All of peds :,(
At what age (typically) can a child go the bathroom independently; sit on the toilet, but may need help with wiping and clothing? 1 year 2 years 3 years 4 years
3 years (At 3 years children can go to the bathroom independently, and sit themselves on the toilet. They may need help with wiping and fastening clothing. (Table 15-6))
what age do kids say first name
3-4 yo
what age do kids take turns with play, separate from parents, imitates parents
3-4 yo
what age brings toys and hands to mouth for chewing on
3-6 mo
what age has more regular sleep schedule
3-6 mo
what age in sitting: prop, sit, tracks, follows movement
3-6 mo
what age prone on elbows to prone on extended arm, reach for toys, weight shift
3-6 mo
what age rolls from back to tummy and tummy to back
3-6 mo
what age takes weight in legs and supported standing
3-6 mo
what age tolerates baths diapering and changing clothes
3-6 mo
what age: in supine reaches up and grasps obj, plays with feet
3-6 mo
what gae drinks liquid proficiency begins cereal and spoon feeding
3-6 mo
when would a kid with a learning disability be diagnosed?
3rd or 4 th grade after successive failure experiences
___ yo visual field 20 feet
4
what age does verbal anger and jealousy start
4
what age plays cooperatively and uses a fork proficiently
4
what age strings beads, cuts a line wtih scissors, copies a cross, draws person with 2 body parts and brushes teeth
4 (its ok to have parental cues w brushing teeth)
at what age climbs on playground, throws ball, skips?
4 yo
what is the typical development for dressing
4 yo is independent! 1: cooperates 2: helps pull pants, outer layer, unbutton large ones can put on coat 3: puts socks on, shirt, zips, dresses with supervision 4: moves pull over, lace shoes, put socks on, ties and unties, dress with no supervision
what age copies cross right oblique line diagnol line letters numerals maybe own name
4-5
what age do kids cooperate with playmates, solve problems?
4-5 yo
what age do kids have more complex imaginary play and uses imagination
4-5 yo (at 4/5 children cooperate with others to solve complex problems in their imagination)
Facts about american teenagers
40 million in the US, 10-24 is more racially and ethnically diverse, 2/3 live suburban, 2/3 live with both parents, 95% are enrolled in schools highest dropout rate with hispanics blacks then whites 1/3 work 17 % under poverty line 5 million + have a disability
what age can they count to 10, have longer stories, and can use future tense
5
what age do we see kids able to move and tract without moving their head to do so? (smooth tracking and accommodation skills)
5
what age plays games and can clean room
5
what age understands under over top
5
what age cuts a square, copies first name, copies triange, lace shoes, zips
5 yo
what age walks heel to toe, walk to a ball and kick, skips
5 yo
what age is inhibition?
5-12 mo
if a kid can jump rope, throw small ball at a target, catch small ball with one hand?
5-6 yo
what age can a kid cut out complex pictures, use handheld hole punch, copies rectangles, writes letters and numbers, and cuts food?
5-6 yo
what age can kids work in small groups and understand/show respect
5-6 yo
what age do kids enjoy throwing bean bags at targets, get on the swing and throw
5-6 yo
what age does kid tie shoes, bathe indep.
5-6 yo
___ mo visual field is 10-24" oculomotor control is developing and eye crossing stops
5-8
at what age do you look for legs coming to tummy?
3 mo
what age does writing fluency develop by
3 or 4th (adult speed by 9th grade)
Which assessment asks the child what he/she likes to do and how competent he/she views his/her performance? Children's Assessment of Participation and Enjoyment (CAPE) Child and Adolescent Scale of Participation (CASP) Child Occupational Self-Assessment (COSA) Youth Experience Survey (YES)
Child Occupational Self-Assessment ((COSA) The Child Occupational Self-Assessment (COSA) is a self-report of competence and value for daily activities based on the Model of Human Occupation. (Also, see Tables 12-1 and Table 12-2))
What type of intervention is provided in the following: The occupational therapist works with a child on the playground to help him engage with the other children. Pull out Consultative Integrative Indirect
Integrative (Integrated service delivery involves the provision of occupational therapy in the child's natural environment (e.g., in the classroom, on the playground, in the cafeteria, on and off the school bus).)
What perceptual skills is a therapist targeting with where the child must identify body parts on himself? External aspects of body awareness Internal aspects of body awareness External aspects of body image Internal aspects of body image
Internal aspects of body awareness (Body awareness refers to the ability to visually discriminate, recognize, and identify labels for various aspects of the body's physical and motor dimensions. Internal aspects of body awareness include body part identification. (Figure 7-4))
What is the occupational therapist's role in regard to writing and literacy? Intervention focuses on writing skill. Intervention focuses on writing as a communication skill. Intervention focuses on writing within the context of literacy. Intervention focuses on literacy.
Intervention focuses on writing within the context of literacy. (Occupational therapy intervention focused on supporting writing within the context of meaningful literacy experiences improves not only writing but a broad set of literacy skills.)
According to IDEA, what is the main purpose of occupational therapy within the school system? Enhance function in play/leisure, work, and self-care Enhance the child's role as a student in academic and nonacademic tasks Improve hand skill development for tool usage Diminish symptoms related to the student's disability
Enhance the child's role as a student in academic and nonacademic tasks (The Individuals with Disabilities Education Act requires stats and public educational agencies to provide a free and appropriate public education to children with disabilities in the least restrictive environment.)
The therapist asks the child to reflect on how he performed a motor task. She asks him to imagine how he wants the movement to look and determine what could help. What type of cognitive intervention does this illustrate? Declarative knowledge Metacognitive knowledge Procedural knowledge Self-regulation
Metacognitive knowledge (Metacognitive knowledge consists of one's awareness of the cognitive processes that are employed to lean and perform new tasks. This is the individual's ability to stop and reflect on how he or she is learning. It is through the use of mnemonics, rehearsal, or imagery that they are able to learn new information. (Table 10-1))
Which founder of occupational therapy proposed that humans maintain rhythms of work, play, rest, and sleep that need to be balanced and that this occurs through actual doing and practice? Wilcox Llorens Fidler Meyers
Meyers (Meyers is a founder of occupational therapy who posited that humans maintain rhythms of work, play, rest and sleep that need to be balanced and that "the only way to attain balance in all this is actual doing, actual practice.")
Differences between IEP and 504
504 kids who dont need intensive special education, for ADHD kids behavior attention handwriting sensory issues, may just need accommodations like sitting close to teacher, more time shorter assignments, input on what is appropriate for child
how can you be diagnosed with hyperactive impulsive type add adhd
6 + items for 6 months inconsistent with developmental level impacts diretly or social and academic/occupational activities
how can you be diagnosed with inattentive type add
6 + items for 6+ months that is inconsistent w developmental level and negatively impacts directly on social and academic/occupational activities
what is the diagnosis for a majority of kids seen in schools and outpatient?
ADD ADHD Learning disabilities
what service delivery is working in the natural child environment, like working on feeding in childs home during breaky or lunch?
ASSOCIATED WITH ECI, NATURAL ENVIRONMENT
which is not a behavioral indicator of a teen with negative self esteem avoids eye contact is overly confident self criticism speaks loudly monitors others behaviors constantly put others down lack of social and emotional support is collaborative
collaborative
why is medication functional in kids w add adhd?
comes down to NT levels, we can activate by what we do and the env stimuli that we get, we need more than that for kids to be functional
how does an occupation develop in children?
community social participation vicarious learning active participation scaffold, guidance, cueing, reinforcement
how can an adolescent be empowerd in their communtiy?
community values them roles in community involved in community service activities safe home and community
putting a handwriting strip on a kids desk for visual problems is an example of what type of VP intervention
compensatory
what is a multi factored evaluation
comprehensive evaluation to determine whether the child needs special education academic and functional needs in school environment
what cognitive development stage is the start of logic, the kid can tell a tall and skinny glass holds the same amount of water as a short fat one
concrete operational (beginning of logical reasoning but child must see it)
if a kid is beign aggressive to their friends and friends animals, destroy a friends dog house, steals their dog, and runs away with the dog with are they diagnosed with?
conduct disorder
what diagnosis is the persistent pattern of violating rights of others an dage appropriate norms, 3 + in past year? affects functioning not antisocial personality
conduct disorder
if a test discriminates groups, uses facotr analysis, and captures progress in performance what psychometric property does it meet?
construct validity
what type of play are kids imitate a manipulation of toys and begin to draw lines adn circles 2 yo 5 yo draw and print, complex art projects
constructive
Red flags noted in childhood
difficulty meeting milestones clumsy difficulty with handwriting and school not ind. in ADLs cutting, playing, interacting
when you are sequencing and adapting tasks what do you have to be aware of?
discrete is easier than continuous closed tasks are those where env is stationary consider cognitive and complexity demands of task/env
object perception, form constancy, visual closure, figure ground are apart of visual ___
discrimination
early or middle adolescence: preoccupied with self, self evaluative, compares their body and apperance, anxiety about development?
early
in early childhood, middle childhood early adolescence or late adolescence is OT a consultant, parents supervise and monitors and advoocates for child, and the young person is active in direction plan and programming, input is given adn received, and ind. and advocacy are facilitated
early adolesence
in early childhood, middle childhood early adolescence or late adolescence does parent provide care and make desicion, young person recieves and follows directions
early childhood
what is considered a home setting, what falls under it
early childhood intervention home health residential facilities
how do you get the least restrictive environment?
edcuate non disabled peers, integrate them into the classroom, make things seem as normal as possible
at what stage of empathy do kids distinguish between their discomfort and others discomfort and shows concern for another baby crying
egocentric empathy (1 yo)
what is an example of a social skill?
facial expressions tone of voice unspoken rules understand emotions take turn analyze social situation
What is the purpose of positioning a child?
facilitate specific movement
what concept of practice do you incorporate the famliy environment, look at the family strengths, and know how to not push the kid if theyre not ready?
family centered practice
how can an adolescent have positive support with their environment?
family communication parental school involvement constructive relationships caring neighborhood and schools
what is the best thing to do for a sensory kid who doesnt have good grading or contraction?
get on swing push and pull scooterboard trapeeze bars swinging and then crashing
what is the best way to address weight bearing in prone?
get the big therapy balls, weight bear in one hand and play with the other hand hold a string up high and have close pins, one holds it high and works on pincer grasp with the close pins to hook it on and switch, co contraction and stabilization while holding and strengthineing and working on grasp can also put little splint on
what are the common neural processing and behavioral traits of an individual with ADD?
gives up easily poor reality/avoids logic and reason integration not developed poor focus poor memory dfficulty making choices poor planning doesnt know which stimuli is most important easily distracted over stimulated by surroudnings poor listening skills, interrupts others and changes the topoic overly excitable temper frustrated, behavioral inconsistencies impatient overly demanding, aggressive poor sleep
if a baby cant cries when another one cries what stage of empathy is the kid at?
global empathy
if you dont have good processing going on in the frontal lobe, prefrontal cortex, amygdala, hippocampus what is impacted?
goal directed behavior social emotional regulation sleep ability to regulate to what is important
what is the typical development for toilet hygiene
goes to bathroom and min cues at 3 yo total independence 4-5 yo
What are the physical and maturational developments seen in adolescence?
growth linked with social confidence physical activity (growth is more challenging to caregiver, menstruation, weight)
if Will decides to stay up 4 hours later to read a book and in return is super tired in the morning what cognitive symptom is this?
hyper focus (when able to focus you become so immersed in it that they have no time for any other pursuits not even sleep, loved ones are pushed a side for one project)
katie is a young girl who is alway squirming in class, leaves her seat during instruction, runs around the room a lot but loves the playground at recees, interrupts when others are speaking and blurts out her own answer, talks way too much , and always wants to go first. what type of add/adhd is this
hyperactive impulsive type
what is low arousal theory
hyperactivity result of child trying to wake themselves up,
sensory integration in visual skills
hypersensitivity (affect dvpt of skills bc they wont touch things) motor planning deficits
what in the brain has mood, anger, responds to signals, homeostatic, improtant when you respond negatively and situations that are difficult
hypothalamus
What are the four states of identity? (marcia 91)
identity diffusion moratorium identity foreclosure identity achievement
how can skeletal integrity affect hand skills while playing?
in down syndrome, thumbs may be bigger, need to accommodate for fine motor which will take some time for being defined
what is perceptual action reciprocity
individuals perception of the environment informs action individuals actions provide feedback about movement and performance
what should you look for when you are first directly observing a child?
which writing tasks are most problematicc behaviors level of ind (how many times does teacher give directions) attention (distractions, do they get started then go off) env (where the child sits) curriculum (what is being taught)
how can add adhd effect occupational performance?
