements to influence muscle tone and postural control and to trigger automatic movement responses.

continuity theory

elders adapt to changes by using strategies to maintain continuity in their lives.

edema reduction

elevation, contrast baths, retrograde massage, pressure wraps, Pam's, active range of motion.

Evidenced Based Practice

emerged in response to health care professionals efforts to be more conscientious and clear about the process of making clinical decisions for individual clients

fx

fracture

task-oriented group (Fidler)

group that allows for focus on both self-awareness and interactions with other group members during a structured activity

stereognosis

identification of an object without vision

cold water

increases muscle tone

ASIA impairment - E

indicates that motor and sensory functions are normal

enabling negative behavior

individuals permit or support behavior of another individual even though it is negative or potentially harmful.

Personality disorder cluster A

individuals seem bizarre or unusual in their behaviors and interpersonal relations.

Shaken baby syndrome

caused by infants being violently shaken. Various levels of severity. Can be diagnosed with Cerebral Palsy as a result of the brain damage in infants.

dermis

composed of highly structured and organized collagen, wandering cells, blood vessels, elastic fibers, and a glue-like substances of glycosaminoglycans. Does not regenerate and heals by scar formation.

gerontology

comprehensive study of aging and how it affects individuals-physically, socially, psychologically, and economically.

third stage in group formation (Yalom and Leszczll)

is cohesiveness and willingness to work within the group, but on their own issues. The group is more concerned about helping each other and maintaining a safe environment for growth.

group protocols

is the overall planning of the group

LTG

long term goals

sustained attention

requires maintaining concentration on one activity or stimulus for a sustained amount of time.

judgement

requires mentally examining the aspects of different options and discriminating the variation in order to form an opinion or belief

enabling activities

requires more active patient involvement. Are a step toward performing purposeful activities.

blocker

resists group progress

countertransference

response is when the leader's psychological world gets a reaction to the group process and the members (because you treat someone like grandma they begin to act like your grandma)

Physiatrist

responsibility is to treat any disability resulting from disease or injury. The focus is on the development of a comprehensive program for putting the pieces of a person's life back together after injury or disease -without surgery. They are MDs and can write prescriptions.

what should one do if angina is present?

rest and medication

akathsia

restlessness

limitations of therapy

restrictions on available or possible service, time, resource or therapist action. Interpersonal event that occur during group process.

neurodevelopmental treatment

retraining perceptual function through experiencing the sensation of normal movement and resulting sensory feedback

Normal muscle tone

right amount of tension inside of the muscle at rest, and that the muscle is inherently able to contact on command.

lever

rigid structure fixed at a point called the fulcrum and acted on at two other points by two forces, causing movement in relation to the fulcrum

parkinsonian

rigidity, tremors, drooling, mask like face, shuffling gait

calming scents

rosemary and lavender

initiator

provides ideas and new perspectives

Directive (Kaplan)

purpose of the group is to provide consistent and structured experience to increase adaptive functioning. FOR: MOHO Dx: acutely ill & minimally functioning

RET

rational-emotive therapy: We create our world through the way in which we interpret experience.

8 Stages of the Intervention Process in OT Stage 6

re-evaluation

protective extension

reaching forward, backward or to the side to catch self when equilibrium cannot be regained.

Ataxia Cerebral Palsy

small shifts in muscle tone. Typically, all extremities involved. Clumsy, with decreased balance and coordination. Decreased equilibrium reactions and lack of proximal stability.

purposeful communication

smiling is purposeful; they have learned that smiling causes adults to smile back.

Peck's stages of Psychological development in the second half of life Middle age -2nd

socializing vs. sexualizing

essential skills for successful intervention with families

solution-focused curiosity and interest collaborative goal setting acknowledgement continuity

backward chain

starting with the last step and having the client perform the process backward

Deductive reasoning

starts with a theory or hypothesis and proceeds to test it under specific circumstances to see if it holds true.

deductive reasoning

starts with a theory or hypothesis and proceeds to test it under specific circumstances to see if it holds true.

Inductive reasoning

starts with specific observations and using them as a basis for generalization or constructing theories., hypothesis.

condition

state the circumstances required for the performance of terminal behavior

medicaid

state-run program for people who have limited income and/or high medial expenses.

kinesiology

study of movement

Characteristics of Effective Supervisors

Solid foundation of technical knowledge desire to achieve high expectations of others Self confidence Ability to instill sense of value in others Communicate effectively

Activity Demands

Space demands

Cardiac risk factors

unchangeable - heredity, male, age changeable - cholesterol, smoking, sedentary contributing - diabetes, stress, obesity

way to achieve service competency

video taping

behavioral theory

1.All behaviors is learned. 2. Actions that have pleasurable consequences tend to be repeated. 3. Normal behavior is learned if "good" behavior rewarded (positive reinforcement) and "bad" behavior punished or ignored.

how an OTA can participate in EBP

1.participating in the review of literature 2.identifying problems of practice that are in need of study 3.assessing client satisfaction or quality assurance outcomes, 4.exploring the theoretical or historical basis for specific intervention practices

Why occupations?

1.sense of control 2. sense of accomplishments 3. go farther 4. transference 5. coordination of different skills 6. feedback

Principles of ergonomics

1.work in neutral postures. 2. reduce excess force 3.keep everything within reach 4.Work at Proper Heights 5.Reduce Excessive Motions 6.Minimize Fatigue and Static Load 7.Minimize Pressure Points 8.Provide Clearance 9.Move, Exercise, and Stretch 10.Maintain a Comfortable Environment

mature group

15-18yr. leader is co-equal.

RUGs Rehab Medium

150 to 324 minutes total therapy per week on any combination of 3 disciplines.

Standard III Intervention

An OT practitioner documents the OT services provided within the time frame, formats, and standards established by the practice settings, agencies, external accreditation programs, federal and state laws, other regulatory and payer requirements and AOTA documents.

Standard II Screening, Evaluation, and Re-Evaluation.

An OT practitioner educates current and potential referral sources about the scope of OT services and the process of initiating OT services.

Standard IV Outcomes

An OT practitioner facilitates the transition or discharge procession collaboration with the client, family members, significant others, other professionals, and community resource when appropriate.

Standard I Professional Standing and Responsibility.

An OT practitioner maintains current licensure, registration, or certification as required by laws or regulations.

Standard I Professional Standing and Responsibility.

An OT practitioner respects the client's sociocultural background and provides client centered and family-centered OT services.

Vocational Rehabilitation Counselor

Assists an individual in selecting appropriate and meaningful work or changing careers as a result of his or her illness or injury.

Minimal assistance

At least 25% assistance needed to complete task

Maximum assistance

At least 75% assistance needed to complete task

AAC

Augmentative and alternative communication. devices- use of switches to activate

1970's

Dr. Jean Ayers and Lorna Jean King; sensory integration for the treatment of chronic psychiatric disorders.

What happens if a pt. doesn't meet the allotted hours for their RUG level?

Dropped to the next lower level and hundred of dollars in therapy service can be lost.

Process

Dynamic occupation and client centered, both used in the delivery of OT services

Area of occupation

Education

Habit Training

Eleanor Clarke Slage developed for mentally ill- a re-education program designed to overcome disorganized habits, and construct new ones, with the goal of restoring and maintaining health.

Performance skills

Emotional regulation skills

Dignity (core value)

Emphasizes the importance of valuing the inherent worth and uniqueness of each person.

Titles of the ADA - Title 1

Equal Employment Opportunity for Individuals with disabilities. Designed to remove barriers that would deny qualified individuals with disabilities access to the same employment opportunities and benefits available to others without disabilities. Employers must reasonably accommodate the disabilities of qualified applicants or employees, unless an undue hardship would result.

Maslow's hierarchy of needs level 4

Esteem needs

Adult/adolescent sensory profile

Evaluate behavioral responses to everyday sensory experiences. Measures the effect of sensory processing, functional performance. Self questionnaire.

Altruism (Core Value)

Exhibits unselfish concern for the welfare of others

compliance

Explain the purpose and goals of the splint to the older adult and caregiver. •Provide simple written and oral instructions. •Use positive reinforcement for correct follow-through. •Listen to the older adult's complaints and make splint adjustments as necessary.

Separation anxiety disorder

Extreme anxiety when anticipating separation or separating from home or primary caregiver. May refuse to go to school or overnights with friends. Nightmares of separation. Somatic or physical symptoms: headache,dizziness, palpitations, stomachaches, nausea, and vomiting. Delayed social development and poor academic performance.

Symptoms of MS

Fatigue, depression, motor involvement, visual changes, sensory symptoms, tonic spasms, brainstem symptoms, cerebellar involvement, genitourinary symptoms.

What are three systemic signs of RA?

Fatigue, loss of appetite, fever, weight loss,

Social Skills Training #4

Feedback

Principle 7

Fidelity - OT personnel shall treat colleagues and other professionals with fairness, discretion and integrity.

Normal Firm End Feel

Firm or slightly springy feel at the end of the range as if it has some "give" to it.

Psychiatric rehabilitation

Forces the development of skills and resources and uses activities and environmental adaptions as a base for therapy. Atheoretical. 1. Stage 1 Rehabilitation diagnosis. Stage 2 Formulation of the rehabilitation plan. 3. rehabilitation intervention.

Context and Environment

Framework. Cultural, personal, physical, social, temporal and visual.

Activity demands

Framework. Objects and their properties, space demands, social demands, sequencing and timing, required actions, required body functions, and required body structures.

Client factors

Framework. Reside within the client and may affect performance in the areas of occupation.

Performance skills

Framework. The abilities clients demonstrate in the actions they perform.

Client factors

Framework. Values, beliefs, and spirituality. Body functions and body structures

Performance skills

Framework. sensory perceptual skills, motor, praxis skills, emotional regulation skills, cognitive skills, communication and social skills

Object relations theory

Gail Fidler utilized activities to evaluate the pt's psychodynamics(Freud). Mental health and mental illness are determined by our relations with objects, human and non-human. Our abilities to love and respond to others is seen as expressions of object relations. Activities are matched symbolically to psychic content.

NDT

General principles brain plasticity, key points of control, inhibition, facilitation.

What is recommended to strengthen the healthy part of the myocardium and improve cardiac output?

Graded exercise/activity

Area of occupation

Instrumental activities of daily living (IADL)

3 types of clinical reasoning OT's use

Interactive reasoning

step 2 in the 4 step intervention process

Interpretation: What are possible explanations for the behaviors? Given what you are observing, what do you think is really going on with the members at the center of the issue?

step 3 in the 4 step intervention process

Intervention: Consider the identified problem and proposed theory and the desired outcome of the intervention. Identify two or three possible approaches.

Prudence (core value)

Is the ability to govern and discipline oneself through the use of reason.

Procedural reasoning

Is thinking about the disease or the disability and deciding on which treatment activities they might employ to remediate the person's functional performance problems.

mature group

Leader is co-equal.

Area of occupation

Leisure

Cri du Chat

Lejoune's syndrome. Rare. Characteristics are weak, mewing cry; widely based, downward-slanted eyes.Cardiopulmonary anomalies, failure to thrive, intellectual disabilities and developmental delays.

Oppositional Defiant Disorders

Negative, hostile, and defiant behaviors. Outbursts of temper. Hostile toward authority figures, poor academic performance, few friendships. DOES NOT violate rights of others or ignore others' feelings.

Abnormal Empty End Feel

No end-feel is reached because pain or other symptoms limit the ROM before resistance is felt.

0 Zero

No muscle contraction

Titles of ADA- Title 3

Nondiscrimination on the basis of disability by Public Accommodations and in Commercial Facilities. This title prohibits discrimination on the basis of disability by private entities in places of public accommodation. Examples include hotels, restaurants, golf courses, private schools, day centers, health clubs, etc.

Titles of ADA - Title 2

Nondiscrimination on the basis of disability in State and Local Government Services. This prohibits discrimination on the basis of disability by public entities. The public entity is required to provide access to programs, services and activities provided by the state or local government,when viewed in their entirety.

Principle 2

Nonmaleficence - OT personnel shall take reasonable precautions to avoid imposing or inflicting harm upon the recipient of services or to his or her property.

Neurodevelopmental (NDT)

Normal movement is learned by experiencing/performing normal movement. Facilitation, inhibition, postural control affects limb control, key points of control.

Bulimia Nervosa

Normal to above average weight. Binging followed by purging but not on a regular basis. Psychosocial symptoms similar to anorexia.

What are the major difference between OA and RA?

OA does not involve inflammation and RA is an inflammatory arthritis and is considered to be an autoimmune disease.

Interactive reasoning

OP's employ when wanting to understand the Pt. as an individual. Helps OP decide what treatment works best, and to understand the experience of having the disability from the Pt. point of view.

Handicapped Amendments in 1986

OT has a direct role in early intervention with children birth through 2 years of age.

Autonomy and Confidentiality

OT personal shall respect the rights of the individual to self determination

Procedural Justice

OT personnel shall comply with laws and Association policies guiding the profession of OT.

Veracity

OT personnel shall provide comprehensive, accurate, and objective information when representing the profession.

Social Justice

OT personnel shall provide services in a fair and equitable manner.

Nonmaleficence -

OT personnel shall take reasonable precautions to avoid imposing or inflicting harm upon the recipient of services or to his or her property.

Fidelity

OT personnel shall treat colleagues and other professionals with fairness, discretion and integrity.

Education for all Handicapped Children act 1975

OT personnel were recruited as a related service by public schools, to assist children 3-21 years old.

OTA Levels of Practice - Advanced Level

OTA has 3 or more years of practice and has achieved the intermediate level. Has demonstrated advance level skills that may be clinical, education, or administrative.

OTA Levels of Practice - Intermediate Level

OTA has worked 1-3 years of practice. Competent to carry out entry-level tasks. May be developing additional, more advance skills in a special interest area.

OTA Levels of Practice - Entry Level

OTA has worked less than 1 year. Competent to deliver OT services. Close supervision is required.

way to achieve service competency

OTR instruction and on the job training

Activity Demands

Objects used and their properties

Abnormal Firm End Feel

Occurs sooner in the ROM than is typical, or in a joint that normally has a soft or hard end-feel.

Ego intergrity vs. death

Old age. Facing the prospect of death. Reviewing life choices.

OBRA

Omnibus Budget Reconciliation, focuses on elder's rights, quality of care, and quality of life in the nursing home setting.

Spina bifida

One or more vertebrae not formed properly. Occulta(hidden), meningocele, or myelomeningocele. Minimal to maximal functional impairment. Comorbidities possible-scoliosis, kyphosis, hydrocephalus

Intervention implementation

Ongoing actions taken to influence and support improved client performance.

The York Retreat

Opened by William Tuke in 1796. Used Pinel's idea of moral treatment with patients.

Stages of Group Process for lower functioning individuals. Stage 1

Opening the session, welcome members, stimulate senses, pass around scented items.

Beneficence

Ot personel shall demonstrate a concern for the well-being of the recipients of their services.

step 4 in the 4 step intervention process

Outcomes and reassessment: What was the effect of the intervention?

Domain

Outlines the profession's purview and the areas in which it's members have established body of knowledge and expertise

Model

Overarching concepts that guide the general approach to clinical practice.

