Pediatrics Final

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Food thickness (low to high) A) regular, minced, liquidized, pureed, soft B) soft, liquid, minced, pureed, regular C) liquid, pureed, minced, soft, regular D) liquid, pureed, soft, minced, regular

C

Which medical conditions are commonly associated with feeding and swallowing disorders?

GERD and GER Food allergies

What are common types of intervention approaches for IADL participation? ________ - strengths based approach - enable participation - 4 guiding principles; situation coaching, understanding, foster deep thinking, explore resources

Occupational performance coaching (OPC)

What are supplemental diagnostic tests used to evaluate underlying causes for feeding disorders?

Pedi-EAT Early feeding skills assess Behavioral peds feeding asses scale Video fluoroscopic swallow study (VFSS) UMBSS

_____ _______ measures: gain insight into perception of skills and importance of ADLs ________: child describes his/her competence ________: assesses client's participation of ADL skills, productivity, and leisure over time; useful for assessment & reassessment

Self-rating COSA COPM

Developmental competences observed through play

TPBA

Form - Described through categories of _______: games, social play, sensorimotor play, sports, digital play - also includes study of the developmental nature: changes in preferences w/ different ages, gender, and ability levels - consider play _________ in children with various disabilities: time, forms, etc; although a child's play may not be typical it is important to understand what children with disabilities want to do

activities, differences

Choosing evaluation consider purpose collect data from multiple sources - measures of ________ behavior - _______ observation measures - _____-rating measures - measures of participation - measures of motor skills

adaptive, ecological, self

________ behavior measures - typically ______ --- vineland adaptive behavior scales --- adaptive behavior assessment system _________ observation measures - gather info in the typical or ______ setting --- performance during daily life -best measure of performance is in a _______ setting - standardized assessment or observation

adaptive, scales ecological natural natural

Establishing, restoring, and maintaining performance Identify skills or gaps Select ____-appropriate tasks and habits to target ________ ADL performance and patterns - consider age - plan tx according to _________ sequence - examine underlying body structures & functions If not possible: ________ or remediate abilities - by targeting underlying factors Use variety of approaches to remediate -NDT, BX, motor learning, etc

age establish developmental restore

Pharynx - mgmt of ______ -> respiration and control of food/liquid during swallowing

airflow

Chaining behavioral approach _________ chaining - OT performs most, PT does last step __________ chaining - child begins task & OT does remaining; OT gives varying level or cues prior to task

backward forward

Factors affecting performance - specific _______ ________ --- body structures and functions - performance ______ & _______ - interest level, self-confidence, motivation - _______ of ADL activities - control

child factors skills, patterns choice

Leisure intervention - allow ______ and ______ - parent education and training using ______ ______ - identify potential leisure opportunities, discover leisure interests - activity _______ or _________

choice, autonomy, activity analysis, adaptation, modification

What are common types of IADLs that are expected of children & adolescents?

chores, taking bus to school, packing lunch, religion

Friendships Prior to age of friendship dev. - interacting w mothers or CG - ___________: engagement of 2 ppl in an occupations such that each person influences the other First stage of friendship dev. - preferences for specific ______ - sharing and engaging in _______ behaviors as early as the first __ yrs High School -students w dis. often socially isolated - barriers - _______ friendships are not friendships

co-occupation playmates, prosocial, 2 incentive

Additional roles of OT - education of others -_________ - advocacy and focus on physical wellness, quality of life, and mental health

coaching

Intervention Strategies: Prevention/Educate problem solving: ________ approach ______ problem solving - prepare of unexpected events during ADLs; children should be part of this; reduce anxiety ________ orientation approach -CO-OP - child _____ a task they want to perform - talk about the task using goal-plan-do-check -review plan coaching and education

cognitive, anticipatory, cognitive, chooses

Modifying ___________ approach - OT enables or enhances independence w/o trying to change client factors Specific strategies: - mod of the ______ or materials - grading - mod of the _____ of completing task - AT and AE - mod of the _________

compensatory, task, method, environment

Activity demands task analysis - helps understand _____ and ____ of activity Analyzing - objects used, _____ & _____ demands, ______ and timing, required actions and _____ Activity demands ____ in clinic, home, school, and community