lower performance as student, worker, in IADLS, decrease social relationships (mothers concern peers react with criticism withdrawal)
if my ot session with little susie is all about play what model am I following?
occupation based
how do you assess participation and performance
occupational profile assessment of performance analyze performance
what is the process of a handwriting eval
occupational profile interviews analysis of occupational work iwth work samples, file review, direct observation
when do children learn movements?
whole vs part performed in many situations actively problem solve (think about how to adjust, think out loud, help shape with other strategies) meaningful (wont work hard if not worth it)
what is the proper pencil grip progression?
whole-hand primitive transitional grip: flexed fingers and a pronated arm mature pencil
if a kid refuses to use a toothbrush what are some strategies?
we will only do it for 5 seconds and count give them control, you brush for five i brush for five
why is puberty a challenge for adolescents with disabilities?
weight menstruation may come later pratical and psychosocial issues more likely to be sexually abused
how do kids develop new motor skills?
when experimenting they need tactile-vestibular-prop input to feel the feed back and know where to go after that participate and get good feed back given opportunities to practice the underlying skills on how we process sensory input leads to efficient and effective motor patterns, we dont think about moving the body and controlling it
what two processes are required for postural control?
sensory organizational process (visual somatosensory vestibular integrated in CNS, postural reactions and vision) motor adjustment process (activates graded musculoskeletal responses)
what is breaking down a task into components and reinforcing each component individually and systematically until desired behavior
shaping
what type of behavioral theory is piano section practicing? starting on a knee to throw a ball, like wrist snaps
shaping
for child with mild disabilities what should you focus on for bilateral hand skills
simulatenous bilateral manipulation skills (scissors)
for in hand manipulation you should move from ___ to ____ skills
translation to rotation
how does something become a performance pattern?
when the way you go about a task becomes effective to you when learning to kick and throw they keep missing then develops a pattern
what is the best way to enhance the carry skills in children with visual impairments?
use contrasting colors or objects that make sound
a kid who is at the beginning of bmake belief and pretend play, now parallel play, and builds simple constructions that represent other objects are in what stage of takata play hisotry
symbolic and simple constructive (2-4)
if a child with CP comes in the clinic and has a very hard time reaching for an item what is the best thing that you can do?
use materials that are easy to activate and easy to reach
when the test actually measures what is says it is measuring?
validity
for child with mild disabilities how do you enhance grasp
variety of grasping patterns pincer grasps elicit intrinsic muscles power grasp
development of bilateral hand use in hand skills
symmetric patterns bimanual action 10-12 months reciprocal and alternating hand movement simultaneous manipulation differentially uses 2 hands
to enhance bilateral hand use begin with what?
symmetrical bilateral skills
for in hand manipulation enhancement what activities do you do to enhance awareness
tactile discrimination and proprioception activities
what part of the brain is emotional and cognitive processing, reward addiction motivation
ventral tegmental area
why is observing an adolescents mental health important?
very vulnerable 1/5 emotional distress 1/10 impaired depression anxiety substance use 9% attempt suicide
what three systems are important for balance/posture?
vestibular proprioceptive visual
what is the learning where a kid learns by seeing consequences of someone else
vicarious learning
how can visual perception and cognition affect hand skills?
vision guides fine motor development cognition influences fine motor interests, attention, interest (Down S. arent interested in shaking rattles, basic in exploration)
what are more handwiriting readiness factors?
visual motor sensory perceptual motor planning eye hand coordination in hand manipulation kinesthesia
what systems contribute to balance
visual vestibular proprioceptive
Alertness, selective attention, visual vigilance, divided or shared attention.
visual attention
what is the ability to maintain your gaze on a signle location?
visual fixation
what are developmental disabilities that affect hand skills?
visual impairment and blindness add autism DCD cognitive disorders
Cate doesnt remember how to spell words, has a hard time with free writing, and recall on how to spell and what words look like. what is going on?
visual memory
short term/working memory, long term memory, visual sequential memory
visual memory
eval with cutting, handwriting, smoothly interating vision and fine motor skills
visual perception
ones ability to interpret the surrounding env by processing information contained in light
visual perception
if a baby sees a super steep ramp and stops what practice model?
visual perception (could tell right away and change motor pattern)
smooth eye movements following an object vs. point to point eye movements like moving word to word jumping
visual pursuits tracking v saccadic movement scanning
what is near point and far point acuity
visual receptive
what are the characteristics needed for reach and carry hand skills?
visual regard midline orientation starts symmetric increased smoothness, consistent, adjust movement rotation with supination (first step in further refinement) carry balls clinged to chest, look for smoothness can they adjust does it roll off by itself
how can you find a way to make 10 minutes not feel like for ever for a child?
visual timers, when the red disappears the tiie is up, let them monitor what they need to do as the red is disappearing, they can organize and change behavior then
what evaluation type assess occupational performance and analyze from that perspective?
top down
Top down v bottom up approach
top down: start with the occupation and work down to the little steps, if feeding watch them during lunch or dinner time bottom up: peabody or bot, look at fine motor skills and specific skills that will build on other ones
if a kid can go from the classroom to nurses office what vp skill is being best used
topographic orientation
what is the team model setting where a team comes in, prioritize concern then have intervention specialist
transdisciplinary
when does something become a motor skill?
when you are effective at the performance pattern when you can change the direction of a ball and kick it to another direction, pattern is strong enough to be adjusted
to intervene with ADLs what questions need to be asked?
which ones are useful and meaningful preference age appropriate realistic alternative? does it improve health, safety, participation cultural issues? can it be taught
difficulty with number sense, memorization, calculation, reasoning
dyscalculia
early or middle adolescence: feel weird and wanna hide from peers?
early
Eligibility for special education and related services
mental retardation hearing impairments speech or language visual impairments autism TBI emotional disturbance
what age do boys get stronger than girls
11
what age assists with dressing removes hat and socks
12-18 mo
what age crawls and climbs upstairs
12-18 mo
what age do kids start to assist with dressing, removing hats, and socks
12-18 mo
what age eats table food uses cup better finger feeds, and use spoon
12-18 mo
what age follows one step directions
12-18 mo
what age puts simple shapes in sorter or puzzle
12-18 mo
what age scribbles on paper
12-18 mo
what age stacks two objects
12-18 mo
what age turns pages of cardboard book
12-18 mo
what age walks, squats
12-18 mo
can catch a large ball, clumsy at throwing, can run with out tripping, balance on one foot, hop, walk up and down stairs is how many yo?
3
joins in singing, follow 3 step directions, play simple games, cant sit still, please adulty, consciuence, curious about body how many yo
3
what age copies vertical and horizontal lines and circles
3
what age is pretending its bed time and can cover up brother? imitate tasks know the number 2
3
what are the levels of social play
unoccupied onlooker solitary parallel associative cooperative
typical development for bathing and showering
2: wash themselves in the tub 4: wash and dry with supervision 8: fully independent, prepare water, wash and dry themselves
if a student has an impairment in word reading accuracy, reading and fluency rate, and reading comprehension what diagnosis do they have?
(SLD with impairment in reading) alternative dyslexia
toddler/preschooler has play where they take up a stick and pretend its a gun
(pretend/symbolic) toddler
typical development for personal hygiene and grooming
2:imitate parents 6: toothbrush independently 4-7 wash face, hands, hair care
_____ yo visual field 10-16 ft
3
what age: begins to mouth hands
0-3 mo
what age: engages in reciprocal interactions with good eye contact
0-3 mo
what age: in supine brings arms to midline and can track across midline
0-3 mo
what age: kicks legs and moves arms symmetrically
0-3 mo
what age: latches onto bottle or breast and takes liquid with little loss
0-3 mo
what age: opens and closes hands
0-3 mo
what age: prone good head control with neck extension
0-3 mo
what age: quiets when picked up and talked to
0-3 mo
At what age (typically) do children cooperate with dressing: holds out arms and legs, pulls off shoes, removes socks? 1 year 2 year 3 year 4 year
1 year (At 1 year children cooperate with dressing: holds out arms and legs, pulls off shoes, removes socks. (Table 15-8))
at what age do kids recognize self, engage in reciprocal interactions, imitate adult actions, respond to name, range of emotions, assert independece
1-2 yo
three tiers that OTs need to envision, articulate, and advocate their role
1. schoolwide services (80) 2. targeted interventions for those at risk (15% struggling but not special ed, target for special interventions, risk kids no OT referral until going through process) 3. individualized interventions (5% specialized intervention, looks like special ed, special teacher etc) caseload model to workload model
what age do kids stop relying on vision for balance
10 (7-8 head trunk stabilization)
what age scribbles on paper?
10-13 months
At what age does a child pretend to drink from a cup or pretend to brush her own hair? 2-4 months 6-10 months 10-12 months 12-18 months
12-18 months (At 12-18 months children engage in symbolic play using single play actions such as pretending to drink from a cup or brush their hair. (Table 22-4))
5-__% of school age kids have learning disabilities and 4% of adults, has a ___ component
15 hereditary
at what age do babies tell you their body parts and refine movements?
18-24 mo
what age begins jumping
18-24 mo
what age builds tower of 5-6 cubes
18-24 mo
what age discriminates circle square triange
18-24 mo
what age imitates directional strokes
18-24 mo
what age points to body parts
18-24 mo
what age runs
18-24 mo
what age says name
18-24 mo
what age speaks 50 words
18-24 mo
what age takes off clothes
18-24 mo
what age throws ball overhand
18-24 mo
what age uses spoon proficiently
18-24 mo
___ mo visual field 4-10 ft
19-36
can build tower of 10 cubes, cut across paper, use thumb finger grasp, unbutton, dress and undress with help is how many yo
3
by what age is the visual pathway complete?
24 weeks gestation (extensive bw 24-40)
by ____ mo has convergence and stereopsis
2
what age imitates horizontal vertical and circular marks
2
if a child shows signs of oppositional defiant disorder in two settings? three? one?
2: moderate 3: severe 1: mild
What is the corrected age of a child born at 30 weeks gestation on May 2, 2014, who is being tested August 5, 2014? 2 weeks 4 weeks 2.6 months 3 months
2 weeks (Infant chronologic age is 3 months 3 days, which is 12 weeks. 40 weeks is considered full term; therefore the infant is 10 weeks premature. 12 weeks − 10 weeks is 2 weeks. (Box 6-1))
at what age do kids say no, show awareness of others feelings, need an ordered predictable routine
2-3 yo
what age do kids join other children in play and become frustrated andaggressive
2-3 yo
___ mo babies have eye hand coordination and depth perceptino
2-4
Why do we need OT to facilitate adolescent development?
23-35 have a need eligible till 21 by 16 needs transition service in place all students w disability are eligible for alternative education programs
how can you be diagnosed with hyperactive impulsive and inattentive add adhd ? (combined type)
6 inattentive symptoms 6 hyperactive symptoms
what age are kids ind. in ADLs and start with chores
6-9
what age do kids become proficient at reading and writing
6-9
what age do kids have an accurate perception and accounting of events and can remember events from the past?
6-9
what age do kids take on more responsibility, have more effective coping skills, rule orientated play, and is motivated to avoid punishment?
6-9
what age babbles
6-9 mo
what age begins to pull to stand
6-9 mo
what age develops pincer
6-9 mo
what age explores toys with rotation and mouths toys
6-9 mo
what age holds own bottle
6-9 mo
what age sits without support?
6-9 mo
what age spoon feeds well
6-9 mo
what age transitions from tummy or back into sitting
6-9 mo
what age transitions to more textured foords
6-9 mo
what age trasnfers objects
6-9 mo
what age plays in organized sports and gets better at those skills, integrates motor and pereptual skills, and begins to play instruments
6-9 yo
if i can read 8 words and there are 12 total how legible is it?
66%
at what age should kids have mastered fundamental movement to transform into combining skills to use in sports?
7
how much info can the brain process at once?
7-9 (working memory)
how many teens are working? positives and negatives of it?
70% too much has emotional distress substance use leads to healthy development those with disabilities dont have this opportunity
what age starts creeping or crawling towards how many months
9
what age begins to eat soft foods
9-12 mo
what age claps
9-12 mo
what age cruises along furniture
9-12 mo
what age finger feeds
9-12 mo
what age follows simple directions
9-12 mo
what age pokes with index finger
9-12 mo
what age releases into a container
9-12 mo
what age responds with no, follows simple directions,
9-12 mo
what age says no
9-12 mo
what age stands alone and takes steps
9-12 mo
what age use mama dada baba
9-12 mo
what age uses cup
9-12 mo
when are the visual cognitive functions mostly mature by
9-12 yo
___mo the visual field is four foot away
9-18
Which statement fosters cultural competence? Treat everyone the same no matter their culture. Acknowledge and respond to influences of cultural beliefs in the intervention plan. Ask the family to outline how their beliefs will influence therapy. Provide an outline of your beliefs as a starting point.
