Environment Review Questions

Clinical Reasoning: Which type does this describe? This type of reasoning focuses on the process of what, when, and how interventions and other solutions will be carried out. It focuses primarily upon the process of therapy. a) Scientific Reasoning: b) Diagnostic Reasoning: c) Narrative and Interactive Reasoning: d) Pragmatic Reasoning: e) Procedural Reasoning: f) Conditional Reasoning: g) Ethical Reasoning:

Procedural Reasoning:

Disability Models: Which model does this describe? Faith based; happened to me because a higher power chose me a) The Morality Model b) The Charity Model c) The Economic Model d) The Welfare Model e) The Social Model f) The Medical Model g) The Minority Model

a) The Morality Model

Universal Design: How can we create an adequate laundry and storage area?

- Ensure there is front-loading washers and dryers, with front controls, raised on platforms - Install adjustable height closet rods and shelves - Install power operated clothing carousels - Install motorized cabinets that raise and lower

Eric is a 66 year old man with low vision. He is a university professor and has been teaching for 35 years. He takes the subway everyday to the university. Just recently his vision has gotten worse and maybe causing him to not be able to read off the projector during his lectures. On occasions Eric has walked into different rooms and has difficulty seeing and recognizing students in the back. He has difficulty reading signs throughout campus and recently has had issues navigating the subways system safely. Which title under the ADA would allow for accommodations in the subway system? a) ADA title 1 b) title 2 c) title 3

c) title 3

Matthew is a mortgage broker in the city of Coral Springs. He works in an office building where he has his own cubicle to complete his daily work. His company's office is on the third floor so he uses the elevator. There is a break room located in the office that has vending machines, a refrigerator, and office supplies needed for his job. Unfortunately, there is a step that leads into the breakroom and Matthew is unable to access the room because of this. Considering Matthew's case, under which disability legislation would there be a ramp added to the breakroom entrance? ADA Title I ADA Title IV ADA Title II FHA

ADA Title I

Match the term to the definition: __________________: delivery system organized to manage cost, utilization, and quality __________________: those who received medical services on a fee-for-service bases; "regular Medicaid:" •Straight Medicaid •Managed Care Model

•Managed Care Model: delivery system organized to manage cost, utilization, and quality •Straight Medicaid: those who received medical services on a fee-for-service bases; "regular Medicaid:"

Match the Medicare part to it's general definition: •Part ___: outpatient or medical insurance •Part ___: prescription drug coverage •Part ___: inpatient or hospital insurance •Part ___: Medicare Advantage A, B, C, D

•Part _B_: outpatient or medical insurance •Part _D_: prescription drug coverage •Part _A_: inpatient or hospital insurance •Part _C_: Medicare Advantage

Does Medicaid Cover Therapy? Does it vary by state?

•States: provide a plan that documents what and how programs are provided and eligibility requirements, as well as required and optional health services •Pays for long term care services in home/community/and nursing homes •Federal governments sets the minimum required states must meet --> OT is one of the optional services (therefore in some states OT might not be a covered benefit)

Timmy is a 14 year old boy who acquired a T11 spinal cord injury. His parents are worried about his transition to high school. When Timmy was asked to create goals with his Occupational therapist, his main priority was to continue playing on his basketball team. What characteristics would you NOT recommend for a wheelchair for Timmy? - Rigid frame, customized and durable - Small caster (Front) wheels for increased speed and quick turning ability - Tilted back wheels, angled for mobility - Tires filled with air for durability

(All of the below are appropriate) - Rigid frame, customized and durable - Small caster (Front) wheels for increased speed and quick turning ability - Tilted back wheels, angled for mobility - Solid tires, not filled with air, for quicker mobility

Under Title I of ADA, what is considered "reasonable accommodation"?

- Any change in the work environment or the way the work is customarily performed - Making existing facilities used by employees readily accessible to and usable by people with disabilities - Includes job restructuring, part-time or modified work schedules reassignment to vacant positions, acquisition or modification of equipment or devices, appropriate adjustment or modification of examination, training materials or policies, the provisions of qualified readers or interpreters, and other similar accommodations

List the most important concepts about this topic: Universal Design Provide adequate interior circulation... how?

- Create an open plan design - Have at least one bedroom and accessible bathroom should be located on an accessible ground floor entry level (same level as the kitchen, living room, etc.). - Have a clear door opening width for all doorways. - Ensure there is turning space in all rooms (5' diameter).

Universal Design: How can we equip the home automation devices to be accessible?

