KIN 465 Test 1
Premack's Principle
(Theory of reinforcement) -Premack provided children with two response alternatives... etc •Basically, more probable behaviors will reinforce less probable behaviors. •So, any high-frequency activity can be used as a reinforcer for any lower-frequency activity
Time outs
(think about age appropriateness before use) -Time outs are often used as a form of punishment, but are often ineffective -I recommend using time outs as a last resort; reward positive behaviors instead!
Motor characteristics
-Balance issues possible, depending on part of ear affected (vestibular damage) -Less participation in physical activity could lead to less balance ability -Poorer motor performance overall -Motor performance could be further impacted by lack of proper instruction/experience -Lower fitness related to higher BMI (Sensory disability, not physical one!)
Incidence of Down syndrome:
1/733 live births -shortened life span -diagnosed at or before birth
what does the dynamic systems theory suggest?
-DST proposes that behavior results from the interaction of multiple subsystems -DST seeks to understand overall behavior of a system and how behavior changes over time. -Other theories focus on how behavior emerges
Motor Behavior Characteristics: CP
-Delayed milestones, but all are intact -Early hand preference -Jerky movements (Caused by hyperactive stretch reflex) -Difficulty tracking thrown objects -Difficulty with grasping/handling objects -Perform better in warm environment -Balance problems -low level of PA
Symptoms of Down syndrome:
-Flattened facial features -Upward slanting eyes -Small head -Vision issues -Hearing/vestibular issues -Oversized tongue (Often protrudes) -Small body stature (shorts arms/legs, Short fingers) -Syndactyly (Webbing of digits, Typically surgically correctedin infancy) -motor delay -ID and speech impairment
When does ID occur? (Prenatal - Period before birth)
-Genetic, chromosomal disorders (DS, williams syndrome, prader-willi syndrome, etc) -Environmental (malnutrition, drugs, toxins, maternal disease) -Brain formation disorders (neural tube disorder, hydrocephalus, microcephalus)
Medical complications of DS:
-Heart defects -Leukemia -Upper respiratory infections -Alzheimer's -Sleep apnea -Obesity -Thyroid issues -Atlantoaxial Subluxation
Motor Behavior Characteristics: DS
-Motor delay -Poor balance -Perceptual difficulties -Slower movement & reaction times -Slower learning of motor skills -Decreased leg strength -Increased sedentary behavior -Altered metabolic functioning -Take less physical risks -Unique motor behavior (bear crawling, prone to sit/flexible)
Motor characteristics of individuals with vision loss:
-Motor delay -Postural deviations -Balance deviations -Gait difficulties -Poor fitness
Treatment of CP:
-PT, OT, Speech -Spasticity Treatment (Oral Medication, Botox, Intrathecal Baclofen Pump (invasive)) -Invasive Treatment (Orthopedic surgery, Selective Dorsal Rhizotomy)
When does ID occur? (Perinatal - Period just before/after birth)
-Placental insufficiency -Abnormal labor & delivery -Neonatal seizures -Infections -Metabolic disorders (could be prenatal depending on cause, PKU for example) -Nutritional disorders
Segregated vs. Integrated education
-Segregated: including only students receiving adapted physical education. -Integrated: a general education environment
Conductive loss:
-Sound is not transmitted well to inner ear -No distortion, but words are faint (like a radio on low volume) -Hearing aids often help. -Most still have intelligible speech. -Good candidate for cochlear implant
Non-invasive treatments for CP:
-Stretching -Casting (for lengthening muscles, starts with injection of botox) -Ultrasound -Bracing/Orthotics
Low Physical Activity: Many studies have been conducted describing Barriers to physical activity with DS... some reasoning
-Syndrome-specific characteristics (obesity, motor skill delay, energy-costs, etc) -Facility & transportation restrictions -Lack of integrate programs options -Parental refusal to participate in segregated programs -Low motivation for PA -Low fitness levels -Few social and recreational opportunities -Increased sedentary behavior with age -Small repertoire of skill
Teaching Implications for CP:
-Team approach (PT, OT, APE, Speech) -Attention to psychological & social development -Use adapted communication -Use assistive technology and assistive devices (Communication devices, Chairs, Lifts, Walkers, Walking sticks, Orthotics, Safety helmets, etc)
When does ID occur? (Postnatal - Period after birth)
-Traumatic Brain Injury (TBI) -Infections (encephalitis, meningitis, etc) -Degenerative disorders -Seizure disorders -Malnutrition -Environment deprivation
Strategies to teaching children with DS physical skills:
-Use visual prompts -Highly structured environment -Reinforce good behavior -Use simple language, speak slowly -Minimize distractions -Use adapted communication -Consider adapted equipment if needed (early intervention, frequency and intensity)
Increasing Desirable Behavior... what are the three basic things to consider?