Acknowledge and respond to influences of cultural beliefs in the intervention plan. (Acknowledging and responding to influences of cultural beliefs in the intervention plan will help foster cultural competence. (Box 22-1))
Troy is 3 years old and is now toilet trained. He feeds himself, and is beginning to dress himself. He freely plays in a variety of positions and enjoys certain toys. According to Erikson, which stage of development does this describe? Basic Trust vs. Mistrust Autonomy vs. Shame Initiative vs. Guilt Industry vs. Inferiority
Autonomy vs. Shame (Autonomy vs. Shame (2-4 years) is the stage in which the child develops autonomy and will, attempts new challenges, and becomes more self-sufficient.)
According to the Occupational Therapy Practice Framework (OTPF), which is not an Instrumental Activity of Daily Living (IADL)? Care of pet Meal preparation Bathing Shopping
Bathing
The International Classification of Functioning views human functioning at which three levels?
Body function and structure, person, society (The International Classification of Functioning (ICF) views humans functioning at three levels: the body (structure and function), the person (activities), and society (participation).)
what are assessments for occupations in children?
CAPE preteen play profile pediatric activity card sort preschool activity card sort
with what diagnosis are there motor control difficulties?
CP (most significant) DCD (subtle) MD (helplessness, takes so much energy and is hard, may not think its worth it) Autism (lots of fleeing and running or hiding) TBI (frustration)
According to the Occupational Therapy Practice Framework, which is not considered an Activity of Daily Living? Care of pets Feeding and eating Bathing and showering Dressing and hygiene
Care of pets (Care of pets is considered an Instrumental Activity of Daily Living (IADL). ADLs include self-care, including learning how to take care of one's body, toilet hygiene, bowel and bladder management, bathing and showering, personal hygiene and grooming, eating and feeding, dressing, and functional mobility.))
What is the meaning of a Z-score of −3.00? Child's score indicates he is ahead of his peers and performing well. Child's score falls below the majority of his peers on this test. Child's score places him within normal limits on this test item. Test is nonconclusive.
Child's score falls below the majority of his peers on this test. (Z-scores are based upon the standard deviation units. This score indicates that he is standard deviations below the mean, suggesting that the child has significant difficulty (with test items). (Figure 6-5))
Assessment measures children's participation in terms of number of tasks and amount of support needed for household tasks (6-14 years) through interview/observation and allows for comparison over time? Assessment of Motor and Process Skills (AMPS) Children Helping Out Responsibilities, Expectations and Supports (CHORES) Scale for Kids (ASK) Hawaii Early Learning Profile (HELP)
Children Helping Out Responsibilities, Expectations and Supports (CHORES) (CHORES is the only one on this list that provides number of tasks and amount of support needed.)
The therapist is helping Sakina (3 years old) ride a tricycle. Sakina needs frequent reminders on how to get on the tricycle and she is unable to keep her feet on the pedals consistently. The therapist holds Sakina's legs and mimics the pedaling motion. At what stage of learning is Sakina in regard to riding a tricycle?
Cognitive (The cognitive stage of learning involves learning new movements; errors are common and movements are inefficient and inconsistent. During this stage learners need frequent repetition and feedback.)
Which intrinsic factors may influence a child's participation? Communication skills, adaptive behaviors, motor function, personality Finances, community resources, family support, transportation Regulations, gender stereotypes, cultural, institutional Diagnosis, cognition, setting, environment
Communication skills, adaptive behaviors, motor function, personality (Intrinsic factors refer to personal factors. Both intrinsic and environmental (family and community) factors influence the diversity of activities and the intensity of participation.)
Which intervention session most closely describes an approach using dynamic systems theory? Repeatedly place a block into a container until the child has mastered the movement. Provide the child step-by-step instructions, allowing for no mistakes so that he learns the "correct" movement. Complete playful activities in variable ways allowing the child to problem-solve. Structure the session so the child completes the movement under controlled situations.
Complete playful activities in variable ways allowing the child to problem-solve. (The principles of dynamic systems theory suggest that a child learns movement more easily and effectively if: (1) the movement is taught as a whole (versus part); (2) the movement is performed in variable situations; (3) the child is allowed to actively problem-solve the actions required; and (4) the activity is meaningful to the child.)
Which statement best reflects how you would evaluate the clinical usefulness of a test? Read the statistical methods used to validate the scores. Consider what needs to be collected and discuss with colleagues. Decide upon one test to use with all of your clients and families. Ask the family which test they would suggest.
Consider what needs to be collected and discuss with colleagues. (Occupational therapists use clinical judgment when determining which test to use with a particular child. Understanding what you want to know and discussing test validity, reliability, and clinical usefulness with colleagues can help you decide. (Box 6-4))
for hemiplegia kids who dont use one hand what is a program to encourage grasp and using the other hand?
Constraint induced movement therapy (remediate less functional arm, can use a cast or splint, bimanual integration) kids hate this, make sure there is a good relationship
Which sequence represents the stages of prewriting and handwriting development? Controlled scribbles; discrete lines, dots, or symbols; straight-line or circular uppercase letters; uppercase letters; lowercase letters, numerals, and words Discrete lines, dots, or symbols; controlled scribbles; lowercase letters, numerals, and words; straight-line or circular uppercase letters; uppercase letters Straight-line or circular uppercase letters; controlled scribbles; discrete lines, dots, or symbols; lowercase letters, numerals, and words; uppercase letters Controlled scribbles; lowercase letters, numerals, and words; discrete lines, dots, or symbols; straight-line or circular uppercase letters; uppercase letters
Controlled scribbles; discrete lines, dots, or symbols; straight-line or circular uppercase letters; uppercase letters; lowercase letters, numerals, and words (Children progress through the following stages of prewriting and handwriting: (1) controlled scribbles; (2) discrete lines, dots, or symbols; (3) straight-line or circular uppercase letters; (4) uppercase letters; and (5) lowercase letters, numerals, and words. (Table 18-1))
What contextual influence includes the family's desire that children should help with all meals?
Cultural values and beliefs
Brianne is an 18-year-old student with cerebral palsy who participates in a transition program. Before services, the education team completes an evaluation. Team members observe her performance during activities in selected environments. Based on careful observation, the activity demands and Brianne's ability to perform in each environment are noted. What kind of evaluation would you call this? Transition evaluation Assistive technology assessment Discrepancy analysis Outcome assessment
Discrepancy analysis (Discrepancy analysis refers to evaluating one's performance and ability to determine what is needed to assist the student in success.)
Which type of grasp pattern is used to hold a jar lid? Disk grasp Hook grasp Pincer grasp Spherical grasp
Disk grasp (Disk grasp is used to hold a disk such as a jar lid. (Table 8-1))
Which question to a parent may help a therapist better understand the cultural values and styles that influence a child's development of occupations? What is the child's diagnosis and prognosis? Do you believe that the disability can improve? What is your ability to pay for services? Who is your primary care provider?
Do you believe that the disability can improve? (Understanding the family's perception of the disability allows the occupational therapist to understand the influence of the child's culture and is useful for designing intervention. (Table 1-2))
No child left behind and its role with OT
Expanded role in assessment, classroom modifications and accommodations
Mary attempts to grasp a rattle placed in front of her but she is inefficient. She drops the rattle on the floor. She tries to reach out for the rattle and sometimes makes contact with the rattle. She is able to reach to midline. What stage of motor learning for reach and grasp does this describe? Exploratory Perceptual Skill achievement Precision and refinement
Exploratory (Exploratory (1-3 months) reach is defined as: swipes at objects; reach is inaccurate; infant cannot combine reach and grasp. Exploratory grasp (3-5 months) is defined as: first voluntary grasp begins between 2 and 3 months. Infant squeezes object with all fingers, thumb does not participate. Release is random, without voluntary control. Grasp is inefficient and infant cannot move object in hand. (Table 3-4))
According to Larson and colleagues, which type of activity did the adolescents with disabilities report as providing significant opportunities for all skills and developmental experiences? Academic clubs and organizations Faith-based youth groups Sports Performance and fine arts
Faith-based youth groups (Youth who participated in faith-based youth groups reported significantly more opportunities for all skills and developmental experiences on the YES when compared to other activities. (See Research Note 12-2))
TF in a school OT is a stand alone service
False, need to qualify for special ed before OT
According to IDEA, the IEP must include several components. Which of the following is not a required component of the IEP? Family report and medical history Measurable annual goals in areas of need Determination of special education and related services that the child needs to accomplish the goals and objectives (including frequency) Present levels of educational performance (academic and nonacademic)
Family report and medical history
Family-centered care is often a hallmark approach in pediatric hospitals. It is characterized by all of the following, but not: Clear descriptions in communicating evaluation results Input from family on expected intervention outcomes Mutually agreed upon treatment plan Family-led team meetings
Family-led team meetings (Family-centered care refers to collaboration with family members but not asking them to lead the team meetings.)
By what grade do children develop fluency in writing? Kindergarten Fourth grade Sixth grade Ninth grade
Fourth grade (Most children learn to write letters in kindergarten but do not develop fluency until the third or fourth grade, and they do not demonstrate adult speed in writing until the ninth grade.)
In what way did the 1997 amendments affect school-based occupational therapy services? General education teachers are now the teachers of all children. Special educators are no longer needed. Special education students spend all of their school time attending general classes. Students with disabilities participate in the special education curriculum only.
General education teachers are now the teachers of all children. (General education teachers are the teachers for all children. However, some children may need assistance from special education teachers.)
Which sequence represents the global strategy used in CO-OP? Do, Check, Plan, Goal Goal, Plan, Do, Check Plan, Goal, Do, Check Plan, Goal, Check, Do
Goal, Plan, Do, Check (The sequence refers to establishing a goal (What do I want to do?); plan (How am I going to do this?); do (Do it.); and check (How well did the plan work? Do I need to revise my plan?).)
The occupational therapist working with a 3-year-old boy moves the ball just a little bit closer so the child can reach it and hit the target. The therapist is careful not to move the ball too close. Which concept does this represent? Using assistive technology to change the activity for success Providing education to teach the child how to achieve skills Using occupation as an end to promote performance Grading and adapting activity to meet the just-right challenge
Grading and adapting activity to meet the just-right challenge (Grading and adapting refers to changing the difficulty, pace, or aspects of the activity. In this case, the therapist wants the child to reach for the object (just-right challenge).)
The occupational therapist sets up a play area and allows the child to explore the toys, while posing some questions during the play. What type of learning is the therapist facilitating? Scaffolding Metacognition Guided Discovery Imagery
Guided Discovery Guided discovery learning offers opportunities for the child to ask questions and generate ideas that can be further tested or researched.
somatosensory functions seen in visual skills
Haptic perception (knowledge of obj gathered through touch) somatosensory information (force to grasp and manipulate)
Gray cannot fully extend his fingers. He has limited range of motion at wrist, forearm, and fingers. What does this describe? Hypertonicity Hypotonicity Sensory feedback Muscle weakness
Hypertonicity (Hypertonicity is characterized by limited range of motion and decreased range of motion. (Table 8-6))
what is the most appropriate ideas on how to implement, school will provide equipment, then child will own it, what skills to be productive after diagnosis
IDEA
what did the EHA turn into?
IDEA individuals with disabilities act
Which law provides for children 0 to 2 who are in need of comprehensive early intervention services? IFSP IDEA—Part A IDEA—Part B IDEA—Part C
IDEA—Part C (IDEA—part C is an entitlement program (acknowledges one's rights to services) for children 0-2 years. (Table 22-1))
**IDEA amendments 97, most significant change
IEP has an increased emphasis on regular curriculum state and district wide testing new disability categories service plan for funding disciplinary action
Mark is a 16-year-old who sustained traumatic brain injury at the age of 6. He now has significant limitations when completing written classroom assignments. What should the education team do to help him? Develop discipline-specific goals. Introduce Jonathan to the special education teacher. Excuse Jonathan from written work. Identify appropriate transition goals.
Identify appropriate transition goals. (Developing a transition plan will provide him with goals for the future and help him prepare for life after high school.)
Marge, a 14-year-old girl followed in OT, is argumentative and disinterested in school, peer groups, or previous hobbies. She gets to therapy late and frequently states "I don't care." The therapist notes that this behavior is new this year. At what stage of identify formation might Marge be functioning? Identity diffusion Moratorium Identity foreclosure Identity achievement
Identity diffusion (Identity diffusion is most frequently associated with early adolescence and is characterized by an ill-defined sense of identity. In this state, adolescents have little or no interest in exploring their options. They have not made any commitments to choices, interests, or values. They may demonstrate an "I don't care" attitude of impulsivity, disorganized thinking, and immature moral reasoning.)