complexity, aspects space, social sequencing skills vary

Facilitating Playfulness - shared negotiations of _______ and decision making - demonstration and _______ - may need to specifically _____ how to play

control, imitation, model

Physical environment Inaccessible buildings rooms ______ with furniture objects used may help or hinder ADLs consider aspects of: clothing items, grooming, bathing -> may motivate or _______ the child

crowded distract

What are some of the intervention approaches that OTs use to improve children's and adolescents feeding/eating? _________ for oral hypersensitivity deep _____ and proprioceptive experiences AE self directed touch to face (distal to prox touch) behavioral intervention strategies ________ reinforcement manage expectations ________ schedule

desensitization pressure positive visual

TPBA (Transdisciplinary Play-Based Assessment) A play assessment which focuses on child's _________, _________ style, interaction patterns, and _________ to determine need for services.

development, learning, behavior

Modern theories - psychoanalytic: cope with and manage their ______ - arousal modulation theory: stimulation of _______ system - metacommunication theory: learn to perform on 2 levels at once- ______ and make believe - cognitive theories: foster cognitive development

emotions, nervous, reality

Social environments Family, other caregivers, peers, etc. provide _______ shape _______ Parents with ID or MH problems - _____ how to help child Parents w physical probs - training in using specific techniques/AD Analyzing social routines - may differ across _________

encouragement expectations training environments

Play deprivation: delayed development, difficulties with social interaction, difficulties with mental health, limited _________ and mvmt, impaired ______ span, limited ________

endurance, attention, resourcefulness

Older theories - surplus energy theory: release excess ______ - recreation or relaxation theory: replenishes ______ and used to relax - practice or pre-exercise theory: practice ______ or practice ____ for future - recapitulation theory: play development mimic the ________ of the species

energy, energy, skills, roles, development

What are the major components of a comprehensive intervention plan for peds feeding, eating, and swallowing problems? _________ adaptations: mealtime structure (30-40 mins) Positioning: _______ feet, ______ pelvis, ______ head and trunk Adaptive equiptment _______ diets Sensory Behavioral

environmental supported, neutral, vertical, modified

Play and leisure assessment Consider: - what, why, how play and leisure occur - use multiple methods, observation, interview, and assessment tools - attitudes, preferences, and playfulness - _________ competencies expressed through play

everyday

Cultural context __________: diff levels of concern ab children meeting milestones Culture also influences: type & _______ of tools and materials Economic conditions Location ________ for education and employment Economics - if water gets shut off

expectations availability opportunity

How does performance and participation in IADLs contribute to positive skill development of children and adolescents? - opportunities for being part of ______ and _______

family community

"Function" of play - way in which it serves the person & influences health and well-being Theories attempt to understand the ________ of play Ex) physical activity found to reduce __________ and ________ area for more investigation

function, depression, anxiety

Play as a ______ - little evidence that play goals are included in intervention plans - for many fams, play/leisure is a desired area for goals

goal

prosocial behavior encouraged as early as:

helping behavior 18-24 mo

Sleep ________: bedtime routines and habits

hygeine

Developing ADL occupations - foundation begins in ________ - ADL _______ & _______ influence engagement in other occupations ---children benefit from _______ participation in ADLS --- mastery of ADLs lead to _______ and ________

infancy habits, routines active self-esteem, autonomy

Child Occupational Self-Assessment (COSA) - find out from the child what he or she finds ______ and ______ - a structure to determine how a child ________ his/her competency - identify interest occupation and rate how well they _________ it

interesting, meaningful, percieves, perform

Self determination: -encompass many life skills that are innate and learned - devel. supported by providing children opportunities to identify ______, make _____, take _____ - Example: Head start; help children identify _____ they need help and guiding them to solve problems

interests, choices, turns, when

Performance Environment & Contexts - _____ and _____ to the child ---_______ - age, gender, education & SES ---Physical - 4 primary environments: ____,_____,_____,______ ---social environments -Personal and ______ contexts: family life cycle & developmental stages

internal, external Personal home, school, community, work temporal

________: defined as nonobligatory activity that is intrinsically motivated and engaged in during discretionary time, that is, time not committed to obligatory occupations such as work, self-care, or sleep - important for development and quality of life - preference, desire, and motivation are critical