- Installing motion detector light switches in garages, utility spaces, entrances, and basements - Use remote controls for selected lights - Use remote controls for heating and cooling - Install Doorbell intercoms that connect to portable telephones

John is a 37 year old with a spinal cord injury at the level T10 and is parapeligic. He uses a wheelchair for mobility but has recently started to ambulate using a walking device. John lives alone in a one-story home in Florida. He is independent in all ADLs and IADLs but has recently been experiencing difficulty when cooking in the kitchen. He has difficulty reaching certain counters in his kitchen impacting his ability to prepare meals. What approach is being used in this situation? - Establish/restore - Create/promote - Modify/Adapt - Prevent

- Modify/Adapt

Universal Design: Ensure all entrances are accessible and safe by: - Only have __________ inch maximum rise at entrance thresholds. - Install power door operators whenever possible

- Only have one-half inch maximum rise at entrance thresholds. - Install power door operators whenever possible

How can we create an environment where the kitchen can be used universally? - for ppl in wheelchairs - visual aids - accessibility standing or in wheelchair

- Provide a clear knee space under the sink - Ensure the counter height and other work surfaces is at 28"- 42" - Create contrasting color borders on countertops - Install adjustable height shelves in wall cabinets - Ensure there is front-mounted controls on all appliances - Instal single-lever water controls at all plumbing fixtures and faucets

Which of the following is not included to be considered as undue hardship? - Nature and cost of the accommodation needed - The comfort of the adaptive equipment must be primary - Overall financial resources of the facility number of employees expenses and resources of an impact on the facility

- The comfort of the adaptive equipment must be primary *****If undue hardship is established by the entity, it would NOT be held accountable liable for discrimination

ICF is complementary to ICD-____ and WHO encourages their use together as ICD-____ classifies mortality, and ICF classifies states of health a) 5 b) 10 c) 11

10

Jason is a 35-yr-old male with left lateral epicondylitis resulting from continuous work overload with typing data information for his entire team. Jason's company has lost some employees due to COVID-19, and his boss has asked him to pick up the extra shifts. Jason expressed his passion and wants to continue to work. Jason is seen by the occupational therapist (OT) in the outpatient clinic for AROM and modified techniques to continue his work. What modification in Jason's environment would enhance his abilities to continue working? A. Adding a visual cue to remind him to take breaks for resting and icing B. Change the lighting C. Adding an air freshener D. Back brace E. Elbow Pad on desk

A. Adding a visual cue to remind him to take breaks for resting and icing

Robert is a 16 year old male living with spastic quadriplegia cerebral palsy. He experiences severe muscle weakness and stiffness in legs and is unable to walk but has full use of upper body. He is very active and plays in the local wheelchair basketball league on weekends. As Robert''s OT, which of the following wheelchair characteristics would you recommend for his leisurely activities? A. Tilted wheels with coasters B. Powered wheelchair C. Rigid-frame manual wheelchair D. Standing wheelchair

A. Tilted wheels with coasters

What is Early Periodic Screening, Diagnosis, and Treatment (EPSDT)?

Covers most screening and diagnostic services for children up to 21 years of age (medical, vision, dental, hearing. . .)

Using the PLISSIT model, permission opens the line of communication of the topic sexual activity. There are two factors required to initiate the conversation with your client. The first is permission giving, and the second is ________. A) Problem-solving regarding specific positioning B) Specific suggestions and critical thinking discussions C) Reviewing handouts and articles D) Consent given by the patient to engage in the conversation

D) Consent given by the patient to engage in the conversation

List the most important concepts about this topic: Universal Design Ensure all ______?______ are accessible and safe by:

Ensure all entrances are accessible and safe by: - Make all home entrances stepless - Ensure the driveway and garage are elevated to floor level so vehicles do the climbing. - Only have one-half inch maximum rise at entrance thresholds.o Install power door operators whenever possible - Provide weather protection such as a porch, stoop with roof, awning, long roof overhang, and/or carport. - Ensure there is light at the outside entry door and is a motion detector-controlled light

T or F: preventative OT services are covered by medicare

FALSE "medically necessary" OT services are covered, but not if they are labeled "preventative"

T or F: Medicare overs long-term care

FALSE Medicare-Title XVIII of Social Security Act 1965 covers: •"Beneficiaries" 65 years of age and older •People under 65 with certain disabilities •Any age diagnosed with end stage renal disease

T or F: The way the therapist "sees disability" doesnt impact environmental and contextual interventions, they are completely observational.

FALSE: The way the therapist "sees disability" impacts environmental and contextual interventions

Teddy is a 35 year old male who suffered a spinal cord injury at level C8 during a MVA. The accident happened 2 months ago and he has since received inpatient care at the hospital. He is about to return home but before being discharged the occupational therapist is going to evaluate his home using the SAFER-HOME assessment. The OT will adapt any areas of the home that are a safety risk to ensure Teddy can engage in his occupations safely. Which approach to home modification is being used here? a) Create b) Prevent c) Modify

Modify- The OT is working to modify any areas of the home that are a safety risk.

Ramona came to occupational therapy services with the complaint of joint pain and challenges throughout her new home due to her Rheumatoid Arthritis. After completing an occupational profile and COPM, the therapist concluded that her main difficulties were in operating door knobs throughout the home. Using the rehabilitative frame of reference, the OT suggested modifying her home by replacing the door knobs with handles. Which approach (es) to treatment are used in this example? a) Prevent b) Restore c) Modify/Adapt

Modify/Adapt Using this environmental modification, her ability to open doors throughout her home will be restored.