John is a 6-year-old boy with cerebral palsy whose family loves baseball. The occupational therapist seeks community resources and provides activity modifications so that John may engage in recreational baseball with his friends. Which type of services are represented? Inclusive and integrated services Intervention services School-based services Recreational services
Inclusive and integrated services (Inclusive and integrated services refer to enabling the child and youth with disabilities to fully participate in the community.)
Which intervention strategy is least likely designed to increase social participation? Increase range of motion. Manage money for increased opportunities. Modify line dancing routine. Modify positioning equipment for child to sit at table.
Increase range of motion. (Increasing range of motion is least likely to increase social participation. The other strategies can be linked more directly to social participation. (Box 12-3))
Which is not an objective of the Cognitive Orientation to Daily Occupational Performance (CO-OP) model? Enable occupational performance in children. Facilitate generalization of the occupations to other settings. Increase upper extremity hand use for functioning. Teach the child to use the strategies.
Increase upper extremity hand use for functioning. (Increasing physical performance may be necessary but is not the objective of the CO-OP model. CO-OP strives to help children use strategies for daily occupations.)
What statement best reflects the role of the occupational profile when conducting a comprehensive evaluation? In-depth structured observation of child's performance Information on the child's developmental and functional strengths and limitations Analysis of the underlying reasons for limitations in performance and behavior Assessment and observation of the child's performance within a variety of environments
Info on te child's developmental and functional strengths and limitations (The occupational profile obtains information about the child's developmental and functional strengths and limitations. It is obtained through interview with parents, teachers, and other caregivers (and child if possible). (Table 1-3))
Which statement is true regarding identity development for adolescents? It begins in early adulthood. It is a series of linear stages. It is a dynamic process throughout adolescence. It is complete by high school graduation.
It is a dynamic process throughout adolescence. (Identity development was originally conceptualized as a series of linear stages. However, research has suggested that identity development is a dynamic process that occurs throughout adolescence.)
Which statement is not referring to a criterion-referenced test? No score distribution needed; a child may pass or fail all items. Items chosen for functional and developmental importance Compares child's performance with a list of skills Items chosen for statistical purposes
Items chosen for statistical purposes (Criterion-referenced tests compare a child's performance with a defined list of skills that are chosen based upon importance, not for statistical purposes. (Table 6-2))
At what age would you expect a child or youth to launder own clothes, practice budgeting and banking skills, and know what to do in case of fire or emergency? Late adolescent (16-21 years) Early adolescent (12-15 years) Middle childhood (6-11 years) Preschool (3-5 years)
Late adolescent (16-21 years) (These skills are expected of late adolescent. (Box 16-1))
***Kevin is a 3rd grade student who has learning difficulties. The team members would like him to be placed in a regular classroom for most of his classes. However, they are not sure that he will be able to keep up with the requirements. What must the team consider to make this placement? Number of children in the classroom Cost of special education Least restrictive environment Teacher's expertise and training
Least restrictive environment (The least restrictive environment mandate requires that students with disabilities receive their educational program, including all their academic and related services, with children who are not disabled to the maximum extent appropriate.)
when we put children in with typically developing peers for the most we can?
Least restrictive environments
What is the therapist evaluating when he/she observes a child producing improper letterforms, poor leading in and leading out of letters, inadequate rounding of letters, and incomplete closure of letters? Writing speed Ergonomic factors Legibility Grasping patterns
Legibility (Legibility is often assessed in terms of its components—letter formation, alignment, spacing, size, and slant. However, the bottom line is readability.)
Drew is a teen who has juvenile rheumatoid arthritis. She does not like to wear her splints to school unless she is allowed to decorate them. She is involved in the yearbook club and posts pictures of her peers. She spends more time at school or with her friends than at home. Her mother is concerned regarding Drew's dress and argumentative nature (with parents). At what stage of adolescents does this describe? Pre-adolecence Early adolescence Middle adolescence Late adolescence
Middle adolescence (Middle adolescence is characterized by increased separation from parents and more involvement in peer groups. Middle adolescents adopt peer value systems regarding appearance and dress. They may become argumentative with parents (as a way to separate and develop their own identity).)
A child bathes and rinses himself but needs help getting into and out of the tub; he has to be cued to monitor the water temperature and to dry himself. What would be his level of independence rating? Independent Supervision Minimal assistance Dependent
Minimal assistance (He requires some assistance and supervision. He does 51% to 75% of tasks independently but needs physical assistance or other cuing for at least 25% of tasks. (Table 15-1))
What type of assistance is assigned to the following scenario: The child needs someone to help him hold onto the spoon, scoop food, and bring it to his mouth. He opens his mouth and swallows. Independent Moderate assistance Minimum assistance Stand-by assistance
Moderate assistance (Moderate assistance refers to 50% assistance of the amount of time required for partial task, whole task, and task transition assistance by a care provider.)
Which statement most closely illustrates dynamic systems theory? The therapist's role is to facilitate normal movement patterns to help children acquire more typical movement. When children complete adaptive responses, change occurs at the neuronal level (brain plasticity). Improving muscle strength improves the quality of movement or performance. Motor control is dependent upon the interactions between person, task, and environment.
Motor control is dependent upon the interactions between person, task, and environment. (Dynamic systems theory suggests that motor control is dependent on nonlinear and transactive person factors (i.e., cognitive, musculoskeletal, neurologic, sensory, perceptual, social-emotional), task characteristics (i.e., goals, rules, object properties), and environmental systems (i.e., contexts).)
Which principle does not follow neuromaturational theory? Movement progresses from primitive reflexes to voluntary control. The sequence and rate of motor development are consistent among infants. Low-level skills are pre-requisites for certain high-level skills. Movement emerges from an interaction and cooperation from many systems.
Movement emerges from an interaction and cooperation from many systems. (Dynamical systems theory refers to performance or action patterns that emerge from the interaction and cooperation from many systems. Neuromaturational theory states that skills emerge sequentially according to the maturation of the CNS structures and thus, children attain developmental milestone in linear and consistent patterns.)
IDEA and its implications with OT
OTs dont make autonomous decisions, knowledge about regular and special ed curriculum, increase delivery, increase team collaboration, increased interaction with teachers
Occupational therapists help to uphold the intent of IDEA. Which of the following represents optimal practice that is consistent with IDEA's intent? Occupational therapists collaborate with special education teachers only. Occupational therapists enable students with and without disabilities to be educated together. Occupational therapists support special education students as they work to meet all general curriculum standards. Occupational therapy evaluation identifies a student's transition-related deficits.
Occupational therapists enable students with and without disabilities to be educated together. (Occupational therapists who work in schools help children engage in activities in the general education classroom.)
Unstructured time and engagement in passive activities are problematic for all adolescents; however, adolescents with disabilities participate in more passive activities than their nondisabled peers. Occupational therapy practitioners would discourage passive activities because: Passive activities are boring and are more likely to lead to poor health outcomes. Extracurricular activities are essential for positive nonfamily relationships. Adolescents who engage in passive activities have few friends. High levels of television and computer activities, common passive activities, are associated with an increased level of violence and antisocial behaviors.
Passive activities are boring and are more likely to lead to poor health outcomes. (Occupational therapists take an active role in assisting teens to identify opportunities for physical activity within supportive environments. Participation in physical activities maintains functional mobility, enhances well-being and overall health, and provides opportunities for social interaction with peers.)
Which standardized test would be most appropriate for a high-risk clinic where you are evaluating an infant who is 2 months old? Pediatric Evaluation of Disability Index (PEDI) Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) School Assessment of Motor and Process Skills (School-AMPS) Peabody Developmental Motor Scales (PDMS- 2)
Peabody Developmental Motor Scales (PDMS- 2) (The Peabody Developmental Motor Scales provides a measurement for children 1 to 84 months of fine and gross motor development. (Table 6-1))
Which stage of motor learning is illustrated as the toddler attempts to place a shape into a container multiple times using an effective reach and grasp pattern often, but making errors? Functional performance Perceptual learning Skill achievement Exploratory activity
Perceptual learning (In perceptual learning the child begins to use the feedback and reinforcement from his or her exploration. In this transitional stage, the child exhibits more consistency in the movement patterns used to accomplish tasks.)
what is the maslow hierarchy of basic needs
Physiological (food shelter water) safety (physical emotional) social (love and belonging) esteem (belief you can do something) self actualization (competence full potential)
John is a 3-year-old boy who breaks his toys often. His mother states he drops things and crushes them. Which explanation seems most possible for his poor hand skills? Cognition and judgment Limited structure and discipline at home Poor proprioceptive or tactile awareness This is typical behavior for his age.
Poor proprioceptive or tactile awareness (An analysis of the performance components for hand skills shows that poor proprioceptive or tactile awareness may result in breaking objects or dropping them frequently. (Box 8-1))
Occupational therapy services in hospital settings are often prioritized. Select the best characterization of priority levels from most to least important. ADL, IADL, school and community participation Infection control, hand washing, fall prevention Prevention, resuming function, restoring skills and abilities Client- and family-centered goals, regulatory requirements, evidence-based practices
Prevention, resuming function, restoring skills and abilities (Preventing secondary disability, resuming function, and then restoring skills and abilities is the best characterization of priority levels.)
Morgan is a 15-year-old freshman in high school with a documented learning disability (reading and writing) who is followed by occupational therapy at school. She is quiet and shy. She does not join groups at school and has difficulty expressing herself. She does not try new things for fear of failure and she is recently skipping school. Which statement best describes the role of the occupational therapy? Consult with classroom teachers regarding Morgan's poor reading and writing abilities. Provide accomodations for Morgan's reading and writing disabilities. Promote identity formation and help her develop interests through participation in age-related activities. Create a social group to include Morgan in after-school activities.
Promote identity formation and help her develop interests through participation in age-related activities. (Morgan is having difficulty creating a self-identity, which is interfering with her ability to perform at school. This will interfere with her sense of well-being. The therapists can make sure that the classroom accomodations are being implemented while helping Morgan develop her identity and advocate for what she needs.)
Which adaptive strategy would help a child, who is having difficulty with judgment and decision making, engage in IADLs? Provide structure when planning Provide hand-over-hand assistance Use work simplification techniques Provide built-up utensils
Provide structure when planning (Providing structure when planning will help a child who has difficulty with judgment and decision making. The other strategies are useful for physical challenges. (Table 16-2))
Grasp pattern + age
Radial palmar, raking, radial-digital, tip pinch (6 months—radial palmar grasp; 7 months—raking; 8-9 months—radial digital grasp; 12 months—tip pinch)
Which progression reflects the sequence of grasp patterns? Radial palmar, raking, radial-digital, tip pinch Raking, radial palmar, radial-digital, tip pinch Raking, tip pinch, radial palmar, radial-digital Tip pinch, raking, radial palmar, radial-digital
Radial palmar, raking, radial-digital, tip pinch (6 months—radial palmar grasp; 7 months—raking; 8-9 months—radial digital grasp; 12 months—tip pinch)
The therapist asks the child to put on his jacket using the key words for important parts. They repeat this three times. What strategy is the child using? Imagery Knowledge Rehearsal Self-questioning
Rehearsal (Rehearsal refers to repeating information visually or mentally to aid in retention of important information related to given task/occupation: repeating key words/actions out loud, creating internalized visual images of the task procedure, and visually carrying out the task in a repeated manner. (Table 10-2))
Special education and services have been made available through the public education system to children and youth who have disabilities since passage of Public Law 94-142 the Education for all Handicapped Children Act of 1975 (EHA), currently known as IDEA. How is occupational therapy described in the EHA and its subsequent amendments? Transition service Supportive service Related service Direct service
Related service (Occupational therapy is considered a related service.)
Hospitalization of children is most common because of which of the following? Respiratory and gastrointestinal disorders Rehabilitation needs Psychological and psychiatric needs Neurologic and musculoskeletal disorders
Respiratory and gastrointestinal disorders (Respiratory and gastrointestinal disorders are the most common reasons for hospital care.)
Which adaptation is best to help a child who is having difficulty with cardiac functioning? Electronically powered wheelchair Scheduling and pacing tasks Reachers Enlarged handles
Scheduling and pacing tasks (Scheduling and pacing tasks is an adaptation that may help a child with cardiac difficulties. (Table 24-1))
Which statement is true concerning early intervention services for children 0-2 years? Only doctors can determine if the child is eligible for services. Specific diagnoses qualify for services. Services are provided to a diverse group of children and families. Families must pay for the services.
Services are provided to a diverse group of children and families. (Early intervention services are available to a diverse group of children and families. Families do not have to pay for services and children qualify without specific diagnoses. Children may be referred to early intervention services by a variety of people and parents may suggest an evaluation if they have concerns. States are required to develop a comprehensive program for the services (including child find).)