5 Normal

Part moves through complete ROM against gravity and full resistance.

4 Good

Part moves through complete ROM against gravity and moderate resistance.

3+ Fair plus

Part moves through complete ROM against gravity and slight resistance.

2+ Poor plus

Part moves through incomplete ROM (less than 50%) against gravity or through complete ROM with gravity decreased

What is the AOTA PAC?

Political Action Committee, lobbyists that go to Washington to fight for laws that benefit OT/

Level of Management

Power does not depend on the level of management. Power can exist at any level of management. Even lower level manager or worker can have power in influence the behavior of a top-level manager.

Behavioral

Predict and shape behaviors. Positive and negative reinforcements.

Psychoeducation

Primarily focuses on training and development of skills. View educational approach, clients are viewed as students, environment is a classroom.

PPS

Prospective payment system rates established in advance, based on the anticipated resource usage by the Medicare beneficiary and are a pre-determined fixed amount.

Automatic Reactions

Protective Extension Reaction, righting reactions, equilibrium reaction

William Rush Dunton

Psychiatrist who devoted his entire life to OT. Founding member of National Society for the Promotion of Occupational Therapy forerunner of (AOTA). Served as President and Treasurer. Published in excess of 120 books and articles related to OT and rehabilitation. Elected president Sept. 1917.

Palmar Grasp Reflex

Pt. cannot release objects placed in the hand.

Symmetrical Tonic Neck Reflex

Pt. cannot support weight on hands and knees, maintain balance in quadruped and creep normally.

Suck/swallow reflex

Pt. has difficulty eating. Involuntary protrusion and retraction of the tongue make it difficult to keep food or liquids in the oral cavity.

Plantar Grasp Reflex

Pt. has difficulty keeping toes from curling in the shoes. Normal equilibrium responses in the foot do not develop if this reflex is not present.

Asymmetrical Tonic Neck Reflex

Pt. has difficulty maintaining the head in midline while moving the eyes toward or past midline. Pt. may be unable to extend or flex arm without turning head.

Positive Supporting Reflex

Pt. has difficulty placing heel on the ground for standing and walking. Balance compensated with other body parts.

Tonic Labyrinthine Reflex

Pt. has severely limited movements. Unable to lift head in supine position.

FIM score -5

Stand by/Prompting/Supervisor or Setup: the patient participates more than 90% of the time and requires prompting, cueing or coaxing less than 10% of the time.

pediatric intensive care unit (PICU)

Step-down nursery. address acute symptoms, wean pt. off external medical supports. OT can address sensorimotor stimulation as tolerated. Pediatrician as medical team leader.

What is the proper response if signs of cardiac distress are observed during Tx?

Stop the activity Have the patient rest Seek emergency medical help if symptoms do not resolve Report symptoms to team Modify future activity

Muscle spasms

Sudden involuntary contraction of a muscle or large groups of muscles.

What is the outstanding clinical feature that causes joint damage in RA?

Synovitis

Titles of ADA - Title 4

Telecommunications. This title requires telephone companies to have developed interstate and intrastate telephone relay services in every state.

Context and environment

Temporal

power dilemmas

Tensions arise in the therapeutic relationship because of clients' innate feelings about issues of power. Interpersonal event that occur during group process.

Visual Closure

The ability to identify a form or object from its incomplete appearance. This enables a child to figure out objects, shapes, and forms by finishing the image mentally, for example, finding a jacket when it is partially covered by others. This ability is required when a letter may not be completely formed.

Figure Ground

The ability to identify the foreground from the background. When looking at pictures, people, or items, it is essential to separate important visual aspects from the background. When writing, children identify written words on lined paper. An example of this is the game of finding hidden objects in a drawing.

Form Constancy

The ability to realize and recognize that forms, letters, and numbers are the same or are constant whether they are moved, turned, or changed to a different size. This means that a square is always a square no matter what size or color. A daily example of this is when a person recalls the shape of the "yield" sign.

Sequential Memory

The ability to remember a sequence or chain of letters to form a word. With handwriting, children need motor as well as cognitive sequencing. Therefore, they need the ability to remember how letters make words and sequence them according to their motor abilities to make those words. For example, when taking a spelling test, the child needs to be able to recall what the word "dog" looks like and remember that it is d - o - g and not g - d - o.

Visual Memory

The ability to remember a shape or word and recall the information when necessary. With handwriting, children must remember how to form letters, numbers, and shapes. In later school years, this skill is used when remembering how to form the letters to spell words or form multidigit numbers.

Gross revenues:

The aggregate, cumulative, or total sum of revenue before any deductions (e.g., the total work volume multiplied by billed charges before any deductions are made).

• Net profit

The amount of revenue that remains after deduction of all expenses, deductions, and allowances.

Net revenues:

The amount of revenue that you expect to collect after deductions, such as discounts for managed care payers, are applied.

Dyskinetic Cerebral Palsy

Typically abnormal tone distorted in all four extremities (quadriplegia)

Stage 1 Parkinson's Disease

Unilateral tremor, rigidity, bradykinesia, minimal or no functional impairment.

confrontation

a deliberate attempt to help another person examine the consequences of some aspect of his or her behavior

closed group

a group no new members join ion which membership remains the same over time

Define team

a group of individuals who are committed to a shared purpose to each other and to working together to achieve a common goal.

open group

a group that allows for new participants to join the group so membership is always changing

Frame of Reference

a guideline for practice that provides direction for evaluation and treatment of particular deficits in the occupational therapy domain of concern. If i do this, then this is what I can expect to occur.

culture

a learned, shared set of basic assumptions or shared way of coin things that is based upon the underlying values and beliefs

substance dependence

a maladaptive pattern of abuse leading to clinically significant impairment or distress.

substance abuse

a maladaptive pattern of substance use leading to clinically significant impairment or distress.

scaffolding

a method of grading an activity by providing assistance to the client at times that he or she might struggle or be unable to complete a task.

Multidisciplinary

a number of professionals conduct assessments and interventions independent from one another.

Power of Attorney

a person is appointed to make decisions on behalf of the Pt. in the event that the patient is physically unable to make the decision.

Social modeling

a person or a video demonstrates the acceptable behavior and the patient copies it.

declarative memory

a person's ability to recite or reproduce info

memory

a property that describes a material's ability to return to its preheated (original) shape, size, and thickness when reheated.

substitution

a realistic goal or object substituted for one that cannot be achieved.

cogwheel rigidity

a rhythmic "give" occurs throughout passive range of motion.

warmth

a sense of friendliness, interest, and enthusiasm the therapist conveys

paradigm

a shared vision- knowledge that specifically addresses the identity and perspective of the OT profession

Mental health

a state of being relative rather than absolute. Being successful at working, loving, and creating with the capacity for mature and flexible resolution of conflicts between instincts.

Frozen shoulder (adhesive capsulitis)

a stiffening and hardening of the glenohumeral joint capsule resulting in a loss of rotation and mobility of the shoulder joint

lifespan or life course theory

an age-graded sequence of socially defined roles and events that are enacted over historical time and place.

Variables

an attribute trait, or characteristic. Any attribute that can vary among individuals, objects or settings.

variable

an attribute, trait, or characteristic that can vary among individuals, object, or settings.

paraphrasing

an effective way to ensure that active listening has occurred and that an understanding of what the client has said is accurate.

approach-avoidance

an individual enters a relationship with an expectation that the other will fulfill certain (often unrealistic) needs.

Brachial Plexus Injury/ Erb's Palsy

caused by stretching or tearing nerves of the brachial plexus. 40% of cases signs go away. Variable severity of deficits.

claw hand

caused by ulnar nerve injury anatomically, this deformity occurs because the MCP joints of the ring and little fingers are positioned in hyperextension.

clinical pathway

certain way to treat a pt w/specific diagnoses, can be a good and bad thing at the same time.

grading

challenge the Pt.'s ability by progressively changing the process, tools, materials, environment to gradually increase or decrease performance demands.

cybernetic theory

changes in the neuroendocrine system result in organ changes.One of the genetic theories.

adaptation

changing the environment for improved performance.

challenge

characteristic that supports hardiness and resilience

commitment

characteristic that supports hardiness and resilience

connection

characteristic that supports hardiness and resilience

control

characteristic that supports hardiness and resilience

Automatic actions-level I

characterized by automatic motor responses and changes in the autonomic nervous system. Conscious response to the external environment is minimal

Postural actions-level II

characterized by movement that is associated with comfort. There is some awareness of large objects in the environment and the individual may assist the caregiver with simple tasks

Exploratory actions-Level V

characterized by overt trial and error problem solving. New learning occurs. This may be the usual level of functioning for 20% of the population

Goal directed actions-Level IV

characterized by the ability to carry simple tasks through to completion. The individual relies heavily on visual cues. He/she may be able to perform established routines but cannot cope with unexpected events

Planned actions-Level VI

characterized by the absence of disability. The person can think of hypothetical situations and do mental trial-and error problem solving

Somatic Symptom disorders

characterized by the experiencing of physical symptom without evidence of physical cause, thus suggesting a psychological cause.

COTE comprehensive occupational therapy evaluation

checklist or other structured format used to record observations of a client performing a task.

sensory integration dysfunction

children have difficulty processing sensory information (vestibular, proprioceptive, tactile)

Multiple Sclerosis

chronic, progressive, autoimmune disease that affects the central nervous system. Body's immune system attacks itself targeting the central nervous system.

extent of burn

classified as a percentage of total body surface area (%TBSA)

impulsivity

client begins a task before formulating a plan; safety issues.

boundary testing

client behavior violates or ask therapist to act in ways outside the defined therapeutic relationship.Interpersonal event that occur during group process.

KELS Kohlman evaluation of living skills

client must perform a task or respond to questions from a evaluator, assess several skills in the areas of personal care, safety and health, money management, transportation, use of telephone, and work and leisure.

enabling

codependent behavior characterized by making it easier for the substance abuser to continue to drink and/or drug

cryotherapy

cold therapy used for acute injuries

eclectic supervision style

combination of cognitive behavioral and developmental supervision styles.

Mixed Cerebral Palsy

combination of high and low tone. Hypertonic movement in extremities. Hypotonic flexor muscles in neck and trunk.

session plans

come out of the outlining group protocols

CARF

commission on accreditation of rehabilitation facilities

nonverbal cues

communications that do not involve the use of formal language. Interpersonal event that occur during group process.

Rehabilitation

compensatory and adaptive equipment. i.e. one handed dressing, showering bench, hearing aid and reachers

Rehabilitation

compensatory and adaptive equipment. i.e. one handed dressing, showering bench, hearing aid and reachers.

Speech Therapist

concerned with an individual's ability to communicate. This includes attention to his or her understanding of language as well as his or her expression of ideas. Also concerned with auditory (hearing) ability and work closely with audiologists.

Rehabilitative approach

concerned with restoration of a purposeful life. Focus is on abilities rather than disabilities to compensate for physical limitations.

Nurse

concerned with the health of the consumer as well as his or her comfort and care if ill. This involves evaluating and addressing the patient's physical, spiritual and emotional needs through established procedures and techniques.

middle childhood 6-12

conduct disorders, ADHD, learning disabilities, drug and ETO abuse, Tourette's syndrome, asperger's

conversion

conflicts turned into real physical symptoms.

RLA IV

confused and agitated. Heightened state of activity with severely decreased ability to process information. Safety during outbursts, shortened treatment sessions.

RLA VI

confused, appropriate. Goal directed behavior dependent of external input for direction. Time management activities, tasks to promote self independence (starting to get ready for discharge)

direct selection devices

considered faster form of device control. It is also considered less cognitively complex because it is more intuitive. Can be accomplished with or without physical contact.

lead pipe rigidity

constant resistance throughout joint range of motion: no give in ROM.

antianxiety medication

control anxiety in disorders

Antimanic

control mania symptoms

gatekeeper

control what health insurance companies pay for, how much they pay

protocols

conventional rehabilitative programs for certain diagnostic populations, can be standardized or non-standardized.

4 types/criteria for trustworthiness

credibility dependability confirmability transferability

normative life cycle events

critical stages can cause stress; stress leads to evolution or change.

family life cycle

critical stages of family life and parenting

Strabismus

cross eyed (eso or exotropia)

wear and tear theory

cumulative damage to vital parts of the body leads to death of cells,tissues, organs, and finally the organism. Nongenetic theory.

CPT

current procedural technology; timed codes, 15=1 unit

aggressor

demeans and attacks the status of others by expressing negativity

Late adulthood and aging 65-death

depression, alzheimer's

ethnographic studies

describe an intact cultural group in its natural setting.

depth of burn

described as superficial, partial, or full thickness injury

occupation-based functional outcomes

describes the "real-life" occupation that the client will be able to engage

Beery-VMI

designed to assess the extent to which individuals can integrate their visual and motor abilities (eye-hand coordination). Drawing test.

Task roles

develop in relationship to group goals. Initiator-contributor, opinion seeker, opinion giver, energizer.

frame of reference

develop methods to apply existing theory to practice - a structure for guiding practice specific to OT.

Gary Kielhofner

developed a term Model of Human Occupation or MOHO using the concepts of occupational behavior theory in 1985.

health belief model

developed by US Public Health Service in the 50's. Ours choices to behave a certain way are based on a set of beliefs and our knowledge on the subject

Anxiety disorders

diagnosed by identifying a general or specific cause of unease or fear. This fear is considered significant when it is excessive and persistent over time.

Paraphilic disorders

diagnosed when a client is sexual aroused to circumstances that deviate from traditional sexual stimuli and when such behaviors result in harm or significant emotional distress.

ICD 9 codes

diagnosis codes used for billing service to insurance company

transdisciplinary

different groups with a common scientific goal

equifinality

different initial states can lead to similar ends states, and families can change in a infinite number of ways to meet goals.

dyslexia

difficulties with accurate word recognition, decoding and spelling

orthopnea

difficulty breathing while lying down which is relieved during sitting or standing

Right-left discrimination

difficulty distinguishing between right and left.

Figure ground discrimination

difficulty finding objects as they may blend into the background

perseveration

difficulty moving from one idea or movement to the next

dyspraxis

difficulty with motor planning

close supervision

direct and daily

minimum supervision

direct and indirect as needed or as mandated by state regulatory board.

routine supervision

direct and regularly scheduled

prescriptive role

direct service

8 Stages of the Intervention Process in OT Stage 8

discontinuation of service

Four Stages of Change and Related Strategies

discovery denial resistance acceptance

special interest pleader

disguises own prejudices through social positions

Disruptive, Impulse control and conduct disorders

disorder characterized by socially unacceptable or otherwise disruptive and harmful behaviors that are outside of the individual's control.

Cerebral Palsy

disorder of movement. Head, neck, trunk, arms, and legs affected. Impairments possible in fine motor, gross motor, language and communication skills, or overall adaptive functioning.

Neurocognitive disorders

disorders are diagnosed when one's decline in cognitive functioning is significantly different from the past and is usually the result of a medical condition.

Elimination Disorders

disorders can include enuresis which is the inappropriate elimination or urine, and encopresis, which is the inappropriate elimination of feces.