Which is NOT one of the 7 principles of Universal Design? - Equitable Use - Flexibility in Use - Comfortability in Use - Simple and Intuitive Use - Perceptible Information - Tolerance for Error - Low Physical Effort - Size and Space for Approach and Use

NOT --> Comfortability in Use •Equitable Use: The design is useful and marketable to people with diverse abilities. •Flexibility in Use: The design accommodates a wide range of individual preferences and abilities. •Simple and Intuitive Use: Use of the design is easy to understand, regardless of the user's experience, knowledge, language skills, or current concentration level. •Perceptible Information: The design communicates necessary information effectively to the user, regardless of ambient conditions or the user's sensory abilities. •Tolerance for Error: The design minimizes hazards and the adverse consequences of accidental or unintended actions. •Low Physical Effort: The design can be used efficiently and comfortably and with a minimum of fatigue •Size and Space for Approach and Use: Appropriate size and space is provided for approach, reach, manipulation, and use regardless of user's body size, posture, or mobility.

Clinical Reasoning: Which type does this describe? This type of reasoning relies on storytelling in order to identify problem areas and solutions. It requires interaction between client and therapist in order to gain an understanding of the situation. a) Scientific Reasoning: b) Diagnostic Reasoning: c) Narrative and Interactive Reasoning: d) Pragmatic Reasoning: e) Procedural Reasoning: f) Conditional Reasoning: g) Ethical Reasoning:

Narrative and Interactive Reasoning:

Virginia is a 19 year old female from West Virginia who had a L MCA stroke following the completion of her first semester at WVU. She has been attending PT and OT services since her stroke two months ago. Virginia's goal is to get back to being with her friends & taking classes at WVU. Virginia's family is supportive of her recovery but feel Virginia suffered a stroke due to being punished by God. Based on this information, the disability model that best represents Virginia family's reaction to the stroke is? a) Charity model b) morality model c) scientific d) procedural e) narrative

The Morality Model

Match: Americans with Disabilities Act (ADA) Title I: ___________________ Title II: ___________________ Title III: ____________________ Title IV: ____________________ Title V: ____________________ - Nondiscrimination by public accommodation in commercial facilities - Nondiscrimination in state & local government service - Employment - Miscellaneous - Telecommunication

Title I: Employment Title II: Nondiscrimination in state & local government service Title III: Nondiscrimination by public accommodation in commercial facilities Title IV: Telecommunication Title V: Miscellaneous

T or F: Part A covers all Medicare beneficiaries

TRUE

T or F: Contexts and environments can not be separated from health and well-being

TRUE!

Clinical Reasoning: Which type does this describe? This type of reasoning focuses on the facts such as impairments, disabilities, and performance contexts. It can be used to identify problems and develop solutions. a) Scientific Reasoning: b) Diagnostic Reasoning: c) Narrative and Interactive Reasoning: d) Pragmatic Reasoning: e) Procedural Reasoning: f) Conditional Reasoning: g) Ethical Reasoning:

a) Scientific Reasoning

Disability Models: Which model does this describe? Views the origins of disability as the mental attitudes and physical structures of society, rather than a medical condition faced by an individual a) The Morality Model b) The Charity Model c) The Economic Model d) The Welfare Model e) The Social Model f) The Medical Model g) The Minority Model

e) The Social Model

Disability Models: Which model does this describe? Highlights that something (the medical condition) needs to be fixed Looks at the disability within the individual a) The Morality Model b) The Charity Model c) The Economic Model d) The Welfare Model e) The Social Model f) The Medical Model g) The Minority Model

f) The Medical Model

Brad is a 22-year old male attending college at NSU. He was in an MVA 2 years ago that left him with a complete level 5 SCI. Before his accident, Brad lived a very active lifestyle. The SCI has impacted his social relationships and engagement in his occupations. The wheelchair he currently uses is not the most comfortable. The wheels are not easier to maneuver, the backrest is stiff and uncomfortable, and he gets tired easily. These issues are impacting Brad's participation in school. He has requested to do his classes online to avoid having to be in a traditional class setting. He also relies on his parents for transportation. The vehicle they have is not properly adapted to suit his needs. The tie-down system they currently use to secure his wheelchair is time consuming and fails to keep the wheelchair in place. What would be the most appropriate type of loading entry to use with a power wheelchair?

side-loading

Universal Design: Ensure all entrances are accessible and safe by: - Make all home entrances __________ - Ensure the driveway and garage are elevated to floor level so __________ do the climbing.

stepless vehicles

What medical equipment is generally not covered?

bathtub benches, reachers, elevated toilet seats, build up handle utensils generally not covered

Laura is a 28-year-female who sustained a C4 spinal cord injury at the age of 19. She works from home as a marketing consultant for a large marketing company in San Diego, California. She is looking for a new device that will help her use her computer at work more efficiently. Laura wants to borrow a device before she purchases it. As her occupational therapist, where do you suggest that Laura looks for devices on the FAAST website? a) Obtaining a loan b) Market place c) Device Lending Library List

Device Lending Library List

T or F? The ICF (International Classification of Functioning) focuses on physical, mental, and social well-being ESPECIALLY disability

FALSE: Focus is on physical, mental, and social well-being NOT disability

Cole is an 8-year-old boy with ASD who is struggling with paying attention during class. Cole is being seen by an occupational therapist via telehealth twice a week. Cole tends to fidget with his hands a lot, has trouble maintaining eye contact, and has outbursts when not understood by his teachers or classmates. What adaptive device would the occupational therapist suggest for Cole's desk to help with his fidgeting at school?