Which statement is not a principle of family-centered care? Respect family autonomy Provide flexible services Collaborate with family members Set strict rules for family to follow
Set strict rules for family to follow (Family-centered care requires that professionals collaborate and listen to the family and work on family goals and priorities. As such, being flexible, listening to the family, and respecting their culture and views are principles of this model. (Box 22-2))
According to biomechanical principles, what is the optimal position for functional tasks? Long sitting on floor with table at shoulder level Sitting with head, arms, hands in midline Standing with head to side, arms and hands midline Supine with head in midline
Sitting with head, arms, hands in midline (Midline position of the head, arms, and hands is optimal for most functional tasks. Sitting with slight flexion is best.)
In adolescence, teens' social participation with peers and others outside the family is important because: Conflict and disagreements with parents increase. Social interactions with peers and others shape social identity and provide emotional and social support. Adolescent social relationships are an essential precursor for adult intimate relationships. Peer interaction promotes the development of social skills and freedom from parental constraints.
Social interactions with peers and others shape social identity and provide emotional and social support. Peer-focused social interactions and relationships formed in school through leisure activities provide social status and develop adolescents' social identity.
Typical v atypical development in 0-3 mo
TYPICAL: head in midline, track left to right in supine, lifts extremities, lifts head in prone and arms under, reciprocal kicking, control muscle contractions ATYPICAL: no head turning, no LE antigravity in supine, use extremities for movement over trunk, flexed hips and legs in prone, movement is an all out effort
typical v atypical 4-6 mo
TYPICAL: roll independently, alert and focused, sit and reach to play, palmar grasp, radial grasp, pivot in prone, dissociation of UE and LE, LE weight bearing ATYPICAL disorganized, no antigravity movement, no protective extension or arm mvt, head lag, doesnt attend to env, need supported sitting, no WB in LE, low tone
Which statement most closely reflects how using evidence-based practice (EBP) benefits occupational therapy practice with children and adolescents? EBP is for researchers only and has little influence on direct practice. The likelihood of positive outcomes is higher when therapists consider EBP guidelines to design intervention. The likelihood of finding EBP guidelines for a given client diagnosis is small and therefore does not need to be considered. Occupational therapists do not have time to consider EBP.
The likelihood of positive outcomes is higher when therapists consider EBP guidelines to design intervention. (Occupational therapy is grounded in research evidence and this should be considered during all aspects of the process.)
Which handwriting problem may be addressed by providing the child with grid paper or requesting the child write on every other line of the paper? Dictation Spacing on paper Sizing letters and words Near-point copying
Spacing on paper (Some potential solutions for handwriting problems of spacing on paper include the following: use of grid paper; write on every other line of the paper; and draw colored lines to mark (e.g., green is left; red is right). (Table 18-5))
Which of the following examples represents the least desirable service delivery option for occupational therapists working in the schools? The occupational therapist conducts a prewriting activity group once weekly, which is integrated in the preschool curriculum. The occupational therapist adapts the student's seat to improve positioning and hand use. The occupational therapist consults with the student's adaptive physical education teacher about sensory processing issues and how these influence the student's behavior in her class. The occupational therapist removes the child from the classroom for 1 hour daily to work on handwriting skills.
The occupational therapist removes the child from the classroom for 1 hour daily to work on handwriting skills. (This choice (D) represents a direct service model wherein the child is pulled out of the classroom for occupational therapy services. Integrated service delivery and consultative models are more conducive to allowing the child to engage in the academic occupations.)
Which statement best reflects the friendships of students with disabilities? They experience the same number of social interactions, but they experience less joy. They experience fewer social interactions, but they are satisfied with the number of interactions. They experience far fewer social interactions and social invitations than their peers without disabilities. They experience more social interactions but mostly with adults, which is less rewarding.
They experience far fewer social interactions and social invitations than their peers without disabilities. (Many students with disabilities, especially those with intellectual and developmental disabilities, experience far fewer social interactions and social invitations than their peers without disabilities.)
T/f according to neuromaturation low level skills are prereqs for higher level skills
True
what is the best way to encourage co-contraction in a child with hypertonicity/spasticity?
UE weight bearing, in prone, use splints, lay on balls, use splints, put pressure and massage hands and palms
According to motor learning theory, how should a therapist provide verbal instruction to a child learning a new motor task? Verbal cues should be provided throughout the entire movement. Verbal cues should be brief, to the point, and use one to three words. Verbal cues should emphasize all aspects of the skill. Verbal cues should not be limited until the child has achieved the skill.
Verbal cues should be brief, to the point, and use one to three words. (Verbal instructions should be brief, to the point, and use one to three words. They should be limited in terms of number of cues given during or after the performance. Only the major aspects of the skill that is being concentrated on should be cued. (Box 7-4).)
Which adaptation principle would help a child who has poor memory? Built up handles Change position of child Provide external supports Visual cues
Visual cues (Visual cues can help cue a child with poor memory. (Table 15-3))
what are the domains of handwriting
Writing alphabet, copying, near-point copying, far-point copying, manuscript-to-cursive, writing dictated words, and composition
2-year-old Mary is able to climb up the slide with her mother's support but otherwise she only climbs two rungs. According to Vygotsky, what is this called? Formal operations Sensorimotor performance Zone of proximal development Pre-operational
Zone of proximal development (Vygotsky defined a zone of proximal development to explain how learning occurs through social interaction. The zone of proximal development is the distance between the actual development level as determined by independent problem solving and the level of potential under adult guidance or collaboration with more capable peers.)
if a child has poor reading, understanding, spelling, writing, and math skills what can they be diagnosed with?
a learning disorder
at what score does a child fall outside of qualifying for therapy?
a standard deviations below the norm (1 or 1.5)
what is the ability to change the focus of the eye so one can see at different distances clearly (look out in distance then able to look closer to you)
accommodation
what is thinking, this is a golden doodle, so I ahve created new categories of dogs that fit into the new ones, so now there are different types of dogs
accommodation
Keyword for rehab act of 1973
accommodations for certain condition
what stage of empathy do kids know world hunger
abstract empathy (10-12 yo)
what is new learning, adapting a cognitive structure to new information
accommodation
exploratory play provides the medium for what?
acquisition of skills develop awareness (of sensory perceptual properties of obj and attach meaning to objects by the child)
why would you want to stretch before fine motor tasks?
activate, stretching recruited big muscles start by bombarding the postural and shoulder girldes w lots of proprioception if you want to refine the fine motor and finger muscles and extrinsic
what are the 9 things that make up temperament
activity level appraoch or withdrawl distractibility intensity of response attention span/persistence quality of mood rhythmicity threshold of response adaptability
what is the first thing eye doc does?
acuitiy test
what are the three medical settings
acute care hospital specialty hospital pediatric outpatient hospital
what is the childs ability to adjust to change to fit into the environment
adaptation
If I give a kid a built up spoon to help eat what model am I following
adaptation compensation
what intervention strategy is using technology?
adapting the task or environment
smaller anterior right prefrontal cortex, caudate nucleus, and globus pallidus is seen in what diagnosis
add adhd
what is the chronic level of inattention impulsive hyperactivity or both that compromises daily functioning
add adhd
what is the most common neurobehavioral condition of childhood
add adhd
long acting, short intermediate acting, non stimulants for add adhd meds
adderal xl concerta ritalin ritaline focalin dextrostat adderal straterra intuniv
what is the fit between the child and the envrionment
affordance
**define the principles of individuals with disabilities education act
all children with disabilities have the right to free appropriate education within the least restrictive environment
if a little one doesnt know what a number is or what it means, they dont really memorize 2 +2 and are not fluent whcih leads into not dong math easily. what impairment is seen
alternative dyscalculia
what part of the brain attaches emotional significance to sensory sitimuli forming and storing memories fear freeze response
amygdala
what are the differences between an evaluation and an assessment?
an eval is the entire process of gathering information standardized assessments follow specific protocol, specific scores, manual to administer
what part of the brain is decision making, empathy, reward system, decision making, impulse control, emotions
anterior cingulate gyrus
which temperment relates to a kid who withdrawl, has an unpleasent mood, is slow to adapt, and has an extreme threshold?
difficult child
what to look for in grasp s with kids?
are they making an adjustment? know how to approach something? or do they reach in an unorganized fashion?
if a kid is throwing or kicking a ball when do you make a comment?
ask how it felt if it is motor fix the problem then so they have a feeling of it if they are upset, wait to give feedback
Describe the play hisotry assessment by takata
assess childs abilities in light of past play experiences interview format through developmental stages
Describe the test of playfulness
assess playfulness, it is a continuum of internal to external perception of control intrinsic to extrinsic source of motivation free to not free suspension of reality assessment is done by watching children play more valuable to assess playfulness than what actually occurs/outcome of play
what is incorporating new knowledge into existing cognitive structures? make knowledge fit into a puzzle?
assimilation
when animals are dogs but then you learn about the different types of dogs and they are in the same category is what practice model?
assimilation
assimilation v accomodation in the sensorimotor stage
assimilation: take info from env and attach to existing categories acc: reorganize information to adopt to environment
what stage of learning are kids more consistent and dont have to rely on cognitive processes? they dont miss a ball being rolled to them very often?
associative
what stage of learning are skills refined
associative stage
what stage of learning are functional movements performed? skills can be transferred?
autonomous
what stage of learning is when you learn something and its hard but you practice a lot and come back the ext day and are better?
autonomous
Rehab act of 1973 implications, section 54
aware of ACCOMMODATIONs for certain conditions
what does fine motor look like for CP or spastic quad who are flexed the whole time, legs scissored and arms crossed in supine
breaking up spasticity and stretching crawl over wedge, weight bearing and shoulders, put toy down, get hands open, in wheelchair work on grasp and release, put things in bucket, they have the support for posture
what are the underlying skills and processes that lead to the dvpt of skills
balance posture
what part of the brain can automatically adjust motor?the differences between sitting down on hard chair and soft couch
basal ganglia
what area of the brain is when you pick up a cup and know how fast you should drink it?
basal ganglia (automatic motor patterns and responses)
IEP individualized education plan
based on Present levels of performance, parent and student, rights are protected
what are the first things developed in the visual cognitive functions?
basic pattern recognition form constancy (then analysis with spatial relations)
what VP skills does a baby at birth have
basic visual fixation brief reflexive tracking ocular motor reflex
what are the symptoms of ADD ADHD
before 7 2 plus settings impairment in functioning no other mental disorder
when a kid can see one image even though both eyes had an image
binouclar fusion
In a therapy session, if OTS Katie helps a kid get stronger so they dont have compensation forever with their injury what approach is it?
biomechanical
a handwriting intervention that consists of addressing sitting posture paper position pencil grip writing tools
biomechanical
what cognitive symptom is when a kid is talking to a teacher but briefly blanks out forcing the teacher to reexplain herself?
blinking (quick loss of focus then refocus on the task)
what allows us to grade our muscles based on spatial awareness? pick foot up so you can step over the curb? writing in a small amount of space?
body awareness and motor control
which is not an evaluation of play revised preschool play history test of playfulness bot
bot
examples of standardized tests ots may use with children?
bot peabody dpat dtvp 3
do you start at the bottom or top layered activities before working on fine tuned skills?
bottom (get the big muscles ready before the small ones!)
what eval assesses performance components and then determines how that impacts occupation
bottom up appraoch
what is the hierarchial model of VP processing
bottom: visual acuity/field/oculomotor control visual scanning and inattention visual memory and pattern recognition visual cognition adaptation thru visino
what injuries do you do e stem to help contract certain muscles?
brachial plexus injuries (it hurts a lot and is uncomfy parents have to be aware of this)
what is the best way to work on a difficult handwriting assignment with an adhd add kid?
break the assignment down in chunks (do these 5 then come back to me, check, do five more, give positive feed back)
if a baby is curled up and needs to get prone what do you do?
bring hips out to elongate body, put pressure to create extension
1989 IDEA amendments included:
different language no more handicapped, person-first terminology section on technology transition services to adult life
according to neuromaturatio, cephalo moves to _____ proximal moves to ______ stability moves to ____-
caudal distal mobility
what part o the brain allows someone to sit in a chair for hours to learn?
cerebellum
what part of the brain allows for smooth and coordinated movements?
cerebellum (sequencing and timing of responses, coordination, balance, posture, sensory and motor integration, proprioceptive input)
what about puberty allows for social processing and ability to mentalize?
changes in amygdala prefrontal cortex and straitum
neglect physical abuse sexual abuse and medial neglect are categories of what
child abuse
what practice is it when you ensure interventions and recommendations match the family culture
child and family centered practice
what practice views the chid as a person first then a diagnosis?