Feeding and eating disorders

disorders describe clients who have severe concerns about the amount of food they eat to the point that serious health problems, or even death, can result from their eating behaviors.

Trauma and Stressor Related disorders

disorders emphasize the pervasive impact that life events can have on an individual's emotional and physical well-being.

Bipolar disorders

disorders in this category refer to disturbances in mood in which client cycles through stages of mania or mania and depression.

Substance-Related and Addictive Disorders

disorders include disruptions in functioning as the result of a craving or strong urge.

Dissociative disorders

disorders indicate a temporary or prolonged disruption to consciousness that can cause an individual to misinterpret identity, surroundings, and memories.

sexual dysfunction disorders

disorders related to problems that disrupt sexual functioning or one's one ability to experience sexual pleasure.

Schizophrenia spectrum disorders

disorders that belong to this section all have one feature in common: psychotic symptoms, that is, delusions, hallucinations, grossly disorganized or abnormal motor behavior, and/or negative symptoms.

Sleep-Wake disorders

disorders where one's sleep patterns are severely impact, and they often co-occur with other disorders (e.g., depression or anxiety)

Open-chain movement

distal aspect of extremity moves freely and is not fixed to an object. Examples seated leg extension, leg curl, bench press, dumbbell biceps curl and lat pull-down

dynamic

distinctive quality, emotional tone and specific interpersonal events that compose an interaction between individuals

Rule of 9's

divided body surface in areas of 9%

Activities

do not have meaning or a functional goal.

Limitations of manual muscle testing

does not test muscle endurance or muscle coordination

Altruism

doing for others without expecting anything in return.

neurotransmitters

dopamine, norepinephrine, serotonin

remotivation

draws on LTM. Nostalgia group-music from the 50's, first job or first automobile. Sing a longs to motivate depresses or confused pts.

Obesity

dysfunctional eating patterns.

4 main arenas for a manager to be aware of

economic arena, legislative arena, technology arena, demographic arena

economic arena

economy influences organizational future plans

compensation

efforts to make up for personal deficits

Peck's stages of Psychological development in the second half of life Old age- 1st

ego differentiation vs. work-preoccupation

Erickson's theory Late adulthood

ego integrity vs. ego despair

Peck's stages of Psychological development in the second half of life Old age - 3rd

ego transcendence vs. ego preoccupation

dichotomous thinking

either or thinking, black or white, good or bad

developmental model supervision

employees evolve through developmental stages; continually growing, learning; supervisors role is to identify needs for growth of employee.

social microcosm

enactment of one's typical interpersonal style.

forward chaining

encouraging the client to initiate the first step and complete as much as possible before the OT completes.

universal design

equal access for all.

8 Stages of the Intervention Process in OT Stage 3

evaluation

OT philosophy

every person is born with a drive to act on the environment, to change things, to produce things, to work, and to use the hands and the mind.

elaborator

expands on suggestions

three levels of motivation for occupation or action

exploration motivation, competency motivation and achievement motivation

Protective extension reaction

extending arms to protect head and face when falling or off balance

credibility

extent data reflects what researchers actually observed, heard, read, or perceived.

confirmability

extent that results are free from the researcher;s biases, values, assumptions and can be confirmed by others.

transferability

extent that results can be transferred, generalized, to persons/settings outside of the study.

dependability

extent to which results would be comparable if study was repeated

expression of strong emotion

external displays in internal feelings. Interpersonal event that occur during group process.

3 keys to active listening

eye contact; nonverbal cues; paraphrasing

saccadic movements

eye moving rapidly and accurately from item to item

tardive dyskinesia

facial movements, writhing of the tongue and fingers.

visual agnosia

failure to recognize common items that can be seen

morphogenetic principle

families have the capacity for change

intimacy vs. isolation

finding a partner to share life.

multimodal

flexibility to match those modes to the client and the situation or to change modes as needed.

developmental groups (Mosey)

focus on teaching group interaction skills that are considered developmental stage-specific

psychoanalytic groups

focused on increasing insight into self and increasing understanding of personal behavior; use therapeutic media as a means to understanding behavior

sensorimotor approach

for treatment of upper motor neuron disorders. Focus is sensory perception and movement patterns. Balance, posture, tone and reflexes are considered. Central nervous system dysfunction.

non-nomative life cycle events

frequent hospitalizations, not reaching developmental milestones, multiple doctor visits and other appointments.

Fx

function

regression

functioning at a more primitive developmental level than previously

RLA level II

generalized response. reacts inconsistently and non purposefully to stimuli. Total assistance. Increase Pt.'s level of response.

Theoretical research

generates new knowledge by using cognitive process to analyze and synthesize ideas and information. This information or idea can come from a book, article, conversations or individual observation and experiences.

theoretical research

generates new knowledge using cognitive processes to analyze and synthesize ideas and information from many sources.

conceptual practice model

generates theory and the methods used by therapists to apply that theory.

generation y

generation born from the early 1980s to the late 1990s.

generation x

generation following the post-World War II baby boom, especially people born in the United States and Canada from early 1960s to the late 1970s.

Fragile X syndrome

genetic condition that causes limited brain development, abnormal skull, prominent jaw and forehead, lax joints and flat feet. As well as various degrees of intellectual disabilities.

extrinsic feedback

given by the therapist

rationalization

giving reasons for drinking/drug use, blames on another

storming

group is likely to highest level of disagreement and conflict. The leader must take on a negotiator and supporting role.

adjourning

group members may adjourn at different times.

splitting

group members will go to one leader in hopes they will get what they want (children use this tactic)

Azimos

group model that increases self-awareness & promote self-understanding to encourage interpersonal change. Recognized therapeutic value of art, music poetry, dance, clay/sculpting.

Integrative (Ross)

group model to facilitate organized sensory, motor, affective and or cognitive responses to increase function. FOR: sensory integration Dx: limited sensorimotor dev who require stimulation and cueing (head trauma)

involuntary

group participation is required

task-oriented group

group that allows for focus on both self-awareness and interactions with other group members during a structured activity.

functional group

group that result in end products or help members achieve desired skills and abilities.

heterogeneous

group with multiple,or different issues

sub-grouping

groups break into smaller groups ( high school clicks)

evaluation group

groups that allow for assessment of both interpersonal and activity skills

Habituations

habits and roles of the Pt.

power grasp

handle or object tight in the palm, and shoulder produce movement (e.g., using a hammer)

secondary brain damage

happen as a result of brain injury; hematomas, edema, hydrocephalus, infection, seizures

hypertrophic scar

hard, red, collagenous bundle of connective tissue raised above the surface of the burn wound, usually visible 6-8 weeks after wound closure.

Dynamic splints

have one or more movable parts [Malick 1982] and are synonymous with splints that employ elastics, springs, and wire, as well as with multipart splints.

insight and awareness

having an understanding on one's strengths and weakness. This means having a realistic concept of one's physical and mental capabilities.

tertiary circular reactions

he or she repeatedly attempts a task and modifies the behavior to achieve the desired consequences.

Group roles

help the group towards its goal

Role of occupational therapy

helping families assess their concerns and priorities for intervention; the use of self-reporting instruments in OT.

hypertonia

high muscle tone; limbs feel rigid and inflexible

spasticity

high tone; too much stability.

intermediate level

higher level of skills gained by experience, continuing education, and involvement in professional activities.

executive functioning

higher order of reasoning and planning functions

body scheme

how a person perceives the position of the body and the relationship of the body parts.

Group process

how the group went; the manner in which the occupational activity is conducted and the emotional tone of the verb and nonverbal content that occurs during group

ADHD - attention deficit/hyperactivity disorder

hyperactive, impulsive, excessive energy and motor activity, and ADD symptoms.

secondary prevention

identification and treatment of persons with early, minimally symptomatic disease to improve outcomes and maintain health. Importance of health screenings.

graphesthesia

identification of numbers and letters when they are written on the skin

evidence based practice steps

identify/define practice-related problem formulate a question around the problem seek out and evaluate info to help answer the question

downward comparison

identifying a situation that is worse than your own

passive appraisal

ignoring a problem and hoping it will go away.

Ataxia

impaired gross coordination and gait. Pt. may have visible tremor like movements. Problems with calibration, step length, postural, and stability.

brachytherapy

implantation of radioactive seeds into tumor bed; while seeds are in place Pt. is radioactive.

development of socializing techniques imitative behavior

improve and develop appropriate social skills through the process of modeling or practicing

meta-cognitive training

improve fundamentals by enhancing self-awareness and improving skills, such as time management, self-control, and self-monitoring.

Role of OT in Educational environment

improve the child or adolescent's performance in the school or educational environment. advocate within the context of the educational setting and the federal laws that mandate services being provided.

Truth

in documentation and billing

Tranquilizers are introduced

in the 1950's. They allowed those with bizarre and psychotic to participate in OT.

Constructional Apraxia

inability to copy, draw or construct a design

Astereognosis

inability to identify familiar objects through touch, proprioception and cognition

Ideomotor apraxia

inability to plan or perform a motor skill

apraxia

inability to plan out movements despite having the necessary range of motion, strength, and coordination

somatodyspraxia

inadequate processing of tactile, proprioceptive, and kinesthetic information that causes difficulty in motor planning.

ADD - attention deficit disorder

inattentive, restless, and distractable

Neurodevelopment disorders

include intellectual disabilities, communication disorders, autism spectrum disorders, ADHD, specific learning disorders and motor disorders.

postural mechanisms

includes postural tone, muscle tone, integration of the primitive reflexes and mass pattern movements, righting reactions, equilibrium reactions, protective extension, and selective voluntary or intentional movement.

Normal phases of swallow 1 Oral preparatory phase,

includes seeing, smelling, reaching for the item, bringing it to the mouth, and putting it in the mouth.

Postural mechanism

includes the righting reaction which maintains the head in midline wight the trunk

Persons

including families, caregivers, teachers, employers, and relevant others

psychostimulant medications

increase mental and physical activity.

hypertonicity

increased muscle tone; increased resistance to passive stretch.

ASIA impairment -A

indicates a complete lesion; there is no motor or sensory function preserved.

ASIA impairment - B

indicates a incomplete lesion; sensory but not motor function is present below the neurological level

ASIA impairment - D

indicates an incomplete lesion; motor function is preserved below neurological level, and at least half of the key muscles below the neurological level have a muscle grade of 3 or more.

ASIA impairment - C

indicates an incomplete lesion; motor function is preserved below the neurological level and more than half of the key muscles below the neurological level have a muscle grade less than 3

general supervision

indirect as needed and direct once each month or as designated by state law.

blood pressure

indirect measure of the force exerted by the blood as it flows through an artery.

divided attentional deficit

individual cannot process all the information for task completion

help seeking-help rejecting

individual establishes a pattern of asking for assistance and hen explaining why it would not work.

intrapersonal

individual factors or beliefs that influence behavior

reluctance-reassurance

individual is consistently anxious, skeptical, or self-doubting about engaging in occupation and others reliably attempt to bolster, entice, and reassure them, a dynamic of reluctance and reassurance is occurring.

demonstrative-voyeuristic

individuals become involved in elaborating on, embellishing, or dramatizing their reactions or hardships, they often have a need for their hardships, they often have a need for their hardship to be recognized and validated.

idealizing-devaluing

individuals can be consistently idealizing of one another, consistently idealizing of one another, consistently devaluing, or they can change between the two states.

helpless-rescuing

individuals fall into a pattern of recruiting assistance when it is not necessary.

enmeshment

individuals have close ongoing contact. It is expected that individuals share information readily, even if it is highly intimate or personal.

manipulating-conceding

individuals may be accustomed to getting their needs met through manipulation, particularly when they perceive that there may be an obstacle to getting what they want.

competitive

individuals often compete to obtain an interpersonal need or a valued resource, particularly if it is perceived to be in short supply.

Personality disorder cluster C

individuals tend to appear anxious, worried, or fretful in their behaviors.

secondary circular reactions

infant begins to use voluntary movements to repeat actions that accidentally produced a desirable result.

Postnatal causes of intellectual disabilities

infections, trauma, and toxins

long term memory

information about past events, language, and sensory experiences that are stored for long periods of time. These memories are retained for years.

methods

information about the techniques and assessment instruments used for the research.

frontal lobe

initiation, problem solving, judgement, inhibition of behavior, planning and anticipation, self-monitoring, motor planning, personality, emotions, awareness of abilities and limitations, organization, attention and concentration, mental flexibility, speaking-expressive language

adaptive approach

intact skills are used to compensate for skills that are deficient. Involves engagement in client's occupation of interest.

fluid intelligence

intellectual processes that impact numerical reasoning and logic.

preparation

intention to begin performance of a health behavior is combined with criteria for action that include a time frame to begin acting

3 aspects of self awareness #2

interests

ICD-9

international classification of disease

organizational

interrelationships between organizations that influence behavior (YMCA and Summa hospitals or ADM board)

8 Stages of the Intervention Process in OT Stage 5

intervention

8 Stages of the Intervention Process in OT Stage 4

intervention planning

orthopedic conditions

involves bones, joints, and muscles. Muscles activated by the nervous system to create movements at joints. Can be congenital or acquired.

active listening

involves reflecting back to the client (group) what was heard and how it was understood

Cystic fibrosis

involves the exocrine glands. Think mucous build up in the lungs. Scarring and cyst build up in the pancreas.

precision grasp

involves the thumb and fingertips used to position or move an object.

Dementia

irreversible impairment of STM & LTM

Caresource

is Medicare

Theory

is a description of a set of phenomena and the relationships among the concepts in those phenomena. Provides the foundation for developing the frames of references and treatment ideas.

Dystonia

is a faulty muscle tension or tone. Tend to involve large portions of the body and produce grotesque posturing with bizarre writhing movements.

conformability

is a performance characteristic that refers to the ability of thermoplastic material to fit intimately into contoured areas.

transference

is a phenomenon characterizers by unconscious redirection of feelings from one person to another.

neurolysis

is a procedure performed on a nerve that has become encapsulated in dense scar tissue, which compresses the nerve to surrounding soft tissues and prevents it from gliding.

sensory processing intervention

is aimed toward the organization of multiple sources of sensory input. The focus is also on the lower brain processing of vestibular input integrated with proprioceptive and visual inputs, making it important to identify the target sensory platforms.

cancer

is an abnormal tissue that grows and spreads or may metastasize throughout the body.

first stage in group formation (Yalom and Leszczll)

is characterized by getting to know each other hesitant participation; searching for a meaning to the group and participation; and a dependency on the leader and other members for structure, for approval, and for an understanding of their role within the group

memory

is closely linked to other cognitive and sensory factors, in that the brain stores information on sensory experiences

Strategic Planning

is determining the long term goals of a site/company/organization and using the goals to accomplish goals. Often useful to review or create a vision or mission statement.

selective attention

is focusing in on one or more stimuli, while all other stimuli or information in the environment are ignored.

transference

is group members projection of their inner world ( treating someone like your grandma because they remind you of your grandma)

metacognition

is having awareness of one's own cognitive processes and the ability to manipulate and control his other own cognition. This is self-awareness of one's cognitive ability and is often defined as thinking about thinking

chaotic-organizing

is one in which one aspect of the systems irresponsible, disorganized, slovenly, undisciplined, or lacking in emotional self-control.

visual discrimination

is our ability to perceive and interpret visual information. It is what allows us to discriminate between different shapes, objects and colors.

sensation

is the ability to identify a sensory modality, its intensity, and its location.

visual perception

is the ability to organize and interpret what is seen.

concept formation

is the ability to organize information and develop ideas based on common qualities of objects or situations

praxis

is the ability to plan and perform purposeful movement

anticipatory awareness

is the ability to predict or accept that a deflect will inhibit success or cause a problem

visual perception

is the cognitive processing of what our eyes detect.

intrarater reliability

is the degree of agreement among multiple repetitions of a diagnostic test performed by a single rater.

interater reliability

is the degree of agreement among raters.

drapability

is the degree of ease with which a material conforms to the underlying shape without manual assistance.

coordination

is the harmonious interaction of muscles throughout the limb that allows for the production of accurate controlled movement.

multisensory processing

is the integration of sensory information from different sources.

role aquisition

is the learning of all daily life, work and leisure skills that enable one to participate in social and productive roles.

perception

is the mechanism by which the brain recognizes and interprets sensory information received from the environment

second stage in group formation (Yalom and Leszczll)

is the most challenging for a leader. During this stage, members begin to let their guards down, become more familiar with their peers, and try to establish their position within the group structure. Some members feel a need to dominate in the group or to impress others.