Fidget ribbons that attach under desk

Medicare or Medicaid? •Insurance Program •Available to all those over 65 (regardless of income) •Federally Managed •Overseen by Center for Medicaid and Medicare Services (CMS)

Medicare

Medicare or Medicaid? - Closest thing to universal form of health insurance- for the elderly - Financed by payroll taxes, insurance premiums, and general revenue from the federal government - Beneficiaries= patients

Medicare

Matthew is a mortgage broker in the city of Coral Springs. He works in an office building where he has his own cubicle to complete his daily work. His company's office is on the third floor so he uses the elevator. There is a break room located in the office that has vending machines, a refrigerator, and office supplies needed for his job. Unfortunately, there is a step that leads into the breakroom and Matthew is unable to access the room because of this. What type of accommodation should be made for Matthew? a) Create another breakroom only for Matthew b) Co-workers lift Matthew into the break room c) A ramp is installed for Matthew d) The breakroom be closed completely since it is inaccessible

c) A ramp is installed for Matthew

Jane is a 7 year old girl with cerebral palsy and uses a wheelchair. She loves to be outdoors and play with her siblings at the park. Every sunday her mom takes her and her two siblings to their community park, this Sunday they wanted to explore a new park. When they arrived they noticed that there was no ramp to get to the elevated play components but Jane could easily use the ground level play components and had a great time anyway. Which approach to intervention is used to improve the playground so it can be accessible for Jane? a) Prevent b) Establish/restore c) Modify/adapt d) Maintain

c) Modify/adapt

Disability Models: Which model does this describe? Worth of person connected to ability to work a) The Morality Model b) The Charity Model c) The Economic Model d) The Welfare Model e) The Social Model f) The Medical Model g) The Minority Model

c) The Economic Model

Virginia is a 19 year old female from West Virginia who had a L MCA stroke following the completion of her first semester at WVU. She has been attending PT and OT services since her stroke two months ago. Virginia's goal is to get back to being with her friends & taking classes at WVU. Virginia's family is supportive of her recovery but feel Virginia suffered a stroke due to being punished by God. When Virginia's OT began her evaluation she asked questions about Virginia's life history, likes, and dislikes. She also asked Virginia what deficits she has experienced since her stroke and what she struggles with or is no longer able to do. Which two types of clinical reasoning did Virginia's OT use? a) Charity model b) morality model c) scientific d) procedural e) narrative

Narrative and Scientific

Jane is a 7 year old girl with cerebral palsy and uses a wheelchair. She loves to be outdoors and play with her siblings at the park. Every sunday her mom takes her and her two siblings to their community park, this Sunday they wanted to explore a new park. When they arrived they noticed that there was no ramp to get to the elevated play components but Jane could easily use the ground level play components and had a great time anyway. Is this playground accessible according to the ADA guidelines?

No, because ADA specifies that 50% of elevated play components must be on an accessible route.

T or F? Medicare and medicaid were BOTH established in 1965 by president Johnson

TRUE: cold war, civil right movement (64'), Vietnam war, poverty 1960's significant medical advancements (equipment, medications, treatment of physical and mental illnesses)- focus shifting from need to treat acute epidemic illnesses like polio or smallpox to now taking care of those with chronic conditions (arthritis, heart conditions). Rise of feminism lead to more concern over womens health and health planning

As Nick's OT you have not addressed sexuality in any of your previous sessions, but he has expressed feeling disconnected from his current girlfriend. (22 y/o in college with T6 SCI) How would you initially address the conversation of sexuality (if he is open to the conversation)? a) you don't, it's not our job b) refer him to a sex specialist c) use the Extended PLISSIT (ex-PLISSIT) Model

Use the Extended PLISSIT (ex-PLISSIT) Model

Sam is a 12 year old male diagnosed with Autism Spectrum Disorder (ASD). He lives in the suburbs of North Carolina and is receiving OT services through telehealth. He resides with his two parents and 2 siblings. His mother is his primary caregiver. His older sister loves to help Sam and he also has two supportive friends from school. Sam enjoys playing with his dog, Shaggy, and loves collecting straws. During the initial evaluation the OT determined Sam has low registration and is sensory seeking. The therapist works with the mother in creating a sensory filled environment for Sam to explore with help in order to get the sensory input he needs. When working with Sam and his mother to create a sensory gym over telehealth, what is important for the therapist to know before the session?

What materials the client has and are able to utilize in their home environment.