-What specific behavior are you trying to increase? -What are appropriate reinforcers? -How & when to administer the reinforce?
Risk factors for Down syndrome:
-advanced maternal age*** -already having 1 child with DS -being a genetic carrier of the genetic translocation
Important aspects of behavior modification:
-build a routine -activity management
Dynamic system:
-complex, thermodynamic system that changes over time (accepts/releases energy) -reflecting interaction of multiple subsystems -changes are often nonlinear and (variable/don't have steady rate) -behavior can be characterized by relatively simple equations of motion (make biomechanics and energy efficient sense)
Who doesn't and does benefit from cochlear implants:
-conductive hearing loss does benefit from cochlear implants -not sensory neural
Why is verbal communication not enough when working with disabled individuals?
-consider processing time, poor attention, complex language, learning style
Symptoms: CP
-intellectual impairment -Epilepsy -Chronic pain -Spasticity -Gastrointestinal issues -Vision problems -Hearing problems -Stunted growth -Over or under weight -scoliosis or lordosis of spine -Contractures
hypotonic and ligamentous laxity as symptoms of DS
-low muscle tone, floppy (hypotonia) -loose ligaments, very flexible (interesting sitting behavior)
Sensorineural hearing loss -
-occurs when there is damage to the inner ear (cochlea) or to nerve pathways from inner ear to the brain -Reduction in sound level, affects speech understanding (raising your voice won't necessarily help) -Cannot be medically/surgically corrected -Permanent loss -Most have difficulty with speech and many use sign language.
common social characteristics of visionally impaired people:
-rocking, finger flicking, digging fingers into eyes -fearfulness and dependence -fewer friends -poor self-worth/perception
Examples of helping with orientating individuals with vision loss:
-should always be touching object/person -guides/guide-wires/railings -noises can be used/beeper -verbal call (refs use these instead of hand signals) -textures/raised surfaces (ropes for boundaries instead of paint lines)
Behavioral characteristics of hearing loss individuals:
-slower learners perception -higher rate of impulsivity -frustration due to communication barriers can lead to misbehavior
Proper use of a time out...
1) Time out must occur during a desired activity 2) Must place child where you can control reinforcers 3) Must allow child back in the activity when appropriate
Motor Behavior is subdivided into 3 categories:
1. Motor Control - study of neurophysiological factors that affect human movement 2. Motor Learning - processes involved in acquiring & perfecting motor skills 3. Motor Development - changes in motor behavior over a lifespan, the processes which underlie these changes & the factors that affect them
3 Neuromotor Classifications:
1. Spastic CP ~ 50% (Primary form) 2. Athetoid CP ~ 30% 3. Ataxic CP ~ 10%
Three causes of Down syndrome:
1. Trisomy 21 (Most common, Three copies, instead of two of a chromosome) 2. Mosaic (Caused by non-disjunction abnormality, Failure of the sister chromatids to separate, One haploid contains 24 chromosomes and one contains 22 chromosomes) 3. Translocation (Least common, Two chromosomes join together and appear as one, but contain the genetic material of two chromosomes)
3 major types of hearing loss:
1. conductive 2. sensorineural 3. mixed
Intellectual Disability: 3 Criteria for diagnosis
1. significant limitations in intellectual functioning 2. significant deficits in adaptive behavior 3. manifested during the developmental period all adversely affects a child's educational performance
PL 94-142: when and what is it?
1975: education for all handicapped children -Right to free & appropriate public education (FAPE) -Physical education available to every handicapped student -Equal opportunity in athletics & intramurals -Individualized education program (IEP) -Due process
Research - Treadmill Training with DS individuals
8 min per day (in intervals), most days of the week, 1 mph -Without intervention, age of onset of walking 24 months -With intervention, walk 101 days earlier *Important outcomes of treadmill training: Decreased age of onset of walking, Improved walking gait (lengthened step length), Increased physical activity
Individualized Education Plan (IEP)
A plan for students (most cases aged 3 - 21) years, developed by a planning committee -A requirement of IDEA. -Must include physical education and extracurricular activities
short term objectives:
A specific statement related to annual goal & present level of performance -Typically includes action or task, condition, criterion
Name a few other forms of communication for disabled individuals:
ASL, picture vocab words, assistive technology
Traumatic Brain Injury (TBI)
Acquired injury to the brain, Caused by external force (does not apply to brain injury resulting from congenital, degenerative, or birth trauma) -Individuals with TBI learned and performed motor skills in the same way as people without disabilities PRIOR to their brain injury. -Individuals with TBI experience many of the symptoms as a person with cerebral palsy (CP) or stroke. -Some individuals experience only physical disabilities, some only intellectual disability... some both
CP through the life:
CP is not curable, CP is managed with appropriate services and interventions, CP does not get worse
Why do these plateaus in motor development last longer for children with DS?