Access

is the point of contact between the user and the aid or device that he or she needs to control

Dynamic tripod grasp

is the preferred mature grasp. The pencil is held between the thumb and the index and middle fingers; the index finger is placed on top of the pencil, with the thumb in full opposition. The ring and little fingers are flexed to stabilize the grasp. The wrist and fingers are used to move the pencil with greater digital control. The arm simply positions the hand for the appropriate manipulation of the pencil by the fingers. This grasp is typically present by 6 to 7 years of age.

critical appraisal

is the process of judging the quality of a piece of information and determining its applicability to practice.

sensory integration

is the way the brain organizes sensations for engagement in occupations

Flow

is total engrossment in activity to the point where you lose track of time.

challenging

is used when the group is experiencing difficulties with one or more members, or is stalled or moving in a less than therapeutic direction.

divided attention

is utilized when a person must focus on two or more stimuli at one time.

Occupation

is viewed as behavior that is internally gratifying and used to fulfill a variety of cultural and socially accepted roles.

Progress notes

justify interventions justify continued interventions used for discharge planning

gate keeper and expediter

keeps lines of communication open and flowing

recorder

keeps notes on group and recalls information

crystallized intelligence

knowledge accumulated through the life span

empirical research

knowledge based on information gained from experience or observation. most common

Splinting requires

knowledge of occupation, pathology, physiology, kinesiology, anatomy, psychology, reimbursement systems, and biomechanics to best design splints for persons

3 basic categories of learning #1

knowledge, acquired information, facts about reality

brown-sequard syndrome

lateral damage to cord. Pt. loses postural control and motor control on ipsilateral side; pain and temperature changes on contralateral side.

dysgraphia

learning disability that affects writing

Profound intellectual disability

less than 25. accompanying physical disabilities require constant support in all areas of occupation. May learn to communicate and to perform routine self-care activities.

Thriving

lifespan theory. Three interacting factors person, human environment, nonhuman environment

Facilitation used with hypotonia

light moving touch tapping, sweep tapping, brush tapping, and/or alternate tapping fast vestibular input heavy joint compression weight bearing and weight shifting quick and variable movements stimulating enviroment

Facilitation used with hypotonia

light moving touch tapping, sweep tapping, brush tapping, and/or alternate tapping fast vestibular input heavy joint compression weight bearing and weight shifting quick and variable movements stimulating environment

homogeneous

like issues,deficits or problems

aging in place

living where the elders have lived for years, typically not in a health care environment, using products, services, and conveniences that allow them to remain home as circumstances change. Elders continue to live in the home of their choice safely and independently as they get older. Livability can be extended through the incorporation of universal design principles, tele care, and other assistive technologies.

RLA level III

localized response. Reacts specifically but inconsistantly to stimuli.Total assistance. ADLs, orient pt., education of family continues.

marketing

looking at the market,listen to market needs, and design a program that meets the "needs, resources, and limitations of potential customers."

basic sitting position in a regular chair

looking for 90-90-90.

disuse syndrome

loss in the ability to preform ADL functions as a result of a sedentary lifestyle disability

Maslow's hierarchy of needs level 3

love and belongingness needs

Hypotonia

low muscle tone (increased flexibility at joint)

flaccidity

low tone; too much mobility.

Athetoid

movements without stability are slow wormlike, arrhythmical movements that affect the distal portions of the extremities. Not present during sleep.

transitional movement

moving from one position to another. Involves weight shifting, unloading and loading of the body.

isotonic active exercise

muscle contraction is used as joint moves through available ROM against no outside resistance.

Isometric exercise

muscle or group of muscles is actively contracted and relaxed without producing motion of the joint. Purpose is to maintain muscle strength when active motion is not possible.

Brunnstrom's stages of motor recovery

no motion, spasticity, synergy, normal movement.

RLA level I

no response to stimuli. Total assistance. Increase Pt.'s level of response and overall awareness

dominance-submission

nondemocratic system that is characterized by a clear power differential that involves the consistent oppression of some individuals by others.

primary aging

normal gradual changes in organ systems. experienced by everyone. Not associated with disease, impairment, or disability.

Psychologist

not a medical doctor; although they may have a PhD. Functions in 3 areas: diagnosis, psychotherapy, and research. Administers diagnostic tests and conducts interviews.

action research type

objectives are to document and improve the quality of individual practice or the function of an organization in a specific setting.

applied research type

objectives are to find answers to practical problems or to test the finding of basic research under real world conditions. Most of research by OT is this type i.e.: cognitive function with different sensory losses.

sidetracking

occasionally a group member will take great interest in a topic that is of little interest to other members and he or she lacks the ability to notice this fact.

purposeful activity

occupational performance and occupational roles.

occupational form

occupational situations including environmental context of the individual's life

co-occupation

occupations by two or more individuals.

diffuse axonal injury

occurs from shearing forces corpus collosum and brainstem are most affected

instilling hope

occurs in a group when a member is encouraged by another member who has dealt with a similar problem or issue

Normal phases of swallow 2 Oral phase

occurs once the bolus is prepared and formed by the tongue.

occupational deprivation

occurs when factors beyond themselves limit the individual's choice or opportuntiy.

interpersonal learning

occurs when group members become more aware of their behavior and their interaction skills

corrective recapitulation of the primary family experience

occurs when group members identify the therapist with members of their own family

disengagement

occurs when individuals have little contact and do not share personal information readily.

Normal phases of shallow 4 Esophageal phase

occurs when the bolus passes into the esophagus and is propelled to the stomach.

Normal phases of swallow 3 Pharyngeal phase

occurs when the bolus passes over the base of the tongue and enters the pharynx.

emergent awareness

occurs when the person is able to recognize limitations or strengths while they are occurring

validity

of manual muscle test, depends on examiner's knowledge and skill in using correct testing procedure.

MMSE

offers a quick and simple way to quantify cognitive function and screen for cognitive loss. It tests the individual's orientation, attention, calculation, recall, language and motor skills.

evaluator critic

offers standards used to measure accomplishments

opinion giver

offers values and attitudes to others

contralateral

on or relating to the opposite side of the body.

ipsilateral

on or relating to the same side of the body

Intradisciplinary

one or more members of one discipline providing treatment to an individual.

Tourette Syndrome

onset at 6 to 7 years of age, genetic disorder. repetitive, involuntary motor and vocal tics.

urostomy stomas

opening between the body surface and the organs that produce and collect the urine.

stomas

opening from the surgically resected site to the outside of the body.

morphostatic principle

order is maintained through daily family rhythms

components of the marketing process

organizational assessment environmental assessment market analysis marketing communications

idealization

overestimating someone or valuing him or her more than the real personality or person seem to merit.

free radical theory

oxidation of lipids, proteins, fats and carbohydrates. Low-level free radical damage occurs over time resulting in age associate decline of function in major organs. Genetic theory

Anterior Cord

pain, temp, and touch are lost; proprioception is preserved.

dystonia

painful sudden muscle spasms

symmetrical patterns

paired extremities perform like movements at the same time

reciprocal patterns

paired extremities perform movements in opposite directions at the same time.

resistance and reluctance

passive or active refusal to participate in some or all aspects of therapy. Interpersonal event that occur during group process.

follower

passively goes along with members

Freedom

patient has the right to refuse treatment.

disengagement theory

people withdraw from roles or activities and reduce their activity levels or involvement .

mood lifting scents

peppermint and lemon grass

remedial approach

perceptual retraining. focus is on repairing impairment through potential reorganization of the central nervous system.

Psychotherapy based supervision style

person and relationship centered

early adulthood 21-40

personality disorders, anxiety disorders, alcohol and substance abuse.

contemplation:

persons are aware of a health problem and are considering taking action but have not committed to any specific action or to begin performing a health behavior.

types of qualitative research design

phenomenology studies ethnographic studies case study design

Biomechanical

physical motion, stress and rest the body. Used in OTA preparatory. 1. ROM 2.Strength 3. Endurance

Maslow's hierarchy of needs level 1

physiological needs

definition of play

pleasurable, self-initated activity controlled by the child.

Public policy

policies of the state, federal and local bodies to influence or regulate behavior (Let's move! campaign-Michelle Obama)

visuodyspraxia

poor processing of visuospatial information and performing visual construction tasks.

wrist drop

position whereby the wrist and MCP joints are unable to actively extend. Caused by radial nerve dysfunction

8 Stages of the Intervention Process in OT Stage 1

referral

assistive technology services

refers to any service that assists an individual with a disability in selecting, acquiring, and using an assistive aid or device. (Communication Aid)

assistive technology

refers to anything that helps a person be more functional in daily life.

cohesiveness

refers to how the members bond or interact

denial

refusing to believe something that causes anxiety

ego

regulates behavior by compromising the demands of the Id, the superego and reality.

sensory modulation

regulatory process of the nervous system that controls the perceived intensity of incoming sensations through the raising or lowering of neuronal thresholds to that sensory input.

Types of MS

relapsing-remitting secondary-progressive primary-progressive progressive-relasping clinically isolated.

imparting information

related to accessing services, obtaining products, or learning new skills

antidepressant medication

relief from depression and the risk of suicide

orientor

reminds the group of its intent and purpose

Individual educational program (IEP)

required for children 3 to 21 years old who receive special education services. written plan and process. Goals, objectives, methodologies.

cognitive flexibility

requires changing strategies when confronting a problem, or changing a set of thoughts. This means when a person is presented with two or more concepts, the person can shift from one to the other.

quadruped

requires head and trunk control coupled with shoulder and pelvic stability.

Social Worker

role is to act as a liaison between consumer and the community in order to make the best use of resources available.

Social role supervision style

role of the supervisor changes based on needs of employees

torque

rotary or twisting force.

elopement

running away from an inpatient treatment facility without being discharged

Maslow's hierarchy of needs level 2

safety needs

8 Stages of the Intervention Process in OT Stage 2

screening

Developmental sequence prewriting skills: 14 months

scribbling

phenomenology studies

seek to understand individual experiences and the meanings people make of their experiences

information seeker

seeks clarification and factual information

case study design

seeks to understand the experiences of one specific individual/group/context.

3 aspects of self awareness #3

self concept

Prudence

self governing; knowing right from wrong

paranoia

self- avoid approaching suddenly, from behind or in a manner that might be perceived as threatening. Do not whisper in these pts. presence because they will believe your are talking about them. environment-stable and reliable as possible. Prepare client in advance for any changes. Do not forces social contact. activity-should be ones that person can control. Structured activities involving controllable materials (e.g., leather work)

anxiety

self- encourage talking, do not criticize behavior,avoid extended discussions of physical symptoms. environment-calm, comfortable, familiar, avoid noise and too many people activity- repetitive motor sequence (woodworking kits, simple cooking tasks) deep breathing

Maslow's hierarchy of needs level 5

self-actualization needs

depression

self-allow them to talk. redirect to positive approaches. environment-safe and subdues, little stimulation, provide choices activity- simple structured, successful, repetitive. don't push socialization at first work-up to it.

cognitive deficits - confusion-impaired memory

self-approach as individual, consider level of functioning, remind pt of where they are and who you are environment-control to maximize safety, use to cue desired behaviors activity-simple, structured,short-term. Simplify known activities instead of introducing new ones. carry notebook, organization, orientation skills

delusions

self-avoid talking about delusion. environment-relatively stimulating. provide opportunities for the person to get involved in real-life activities. activity-should be suited for intellectual level. board games, current event discussions, crossword puzzles, word games.

intrinsic motivation

self-initiation or drive to action that is rewarded by the activity

cognitive deficits -attention deficits-disorganiation

self-may need to be loud, may need to touch firmly but gently on the arm or shoulder. environment-reduce distractions, work alone. classical and/or favorite music played in background. activity-simple craft projects, self care task, training in safety, coping and stress management, computer games.

seductive behavior

self-nonjudgemental manner, avoid any physical contact, stop/explain therapeutic relationship. environment-avoid crowded situations. Pt. should have personal space, protected from touch, smell and warmth of others. activity- instruct masturbation, gross motor activities, social skills training, sports, physical exercises.

mania

self-remain calm, matter of fact, firm. environment- eliminate distractions, may start person out by working alone. activity-short term, immediate gratification. 3 steps or less and predictable. Gross motor exercise.

hostility

self-sensitive to client's feelings. Alert to signs that client is feeling tense threatened or suspicious. Get them to talk. environment-private environment to avoid embarrassment. 4 or 5 foot distance. door left open for safety. activity- art and dance

hallucinations

self-talk to them in a calm, firm, natural, rhythmic, soothing manner. Acknowledge hallucinations and how they make the pt. feel but focus them on neutral topic. environment- low stimulation, do not allow them to isolate themselves. activity- interactions with small selective groups. music or sing along, bright colors.

leadership

senior management and executives at the top

phantom sensation

sensation still seems to come from missing limb and feels as though its movement can be controlled.

Parietal lobe

sense of touch, differentiation of size-shape-colors, spatial perception, visual perception

Piaget's stages of cognitive development

sensorimotor, preoperational, concrete operational, formal operational

intrinsic feedback

sensory stimulation as a consequence of task performance

Egocentric group roles

serves the needs of the individual but interferes with group process. Aggressor, blocker, dominator

Interdisciplinary

several disciplines agree to collaborate for decision making. Evaluations are still performed independently defined within each other's expertise. Formal communications such as treatment planning meetings occur.

coordination of secondary schemata

several significant changes take place. Infant readily combines previously learned schemes and generalizes them for use in new situations

Autism

severe and complex impairments in reciprocal social interactions and communication skills; stereotypical behaviors, interests and activities.

neutropenia

severe impairment of immune response with decreased resistance to infection

Complete spinal cord injury

severing of the spinal cord. Does not regenerate, everything below that level has no voluntary control

group observer and commentator

shares views and interpretations

failure to thrive

sharp decline in physical health with no real physical or illness-related reason.