leisure

Youth with disabilities report ____ levels of civic engagement

low

What is play? - spontaneous, fun, joyful - intrinsically ________ and internally _______ - emphasis on ______ - imaginative - nonliterality - often ______ Changes with __________ levels

motivated, guided, process, developmental

attitudes of children when they play -> playfulness (intrinsic _______, internal ______, ability to suspend _______) -> each occur on a continuum -> framed so that all players understand the context

motivation, control, reality

Play as an occupation Examining play in ______ environments OTs may consider the occupation through the substrates of _____, _______, ______, and _______

natural, form, function, meaning, context

Assessing IADLS

occupational profile analysis of occupational performance COPM card sort CAPE/PAC

Promoting or creating supports Create environment & _______ Team or system _______ Examples: PK center activity, free time box for K, community building committee

opportunities supports

Contexts Cultural - perceptions of importance, use of time, etc Temporal - seasons, time of day, consider SES Virtual contexts - the digital realm Intersection of contexts and impact on play - less free play, particularly ______ free play

outdoor

ADLs are key in supporting _________ Motor skills are a part of activity _______ & part of participation in ADLs Explicitly determine the relationship of motor skills to ADL performance

participation sequences

IADL performance is closely linked to ________ IADL is relevant from infancy to teens IADL is addressed across multiple practice contexts Person, environ., occupation factors -> IADL Variety of ______ and ______ approaches

participation, evaluation, intervention

________ context: playgrounds, play spaces, toys and materials, barriers _________ context: interactions w parents and peers, sibling play, changes in play with adult present, gender, proximity of a teacher

physical, social

What factors are essential to consider when the OT completes an assessment of feeding, eating, and swallowing? Context - _______, ______, _______, _______ ____ _____ function ______ issues (____ high prev. of feeding difficulties)

physical, social, temporal, cultural oral motor sensory, ASD

The Test of Playfullness (ToP): assesses degree of _________ (4 elements) - intrinsic ___________, internal _______, ability to suspend ________, and ___________ - the child is rated - scored from direct __________ or video

playfulness, motivation, control, reality, framing, observations

Steps to Activity Analysis - occupational _____ -choose an ________ method - team evaluations

profile, evaluations

Phases of swallowing - oral prep, oral, pharyngeal, esophageal Oral prep: _______ in young, ______ in older children Oral: ____ in young, ______ in older children Pharyngeal: primarily _____ Esophageal: _______ (hint: reflexive or voluntary)

reflexive, voluntary reflexive voluntary reflexive reflexive

3 areas related to sleep and rest

rest, prep for sleep (sleep hygeine), participation in sleep

_______ play: child can play at great heights, high speeds, with harmful tools, or near dangerous elements of the environment - rough and tumble play - in natural environments without boundaries - adventure playground; "cast off" objects and scraps to build with, climb on, etc

risky

__________: process of setting up, arranging, bringing food to mouth _______: ability to keep/manipulate food or fluid in the mouth and swallow _________: travel from mouth to stomach

self-feeding, eating, swallowing

Takata's Taxonomy of Play - Birth to 2 year: ____________ - 2-4 years: ________ and ______ constructive - 4 to 7 years: ________, _______ constructive, and ____________ - 7 to 12 years: __________ - 12 to 16 years: __________

sensorimotor, symbolic, simple, dramatic, complex, pregame, game, recreational

Oral cavity - management of food/liquid - newborns = ______ oral cavity - 4-6 months = ______ oral cavity, ______ tongue, _______ mobility

small larger, thinner, increased

What are the relevent factors of an OT to consider when evaluating IADL performance? When and where - from early childhood through adolescence - children first engage in IADL skills as _______ - _________ behaviors Factors: ______, ______, _______

toddlers prosocial person, environmental, occupational

3 ways to use play: As a ________: specific skill may be developed by play As a ______ As an _________: focus on play itself and dev. of play performance, playfulness, intrinsic motivation and exploration of play preferences AKA as a _______

tool, reward, occupation, goal

The quality of the experience, a person's state of mind, and the value that the play experience has It is the individuals "_____" of play Ex) losing oneself in an activity, experiencing a flow - difficulty had to be ______ _____

why, just right

Meyer - ______, ______, ______, ______ = 4 rhythms that shape human organization

work, play, rest, sleep


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