As Nick's (22 y/o in college with T6 SCI) OT you have not addressed sexuality in any of your previous sessions, but he has expressed feeling disconnected from his current girlfriend. What would you, as an occupational therapist, address with Nick regarding his participation in sex? a. positioning, adaptive devices, intimacy, relationships, personal hygiene b. self-image, impact on relationships, emotional adjustment to injury c. positioning, mobility d. impact on relationships

a. positioning, adaptive devices, intimacy, relationships, personal hygiene

Clinical Reasoning: Which type does this describe? This type of reasoning specifically relates to the client's diagnosis and how that diagnosis affects the clinical picture. It is sometimes considered a component of scientific reasoning. a) Scientific Reasoning: b) Diagnostic Reasoning: c) Narrative and Interactive Reasoning: d) Pragmatic Reasoning: e) Procedural Reasoning: f) Conditional Reasoning: g) Ethical Reasoning:

b) Diagnostic Reasoning

Other definitions important to ADA I Employment: ____________________: impairments that limit major life activities a) Mitigation measure b) Major life activity c) Substantially limits d) Covered Entity e) Essential Job Function f) Qualified

b) Major life activity

Jane is a 7 year old girl with cerebral palsy and uses a wheelchair. She loves to be outdoors and play with her siblings at the park. Every sunday her mom takes her and her two siblings to their community park, this Sunday they wanted to explore a new park. When they arrived they noticed that there was no ramp to get to the elevated play components but Jane could easily use the ground level play components and had a great time anyway. Which model would be best to guide the thinking in creating an accessible playground to fit Jane's needs and allow her to play inclusively with the other children? a) Biomechanical b) PEO c) Transtheoretical d) Cognitive behavioral therapy

b) PEO

Disability Models: Which model does this describe? Poor individuals that have disabilities that can't function the way we can, so we need to provide for them a) The Morality Model b) The Charity Model c) The Economic Model d) The Welfare Model e) The Social Model f) The Medical Model g) The Minority Model

b) The Charity Model

Which of the following does not aid in making medical equipment Necessary and Reasonable? a) Must have a doctor's order to support that it is necessary (prescription) b) The cost of the device must be reasonable relative to its benefit •Partial payment possible c) Letters of Medical necessity most often required d) Additions to a device can be costly, but covered

d) Additions to a device can be costly, but covered --> most of the time insurance only gets patients the bare minimum

Disability Models: Which model does this describe? Society assumes responsibility over the well-being of people who are less fortunate or incapable of taking care of themselves a) The Morality Model b) The Charity Model c) The Economic Model d) The Welfare Model e) The Social Model f) The Medical Model g) The Minority Model

d) The Welfare Model

Clinical Reasoning: Which type does this describe? This type of reasoning is the most complex, and it encompasses both an empathetic understanding of the situation, as well as a vision for its resolution. It incorporates the other types of reasoning into an integrated picture of the client and a framework for selecting the most appropriate course of action in order to achieve the ideal end goal. a) Scientific Reasoning: b) Diagnostic Reasoning: c) Narrative and Interactive Reasoning: d) Pragmatic Reasoning: e) Procedural Reasoning: f) Conditional Reasoning: g) Ethical Reasoning:

f) Conditional Reasoning:

Clinical Reasoning: Which type does this describe? This type of reasoning brings in the aspect of right and wrong as it looks at issues and aims to develop the best and most moral solution to a problem. a) Scientific Reasoning: b) Diagnostic Reasoning: c) Narrative and Interactive Reasoning: d) Pragmatic Reasoning: e) Procedural Reasoning: f) Conditional Reasoning: g) Ethical Reasoning:

g) Ethical Reasoning:

Disability Models: Which model does this describe? The manner in which the able-bodied majority of society views us and either molds or does not mold itself to allow us to fit a) The Morality Model b) The Charity Model c) The Economic Model d) The Welfare Model e) The Social Model f) The Medical Model g) The Minority Model

g) The Minority Model

Cole is an 8-year-old boy with ASD who is shorter than most boys at his age. Cole is being seen by an occupational therapist via telehealth twice a week. His teacher expressed concerns about his posture to his mother. Cole's mother asked the occupational therapist how to best improve his posture. Which device at school would overall improve Cole's posture?

An Ergonomic tilting footrest

Oliver is a 22-year-old male with a C8 spinal cord injury acquired during a street race done from a dare ending in a severe car accident. After attending a rehab facility, he was able to acquire a power wheelchair for mobility through his family's gofundme. He desires to drive independently to attend his favorite sporting events, thus is looking into vehicle options. He only has a limited amount of funds left from the gofundme page and cannot afford very expensive adaptations. Oliver lives in Chicago, Illinois which has busy traffic and mostly parallel parking options. Oliver received a generous anonymous donation to use towards purchasing his vehicle. Because Oliver desires to be independent, what restraint system would be most suitable given his new situation?

Answer: Docking system

Mary is a 70-year old woman with OA affecting her knees and hips & RA affecting her hands, wrist, and feet. Mary lives alone in her one-story home. She has three daughters who all live out of state and mostly visit on the holidays. On their recent visit, they noticed Mary has been tripping on the stairs on her way to her garden due to no handrails, slipping over her rugs in the house and having cluttered areas around the home blocking hallways. They grew some concern about her mother's safety in her home. Before leaving their mother's, they contacted an occupational therapist to assess and evaluate the home. As an occupational therapist, what assessment would you choose to identify home safety, fall hazards, and accessibility modifications in Mary's home to ensure safety?