child and family centered practice
what concept of practice is asking the kid "what do you want to do today" and let them make up activities
child centered
what is the top 3 in te top 10 best practices
child centered/family therapeutic relationship just right challenge
when a parent is depressed, other mental disorders, deprivatoin mixed with child being prolonged depenency for dvpt or medical reasons, with parent immaturity are risk factors for what
child neglect
if a child is not using a pincer grasp what is a goal to use
child will pick up 8/10 cheerios with a pincer grasp
what is learned non use?
children with hemiplegia, CP can have learned non use they do not use the weaker arm at all because its easier to use the other hand
strategies for intervening with ADL/IADL
client centered ability and success body image mentoring for good future inclusive social skills support grup
if adolescence is talking about where they want to go to college what is developing
cognitino
if an adolescence is pushing to make a decision by them selves based on their values what is developing?
cognition
if an adolescence is really thinking out problems logically and have symbolic thought and hypothetical deductive reasoning what is developing
cognition
ATTENTION MEMORY VISUAL DISCRIMINATION ARE APART OF VISUAL ___
cognitive
hand writing w/o tears is a ____-based intervention?
cognitive
handwriting intervention with prompts and cues strategies to remember adaptation raised line pencil grips spacers education consultation
cognitive
what stage of learning is wehre errors are common, movement is inefficient, and you gain skill
cognitive
what are the three stages of motor learning?
cognitive associative autonomous
at what stage of empathy do kids take anothers perspective and increase in trying to help them fix the problem and give comfort
cognitive empathy (6yo)
if the skills for the test domains are adequately represented what validity is it?
content
Which practice model is most useful for generalizing performance and transfer to natural environments? Biomechanical approaches Cognitive behavioral interventions Sensory integration intervention Contextual interventions
contextual interventions (Contextual interventions are those that occur in the natural environment and support caregiver problem solving. (See Figure 2-6, p. 36.) These types of interventions help children generalize performance.)
when eyes move in and out to fixate on an obj
convergence and divergence
if you work out and get injured a lot what do you need to work on?
core
how can you promote or create a support when intervening with ADLs
create env and opportunities team or systems in place like making a visual board for the family identify skills and gaps remediate respotre performance by targeting underlying factors
norm or criterion referenced test: detailed test, may cover specific objectives or milestones
criterion (norm is general)
norm or criterion referenced test: items chosen for functional and developmental improtance, info to develop therapy objectives
criterion (norm items for stat performance may not relate to functional skills)
if a test can predict performance on other measures it has what psychometric property
criterion-related validity
what are associated conditions and problems kids can or cant have in relation with add adhd
decreased cognitive learning disabilities acdemic and variability performance self regulation motivation anxiety, depression, bipolar
if children has inadequate strength what does it affect
decreased freedom of movement negatively impacts motor skills
what are some strategies for kids with ADD ADHD
deep pressure input sensory treatment goal directed behavior to do something functionally which is what makes new connections drive input towards something meaningful decision making
are mean median mode standard deviation descriptive stats or standard scores?
descriptive stats
to enhance grasping skills for a child wtih hypersensitivity whats the first thing to do
desensitize
what are the three steps for a fine motor intervention?
determine problem set goals sequence int. sessions
what part of the evaluation is: base of looking at postural control grasp
determine the problem (evaluation)
what part of the evaluation is: testing strength ROM endurance tone sensation
determine the problem (evaluation)
what part of the evaluation is: looking at what is the chids movement and what is the childs motivation?
determine the problem (evaluation)
why is body awareness important?
develop internal aspects and external, self awareness, hand dominance, body part identify, directionality (left right top bottom) spatial awareness obj to obj relationship
why is sexual orientation important to think about with adolescents?
developing psychosocially, 15% attracted to own gender, 5% gay, use gender neutral
two types of remedial interventions?
developmental neurophysiological
What are some cultural considerations?
different families expectations for childs independence who is primary caregiver? cultural norms? eaitng? expectations for independence
what are some red flags for infants and toddlers?
doesnt bring hands to midline doesnt follow movement with eyes doesnt notice or play with hands asymmetrical baby doesnt respond to you baby doesnt bear weight in supported standing motor milestones not met baby is stiff or floppy
downsides of stimulants?
dont relieve symptoms intolerable sdie efffects another diagnosis
stimulants increase ____ in the brain to allow better _____
dopamine focus
a kid who is expanding social participation, starts associative play, dramatic role playing with fairy tales and myths, increase in ahnd dexterity and stregnth is in what stage of takatas play
dramatic and complex constructive (4-7)
simple drama with toys and pretend to use them to represent things in 2 yo?
dramatic or symbolic
type of play in 5 yo, competitive and cooperative
dramatic or symbolic
What are common IADLs for teens?
drive shop spend money baby sit use technology achieve competencies inIADLs with a disability
communication disorders (speech sound, childhood onset fluency stuttering, social communication, unspecified communication) and motor disorders (dvcd, stereotypic movement, tic disorders) are other categories of learning problems NOT in
dsm v
if a baby doesnt have flexibility of mvmt or problem solving what theory is this related with ?
dynamic systems
at what stage of empathy do kids identify the source of discomfort and ask questions/offer help
emotional empathy (2-3 yo)
what do children develop from play?
engagement in age appropriate play and social facilitates emotional psychological motor cognitive development
3 rules on choosing developmentally appropriate activities?
engaging safety decreased behaviors
what does the ot do in early intervention
evaluation and planning
type of play where nonpurposeful sensory exploration facilitates learning about properties or affordances of objects
exploratory
what are the three stages of learning
exploratory perceptual skill achievement
the evaluation in which if you flinch or get scared with a thrown ball
extraoccular movement
if i ask a kid"look in you desk and quickly find an eraser" what is it?
figure ground
if a kid is unwilling to hoold a pencil and dont wanna touch it what should we do?
find other ones they like, littler things, so there is more pressure doing it to overide noxious of touch, makes me feel better to squeeze hands heres how you can do it
what are the performance skills in K, middle childhood, adolescents
fine motor and manipulation gross motor and mobility cognitive social
what are the in-hand manipulation skills?
finger to palm (grasp with fingers move to palm, moving a penny) palm to finger (put coin into vending machine) shift (separating two pieces of paper) simple rotation (90 degrees, unscrew cap and a puzzle) complex rotation (180-360 flip pencil over to use the eraser)
for in hand manipulation skills what activities to do you start with?
finger to palm translation
Jerry is a little boy who during the therapy ran and hid in the supplies closet. what add adhd cogntive symptom is being represented?
flooding
what is the absorbing all in environment, in intense and a pervasive way, which causes an overreaction? the result is pushing away from stimulation that is too painful or too stimulating?
flooding
what part of the peabody tells us most about bilateral hand?
fluidity of paper, can they make small adjustments and move fluidly or do they stop and turn it? assess posture, midline, in hand manipulation
how do you promote isolated arm and hand movements?
focus on specific movement patterns embed movements in games and songs supination control is a focus of the activity
intervention for kids with low tone and MS?
for strength go to prone, hand manipulation go sidelying in gravity eliminated and supported sitting)
what cognitive stage is abstract and hypothetical thinking?
formal operations
what stage uses combinational reasoning (1+ variable) deductive thinking, propositional logic (truth) metacognition(think about thinking, if i want to change behavior and improve what do i do)
formal operations
**What does FAPE stand for
free appropriate education defined in the IEP (individualized education plan), therapy must be at the appropriate level related services must be provided if the child requires them to benefit from special education
when a child isnt able to perceive how long something lasts what in the brain lacking?
frontal lobe: organization of time and space
voluntary release skill ideas?
full finger release to side splinting finger extension move trarget closer to body so child extends fingers while flexing arm release in bimanual activities
when working on the enhancement of voluntary release skills what should you begin with
full finger release
type of play where kids are using a plastic fork and knife to cut a steak?
functional
what types of play do infants engage in
functional social exploratory
a kid who is playing games with rules, have a leader, concerned with peer status, takes risks, interested in sports and friendships, cooperative play, crafts and nature is in what stage of takata play
games (7-12)
what type of play does middle childhood engage and adolescents in
games with rules crafts and hobbies organized sports social play
what type of play do kinder engage in
games with rules dramatic play sports social play
what drives further refinement of movement patterns?
grasp and cognition
what are some fine motor activities that the peaabody looks at
grasp cubes stack and release cubes tracing cuting coloring lacing pick up obj clap and bang blocks
what are the 4 common interventions for handwriting?
grasp help adapted paper strengthening activities spacing strategies for coping
what is a predictor of physical fitness in kids
grip strength
what can we do as OTs with learning disabilities
gross fine motor handwriting visual perception adaptive functioning self care educationally or therapeutically based pharm based for add
what are some other things you can do to develop hand skills
group intervention (start with exercises end with writing and cutting see skills in functional activities) watch buttoning while getting dressed baking cookies (hold bowl and stir) adapted equipment technology caregiver training
what is a natural way to facilitate voluntary release skills
have it in hand natural wrist in extension to hold and carry then flip into flexion to let it go add positive reinforcements of the natural patterns show
how can baby kt develop more schemas on objects?
have more touch experiences, more informatino to build on the schema and build on development of recognition dvpt of visual areas of brain is dependent on touch experiences
what game can you play to work on refined pincer grasp
hi ho cheerios
what part of brain has episodic memory, ltm
hippocampus
if you are looking for a certain grasp how should ou present an object?
hold an obj in front and off the table only way to pick it up is to isolate fingers, cant rely on table to rake it use an egg carton and put little things in there for them to pick it up
when is it easier to do a whole v repetitive task?
if kicking its easier to do whole thing for dressing it is easier to learn if doing buttoning repetitively
characteristics of enhancing carry skills (dvpt of hand skills)
if weak: start by stabilizing with table surface for elbows carry at shoulder
when a teacher sits wtih kids in 1st grade and have them write the alphabet and they do not know the sequencing what can they be diagnosed with ?
impairment in written expression: learning disabilities
what is the first step in enhancing carry skills?
improve trunk control
what are possible motor problems that can affect hand skills?
inadequate isolation poorly graded movement lack of ability to use middle range lack of force and timing lack of variety disorder in bilateral integration and control trunk instability/posture compensation
Katie is a little girl who becomes very distracted by loud music from the neightbors and doesnt color in her painting, leaves her painting project after 2 minutes, doesnt listen when i tell her to finish it, loses her brushes frequently, and refuses to use a fine tip brush what type of add adhd does she have
inattentive
what is the behavioral theroy setting up a highly STRUCTURED play env with toys and activities that peaks the childs interest and curiosity to expand the play
incidental teaching
when planning and implementing an intervention what are some goals?
include family transition to independence strategies for IADLs for physical cognitive and psychosocial challenges
what service delivery is working on writing with child during journal time? (school setting)
inclusion
what concept of practice is doing feeding during lunch time or working on handwriting during journal time?
inclusive
when working with kid with lots of vestibular issues what do you do?
incorporate strengthening and other exercises that work on postural control
the benefits of leisure and play in adolescence w and w/o disabilities
increase self esteem promote skills and relationships disabilities need opportunities for social interaction and enhance self efficacy and autonomy
if you are seeing an adolescent with disabilities and seems upset and quieter than normal what is the best thing to do?
increase social participation 0 phone calls from friends 0 for social participation lack of evolving in relationships and social skills youth group is best place for them to go to
IDEA Reauthorization 2004 implications
increased focus on results expected outcomes for students with disabilities leaving high school include higher education employment, living OT collaborates wtih members of the team
to enhance grasping skills for a child with spasticity whats the first thing to do
inhibit tone
what is the first thing to do with a child who is spastic
inhibit tone
what is the development of voluntary release?
initially stabilizes to release without stabilization release pattern refined modulate force like stacking
what clients is the biomechanical model best for
injury posture rom spasticity weak down syndrome and low tone
what is the use of reinforcements to modify behaviors, from skillner, applied behavioral interventions, lovaas
instrumental operant learning
what service delivery is going into classroom and integrating the childs goals in centers
integrated
if I score a test, the prof scores the test, and Will scores the test and all of the scores are the same what psychometric property is met
inter-rater reliability
if baby has poor social interactions what do you do?
interact with them on the floor
what is the team model setting where people come in, do separate evals, then create one single IEP that incorporates all the areas of need
interdisciplinary model
Development is an interplay of what factors
intrinisic and environmental, between the environment and childs innate abilities
when developing hand skills, what do you MOST want to develop
isolated movement
quality of movement difference 0-3 mo
kind of like all or nothing difference, no midrange grading
Kinder vs 6th grade Least restrictive environment
kinder: easy to put them in generalized classroom becasue their kids arent equal but its not obvious, easier to be accepted 6th: may not be the classroom, they have different work and it gets harder to be with general peers, best to integrate them in art music and lunch dont go to cafeteria to work on eating, its embarrising to stand out
if a kid has fatigue eye after school all day what is probably going on?