STG

short term goals

cognition

skill of understanding and knowing. the ability to judge and make decisions. Overall awareness of an individual's surroundings. Allows individuals to use and process sensed and perceived information.

Pressure sores - Stage 1

skin intact reddened for 20 minutes, warm to the touch

operant conditioning

skinner box

Open brain injury

skull has been penetrated or cracked

pursuit tracking movements

slowly following an object with the eye.

ataxia

small shifts in muscle tone with decreased equilibrium cannot be regained

Mosaic Down Syndrome

some cells have the trisomy (extra chromosome) and some do not. Intelligence level will be 10 to 30 pts. higher compare to downs syndrome.

advanced level

specialized skills with expertise in a particular area of practice.

purposeful activity

specifically selected, goal-directed activities that allow the client to develop skills that enhance occupational engagement.

statement of terminal behavior

specifies the physical changes, types of behavior, or performance skill that the Pt. is expected to display

isokinetic contraction

speed is set and will stay the same. Done with special equipment like the cybex or universal system in a gym.

norming

stage is characterized by the recognition of individual differences and shared expectations

criterion

states the degree of competence or the performance standard by which the patient's behavior is to be measured

results

statistical analyses are explained that led to the authors conclusions.

dsyphagia

stiffness in jaw, mouth, neck, shoulders

short term memory

storage of information temporarily, very limited time frame

primary prevention

strategies that reduce risk for disease before its onset. Facilitation of lifestyle changes.

COPM Canadian Occupational Performance model

structured interview that measured a client's own perceptions about his or her own occupational performance

statics

study of forces acting on objects at rest.

kinetics

study of motions of objects and the forces acting on them.

Act

study the results and make lasting changes with decisions based on data. Root cause analysis to make sure you truly identified the cause of the problem.

medical informatics

study, invention, and implementation of structures and algorithms to improve communication, understanding, and management of medical information.

OT treatment for UE Amputation

stump care/skin hygiene, stump wrapping, ADL/IADL training, ROM exercise, desensitization, wear schedule and use schedule, prosthetic skill training.

denial

substance abuser ignores the disease

Dynamic splint can

substitute for loss of motor function (example is the tenodesis splint.)This splint helps persons with spinal cord injuries at the cervical level of six or seven grasp objects using a tenodesis grasp pattern.

Organizations

such as businesses, agencies or industries

existential factors of life

such as the meaning of life, acceptance of mortality, and recognition of personal responsibility in one's life can be addressed in the group process

conclusions

summarizes the findings, as well as discusses what value the research has on a real-life application public knowledge. It may also offer suggestions for future research, and issues that may have come up during the study.

encourager

supports others in a positive ways

arthrokinematics

surface movement of the joint (small movement, involuntary with the joint surface, usually invisible to the naked eye.)

autograft

surgical transplantation of person's own skin from unburned area (donor site)

Decorticate posturing

sustained contraction and posturing of BUEs in flexion and trunk and BLEs in extension

concentration

sustained focused attention for a period of time

Inhibition used with hypertonia

sustained pressure on tendon slow rocking, rolling, or stroking rotation weight bearing and weight shifting heavy joint compression wrapping and swaddling hand vibration calming enviroment

Inhibition used with hypertonia

sustained pressure on tendon slow rocking, rolling, or stroking rotation weight bearing and weight shifting heavy joint compression wrapping and swaddling hand vibration calming environment

Dystonia

sustained twisted postures, triggered by movement.

neuromas

swelling or tumor along the course of a nerve or at the end of a divided nerve.

the three categories of group membership

task (worker) roles, maintenance roles, and individual (blocker) roles

compensation

teaching alternative strategies or methods

Role acquisition

teaching of "all" daily life roles.

social skills training

teaching of interpersonal skills needed to relate effectively to other people.

Social skills training

teaching of interpersonal skills needed to relate to other people effectively.

forward chain

teaching step by step; client performs the process in order

low technology

technology that is easy to obtain and use (reacher)

medical technology

technology used to sustain life (respirator)

isotonic eccentric contraction

tension in the muscle increases or remains constant as the muscle lengthens. Motion is done with gravity. Lowering arm place napkin next to a plate on the table.

Validity

that the measurement actually represents; what it is suppose to represent.

Reliability

that the measurement remains consistent and free from error.

therapeutic reasoning

the ability to anticipate, identify and cope. determine if a mode shift is required, choose a response mode. Draw on relevant interpersonal skills. Gather feedback and review.

hardiness

the ability to bounce back quickly from adversity or illness.

praxis

the ability to plan and perform purposeful movement.

empathy

the ability to share and understand feelings of another.

flow

the act of doing without thought-effortless action. This is experienced with active leisure vs. passive like reading

Supervision

the control and direction of work of one or more employees in a manner that promotes improved performance and a higher quality outcome.

scapegoating

the entire group may "gang up" against one member. May blame failure to meet group goals.

altruism

the experience of being able to help another person

catharsis

the experience of relief from emotional distress

internal control

the extent to which the child is in control of the actions and to some degree the outcome of the activity

primary circular reactions

the infants repeats the reflexive movements and patterns simply for pleasure.

universality

the realization that other members have similar concerns and feelings and may have very similar experiences

recapitulation of ontogenesis

the stage by stage repeating of development

components of IRM #2

the therapist

family ecology

the way family operates in society, including the immediate community and the state and federal systems

instructing

therapist carefully structures therapy activities and is explicit with clients about the plan, sequence and events of therapy.

empathizing

therapist continually strives to understand the client's thoughts, feelings and behaviors while suspending judgement.

advocating

therapist ensures that the client;s rights are enforced and resources are secured.

collaborating

therapist expect the client to be an active and equal participant in therapy, and ensures choice, freedom, and autonomy to the greatest event possible.

problem solving

therapist facilitates pragmatic thinking and solving dilemmas by outlining choices, posing strategic questions and providing opportunities for comparative or analytic thinking.

empathic breaks

therapist is perceived by the client as hurtful or insensitive. Interpersonal event that occur during group process.

encouraging

therapist seizes the opportunity to instill hope in a client and celebrate a client's thinking or behavior through positive reinforcement.

therapeutic use of self

therapist's planned use of his or her personality, insights, perceptions, and judgement as part of the therapeutic process.

hypotonia

there is not enough tension in the muscle when it is at rest. The muscle may have a slightly mushy or floppy feel to it, and there is a lack of graded control of the muscle hen it is being used.

hypertonia

there is too much tension in the muscle at rest. The muscle is tight and tense even though it is not doing anything.

Personality disorders

these disorders all involve a pattern of experiences and behaviors that are persistent, inflexible, and deviate from one's cultural expectations.

Depressive disorders

these disorders describe conditions where depressed mood is the overarching concern.

Personality disorder cluster B

these individuals seem overly emotional, are melodramatic, or unpredictable in their behaviors and interpersonal relations.

cognitive behavioral supervision style

thinking changes behavior, begin by changing thinking. 1. establish trust 2. analyze employees skills 3. set goals 4. implement strategies 5. follow up assessment

Basic research

to discover new knowledge. How things work and what they are made of.

Applied research

to find answers to practical problems or to test the findings of basic research under real world conditions. This is the most common type.

functional groups

to incorporate the use of purposeful activity and meaningful occupation into the process and dynamics of group work

sanction

to preserve their integrity a group may "punish"a member who violates the norms.

interventions of new means through mental combinations

toddler begins using trial and error to solve problems

anosognosia

total inability to recognize deficits

RUGs extensive services

tracheostomy care OR ventilator or respirator OR isolation for infectious disease AND ADL score greater than or equal to 2.

classical conditioning

trail and error

projection

transfer onto others of one's own feelings

forming

transition from a group to a functioning team; members build confidence and trust in each other as well as their leader

8 Stages of the Intervention Process in OT Stage 7

transition planning

push-in

treat child in the classroom.

Equality

treating everyone equal.

undoing

trying to reverse the effects of what one has done by doing the opposite

Leukemia

tumors of the bone marrow.

Rotation:

turning the pencil from the lead end to the eraser end without putting the pencil down on the table or using the chest to stabilize the pencil while turning it.

scapegoating

two or more individuals collude to influence, criticize,or otherwise control another individual.

groups

two or more people who meet to address a specific task or goal

milieu treatment approach

type of treatment that involves changing the environment in hopes it will encourage a client to develop new coping strategies.

sublimation

unacceptable wishes channeled into socially acceptable activities

crisis points

unanticipated, stressful events can clients to become distracted or temporarily interfere with client's ability for occupational engagement. Interpersonal event that occur during group process.

inhibition

used for hypertonia to decrease abnormal muscle tone and patterns of movement.

biomechanical approach

used in the treatment of lower motor neuron and orthopedic dysfunction. Emphasis of activity analysis is muscles, joints, and motor patterns. All voluntary movements.

playboy

uses joking and provocative behavior to distract attention onto self

quantitative approach

uses methods that can define, measure, collect, and analyze data in numerical formats. This method looks at variables.

qualitative approach

uses methods that can identify, collect, and analyze data that exists i a non-numerical format. Researchers pose a questions that need to be answered with words or visual displays. Is non experimental.

isotonic resistive exercise

uses muscle contraction against a specific amount of weight to move the load through certain ROM. Primarily used to increase fair plus to normal muscles.

Recreational Therapist

uses play, leisure, exercise, and other activity to meet individual needs.

Sensory integration

uses the patient's ability or inability to process sensory information to promote change.

Translation:

using only the fingers, the student "walks" his or her hand from the lead end of the pencil to the eraser end without the aid of items for stabilization

use of spiritual beliefs

using philosophical or spiritual beliefs to make sense of and find meaning in a situation

Developmental sequence prewriting strokes: 2-3 y.o.

vertical and horizontal lines

Occipital lobe

vision

Post Traumatic Amnesia (PTA)

waking up after the injury and not remembering injury. The longer the PTA the worse the injury

opinion seeker

want clarification of values and attitudes

What are the clinical signs of joint inflammation?

warm, swollen, tender, red, painful to move

Performance capacity

what Pt. can achieve

Etiology

what is the cause? the syndrome or disorder may be a result of some behavioral, and/or psychological condition, or related to a secondary physical condition, or illness.

Plan

what process could be improved and how would that lead to increased efficiency and ability to meet customer requirements? Decide what you are going to focus on-what are the issues?

group content

what the group did; what is said, written or produced during the course of the group.

Asthma

wheezing, coughing, chest tightness. Chronic inflammation of the airways. Treat with inhalers-corticosteriods.

Unskilled services

would be exercises that are a repetitive in nature, or passive exercises to maintain range of motion or strength that do not require the involvement of skilled rehabilitation.

Pressure sores - Stage 3

wound is in deeper areas of skin

Advantages of prefabricated splints

• May save time and effort (if the splint fits the person well) • Immediate feedback from client in terms of satisfaction and therapeutic fit • Variety of material choices • Some clients prefer sports-brace appearance

Moderate assistance

At least 50% assistance needed to complete task

3 types of clinical reasoning OT's use

Conditional reasoning

3 Fair

Part moves through complete ROM against gravity.

Standard II Screening, Evaluation, and Re-Evaluation.

A COTA contributes to the screening, evaluation, and re-evaluation process by implementing delegated assessments and by providing verbal and written reports of observations and clients capacities to the OTR in accordance with federal and state laws, other regulatory and payer requirements, and AOTA documents.

Standard IV Outcomes

A COTA contributes to the transition or discontinuation plan by providing information and documentation to the supervising OTR related to the client's needs, goals, performance, and appropriate follow-up resources.

Standard I Professional Standing and Responsibility.

A COTA is responsible for providing safe and effective OT services under the supervision of an in partnership with the OT and in accordance with laws or regulations and AOTA documents.

Mental Illness

A behavioral or psychological syndrome that causes significant distress or disability or a significantly increased risk of suffering death, pain or an important loss of freedom. Impaired functioning in one or more areas.

William Tuke

A coffee merchant and Quaker who came from a wealthy family who had a long history of philanthrophy.

neurapraxia

A condition in which a nerve remains in place after a severe injury, although it no longer transmits impulses.

Cost centers:

A manner of referring to the grouped costs associated with a set of activities within the organizational structure (e.g., the occupational therapy department, the behavioral health day treatment program, or the human resources department).

Physician

A medical doctor who practices the science and art of preventing and curing disease and preserving health.

Allowances or deductions

A percentage of fees that is negotiated with a payer to be deducted or discounted from the gross charge for services.

neurotmesis

A peripheral nerve injury in which laceration or traction completely disrupts the nerve.

Standard II Screening, Evaluation, and Re-Evaluation.

An OT practitioner uses current assessments and assessment procedures and follows defined protocols of standardized assessments during the screening, evaluation and re-evaluation process.

Standard III Intervention

An OT practitioner uses professional and clinical reasoning to select the most appropriate types of interventions, including therapeutic use of self, therapeutic use of occupations and activities, consultation, education, and advocacy.

axontomesis

An interruption of the axon with subsequent degeneration of the distal nerve segment.

What is point of service?

As you perform the treatment you write it down.

Stage 5 Parkinson's Disease

Confided to a bed or wheelchair, maximal assistance required.

early childhood birth to 5

ADD/ADHD, pervasive developmental disorder, autism, mental retardation, failure to thrive, reactive attachment disorder, separation anxiety disorder

Area of occupation

Activities of daily living (ADL)/Basic activities of daily living (BADL) or Personal activities of daily living (PADL)

Gullian-Barre Syndrome

Acute inflammatory condition that affects spinal roots, peripheral nerves, and some select cranial nerves. Following a viral illness, immunization, or surgery.

identity vs role confusion

Adolescence. Parental rebellion. Vocational choices and gender identity.

Living Will

Advance Health Care Directive, is set instructions to give an appointed individual the right to make decisions concerning the health care actions to be taken when the person is no longer able to make the decisions.

Arthrogryposis

Affects joints of the lower and upper extremities but not the spine. May or may not be genetics. Splinting as an infant can help with the deformities. Curving of the joints, abnormal fibrosis of the muscle tissue

Rett Syndrome

Affects only females. Characteristics microcephaly, seizures, intellectual disabilities. Progressive disorder.

Neuroscientific theory

All mental processes, including behavior and emotion, originate in biochemical and electrical activity in the brain.

Freedom (core value)

Allows the individual to exercise choice and to demonstrate independence, initiative and self-direction.

Standard III Intervention

An OT practitioner collaborates with the client to develop and implement the intervention plan, on the basis of the client's needs and priorities, safety issues, and relative benefits and risks of the intervention.

Standard II Screening, Evaluation, and Re-Evaluation.

An OT practitioner communicates screening, evaluation and re-evaluation results within the boundaries of client confidentiality an d privacy regulations to the appropriate person, group, organization, and or population.

Standard III Intervention

An OT practitioner coordinates the development and implementation of the OT intervention with the intervention provided by other professionals, when appropriate.

Flow

Authority flows downwards in the organization. This is because it is delegated by the superiors to the subordinates. Power can flow in any direction. Even subordinates have power over their superiors, if they can influence their behavior. So power can flow upwards, downwards or horizontally.