Safe at Home Checklist

Sam is a 12 year old male diagnosed with Autism Spectrum Disorder (ASD). He lives in the suburbs of North Carolina and is receiving OT services through telehealth. He resides with his two parents and 2 siblings. His mother is his primary caregiver. His older sister loves to help Sam and he also has two supportive friends from school. Sam enjoys playing with his dog, Shaggy, and loves collecting straws. During the initial evaluation the OT determined Sam has low registration and is sensory seeking. The therapist works with the mother in creating a sensory filled environment for Sam to explore with help in order to get the sensory input he needs. What frame of reference is the therapist utilizing in Sam's treatment?

Sensory Integration

Oliver is a 22-year-old male with a C8 spinal cord injury acquired during a street race done from a dare ending in a severe car accident. After attending a rehab facility, he was able to acquire a power wheelchair for mobility through his family's gofundme. He desires to drive independently to attend his favorite sporting events, thus is looking into vehicle options. He only has a limited amount of funds left from the gofundme page and cannot afford very expensive adaptations. Oliver lives in Chicago, Illinois which has busy traffic and mostly parallel parking options. Based off personal and environmental factors, what kind of modified van will support all of Oliver's needs?

Side-loading van with a ramp

Steve is a 50 year old male who served in the Marines for 20 years. When he returned from war, he started experiencing nightmares, flashbacks, and panic attacks. His psychologist diagnosed him with Post Traumatic Stress Disorder (PTSD). Steve was having a hard time when he would go out in public and would frequently experience feelings of severe anxiety and panic. Steve's psychologist suggested that he get a therapy dog to assist him when he has to go out. Steve has now had his service dog for over 5 years and feels more at ease when going out in public. Steve wants to fly to California to take a trip with his wife for their anniversary. This is his first time trying to fly with his therapy dog and he does not know what the rules are for flying with him. The flight attendant told Steve that his service dog is not allowed on the flight as there is no extra room for him. Which act is the flight attendant violating?

Air Carrier Access Act: ACAA

Coco is a 65 year old woman who experienced a stroke one year ago. She recently moved to the United States with her husband and currently lives with her daughter and grandchildren.The stroke resulted in a left side hemiplegia, which has impacted her ability to independently complete her ADLs. The OT and Coco have discussed adaptive equipment that can assist her in her daily routines. Coco stated that she lives a very active lifestyle, and wants to be able to dress herself, cook for her family, engage in sexual activity with her husband, and maintain a clean home. Coco is experiencing difficulty while she is preparing meals for her family. She is experiencing a lack of coordination and deficits in her strength, and gripping abilities. Which adaptive device would be useful for Coco to use in the kitchen? A) Reacher B) Adaptive cutting board C) Rolling walker D) Knife sharpener kit

B) Adaptive cutting board

Brad is a 22-year old male attending college at NSU. He was in an MVA 2 years ago that left him with a complete level 5 SCI. Before his accident, Brad lived a very active lifestyle. The SCI has impacted his social relationships and engagement in his occupations. The wheelchair he currently uses is not the most comfortable. The wheels are not easier to maneuver, the backrest is stiff and uncomfortable, and he gets tired easily. These issues are impacting Brad's participation in school. He has requested to do his classes online to avoid having to be in a traditional class setting. He also relies on his parents for transportation. The vehicle they have is not properly adapted to suit his needs. The tie-down system they currently use to secure his wheelchair is time consuming and fails to keep the wheelchair in place. What is the most appropriate system for his power wheelchair? A. 4-point secure system B. Docking system C. Rear tie-down straps

B. Docking system

What program provides healthcare coverage for families that are low-income but do not meet financial eligibility for Medicaid? How is it funded?

Children's Health Insurance Program (CHIP) •State and federally funded •Federal government dictates coverage by states

Sam is a 12 year old male diagnosed with Autism Spectrum Disorder (ASD). He lives in the suburbs of North Carolina and is receiving OT services through telehealth. He resides with his two parents and 2 siblings. His mother is his primary caregiver. His older sister loves to help Sam and he also has two supportive friends from school. Sam enjoys playing with his dog, Shaggy, and loves collecting straws. During the initial evaluation the OT determined Sam has low registration and is sensory seeking. The therapist works with the mother in creating a sensory filled environment for Sam to explore with help in order to get the sensory input he needs. What is an example of the therapist using the coaching model?

Collaboration between the therapist and Sam's mother to come up with a sensory gym suitable for Sam within their home environment.

Marcus is a 32-year-old male who sustained a C6 complete SCI one year ago. He is married with one child and works as a pharmaceutical representative for a large company in Miami, FL. He uses AT including a powered wheelchair with an adaptive joystick and uses a switch device to access the elevator in his apartment building. Marcus is currently looking to return to work and is looking for a wheelchair that is able to accommodate him at work and his job responsibilities, including promoting different pharmaceutical products. However, he does not want to spend a lot of money on a new wheelchair, and he does not have much time before he needs to go back to work. What is a local community resource that the OT and Marcus can look into for currently available wheelchairs that can meet his needs?