lack of ability to track well and the saccade eye movements
in early childhood, middle childhood early adolescence or late adolescence is OT a resource for future planning and implementation, parents are a consultant, supports, gives a safety net and then young person leads and supervises program through self determination?
late adolescence
if a child has trouble with spelling, messy handwriting, has a limited vocab, uses worng word that sounds familiar and cant retell a story in order it is a red flag for what?
learning disabilities
if a chid has trouble learning the alphabet, rhyming words, connecting letters to their sounds, make mistakes reading, pauses often what are they red flags for
learning disability
CHILD HAS PROBLEMS WITH SPElling accuracy, grammar, and clarity/organization of their work:
learning disability with impairment in written expression
a child who has difficulties learning and using academic skills, one of symptoms in 6 + mo that affects academic skills and are quantifably below peers, began during school but not manifest until demanded, not due to disability
learning disorders
why is self efficacy so important with kids?
learning is based on motivation and the success makes them want to try even harder tasks and persevere teach them that failure is ok
being able to distinguish the letters and words is what
legibility
if you have a kid who keeps fidgeting in their chair and cant focus in class what is the best thing you can do for them?
let them stand1
characteristics of legibility
letter formation alignment spacing size slang readability
postural control characteristics
linked with cognitive motor dvpt allow ind. to maintain balance dependent on ability of CNS to anticipate destabilizing events (4-5 yo) improves quality of reaching linked with attention and problem solving and problem reduction (remember and plan successive steps to solve problem) able to rotate and maintain stability
intervention techniques for bathing and showering
look at book establish and restore performance adapt task or env prevention/education for safety
intervention techniques for dressing
look more in book limitations are seen in cognition and sensory perceptual skills, physical or motor, adatpive methods may be needed
differences of angry/irritable argumentative/defiant vindictiveness
lose temper, touchy, annoyed, angry and resentful argues, defies and refuses, annoys, blames others spiteful
what are three behavioral management techniques for kids with add adhd
make rules and instructions (clear brief frequent repeated back multimodal) immediate rewards immediate consequences
Sally comes in as a weak uncoordinated kid with a poor attention span. If you want her to focus on using the right grasp patterns what is the FIRST thing you should do
make sure attention is in the right place (they are tuned into activity that they are doing. movement and prepare then nervous system. how to regulate attention and strategies to maintain attention, do movement and exercise in form of play to get the nervous system ready to go before a difficult task that they work hard on)
if a kid hates some activities what are some strategies to do
make sure they feel safe work their way up to the task, probide deep pressure, expand their willingness to do things so that it is a positivie experience for them dont force them to be not sensitive or unwilling to touch thnigs
are kids with ADD ADHD generally oppositional defiant?
no, word thrown around. just a way of adults to say they havent figured out how to set up their world in a positive way for the kiddo
type of play where youre using and manipulating objects purposefully like combining them for experiementation
manipulative or relational
domains of handwriting legibility writing speed ergonomic factors are all ways to what
measure handwriting performance
what skills are involved in handwriting
mechanical (grip posture motor planning) perceptual (visual memory form constancy visual closure position in space) acquire language spelling ideation and organization of thought
What are the three pediatric OT settings?
medical (acute specialty, pediatric otupatient) educational (school day care specialty school) home (ECI home health residential setting)
how can you adapt the task or environment for ADLs
methods, assistive technology, physical environment
early or middle adolescence: develop acceptance of bodies, starts to groom and try to be attractive, eating disorders
middle
early or middle adolescence: every one starts to look the same you wont stand out
middle
early or middle adolescence: experiment with make up and hair?
middle
in early childhood, middle childhood early adolescence or late adolescence is OT in the school, parents manages and monitors the program, begins chores, and the young person particpates in planning and program
middle childhood
when does LTM improve?
middle school
if a kid just gets accommodations with their learning disability is it mild moderate or severe
mild
moderate v severe severity of learning disabilities
mod: 1 or more academic domains need intensive intervention w accommodations severe: several unlikely to learn iwthout intensive and individualized teaching
what is it when you take a toy and make it easier to use?
modify
If kids have poor motor performance do they have poor balance
mostly yes
if baby at first refines each successive time then it becomes too much and beyond their abilities what did you see?
motor learning
If a child with DCD has poor fitness, how can you improve it?
motor skills training
What are the developmental considerations and motor skill prereqs for in hand manipulation?
movement into stability in supination wrist stability opposed grasp with thumb opposition, object in contact with fingers not the palm isolated thumb and radial finger movement (precise in grasp, look for good intrinsic muscles) control of transverse metacarpal arch dissociate radial and ulnar sides of hand (holding +stabilization) increase and decrease in fingertip force
what is the sequence of neuromaturation
movement progression from primitive reflexes to voluntary controlled movement
Cate is working on a project for NEURO but keeps having people text her about the wild social next thursday so she keeps picking up her phone to respond with hilariuos memes. What cognitive symptym of add adhd is she showing?
multi-tracking (results in disjointed conversation and loss of work)
what is the team model setting where each team member evals the child in their own discipline, and then discuss strategies and intervention plan
multidisciplinary
What are the team models used in a pediatric setting?
multidisciplinary (medical) interdisciplinary (school) transdisciplinary (early childhood intervention)
when your house is a disaster in which you have to do 5 loads of laundry, clean the sink, mop and you walk to do the next load but see the sink full you stop and do dishes, but you in turn arent able to get all the laundry done----what cogntiive symptom of add adhd is this
multitracking
the handwriting intervention in whcih you work on posutral and arm preparation muscle tone proximal stability and strength
neurodevelopmental
do passive unstructured activities have positive benefits on dvelopment
no
if a kid shows symptoms of add only at school is he diagnosed with it?
no
is a criterion referenced test always standardized?
no
katie has a learning disability, would you be surprised if she also had coordiation and psychosocial issues?
no
Will a kid with poor stabilization and balance have good hand manipulation skills?
no (check for compensation, where they are stabilizing
if a child is struggling in class would you automatically assume they have learning disability?
no check for ID, sensory, or physical impairments first
what act exampled OTs role in assessment?
no child left behind act
casues of learning disability?
no single cause known genetics pregnancy env toxins
To ensure free and appropriate education, should you pullout a student during math to work on handwriting?
no, not a good idea be careful if its during PE etc they need the interaction
Types of grasp
non-prehensile v prehenside precision v power grasp hook power lateral pinch pincer (pad to pad fingertip) spherical/cylindrical/disc
norm or criterion referenced test: distrubution of scores, standard deviations and means are created
norm referenced test
what is the difference between norm and criterion referenced standardized assessments?
norm: the norm or average is derived from all scores, determine how kids SHOULD be performing at the certain age, strict criteria, materials/activities familiar to kid criterion: what skills the child has NOT compared to peers, performance is scored based on level of performance of a skill, can they do this or not?
what type of play do preschoolers engage in
symbolic constructive gross motor social complex imaginary games with rules social and dramatic play
multimodal is the sophistication of what?
object exploration (not just tactile but visual auditory proprioceptive info from play)
characteristics of visual discrimination?
object perception form constancy visual closure figure ground spatial perception position in space depth perception topographic orientation
what does working memory begin with?
object permanence
when a kids mom walks out and they start crying what skill do they lack
object permanence
if katie has emotinoal outbursts while getting ready for school adn getting dressed but is angry and cries and screams what is the best intervention idea for her?
provide a structured environment with a routine
what diagnosis is a pattern of angry and irritable mood, argumentative/definat behavior, vidictiveness loonger than 6 mo exhibited in interaction with at least one ind. who isnt a sibling? affects functioning
oppositional defiant disorder
what is it when you pick activities that are appealing? and picking right enviroment for kid?
optimize
how can you incooperate propception over noxious in the clinic?
organize nervous suystem, if something bothers them dull it bear walk around the room, pretend you are animales, get whole body tactile while doing lots of proprioception , work on the activity
if a child has a hard time maintaining a tripod grasp what intervention can helP?
pencil grasp
position in space, depth perception, topographic orientation are part of spatial ___
perception
what stage of learning does child exhibit more consitency in the patterns?
perceptual learning
what is the basis on adjusting ones social behavior and taking others perspectives
perspective taking
what do children develop from play
physical cognitive perception language social emotional (self concept esteem regulation, empathy relationships social comp)
if parent has history of substance abuse, limited coping skills, difficulty interpreting childs communication, lack of knowledge about development, and unrealistic expectations what is it a risk factor for when the child has prolonged dependency due to dvpt or medical reasons, difficult tempermant, displeasing appearance
physical and emotional abuse
quick way to assess fine motor in older kids?
pick up 10 pennies at a time and get one to your finger and pass it to other (pincer grasp to pick it up, radial palmar manipulation in hand manipulation to get them from palm to finger(
what types of games do you look for when wanting to promote isolated arm and hand movements?
pincer grasp in hand manipulation and games that work on supination flipping cards bean bag games pick up pegs and put them into other hand
what is the behavioral theory where the child is given choice of toys/play materials and uses natural reinforcers when the child attempts new play?
pivotal response
what occupations do kids need good hand skills?
play ADLs school functions
main area of intervention
play motor performance sensory processing self care/adaptive adapted equipment/positioning
what are the occupations that children engage in
play rest ADL: eating dress groom hygiene
how do OTs use play as a means and end
play is the end goal and our treatment sessions are play
how can families support play
play space saying its important time in schedule overcome physical limitations flexibility
why do certain kids always get hurt in sports?
poor core strength they rely on distal motor control and wont have enough strength to prevent injury
what are somatosensory problems that can affect hand skills in children w disabilities
poor tactile discrimination can result in less feedback (limited perception, may not know they are manipulating something or have something)
what are some bilateral hand use games
pop beads clapping and singing scissors
what are the 5 charecteristics of preparing for hand skill development?
position the child attend to postural tone issues improve postural tone and control improve muscle strength
a teen who expresses opinions, mixes with others, initiates friendly interactions, makes eye contact and keeps comfortable space has + or - self esteem?
positive
a teen who talks fluently, participates, is collaborative and wants to volunteer has + or - self esteem
positive
what is the interplay between posture and movement
postural control
if a ball is being kicked out of bounds, but I think i can go get it what am I using?
postural control and schemas to speed up and know the fastest wat to get there, you already have the schemas built to problem solve, leads to more synapses in the brain more routes and neural connections for problem solving
Jonah is 2 yo, picks up cubes and toys with raking palmar grasp and holds briefly. Sits independently but not transitioning into and out of sitting and cries in prone and rolls onto his back what else should be worked on?
postural control and trunk short time with reinforcements enhance grasp enhance release weight bearing in prone shift weight radial palmar radial digital and pincer grasp
what is the coupling of muscle activation to help correct balance disturbances, ankle hip and step strategies
postural synergies
what is the order to work on handwriting?
practice repetition feedback reinforcement
when is transfer of learning easiest?
practiced in natural context during functional activity
what cortex is important for goal directed behavior?organizes the representation of the goal
pre frontal cortex
what in the brain organizes movement?
pre-motor cortex motor cortex cerebellum basal ganglia prefrontal
if looking at IQ test how closely does it predict the difficulties being seen, if you have these problems in this area it may lead to other problems later on is what psychometric property
predictive validity
what are the 3subtypes of add adhd
predominantly inattentive type predominantly hyperactive impulsive type combined
what part of the brain is emotional control judgement problem solving insight
prefrontal cortex
what motor cortex allows flexors and extensors to work?
premotor cortex (sets up movement, prepare for movement, responds to env/behavioral aspects)
what cognitive development stage includes illogical thinking which includes egocentrism, animsm, and magical thinking
preoperational stage
how can poor handwriitng effect performance
preschool dvpt of concepts school age reading math spelling writing visual motor integration
how can you add structure to an activity to promote reach?
present activity at different heights and angles reach in all directions shoulder neutral then move towards harder external rotation if playing a puzzle have them reach for a piece before putting it in manipulate the games to figure out what is needed therapeutically
what is the IEP based on?
present levels of performance
at 2yo this play is jumping and running while at 5 is skilled sport with balls
rough and tumble play
how do you open up a CP kids hand that is flexed?
pressure on hand or palm open it by giving deep pressure spend time opening hands then put them in weight bearing position lean forward on palms
what is the order of postural reflexes?
primitive righting equilibrium and protective
what is the proper gross motor development order?
primitive reflexes voluntary movement controlled movement movement patterns motor skills
interventions for prevention and education about ADLs
problem solving with a cognitive approach, anticipatory, cognitive orientation, coaching and educating
what memory is when you can automatically know how to pick up your pencil?