Legitimacy

Authority is always official in nature. So it is legitimate. Power need not be official in nature. So it need not be legitimate.

Position and Person

Authority is given to a position or post. the manager get the authority only when he holds that position. Power resides (lives) in the person who uses it.

Nature

Authority is the formal right given to a manager to make decisions or to command. Power is the personal ability to influence others or events.

Organizational Charts

Authority relationships (superior-subordinate relationships) can be shown in the organization chart. Power relationships cannot be shown in organizational charts.

Principle 3

Autonomy and Confidentiality - OT personal shall respect the rights of the individual to self determination

Stages of Alzheimer's Disease - Early/Mild impairment

Average 1to 3 years, possibly longer.Memory loss, especially with recent events. Difficulty with complex cognitive tasks. Difficulty with decision making and planning. Decreased attention span and concentration. Lack of spontaneity and lessening of initiative. Impaired word-finding skills. Preference for familiar settings.

Cognitive disabilities

Claudia Allen 6 levels of cognitive development used focused on the effects of impaired cognition on task performance.

Stages of Group Process for lower functioning individuals. Stage 5

Closing the session. Emphasize the positive. Familiar and relaxing activities. Examples repeat stage 1, candy, refreshments. Say goodbye to each person.

Social Skills Training #1

Coaching- motivation

Performance skills

Cognitive skills

Adolph Meyer

Coined the term "Psychobiologic approach" to mental health; indicating the human is an indivisible unit of study, rather than a composite of symptoms. Established the foundation of what is now know as occupational behavior, the model of human occupation and occupational performance.

Generalization

Cole's 7 steps of group process. Address cognitive learning aspics of the group.

Sharing

Cole's 7 steps of group process. Clients share experiences. Leader acknowledges each member.

Application

Cole's 7 steps of group process. How does this apply to everyday life? Ask members how they might use skills from the group in other settings and in their daily lives.

systolic

BP at time of the contraction of the left ventricle

diastolic

BP at time of the rest period of the heart

Cognitive Rehabilitation

Balance of the entire brain. What the Pt. can and can't do

Define MET

Basal Metabolic Equivalent

Object relations theory

Based on psychoanalytic theory. Mental health and mental illness is determined by our relations with objects in our environment. These objects are physical (non human) or human. Our abilities to love and respond to others is seen as expression of object relations.

Social Skills Training #2

Behavior modeling-demonstration

Social Skills Training #3

Behavior rehearsal- practice

Prader-Willi Syndrome

Behavioral manifests - overeating and self-mutilations. Various degrees or intellectual disability.

Susan Tracy

Believed "the patient is the product, not the article he or she makes". She coined the term occupational nurse. She was a nurse who worked to apply moral treatment principle to acute medical conditions.

Principle 1

Beneficence - Ot personel shall demonstrate a concern for the well-being of the recipients of their services.

Stage 2 Parkinson's Disease

Bilateral tremor, rigidity, bradykinesia, with or without axial signs such as facial involvement, independent with ADL, no balance impairment.

Client factor

Body functions

Client factor

Body structures

Normal Hard End Feel

Bone contacting bone resulting in a hard yet painless end-feel.

Sensory Integration

Brain plasticity-can be rewired. Sensory feedback allows for continued normal response. 7 senses.

Fractures

Breaks, ruptures, or cracks in bones or cartilage. Immobilization for healing.

Processing

Cole's 7 steps of group process. Members express feelings about experience and others.

Summary

Cole's 7 steps of group process. Review goals, content, and process.

activity

Cole's 7 steps of group process. timing and therapeutic goals. Physical and mental capacity of members. Knowledge and skill of the leaders. Adaption of the activity.

introduction

Cole's 7 steps of group process. warm-up setting the tone of the group.

Performance skills

Communication skills

FIM score -7

Complete independence: Patient participates 100% of the time without helper and without an assistive device.

CMS

Center for Medicare and Medicaid Services is a government agency that oversees the program and interprets the laws developed by Congress.

Cognitive-Behavioral

Changing irrational thoughts to rational thoughts. How you think is how you behave.

Juvenile Rheumatoid Arthritis (JRA)

Characterized by exacerbations and remissions-75% have remission by adulthood permanently. Interventions-education about joint protection, energy conservation, assistive technology devices, PAMs, orthoses.

Spastic Cerebral Palsy

Characterized by hypertonia and spasticity. Distribution of abnormal tone variable. Initiation of movements leads to increases in abnormal tone.

What is COPD and the diagnosis involved?

Chronic Obstructive Pulmonary Disease -- Damage to the alveolar wall and inflammation of the conducting airways

Athetosis

Fluctuation of muscle tone from low to normal, with little or no spasticity and poor co-activation.

Total assistance

Dependent with task completion

What are two psychological symptoms common in COPD clients?

Depression and Anxiety

Plan

Determine and set forth the specific treatment that will be used to achieve the occupational goals. Document follow up required. What you plan on doing next session. Recommendations for family or caregiver. How much longer the pt. will be seen for treatment. Can document goals in this section: measurable, objective and in behavioral terms. The plan allows another practitioner to carry out tx. if you are unable at the next session.

Medical 203

Developed by the war department in 1943 first formal classification system

DRG

Diagnosis-related group. A group of patients classified for measuring delivery of care in a medical facility; used to determine. Medicare payments for inpatient care.

DSM V

Diagnostic Statistical Manual

Developmental sequence prewriting strokes: 4-6 y.o.

Diagonal lines.

Discovery:

when and how persons learn about the change • Plan communication carefully so that all hear the same information at the same time. • For large-scale changes, develop a formal and written communication plan. • Put any facts, dates, or other concrete information that will help staff understand and be clear on what is to happen in writing.

occupational alienation

when people are unable to meet basic occupational needs or use their particular capacities because of intervening sociocultural factors.

Denial:

when persons don't really believe that a change will occur or believe that, after a time, things will return to the way they were • Continue wide communication in writing and in person. • Offer "town hall" meetings or allow time for questions and answers at a staff meeting. • Continue to express why the change is occurring and when. • Include persons in planning and implementing change so that they see that it will indeed occur.

Evidence based practice

when practitioners locate, review, and interpret research literature related to a specific problems to gather evidence to support their clinical decisions.

extrinsic rewards,

which are rewards given by another person, often a manager or supervisor (Braveman 158)

intrinsic rewards,

which are rewards received as a direct consequence of a person's actions.

falling-in-love stage

which the he or she forms strong attachment to the primary caregiver(s). Responds to the facial expressions and vocalizations of the caregivers with smiles and coos.

action planning

who will do what by when.

compromiser

will accommodate and trade off own position for the good of the whole

Peck's stages of Psychological development in the second half of life Middle age -1st

wisdom vs. physical powers

Populations

within a community such as refugees, veterans who are homeless, and people with health disabling conditions

Shifting:

working items from the palm of the hand to the tips of the fingers without dropping items

consultative role

working with the family (most important role)

Pressure sores - Stage 4

wound has gone into muscles. May be life threatening

Defining contribution of OT is the application of

Core Values - Knowledge - Skills

What is CABG?

Coronary Artert Bypass Grafts

What is CHF?

Coronary Heart Failure

CQI process

Plan Do Check Act

Area of occupation

Play

Young Old

65-75

When considering technology ask...

"What is it the user wants to do? and/or "What is it the user needs to be able to do?

According to ASHT what are the purposes of a splint?

(1) mobilization, (2) immobilization, (3) restriction, and (4) torque transmission.

To have a strong functional grasp, the hand uses the following three arches

(1) the longitudinal arch, (2) the distal transverse arch, and (3) the proximal transverse arch

State Children's Health insurance program

(SCHIP) federal-state partnership wight he goal of expanding health insurance to children whose families earn too much money to be eligible for Mediciad, but not enough money to purchase private insurance

Crepitation

- Seen by RA and OA and occurs as the joints degenerate - Characterized by grating, crunching, or popping sensation that occurs during joint or tendon motion

Treatment objectives for arthritis

- maintain and increase joint mobility, strength, and endurance - prevent/correct/minimize deformities - maintain/increase I with ADLs - educate

Gout

- metabolic disease with a sudden onset and severe inflammation - occurs when there is an excess of uric acid in the body

Context and environment

Personal

AFO

ankle foot orthosis

PT

physical therapy

Responsibilities Stemming from Evidence-Based Practice

• Staying up to date with the sources of information in your area of practice • Communicating with others about what you have learned from synthesizing information • Using good judgment about the information you have gathered by critically evaluating its quality • Recognizing that translating evidence into everyday practice will not be easy and will require creativity

Frames of reference

1. Biomechanical 2. Neurodevelopmental 3. Rehabilitation 4. Role Acquisition 5. Behavioral 6. Sensory Integration 7. Psychodynamic 8. Cognitive-Behavioral 9.Cognitive Rehabilitation

developmental theory

1. Humans mature through a series of stages that occur in a fixed sequence. 2. Problems occur when developmental tasks are not sufficiently mastered developmental lag. 3. A developmental lag can be corrected by exposing the person to s situation that will encourage growth in the deficient area.

developmental theory

1. Humans mature through a series of stages that occur in a fixed sequence. 2. Problems occur when developmental tasks are not sufficiently mastered developmental lag. 3. A developmental lag can be corrected by exposing the person to s situation that will encourage growth in the deficient area.

When establishing goals for the individual users, OT practitioners consider the following:

1. Is this goal rehabilitative or functional? 2. Is the goal shared by the student/user, the family, and other members of the team? 3. Does the goal make sense; is it logical?

Identify 5 principles of joint protection.

1. Respect pain 2. Maintain muscle strength and joint ROM 3. Avoid positions that put stress on involved joints 4. Avoid saying in one position for a long time 5. Distribute the workload over several joints

Education for all handicapped children act (renamed education of the handicapped act (EHA))

1975 All children have the right to free and appropriate public education. 1986 Part H added extended service from birth to threes services should be equal in all states and counties. Renamed in 1990 Individuals with Disabilities Education Act (IDEA)

Technology-Related Assistance for Individuals with Disabilities Act

1988 allocated a considerable amount of dollars to support efforts of the states to increase the awareness of the benefits of technology for people with disabilities, funding for the provision of AT devices and AT services and coordination among state agencies and public and private entities to deliver AT devices and AT services.

Americans with disabilities Act

1990 In areas of public services, discriminatory practices against individuals with disabilities by employers are prohibited

autonomony vs shame and doubt

2 to 4 yr. Bowel and bladder control. exploring enviroment. Their sense of motivation will be shaped by the parents' reaction to this.

project group

2-4yr. Short term task emphasis; group cooperation is encouraged; leader provides for member needs. (Mosey)

No Child Left behind

2001 stresses the use of scientifically based or evidence-based programs and practices.

Severe intellectual disability

25-39 Requires regular support in all areas of occupational performance. May learn habitual self care skills. May have physical disabilities.

initiative vs. guilt

3 to 5 yrs. Imitate adult roles, terry out new ways to do things.

RUGs Rehab High

325 to 499 minutes total therapy per week AND 1 discipline 5 days/week.

Moderate intellectual disability

40-54 Writes name in cursively. reads simple text and emergency words. Works in sheltered workshops or community- supported employment setting. Successfully lives in supervised living situations.

RUGs Rehab Low

48 to 149 minutes total therapy per week and at least 3 days of any combination of 3 disciplines.

When are the assessment periods for RUG levels?

5, 14, 30, 60,90 days

egocentric-cooperative group

5-7 yr. Moderately long term projects with more personal interaction among members; leader provides for needs but less so. (Mosey)

RUGs Rehab Very High

500 to 719 total therapy per week AND 1 discipline 5days/week.

Mild intellectual disability

55-69. Reads at 4 or 5 grade level. Writes simple letters or lists. Performs simple mathematical functions, such as multiplication and division. Uses the computer and internet to perform simple research or communicate with others. Lives alone or with minimal supervision.

Ramps

5ft. at the top and 10ft at the bottoms.

industry vs. inferiority

6 to 12yrs. Teachers and parents attitudes towards them. Compares self to peers.

Borderline IQ

70-84

RUGs Rehab Ultra High

720 minutes expected or actual therapy per week AND one discipline 5 days/week AND a 2nd discipline 3 days/week.

Mid Old

75-85

Confidentiality of health information

8 basics of the Patient Bill of Right. HIPPA. Protects all "individually identifiable health information"

Access to emergency services

8 basics of the Patient Bill of Right. If you have severe pain, an injury, or sudden illness that makes you believe your health is in danger, you have the right to be screened and stabilized using emergency services.Even if they are out of your network, without needing to wait for authorization and without finical penalty.

Consumer responsibilities

8 basics of the Patient Bill of Right. In a health care system that protects consumer or patients' rights, patients should expect to take on some responsibility. Patients are expected to do things like treat health care workers and other patients with respect, try to pay their medical bills and take responsibility for their lifestyles to help improve their health.

Information for patient

8 basics of the Patient Bill of Right. You have the right to accurate and easily understood information about your health plan, health care professionals, and health care facilities.

Taking part in treatment decisions

8 basics of the Patient Bill of Right. You have the right to ask about pros and cons of any treatment, including no treatment at all. You have the right to refuse treatment.

Choice of providers and plans

8 basics of the Patient Bill of Right. You have the right to choose health care providers who can give you high-quality health care when you need it.

Respect and non-discrimination

8 basics of the Patient Bill of Right. You have the right to considerate, respectful care from doctors, health plan representatives, and other health care providers that do not discriminate against you based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation or source of payment.

Standard III Intervention

A COTA contributes to the modification of the intervention plan by exchanging information with and providing documentation to the OTR about the client's responses to and communications throughout the intervention.

Standard III Intervention

A COTA selects, implements, and makes modifications to therapeutic interventions that are consistent with the COTA's demonstrated competency and delegated responsibilities, the intervention plan, and requirements of the practice setting.

1 Trace

Contraction can be felt, but no motion or slight twitch observed.

ADA is modeled after

Civil Rights Act of 1964 and Rehabilitation Act of 1973

Amputation

Congenital or acquired. Thumb and below the elbow most common.

Domain and Process framework

Direct OT practitioners to focus on performance of occupations that result from the dynamic intersection of the client, the context and environment, and the client's occupations.

Congenital Hip Dysplasia

Dislocation of one or both hips. Genetic or environmental. Medical treatment consists of surgery, casting or bracing. Intervention- infant wears cast to promote proper alignment, can result in gross motor development.

Closed chain movement

Distal end of the extremity is fixed, emphasizing joint compression and, in turn, stabilizing the joint. Examples squats, wall slides, lunges, elliptical training, stair stepper, push-ups.

Sickle cell anemia

Hematological disorder that occurs in people of African descent. Crescent shaped red blood cells.

cognitive-behavioral theory

Human behavior is based on what we think and believe. What we think determines how we act. We create our own experiences of the world and can change it by becoming aware of how we think and feel.

Occupational Science

Human beings are viewed as complex multilevel systems who participate in their environment.

Cardiac Rehab - Phase 1, 2, 3

I - Inpatient - monitored low level activity II - Outpatient - Exercise is advanced with close monitoring III - Community Based Exercise Program

static tripod grasps

In this grasp, the implement is held with the thumb and the index and middle fingers. For the first time, the thumb is in full opposition to the index finger. Can be fatiguing or painful but offer more stability and power. Tight grasps limit the variety of movements and make smooth, flowing motions difficult. The hand moves as a whole unit, with very little or no finger action.