Florida Alliance for Assistance Services and Technology (FAAST)

Sam is a 12 year old male diagnosed with Autism Spectrum Disorder (ASD). He lives in the suburbs of North Carolina and is receiving OT services through telehealth. He resides with his two parents and 2 siblings. His mother is his primary caregiver. His older sister loves to help Sam and he also has two supportive friends from school. Sam enjoys playing with his dog, Shaggy, and loves collecting straws. During the initial evaluation the OT determined Sam has low registration and is sensory seeking. The therapist works with the mother in creating a sensory filled environment for Sam to explore with help in order to get the sensory input he needs. What could be a challenge to working with Sam and his mother over telehealth?

Fluctuating help from his mother due to having a younger brother who may need her attention.

Mary is a 70-year old woman with OA affecting her knees and hips & RA affecting her hands, wrist, and feet. Mary lives alone in her one-story home. She has three daughters who all live out of state and mostly visit on the holidays. On their recent visit, they noticed Mary has been tripping on the stairs on her way to her garden due to no handrails, slipping over her rugs in the house and having cluttered areas around the home blocking hallways. They grew some concern about her mother's safety in her home. Before leaving their mother's, they contacted an occupational therapist to assess and evaluate the home. As an OT you want to do a quick home assessment that takes 20-30 min to administer that examines home hazards. Which assessment tool would you choose? a) Safe at Home Checklist b) I-HOPE c) Housing enabler d) Home Fast

Home Fast

What does this define? Developed by the WHO and officially endorsed by 191 nations May 22nd 2001 A classification system of function Used across various: - Countries - Health care disciplines - Services - Time

ICF: International Classification of Functioning

____________________ is the largest purchaser of health care and biggest government insurance program in the US Medicare or Medicaid?

Medicare

While Steve is visiting the therapist he explains that he is having trouble enjoying activities or community events with other veterans. Due to his condition of PTSD he often avoids participating in events that might trigger increased arousal or flashbacks of the traumatic event. Steve is feeling very isolated and detached from his family and friends. Steve has the motivation to overcome these feelings and participate in more activities with his family, but does not have the tools to do so or where to start. What model should the occupational therapist use when working with Steve?

MOHO

Medicare or Medicaid? Largest payor of long-term care in the US

Medicaid

Medicare or Medicaid? •Assistance Program •Income based or means-tested •State Managed with contributions from federal government

Medicaid

Medicare or Medicaid? •Covers 1 in 5 Americans •Eligibility differs from state to state •Means tested: assets and income level below standard set by the program •Goal: To provide medical assistance to persons in need and to furnish them with rehabilitation and other services to help them "attain or retain capability for independence or self-care" (42 USC. 1396)

Medicaid

Sam is a 5-year-old girl who has spastic cerebral palsy. She experiences mild cognitive dysfunction and is wheel-chair bound. She grew up in Palm Beach Gardens, FL with her mom, father, and older brother. Sam's mother wants to ensure that Sam does not lose play and social participation and wants to find a playground that she will be able to navigate and make friends. She does not have much of a social circle because she is often isolated at school. The majority of her social time is spent with her parents at home. The playground near her house in her neighborhood does not have ramps or railings, and is built on sand, which makes it nearly impossible for Sam to use her wheelchair on. What occupations are limited to Sam because the playground at her house is not ADA accessible or inclusive?

Play (exploration and participation), social participation (creating new friendships, being engaged in community participation)

Clinical Reasoning: Which type does this describe? This type of reasoning focuses on logistics such as cost, time, therapist's skills, client wishes, and physical location. It looks at the problems and the contexts and focuses on developing practical and realistic solutions. a) Scientific Reasoning: b) Diagnostic Reasoning: c) Narrative and Interactive Reasoning: d) Pragmatic Reasoning: e) Procedural Reasoning: f) Conditional Reasoning: g) Ethical Reasoning:

Pragmatic Reasoning:

Georgette is a 65 year old woman who is a retired English professor at Columbia University in New York. Georgette enjoys cooking, gardening, reading and spending time with her grandchildren who live close by. She uses the subway system to attend her favorite museum, the MET, and shows on Broadway, but her loss of central vision due to macular degeneration makes reading the signs and navigating the subway difficult. Over the previous 3 months, Georgette has noticed a gradual worsening of her visual function and her ability to complete valued occupations. She wants to learn strategies for maintaining independence in her desired leisure occupations. What are some possible interventions that can be used to increase her quality of life in participating in leisure occupations despite her visual limitations due to age related macular degeneration?

The OT can increase contrast between dark and light objects in Georgette's home to support her independence in cooking. ● The OT will also focus on identifying potential strategies to enhance reading for Georgett's occupational performance and integrating these strategies into daily routines. ● The OT will also teach and educate Georgette on techniques such as eccentric viewing, visual tracking, and visual scanning to help her learn to use her remaining vision more efficiently and effectively ● By doing so, Georgette will be more independent in navigating her route on the subway, tutoring children in reading, attending musicals, and visiting museums, with more confidence and safety. ● The OT can educate and train her to use special glasses to watch her favorite Broadway shows at the theater with her husband.

Is the occupational therapist part of the client's social context?

Yes!

Does medicaid cover wheelchairs, hearing aids, some medically necessary devices?