Child gets stuck in a preferred pattern of behavior & it takes increased frequency and intensity to improve their movement patterns (attractors)
Athetoid CP
Damage to basal ganglia -Muscle tone fluctuates from hypertonic to hypotonic -Involuntary muscle movement -Difficulty in head control, facial grimacing, protruding tongue, little control of salivation, lordotic posture (Causes difficulty with eating, drinking, speaking, tracking objects, performing quick or accurate movement)
Ataxic CP
Damage to cerebellum -Results in balance & muscle coordination issues -Diagnosed at onset of walking -Display ataxic gait: wide, unsteady -Difficulty in basic locomotor skills -Clumsy, frequently fall -Involuntary eye movement
What is the current term accepted for describing these mental/physical impairments
Disability is the current accepted term -Not impairment, not retarded, not handicapped
Paralympic Games
Equivalent to the Olympic Games for the world's top athletes with disabilities. -Athletes 15+. -International competitions every four years -same venues as the Olympic Games.
Demeanor of Down syndrome
Generally friendly & happy demeanor, Very social, Can be stubborn, Frustration often result of miscommunication (Undesirable behavior)
Genetics of Down syndrome
Genetic disease -Trisomy 21: Trisomy is a genetic abnormality in which there are three copies, instead of two of a chromosome
Abnormal gait and its effects on individuals with DS:
Given these issues with abnormals gait (often caused by hypotonia or loose ligaments) a step for a person with DS is more energy costly and less stable than the typical step
Motor Behavior
Human skilled movement generated at a behavioral level
Poor Balance with DS individuals related to:
Hypotonia & loose ligaments, Poor eyesight, Vestibular issues, Small foot, Decreased control of center of mass
What is the severity of an intellectual disability most often determined by?
IQ
IDEA
Individual's with Disabilities Education Act (1990). •Reauthorization and expansion of the Education for All Handicapped Children Act of 1975 (PL 94-142 -THE BIG ONE) •Reauthorized in 2004 - IDEIA - Individual's with Disabilities Education Improvement Act •Governs how to provide early intervention, special education, and related services to children with disabilities (only federally funded programs) •Related services - services not required for all individuals, but are recommended for some based on assessments (PT, OT, Speech, etc.)
IQ:
Intelligence quotient (IQ) -Measure of cognition or intelligence -Can be measured using a number of assessments
Why is time on-task so important?
It takes much more time to teach a skill to a child with a disability, therefore time is the limiting factor. If time on task is low, then learning will suffer
Vision impairments affect on motor development:
Loss of vision is more disruptive to motor control development than loss of any other sensory system -onset of motor skills significantly delayed
Most common known causes of ID include:
MOST COMMON genetic cause= Down syndrome (DS) Also... -X-linked syndromes -Fetal alcohol syndrome
Motivation for Physical activity increase in individuals with DS:
More likely to be physically active when: -Perceive a social opportunity (Most likely reason to be active) -Highly structured environment -Motivating environment -A sibling is present
Special Olympics
Provides year-round sports opportunities for children (8+) and adults with intellectual disabilities. -Founded by Eunice Kennedy Shriver in 1968. -Has operated in 170 countries.
Direct Services (IDEA)
Refers to instruction designed to meet the unique needs of a student with a disability that directly affects educational goals. -Physical Education is a direct service! -Provisions for direct services MUST be specified in the IEP
Related Services (IDEA)
Related services are services to assist a child with a disability to benefit from special education (Example related services: PT, OT, Speech-language, Audiology, Psychological services, therapeutic recreation) -Early identification & assessment -Counseling services, Medical services for diagnostic & evaluation purposes -Provisions for related services do not have to be specified in the
Spastic CP
Repetitive contraction of affected muscles -Hypertonic (increased muscle tone) muscles -Mostly flexors & internal rotators -Nearest limbs tend to pull towards midline -Display spastic or scissor gait
Benefits of spasticity in CP:
Spasticity is not always bad -Can help with function -Maintains muscle mass -Maintains active tissue
Diagnosing down syndrome:
Routine in prenatal care for all women -Initial steps in screening to determine risk level -Blood tests during 1st or 2nd (more likely) trimester -Tests hormone levels (around 13 weeks) -Ultrasound fetus' neck (1 week after blood work typically), Called nuchal translucency screening -1 in 20 women are positive after screening, obviously many of these result in healthy pregnancies
Spastic gait vs scissor gait vs. ataxic gait:
Spastic gait: Legs held together and move in a stiff manner, the toes tend to drag and catch Scissor gait: Caused by spasticity in lower limbs, Flexion of hip, knee, and ankle with rotation of the leg towards midline ataxic gait: Unsteady, uncoordinated walk, with a wide base
Why do people with CP have difficulty with learning motor skills and Difficulty adapting their movements to changing task conditions?