IEP

Individual Education Plan-specific goals developed jointly by the teacher, therapy, medical and family

Acquired Musculoskeletal Disorders

Injury or trauma to the skeletal or muscular system, or both. Soft tissue injuries and fractures. Care by orthopedist.

Conduct Disorder

Long standing behaviors that violate the rights of others and rules of society.Physical aggression toward others. Participation in mugging, shoplifting, burglary. Destruction of others' property. Breaking rules. Impaired school performance, skipping school and suspensions from school.

Cooperative group

Longer-term projects; task accomplishments and socio-emotional needs met mostly by members. (Mosey)

FIM score 2

Maximal Assistance: Patient participates 25%-49% of the time.

What is the largest funding source for OT services?

Medicare

Team

Member recognize their interdependence and understand both personal and team goals are best accomplished with mutual support. Time is not wasted struggling over "turf" or attempting personal gain at the expense of others.

Team

Members contribute to the organization's success by applying their unique talent and knowledge to team objectives.

Team

Members feel a sense of ownership for their jobs and unit because they are committed to goals they helped establish.

Team

Members practice open and honest communication. They make an effort to understand each other's point of view.

Team

Members work in a climate of trust and are encouraged to openly express ideas, opinions, disagreements, and feelings. Questions are welcomed.

generativity vs. stagnation

Middle adulthood. Making contributions through work. Child-rearing.

Titles of ADA - Title 5

Miscellaneous Provisions. The final title contains a variety of provisions relating to the ADA as a whole, including its relationship to other laws and its impact on insurance providers and benefits.

MOHO

Model of Human Occupation. Habituations, performance capacity, volition.

FIM score -3

Moderate Assistance:Patient participates 50% - 74% of the time.

egocentric-cooperative group

Moderately long term projects with more personal interaction among members; leader provides for needs but less so. (Mosey)

FIM score -6

Modified independence: Patient has mild difficulty but self-corrects without prompting from a helper. May use an assistive device or require extra time (3x normal).

Stages of Group Process for lower functioning individuals. Stage 2

Movement phase, increases non-verbals, match movements to abilities. Shaking hands, clapping, ROM, dance.

Brunnstrom's theory

Movement therapy. Syneries, reflexes and other abnormal movement patterns as a part of the process through which an individual with CNS dysfunction must go before normal voluntary movement can occur.

Proprioceptive Neuromuscular Facilitation (PNF)

Multisensory, focusing on mass movement patterns that resemble normal movement. All movement has a diagonal or spiral pattern.

Level T1-9

Patterns of weakness: lower trunk paralysis; total paralysis of lower extremities. Movement possible:upper extremities fully intact; limited upper trunk stability; endurance increased secondary to innervation of intercostals. Independent with most tasks.

Level T10-L1

Patterns of weakness: paralysis of lower extremities. Movement possible: fair to good trunk stability. Independent with modification.

Level C7-8

Patterns of weakness: paralysis of trunk and lower extremities; limited grasp and dexterity secondary to partial intrinsic muscles of the hand. Movement possible: elbow extension, ulnar/wrist extension; wrist flexion; finger flexions and extensions; thumb. Minimum Assistance

Level C4

Patterns of weakness: paralysis of trunk, upper extremities, lower extremities. May be able to breath without a ventilator. Movement possible:neck flexion, extension,rotation, scapular elevation;inspiration. Mostly total assistance.

Level C1-3

Patterns of weakness: total paralysis of trunk, upper extremities, lower extremities; dependent of ventilator. Movement possible: neck flexion, extension, rotation Total assistance

Level C5

Patterns of weakness:absence of elbow extension, pronation, all wrist and hand movement; total paralysis of trunk and lower extremities. Movement possible:shoulder flexion, abduction,and extension; elbow flexion and supination; scapular adduction and abduction. Moderate Assistance.

Level L2-S5

Patterns of weakness:partial paralysis of lower extremities, hips,knees, ankle, foot. Movement possible: good trunk stability; partial to full control of lower extremities. Independent with adaption.

Level 4 - Goal Directed Actions

Person able to copy demonstrated directions presented one step at a time; can visualize the goal of making something; is interested in doing simple two-dimensional projects, however does not plan for details; tends to rely on prior learning and finds it easier to imitate a sample than follow a diagram or picture; cannot recognize errors and may not be able to correct them when pointed out; does not understand that objects can be hidden from view; does not notice glue sticking to bottom of tray [Imitated motor actions: copy or reproduction of an example, rote learning; Attn to sensory cues: visible - what is not visible is ignored i.e. color, size, discomfort]

Level 6 - Planned Actions

Person appreciates relationships between objects even when they are not obvious; able to anticipate errors, reasons why they may occur, and plan to avoid them; associated with higher levels of education, occupational background and socioeconomic status [Imitated motor actions: often unnecessary; Attn to sensory cues: symbolic - abstract or intangible i.e. evaporation, electrical, current, heat, time, gravity]

Level 3 - Manual Actions

Person is interested in what is going on; easily distracted by objects in the environment, enjoys touching and manipulating them; engages in simple repetitive craft or activity but is likely to be surprised to see something has been produced; has difficulty understanding cause and effect except in his own simple actions; easily disoriented and may get lost [Manual or manipulative imitations of motor actions; Attn to sensory cues: Tactile i.e. texture, shapes]

Psychodynamic

Person is valuable and unique. People give meaning to objects and things. ID, ego, super ego.

Level 1 - Automatic Actions

Person seems mostly unaware of what is going on; pays attention for only a few seconds but carries out automatic habitual motor routines (self-feeding when food is presented); very slow to respond to request or cue (may respond by rolling over or holding up hand) [no imitated motor actions; Motor actions: sniffing, withdrawal from noxious stimuli, swallowing; Only dimconscious awareness of sensory cues i.e. hunger, thirst, discomfort]

Level 2 - Postural Actions

Person seems to be aware of movement and position and of effects of gravity; sits and initiates some gross motor actions; not aware of social context and may wander off; may assume bizarre positions or perform strange-looking movements [Approximate imitations of motor actions; Attn to sensory cues: proprioceptive i.e. posture, gesture, motion]

Level 5 - Exploratory Actions

Person shows interest in relationships between objects, however relationships must be concrete and obvious; interested in effects that can be produced using the hands and may vary the pressure or the speed of hand motions, can generally perform a task involving three familiar steps and one new one; new steps must be demonstrated; may appear careless because of inability to anticipate the possible consequences of actions; may benefit from social skills training to improve attention to nuances of expected social behavior; may function in community but may not take ordinary and reasonable care regarding rights of others [Imitated motor actions: new steps initiated; Attn to sensory cues: related - between 2 visible cues i.e. overlapping, color mixing, spatial relations]

Context and environment

Physical

Neonatal intensive care unit (NICU)

Physiologically unstable: unable to maintain body temperature or heart or breath rate. Neonatologist as medical team leader. OT does not work in this area.

PECS

Picture Exchange Communication System

Eleanor Clark Slagle

Pioneer of OT. Worked for 2 years at Hull House as a staff member. Established first training program for Occupational Workers (forerunner of OT personnel). Went on to work with William Dunton. She is consider on to the founding members of the national professional organization. Considered the most distinguished 20th century OT, she held every major office.

Objective

Place where you record all measurable, quantifiable, and observable data obtained during your client's occupational therapy treatment sessions: any social interactions. Judgement and problem solving behaviors, appearance and work skills.

Justice (core value)

Places value on the upholding of such moral and legal principles as fairness, equity, truthfulness, and objectivity.

subacute setting

Pt. more medically stable but not ready to go home for medical or family reasons. Continue to monitor and treat acute symptoms. wean off external medical supports. OT provides developmentally appropriate interventions. Pediatricians as medical team leader.

Volition

Pt. motivation

Independent

Pt. performs activity without assistance.

RLA VIII

Purposeful appropriate. Alert and oriented. Pt may drive. Stand-by-assistance. Community reentry, any ADLs or IADLs that have not been mastered

Which form of arthritis is symmetrical?

RA

Symptoms of Gullian-Barre Syndrome

Rapid onset and patient decline; then rapid recovery. Pain and tenderness of muscles, weakness, and decreased deep tendon reflexes occur; trouble walking then may not be able to move then on vent. Most recovery is within a few weeks to few months. May continue to recovery for up to 2 years.

Most common type of MS

Relapsing-remitting shows clearly defined relapses with some amount of recovery in between and no progression in-between

Activity Demands

Required actions

Supervision

Requires direct supervision for safety.

Stage 4 Parkinson's Disease

Requires help with some or all ADL, cannot live alone without assistance, able to walk and stand.

Equality (core value)

Requires that all individuals be perceived as having the same fundamental human rights and opportunities.

Truth (core value)

Requires that we be faithful to the facts and reality.

Area of occupation

Rest and Sleep

Primary symptoms of Parkinson's Disease

Resting temor Rigidity Bradykinesia Postural instability

Anorexia Nervosa

Restrictive: limits food intake and uses activity,exercise to control weight. Intense fear of being overweight.

intimate self disclosures

Reveal too much personal information. Interpersonal event that occur during group process.

Common diagnoses for a resting hand splint

Rheumatoid Arthritis,hand burns,Dupuytren's disease,contractures,trauma, and crush injuries of the hand.

Public law 99-457 (1986)

Rights of families. Central role of families in intervention with young children. Families as co-leaders on state-level advisory boards. Families' concerns, resources, and priorities important to the development of an intervention plan. Added Part H (now know as Part C) to EHA, mandating early interventions for birth to age 3 population. Included identification and referral, evaluation, determination of eligibility, development of individual family service plan (IFSP), and transition plans.

Performance patterns

Rituals

Performance patterns

Roles

Performance patterns

Routines

Stages of cancer

STAGE I-may be localized to one region, usually early stage. STAGE II-cancers spreads to another adjacent local region of the body ( a tumor and metastasia). STAGE III-disease spreads to another organ. STAGE IV-disease is wide spread and multiple systems /organs are involved.

Performance skills

Sensory perceptual skills

Activity Demands

Sequencing and timing

Traumatic Brain Injury (TBI)

Serious injury to the brain, can cause motor, cognitive, and emotional changes.

project group

Short term task emphasis; group cooperation is encouraged; leader provides for member needs. (Mosey)

Narrative notes

Similar to SOAP notes but one big paragraph. Allows for more flexibility all data is included in a smooth flowing descriptive note.

Parkinson's Disease

Slow,chronic progressive disease of the nervous system. Caused by a reduction of dopamine in the brain.

What is the leading cause of COPD?

Smoking

Context and environment

Social

Principle 4

Social Justice - OT personnel shall provide services in a fair and equitable manner.

Area of occupation

Social participation

Client-centered therapy

The client has the ability to freely choose and act because one is aware of one's feelings and the possible consequences of an action no matter how psychotic or disorganized the behavior may be. Techniques: the therapist takes a non directive approach. Active listening very important. There is an open invitation to talk, minimal response, reflection of feelings, paraphrasing, withholding judgment.

Tinel's test

The first method involves gently tapping over the suspected entrapment site to help determine whether entrapment is present. The second method consists of tapping the nerve distal to proximal. A positive sign if he or she experiences tingling or shooting sensations in one of two areas: at the site of tapping or in a direction distally from the tapped area.

Normal Soft End Feel

The range is limited by soft tissue compression.

Family systems theory

The way families operate as units, the impact of diverse cultures and child-rearing patterns on family life, and difference in child rearing.

Adult/adolescent sensory profile- Sensory Sensitivity

These individuals have low neurological thresholds that cause them to respond readily to sensory stimulus. They are distractible and are uncomfortable around intense stimuli. They tend to notice each stimuli as it presents itself. They are able to discriminate and attend to detail.

Adult/adolescent sensory profile- Low Registration

These individuals tend to miss or take longer to respond to stimuli that others notice. This person may be the last to understand a joke or the last one to smell an odor. These individuals are more flexible and more comfortable in a wide range of sensory environments.

Adult/adolescent sensory profile- Sensory seeking

These individuals will create additional stimuli or seek out environments to get more sensory stimuli. These individuals will listen to music while they ares studying or eat at a restaurant that have unfamiliar foods. They enjoy exploring the environment and regard sensory experiences as pleasurable. They become bored easily and find low stimulating environments intolerable.

Adult/adolescent sensory profile- Sensory Avoiding

This individual is overwhelmed or bothered by sensory stimuli. They purposely avoid stimuli in their environments and engage to reduce the stimuli. This individual may use rituals to increase predictability. They enjoy being alone.

faded assistance

This involves providing assistance for all, or a portion, of the activity. Could occur in the form of physical assist or grading of the activity in the form of adaptations or accommodations to the size of objects, speed, frequency or duration of the activity, height and angle at which the activity is performed, number of steps, complexity, and sensory components of the activity.

Subjective

This is the section that OTA will document the patient's concerns and comments. It is the client's perspective. Any reports of pain or discomfort from Pt. goes here. Any reports from the caregiver or family member goes here also. Should specifically pinpoint a specific issue rather than noting general comments.

Assessment

This section consists of the occupational therapy practitioner's skilled appraisals of the client's progress, functional limitations, pertinent issues and expected gains from rehabilitation. Rehab potential in Areas of Occupation. Progress or regress report here. Justify why the patient needs to continue OT Tx. Not for new information, reiterates what was documented in the O and S sections.

Adaptation

To modify the activity. Changing the components that are required to complete the task. It allows Pt. to experience success in task accomplishment at his or her level. An example would be using a vice to stabilize needlepoint or wood project for a patient that has only one arm.

Adaptation

To modify the activity. Changing the components that are required to complete the task. It allows the patient to experience success in task accomplishment at his or her level of functioning.

Domain of OT

To support health and participation in life through engagement in OCCUPATION.

FIM score 1

Total assistance: Patient participates less than 25% of the time or not at all, requires more than one helper, or 1:1 supervision.

Contact guard assistance

Touching Pt.

William's motor learning principles

Transfer of learning Feedback (modeling or demonstration) verbal instruction knowledge of result/ knowledge of performance distribution and variability of skill practice whole versus part practice mental practice

sensory diet

a carefully designed activity plan for sensory input a person needs to stay focused and organized

Lazarus Project

Used in long-term care facilities it involves empowering individuals by creating communities which govern themselves by drawing on diverse strengths of members to address common problems.

What is therapeutic use of self?

Using your personality, insights, perceptions and judgements as part of the therapeutic process.

3 aspects of self awareness #1

Values

Client factor

Values, beliefs and spirituality.

Principle 6

Veracity - OT personnel shall provide comprehensive, accurate, and objective information when representing the profession.

Stages of Group Process for lower functioning individuals. Stage 4

Verbal and Symbolic activities, enhanced cognition. Examples making fruit salad, memory games.

parallel group

Very little group interactions; leader provides essentially all needs of each member. (Mosey)

Context and environment

Virtual

Stages of Group Process for lower functioning individuals. Stage 3

Visual motor perceptual activities, increases demands on members to respond. Incorporates; sensory stimulation, movement, cognition, Simon says, relay races, pantomime games.