Yes, it must be medically necessary --> Unless such services or equipment are included in nursing home per diem (daily rate)

Eric is a 66 year old man with low vision. He is a university professor and has been teaching for 35 years. He takes the subway everyday to the university. Just recently his vision has gotten worse and maybe causing him to not be able to read off the projector during his lectures. On occasions Eric has walked into different rooms and has difficulty seeing and recognizing students in the back. He has difficulty reading signs throughout campus and recently has had issues navigating the subways system safely. Which title under the ADA would allow for reasonable accommodations at his job? a) ADA title 1 b) title 2 c) title 3

a) ADA title 1

Ramona is a 68-year old woman with Rheumatoid Arthritis. Recently she has been experiencing pain in her wrists and noticed a significant decrease in her grip strength and manual dexterity. She recently moved into a one-story home in Davie, FL. She has emphasized difficulty in using the door knobs throughout the home. Which home modification would Ramona benefit from? a) Changing the door knobs to handles b) Applying dycem to all of her countertops c) Giving her a reacher for the handles

a) Changing the door knobs to handles

Other definitions important to ADA I Employment: ____________________: do NOT determine if a person has a disability that impacts a major life activity a) Mitigation measure b) Major life activity c) Substantially limits d) Covered Entity e) Essential Job Function f) Qualified

a) Mitigation measure

Sam is a 5-year-old girl who has spastic cerebral palsy. She experiences mild cognitive dysfunction and is wheel-chair bound. She grew up in Palm Beach Gardens, FL with her mom, father, and older brother. Sam's mother wants to ensure that Sam does not lose play and social participation and wants to find a playground that she will be able to navigate and make friends. She does not have much of a social circle because she is often isolated at school. The majority of her social time is spent with her parents at home. The playground near her house in her neighborhood does not have ramps or railings, and is built on sand, which makes it nearly impossible for Sam to use her wheelchair on. What is the difference between an inclusive playground, and an ADA accessible playground?

ADA accessible means the playground meets the ADA Regulation guidelines for playgrounds, but an inclusive playground is making sure that people feel like they belong, are engaged, and connected. They are designed to ensure that children of all abilities can play together.

Brad is a 22-year old male attending college at NSU. He was in an MVA 2 years ago that left him with a complete level 5 SCI. Before his accident, Brad lived a very active lifestyle. The SCI has impacted his social relationships and engagement in his occupations. The wheelchair he currently uses is not the most comfortable. The wheels are not easier to maneuver, the backrest is stiff and uncomfortable, and he gets tired easily. These issues are impacting Brad's participation in school. He has requested to do his classes online to avoid having to be in a traditional class setting. He also relies on his parents for transportation. The vehicle they have is not properly adapted to suit his needs. The tie-down system they currently use to secure his wheelchair is time consuming and fails to keep the wheelchair in place. What type of wheelchair would you recommend to facilitate community mobility and enhance Brad's school experience?

Power chair

John is a 37 year old with a spinal cord injury at the level T10 and is parapeligic. He uses a wheelchair for mobility but has recently started to ambulate using a walking device. John lives alone in a one-story home in Florida. He is independent in all ADLs and IADLs but has recently been experiencing difficulty when cooking in the kitchen. He has difficulty reaching certain counters in his kitchen impacting his ability to prepare meals. What would be an appropriate modification to make to the kitchen?

Provide a clear knee space under the sink and counters and ensure the counter height is at the correct height

International Classification of Functioning: ____________: codes used to record the presence and severity of a problem in functioning at the body, person, and societal levels a) DSM-5 classification systems b) Cues c) Qualifiers

Qualifiers

She recently moved into a one-story home in Davie, FL. She has emphasized difficulty in using the door knobs throughout the home. The home modification Ramona would benefit from would be changing the door knobs to handles. This internal adaptation process to her occupational challenge represents which FOR? A) Rehabilitative B) Biomechanical

Rehabilitative

Jason explains to the therapist that he is having difficulty with typing for long hours and submitting his work on time. Jason expressed that lately he has been calling out of work due to the pain increasing in his elbow. He is concerned that he might lose his job from calling out and how he might have to change careers due to the pain he is having. Which model would be best to guide Jason to allow him to continue his work without pain?

Rehabilitative (compensatory)

As Laura's occupational therapist, you are worried about her current performance range and would like to increase the number of tasks that are available to her within her context. You suggest the use of assistive technology, such as the GlassOuse Head Mouse with Bite Switch to allow for efficiency at work. Through what model are you using to guide your intervention? a. Ecology of Human Performance (EHP) b. MOHO c. KAWA d. Occupational Analysis Model

a. Ecology of Human Performance (EHP)

What services does medicare Part A NOT include? •Annual length of stay over 96 hours in emergency care •Inpatient hospitalization •Critical access hospitals •Skilled nursing facility •Home health agencies •Inpatient rehabilitation facilities •Hospice care

•Annual length of stay over 96 hours in emergency care --> must be under 96

What is the Medicaid Waiver Program? What does it aim to do? Is it in congruence or separate from medicaid?

•Extension of Medicaid eligibility --> Allows states to choose groups of people with particular needs and health conditions to receive tailor-made healthcare options at home or within the community. Must apply separately from Medicaid (Available in all 50 states and Puerto Rico) •Aims to keep people in their homes despite healthcare needs