procedural memory (basal ganglia)
what is early childhood intervention
program implementation to maintain or enhance the child's development in natural environments birth to 3yo
4 characteristics of intervention on development of hand skills
promote isolated arm and hand movements enhancement of reach and carry skills (grasp release in hand manipulation) facilitate bilateral hand use generalizing skills (integrate into functional activities)
what makes a child resilient?
protective factors (intelligence social behavior love nurturance) positive internal and contextual factors
brian is 9 yo with developmental coordination disorder, disorganized written work with illegible hand writing and has a hard time going to recees in time, what approach is best to use?
provide compensation approach, hes disorganized doesnt write too well needs something in place in the classroom in which he can have success for his organization, new game plan for handwriting since he is 9 or need to remediate
if a baby isnt sleeping a lot and very fussy how should you help the family?
provide routines
handwriting intervnetion that focuses on self control coping and social behaviors
psychosocial
if an adolescence brags about being good at sports and other interests what are they developing?
psychosocial
when an adolescence asks who am I and where and how do I fit in to my world is a development of what?
psychosocial
when an adolescence searches for their gender orientation and personality what is developing
psychosocial
what are some fine motor goals?
put 5/6 pegs on board string 10 beads on a necklace in under 10 minutes
if you dont see trunk and neck control what should you advise parents to do?
put baby on floor more often, hold less
Katie is talking to cate about peds but she says range of motion so katie immediately changes the subject to her patient at st vincents who could hardly do shoulder extension. this is an example of what cognitive symptom of add adhd
radial thinking (connects topic laterally not sequentially, new topics come unannounced based on thought, frustrating to listen to)
what are the components of hand skills?
reach grasp carry voluntary release in hand manipulation bilateral hand use
what should we expect in 3-6 mo?
reaching up in supine position playing with feet back to tummy tummy to back neck and complete roll
how should boundaries and expectations be defined in adolescents?
realistic and fair with consequences school and neighborhood needs rules consequences, behavior monitoring positive adult role models positive peers high and positive family expectations
how does problem solving develop?
recall different approaches, consequences of previous decision and make a new one, recall a past problem like it and take what worked what did not work, gives a resource
formal peer group orientation, teamwork, respect for rules and games that challenge skills, service clubs, realistic constructive projects is in what stage of takata play
recreational (12-16)
why is it a bad thing if physical activity decreases during adolescent?
red flag for lifelong development lower self efficacy bad habits and routines
sequential development of grasp patterns?
reflex voluntary palmar (lift straight up) radial palmar radial digital pincer grasp/precision wide variety
what are the steps on the learning triangle?
reflex on bottom tacitle-vestibular-proprioceptive visual-auditory motor response motor pattern motor skill
put the grasping patterns with associated months it is seen****
reflex to voluntary grasl 0-3 mo radial palmar 3-6 crude raking 7
what are the performance skills in infants, toddlers, preschoolers
regulatory/sensory org fine motor and manipulation gross motor and mobility cognitive social
with free and appropriate education, what must be provided if the child requires it to benefit?
related services from special education
what types of play do toddlers engage in
relational functional gross motor pretend or symbolic social play
if you give a kid a test today and also next week and the scores are the same what psychometric property is met?
reliability (test retest)
what are the two best interventions for VP?
remedial compensatory
what is an OTs role with preventing child abuse?
report referral to CPS
how can infants grow?
routine, schedules, explore time, play time, need to feel secure, have needs met, establish attachemnt, skill promoted by modeling, assisting, and reinforcement
what is it when you go through an intervention with the kid and pick up and help in certain spots
scaffolding
what is the process by which therapists support or guide a child's actions to improve competence
scaffolding
Mind does not filter environmental stimuli
scanning
karen is in the classroom and lost attention when she saw a fly near the window. what cognitive symptom is being presented?
scanning
what add adhd cognitive symptom gives a child a hard time with sitting in a classroom and test taking
scanning
will is not able to pay attention or is interested in katie the prettiest of the 8 dancers at the basketball pep rally he is showing signs of what cognitive symptom of add adhd
scanning
what is how children represent objects events and relationships
schema
what is the mental category where information is stored
schema
What is considered an educational setting
school district specialty school daycare centers
what pracitce model is based on motivation?
self efficacy
a handwriting intervention that consists of proprioception tactile visual auditory olfactory and gustatory that incorporates a variety of senses into the intervention
sensorimotor
a kid who is playing peek a boo and imitating caregivers is in what stage of takata play history
sensorimotor (0-2)
what stage of cognitive development do infants use the senses to learn about the world, manipulate objects etx (object permanence)
sensorimotor stage
what is the awareness of body parts and separateness from space?
sensory dominance
if youre walking and step over a hole, what motor cortex adjusts the movements so you wont fall?
supplemental motor area
which temperament is initally withdrawn, mood varies, and slow to adapt
slow to warm up child
what needs to be strong and ready for handwriting?
small muscles eye hand coordination hold writing tools form strokes letter perception right left discrimination/.
2 yo it is parallel play while 5 yo organized group activities with common goal
social
how can we adapt to improve toileting ind.
social and temporal context support use a stool or rails adaptations for posture
what practice model is wanting child to watch other kids eat foods that we are eating?
social learning
what is the practice model in which learning occurs in a social context, children learn by watching others, direct own learning, and learn in a group setting?
social learning theory
for a child with basic in hand manipulation skill emphasize ___ andn ____ of skills
speed variety
what is a good in hand manipulation goal?
stabilize 10 objects and put them down one at a tme without losing any of the obj 3/4 trials
to enhance bilateral hand use skills what should you do?
stabilize with one hand manipulate with other use things that need both hands unstable surface to promotoe stabilizing with one hand
characteristics of proper positioning?
stable chair adequate foot support size for good posture support if posture is unstable stand
z score t score deviation IQ percentile and age equivalent descriptive stats or standard scores
standard scores
what are some fun things to do in strength programs?
starfish sit ups supine and flexion in prone roll ball hit w noodle
0-3 month atypical differences
supported sitting while holding front adn back of trunk to sustain sitting posture, need the strength with max support theres no muscle activity to sustain the posture, when trying to put weight on feet collapses
type of play where its pretend play
symbolic
Jonah is 2 yo, picks up cubes and toys with raking palmar grasp and holds briefly. Sits independently but not transitioning into and out of sitting and cries in prone and rolls onto his back. what is the best intervention to do with him to address fine motor?
start with posture and UE strengthening protective extension, wheelbarrow walk, weight bearing and strengthening is needed start day with tummy time cause and effect toys work on release look for cognitive delays if he is not interested in toys if low tone look for feeding problems
to work on voluntary release in functional games and activities what can you use?
start wtih shape sorter containers makes lots of noise motivating to hear it drop and fall down into the bucket
what are some splints used with children?
static dynamic neurophysiologically based spastic reduction resting pan (sleep at night) soft (comfy) weight bearing dorsal thumb volar Jo cool (opens hand to get sensory feedback and tactile input)
3 ways postural control systems can maintain stability
static balance (hold stationary position) balance when moving equilibrium with continuous motion
intervention ideas (primary and secondary components) of improving balance
static v dynamic, vision and without, change external base of support (wide to narrow rigid to compliant stable unstable tilt board) secondary: platform swing then have them throw something
binocular visual perception of 3D space
stereopsis
chris is 15 yo with low mood, lack of motivation, poor social adj, disturbed family relations. what approach?
strategies to do when hes upset, social skillls counselor get him moving and active important to have physical activity, better habits and fitness mood activity interest, what is he motivated by? maybe dont give him tons of choices
what improves motor dvpt athletic performance and protects against injuries?
strength and endurace
how does muscle function affect hand skills and fine motor?
strength and tone: MD kids who arent as strong wont have ability to manipulate as well, CP high and low tone, if flexed at rest cant explore and play with kids, grasp and release may not look normal
what approach provides a match of the childs skills and interests?
strength based appraoch
what approach scaffolds to support the childs current skill and push them to the next level while providing the just right challenge
strength based appraoch
what concept of practice is when the therapist asks "no tell me something good about the kid" "does he smile, do kids like to talk to him" our job to find and highlight their strengths and put them at the right level to feel successful
strength based appraoch
for a kid with MD how do we work on fine motor?
strengthening but dont wanna work down to a T sense of weight bearing, do things in prone or side-lying with elbows out for co-contraction and weight bearing then switch sides totally normal cognitively so they do like games hi ho cheerio trouble operation
what are ways to improve muscle strength
strengthening programs estem
what are 6 environmental and task modifications for kids with add adhd?
structured env reduce distractions increase arousal levels novel stimuli shorten assignments/instructions times for success
site for mirror neurons
superior temporal sulcus
why is wrist supination and extension a good position for maturing grasp?
supination: controlled opposition and isolated finger movements extended: imp for distal fingertip controll thumb and radial fingers are free for obj exploration and using fingers
according to the dynamic systems theory what is movement dependent on?
task characteristics interaction with PEO (dysfunction is when flexibility or adaptability is limited)
how do you go about a handwriting intervention?
team approach examine handwriting programs assistive tech
what is the first thing to look at when kids come to us?
the bottom layers (bilateral posture symmetry rhythmicity trunk rotation)
impact of puberty on brain?
the hormonal changes in puberty spur development in the brain emotional not formal operation cognition is in frontal lobe and takes till 20s or so to develop, impacts social processing, impacts ability to interact, consequences of decision, ability to mentalize, decisions based on emotion
for enhancement of reach what is the first thing you should think about?
the position they are in (sitting prone sidelying, what makes it easiest and what position forces a kid to do what we want)
Which statement most closely resembles the coaching model as used in occupational therapy practice? The therapist supports parents' reflections about child's behaviors and guides them in identifying solutions. The therapist informs parents about the next action steps to work on the child's goals. The parent determines all steps in the intervention process, while the therapist provides advice. The therapist details the steps of the intervention plan and provides regular feedback regarding the child's performance during intervention sessions.
the therapist supports parents' reflections about child's behaviors and guides them in identifying solutions. (Coaching can be defined as a reciprocal process between a coach (occupational therapist) and learner (parent) comprising a series of conversations focused on child outcomes that allow the learner to discover his or her own solutions for achieving the agreed on outcomes.)
what social skill is the following: walking in and seeing all of the students with their faces down looking out the window sad
theory of mind (understand peoples states)
why is it necessary to have immediate consequence?
they may forget or have anxiety rooted from it
what is the best way to get a kid to clean up a certain area in 5 minutes?
this is a 3 skittle fast time! 3 skittles means really fast and thats what they get at the end, define it for them, put in place how fast they have to go to get the reward
when do you prepare the nervous system?
to improve regulation to use organizing activities and to improve attention
T/F proprioception overides noxious?
true
integrated is school terminology inclusive is anywhere
true
the more experiences with grasping the more obj kids can learn how to grasp and leads to more patterns, gives them opportunities to make it work so that they can be successful
true
if a kid isnt developing motor skills what should we look at?
trunk control mobility and stability
for child wtih severe disabilities how do you enhance grasping skills?
try different positions wrist extension with grasp splinting built up handles deep pressure stretch while holding wrist in extension, open up the elbow open up the shoulder so more range and open trunk and chest, work out the tight tendon underneath may smell, so stretch and rub lotion wet wipe to help
who is the best client to use CIMT on
unilateral CP the constraint prevents or improved developmental disregard results in corticaal reorganization
what are some adaptation compensation model examples
universal cuff built up chair pencil grip small writing utinsels raised lines
how do you measure writing speed
words per minute (think about context of room assignment child ergonomic)
if a patient is tight and cannot move full range what do you do before fine motor task?
work on ROM stretch
posture UE stability mobility and pencil grip all effects what
writing speed
if you ask a kid write me a sentence about anything, they look at you, tell me what you ate for breaky, they look at you, did you have toast? they look at you, write i had toast this morning then they write. shows a problem with what
written expression (deeper than writing and letter formation issue)
Is volunteering considered work
ya duh
are beads too small for in hand manipuation?
yes
at 3-6 mo is it normal to look like a starfish in horz suspension?
yes
does puberty involve biologic and psychosocial development?
yes
if katie has a learning disability and has attention and memory with auditory and sensory integration issues is that normal?
yes
would a kid qualify for therapy if the mean is 50, standard deviation is 10, and their score is 34?
yes
Do you strengthen when there are postural control issues
yes never a time where you dont do strengthing
is it normal for a 9 yo to not have a change in anticipatory control and stabilization?
yes (6 yo)
is add adhd genetic?
yes, seen in parent and twins and relatives
what is the distance between a childs actual developmental level when acting ind. and the level of potential development from an ADULT
zone of proximal development