VOCAs

Voice Output Communication Aids. High-tech devices are able to store information and produce auditory communications.

BMI calculation

Weight (lb)/[Height(in)]2 × 703

Role Acquisition

What roles did they have? What roles can they have?

Area of occupation

Work

Describe how energy conservation techniques can be applied to daily activities.

You can plan ahead, remove yourself from stressful situations, and include daily rest periods and breaks

whose covered under ADA Act

You must actually have what is considered to be a "physical or mental impairment". The impairment must "substantially limit one or more of your major life activities."

mental illness

a behavioral or psychological syndrome that causes significant distress or disability or a significantly increased risk of suffering death, pain or an important loss of freedom. Impaired functioning in one or more areas.

genuineness

ability to be oneself openly

initiation

ability to begin a task, generate ideas, responses, and problem-solving strategies

working memory

ability to hold information in mind for completing a task.

Stereognosis

ability to identify common objects through touch

organization of materials

ability to impose order on work, play, and storage spaces

judgement

ability to make realistic decisions based on environmental information

planning and orientation

ability to manage present and future-oriented tasks

self-monitoring

ability to monitor self-performance and measure against a standard of what is needed or expected

sequencing

ability to organize an activity in logical and timely steps

freedom to suspend reality

ability to participate in make-believe activities or pretend play.

form discrimination

ability to perceive or understand what they see

graphesthesia

ability to recognize numbers, letters, or forms written on the skin. Tracing letters on hand vision occluded.

emotional control

ability to regulate emotional responses

motor control

ability to regulate or direct movement

Inhibition

ability to stop actions and thoughts at appropriate time.

Shift

ability to think freely and move from one situation to another

empathy

ability to understand how the other person feels

secondary aging

abnormal changes in organ systems. Experienced by some individuals but not all. Associated with disease, impairment, or disability. Frequently preventable through lifestyle changes.

Anorexia Nervosa

abnormally low body weight, refusal to gain weight, disturbed body image

Therapeutic exercise

activities like stationary bicycle

emotionally charged therapy tasks and situations

activities or circumstance that can lead to the client to become overwhelmed. Interpersonal event that occur during group process.

Self care training

activities that focus on ADL's and IADL's

Neuromuscular re-ed

activities that involve the brain and muscles working together.

primary brain damage

actual damage done to the brain; contusion or diffuse axonal injury

identification

adopting the habits or characteristics of another person.

normal range for resting heart rate

adult: 60 to 100bpm

Dietician

advises individuals about understanding complex nutritional needs and planning and preparing special diets.

Justice

advocate for the patient so they are getting the treatment they need.

JRA-Pauciarticular

affects 4 or fewer joints.

JRA-Polyarticular

affects 5 or more joints.

JRA-Still's disease

affects internal organs and joints. Can lead to death.

demographic arena

age, socioeconomic status, racial mix, and other characteristics of local and national populations change

assistive appliance

aid/device that is beneficial without development of skill (foot orthotics)

assistive tool

aid/device that requires development of skill to be useful (switch-adapted toy)

sensitivity

alertness to the patient's needs and awareness of your affects on him or her

perceptual skills

allow interpretation of and meaning of sensory input.

olfactory discrimination

allows for distinguishing differences in smells

adapting

allows for greater participation and independence 9 compensatory techniques are adapting)

auditory perception

allows for the ability to discriminate between different sounds, tones and pitches

Mobility

allows learning by moving and exploring the environment. Helps to develop spatial awareness.

activity analysis

allows the OT practitioners to understand and address the skills and external components needed for performance of the activity. Addresses the typical demands of an activity, the range of skills involved in its performance, and the various cultural meaning that might be ascribed to it.

tactile discrimination

allows us to distinguish different textures by touch. It is our ability to perceive the difference in textures, not just the body's ability to sense touch.

working memory

allows us to hold information and use it during a tasks. It is theorized that our working memory can handle seven pieces of information at one time.

Antipsychotic medications

also know as neuroleptics. help control hallucinations and delusions

Down Syndrome

also know as trisomy 21-extra chrome. On the 21 chrome making it 3. Diagnosed shortly after birth. Characteristics include facial features, cardiac anomalies, and low muscle tone.

Temor

an involuntary trembling or shaking of the body or limbs.

evidence based practice

an never ending process of gathering appropriate clinical evidence from clinically relevant research to enable accurate, efficient, and safe decisions about patient care.

successful aging

an optimal state attained by avoiding disease and disability maintaining high cognitive and physical functioning, and continuing to be actively engaged with life.

splint

an orthopedic device for immobilization, restraint, or support of any part of the body

respect

and recognition as a unique individual with personal interests and values

What are the eight signs and symptoms of cardiac distress?

angina, dyspnea, orthopnea, neausea/emesis, diaphoresis, fatigue, cerebral signs, orthostatic hypotension

contingency assessment

answers the "what if's".

health promotion

any planned combination of educational, political, regulatory, environmental, and organizational supports for actions and conditions of living conductive to the health of persons, groups, or communities.

thermotherapy

application of thermal agent used to increase cell metabolism, blood flow, soft tissue elasticity.

Rood's theory

appropriate sensory stimulation can elicit specific motor responses. Normal muscle tone is a prerequisite to movement. Movement occurs in a developmental sequence, each skill build upon the other.

long term goals

are broad, observable outcomes that will be achieved at the end of the group program

occupational therapy groups

are formed to address invention goals; they consist of content and process.

intrinsic muscles of the hand

are located within the hand itself. They are responsible for the fine motor functions of the hand.

Group maintenance roles

are needed to promote closeness among the group members. Encourager, Gatekeeper, Follower.

leukemia

arises from blood-forming organs such as bone marrow

lymphoma

arises from cellular components of lymph nodes.

sarcoma

arises from connective tissue (tissue that supports and connects other tissues and parts of the body including adipose, fibrous, elastic, cartilage, and bone.

carcinoma

arises from epithelial tissue (skin, epidermis)

Achondroplasia or dwarfism

arrested or stunted growth. Is a disorder of the growth cartilage.

backward chaining

assist the patient until the last step. Then allows the client to try to finish the last step on their own. This is repeated to include the second to last step then so on..

exchange theory

assumes people attempt to maximize their rewards and minimize their costs in interactions with others. Elders continue with interactions that are beneficial and withdraw from those perceived as having no benefit.

3 basic categories of learning #3

attitudes, learned feelings, values or beliefs

self confessor

attracts attention by inappropriate disclosures

recognition seeker

attracts attention to self

Peck's stages of Psychological development in the second half of life Middle age -3rd

cathectic flexibility vs. impoverishment

RLA VII

automatic appropriate. appears oriented within hospital and home setting. Complete daily routine automatically. Community mobility and awareness, support groups, develop plan to return to work, coping skills for family. Do not let them drive.

tactile defensiveness

aversion to touch

body scheme

awareness of the position of the body and its parts in relation to themselves and the environment.

cerebellum

balance, coordination, skilled motor activity

Glasgow Coma Scale

based on a 15 point scale for estimating and categorizing the outcomes of brain injury on the basis of overall social capability or dependence on others. The test measures the motor response, verbal response and eye opening response.

development of adaptive skills

based on developmental model. Developmental stages within each skill. There are 6 areas of adaptive skills

3 types of research

basic applied action

informed consent

before providing any form of treatment, the caregiver must orient the patient. Caregiver should greet and identify the patient and clearly state his or her name and professional or technical status. Patient should be informed why he or she has been referred to the service unit, the type of treatment to be received, and any serious risks or adverse affects associated with the proposed treatment.

organized sense of self

begins to realize how behaviors can be used to get different reactions from others.

Manual actions-Level III

begins with the use of the hands to manipulate objects. The individual may be able to perform a limited number of tasks with long-term repetitive training

social cognitive theory

behavior is determined by expectancies and incentives interacting together. Also the impact of self efficacy is crucial. The patient has to believe he or she can make the change or perform the behavior. This is achieved through performance accomplishments, vicarious experiences and verbal persuasions. The clients physiological state also will influence his or her own readiness to change behavior.

reflexive stage

behavior is dominated by reflexes such as sucking and the palmar grasp/

behavioral FOR

behaviors that elicit or inhibit functioning in the area of ADL, work, and play/leisure. There is an emphasis on the stimuli that act as cues to the behavior and the reinforcers for specific behaviors.

projection

believing that an unacceptable feeling of one's own belongs to someone else

BKA

below the knee amputation

colostomy stoma

between colon and the body surface

Development of fine motor skills, elements that make up the foundation

bilateral motor control, reaching/grasping, object manipulation and implement usage.

bulimia nervosa

binge eating followed by self-induced vomiting, average or above average weight

basic trust vs. mistrust

birth to 18 mo. Nurturance from mother.

sensorimotor stage

birth to 2yr. infant develops the ability to organize and coordinate sensations with physical movement and actions

Two types of prostheses

body powered and externally powered.

Peck's stages of Psychological development in the second half of life Old age - 2nd

body transcendence vs. body preoccupation

NDT General principles

brain plasticity, key points of control, inhibition, facilitation.

abstract

brief summary of the research questions that are targeted and the methods that are used to answer those questions

What adaptive equipment would be useful for patients with arthritis?

build up handles, button hooks, washing mitts

heterotopic ossification

build up of calcium in the joint; you can not stretch the joint once this happens

Set up only

can leave area

way to achieve service competency

can perform the same or equivalent tasks and obtain the same results.

Skilled Therapy

care is covered if performed under the supervision of a professional and ordered by a physician and provided on a daily basis. Care must be reasonable and necessary for the treatment of a patient's illness or injury and reasonable duration and quality.

geriatrics

care of elderly people based on the integration of knowledge of gerontology and chronic disease.

Hospice/palliative care

care to help alleviate suffering while maintaining the elder's dignity. All services provided should be coordinated to be ever-mindful of maintaining the emotional adjustment and support of the entire family.

Gender dysphoria disorders

category includes those individuals who experience significant distress with the sex they were born with and with associated gender roles.

Equililbrium reactions

maintains and restores a person's balance in all activities.

Righting reaction

maintains or rights normal position of head in space and in relationship with trunk and limbs

adolescence puberty -21

major psychiatric disorders, schizophrenia, substance related disorders, eating disorders, identity issues

compensation

makes client aware of a problem and teaches compensatory measures to improve performance.

rationalization

making excuses for unacceptable behavior or feelings

Empirical research

making observations and collecting data. Evidence based practice. Knowledge based on information gained from experiences or observations using the senses.

teams

management and employees at all levels and consultants

multidisciplinary

many different groups each with different goals, each group works independent.

Interdisciplinary

many different groups with different goals, groups compare findings

hand rails

max load 250 lbs.

client-centeredness

means that goals are discussed with the clients and that the language used is straightforward

force

measurable influence acting on a body

Check

measure the impact of the improved process. Analyze the data

Monkey hand

median nerve injury, loss of the ability to abduct the thumb.

Tricare

medical insurance for military.

Transdisciplinary

members are committed to ongoing communication, collaboration, and shared decision making for the patient's benefit. Evaluations and treatments are planned cooperatively. There is usually a primary interventionist but treatment is often shared. Consultations among disciplines are important.

voluntary

members attend based solely on their personal desire to attend the group, they will be more invested in engaging in the process

confabulate

memory deficit. fill in memory gaps with imaginary material. Unaware of adding information, confused regarding past events.

procedural memory

memory for a skill or series of actions

Temporal lobe

memory, hearing, understanding language, organization, sequencing.

grading activity

modifying to obtain the patient's maximal performance; provide the "just right" demand for performance.

central cord

more paralysis and sensory loss in UE than LE; usually from tumor or infection

energizer

motivates the group to decide and/or take action

Social skills training session phases

motivation, demonstration, practice and feedback

peripheral neuropathy

motor and sensory impairment of extremities

Developmental coordination disorder

motor coordination is significantly below chronological age expectation and intellectual ability. Impairments in occupational performance.

metastasize

move and start in new sites

osteokinematics

movement of bones around a joint axis. (big movement of the joint, voluntary movement, can be seen.)

contralateral

movements are the forerunner of the arm/foot opposition inherent in most locomotion.

Choreiform

movements are uncontrolled, irregular, purposeless, quick, jerky and dysrhythmical movements; may also occur during sleep.

self-disclosure

practice of revealing things about oneself when appropriate - for the patient's benefit

perceptual skill remediation

practicing skills during meaningful tasks. Examples lighthouse strategy and constraint-induced therapy

transfer of training approach

practicing skills in skill-based training.

National Society for the Promotion of Occupational Therapy

preceded the American Occupational Therapy Association

stages of transtheoretical model of change

precontemplation contemplation preparation action maintenance

ageism

prejudice or discrimination against a particular age group, particularly the elderly.

adjunctive methods

prepare the person to engage in activity.

anti-deformity position

preserves a balance between extrinsic and intrinsic muscles, and provides localized rest to the tissues of the fingers, thumb, and wrist

tertiary prevention

prevention of the progression of existing conditions. Relates to the function assessment and rehabilitation both to reserve and prevent the progression of the burden of illness.

Psychoeducation

primarily focuses on training and development of skills

play

primary occupation of children. critical to the development and refinement of skills. Opportunities for problem solving, communication, understanding nonverbal communication, and socialization.

Dignity

privacy and respect of the patient at all times.

Role of OT in Pediatrics

promote active engagement in developmentally appropriate occupations. (Play, ADL's, school, self-care, socialization

home care

promote caregiver and child bonding. Medical services on an outpatient or home delivered basis. Community based supports and resources vary with the child's age. OT should continue to facilitate the acquisition of developmentally appropriate skills.

dynamical systems theory

proposes that movement is a function of interactions among the neuromuscular system, environment, cognition and task itself.

Sensory Integration

proprioception, kinesthesia, and vestibular treatment focus on the outcome of the activity rather than the movements used.

Long-term care facility

provide the necessary medical care. OT should provide appropriate therapeutic interventions.

Principles of positioning as a therapeutic tool

provide variety, promote function, avoid restricting movements, consider safety, promote skeletal alignment and symmetry, and provide proximal stability to promote distal mobility.

Principles of positioning as a therapeutic tool

provide variety, promote function, avoid restricting movements, consider safety, promote skeletal alignment and symmetry, and provide proximal stability to promote distal mobility.

smaller height wedge

provides more difficulty head control.

Physical Therapist

provides treatment for patients with disabilities resulting from disease or injury. Purpose of treatment may be to relieve pain, to increase function of the body part by improving muscle strength and joint ROM.

RLA Level X

purposeful and appropriate. modified independent

RLA Level IX

purposeful and appropriate. stand by assist with request

Ballism

rare symptom produced by continuous, gross, abrupt contractions of the axial and proximal musculature of the extremity. Causes the limbs to fly out suddenly and occurs on one side of the body.

information giver

readily provides facts as needed

reframing

redefining the situation i ways that make it more manageable

countertransference

redirection of a therapist's feelings toward a patient, or more generally, as a therapist's emotional entanglement with a patient.

akinesia

reduction in movement, fatigue and weakness


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