Spasticity in the muscles causes sensory information problems that are needed to learn and adapt to environmental changes
Spasticity as a Symptom of CP:
Spasticity is involuntary muscle movement -brain communication w spinal cord is disrupted due to illness/injury in NS -brain can no longer send signals that inhibit/moderate muscle tone, always on -Easily stimulated by movement or irritation -Causes contractures
Adapted Sport
Sport modified or created to meet the unique needs of individuals. (Ie: Basketball is a general sport, wheelchair basketball is an adapted sport) -Encompases "Disability sport"
Occupational Therapy (OT)
Supporting health and engagement in life through participation in occupation; applying core values, knowledge, and skills to assist individuals to engage in everyday activities or occupations that they want and need to do in a manner that supports health and participation
Time on-Task
The actual amount of time the child is engaged in activities related to the objectives of his/her program -the most critical factor in teaching & rehabilitation, determines the rate of learning and amount of learning or progress that occurs over time in a child with a disability.
Self-Actualization
The assumed purpose of adapted physical education. -Consistent with humanistic philosophy: helping people become fully human, thereby actualizing their potential for making the world the best possible place for all forms of life.
Context, Task, Intrinsic dynamics:
The probability that an individual will perform any task involves multiple factors, including the intrinsic dynamics (personal resources), the task, and the context (environmental conditions).
Why do children with DS experience more frequent plateaus in motor skill development?
The underlying control parameters change more slowly than other children without DS
Disability Sport
Typically focuses on segregated participation in a general or adapted sport. (Ie. Deaf sport)
During times of decreased spasticity with CP individuals...
Work on range of motion (ROM) -Strengthen muscles overwhelmed by spastic muscles -Stretch to lengthen muscles
ADL:
activities of daily living
Is it adaptive or adapted physical activity:
adapted
Adaptive behavior =
age-appropriate behaviors necessary for people to live independently and function safely and appropriately in daily life
Medical Model
aka Biomedical model -treats disabilities as impairments -sees impairment first, seeks to "fix" impairment ex: China
Economic Model
aka functional model -extent of disability is equal to ones ability to make an economic contribution to society -aims to "accommodate" disability ex: United States
Social Model
aka psychosocial model -sees disability as handicap -suggests that ones disability experience is defined by their environmental context -aims to "include" individuals with handicaps ex: Ireland
Physical Disability
any impairment which limits the physical function of limbs or fine or gross motor ability
Adapted Physical Activity
comprehensive and interdisciplinary study of physical activity for the education, wellness, sport participation, and leisure of individuals with unique needs -Encompasses total life span
when structuring verbal communication for disabled individuals...
consider syllables, sentence fade out, name first, short sentences, repeat, proximity
Which deaf children are more likely to be physically active?
deaf children with deaf parents are more likely to be active than a deaf child with hearing parents
Cerebral palsy (CP)
disorder of movement, muscle tone or posture caused by lesion in the developing brain -Occurs before, during, or shortly after birth -Signs and symptoms appear during infancy or preschool years (Impaired movement assoc. w exaggerated reflexes/rigidity of the limbs and trunk, abnormal posture, involuntary movements, unsteadiness of walking)
Causes of Intellectual disability can be both...
genetic and non genetic
Some motor behavior milestones for DS:
grasps cube, rolling, sits without support, pulls to standing, stands alone, walks without support
What is the number one disability in the US?
hearing loss
There is a ______ rate of termination in the prenatal diagnosis of Down syndrome.
high
Adapted Physical Education
individualized program including physical and motor fitness, fundamental motor skills and patterns, skills in aquatics and dance, and individual and group games and sports designed to meet the unique needs of individuals. -Focuses on ages 0-21
What has research shown that CP is associated with...
inflammation of the connective tissue in the umbilical cord -more common in premature births -
who is twice as likely to sustain a TBI ?
males over females
Always use the _______ restrictive prompt needed.
least
Atlantoaxial Subluxation
loss of ligamentous stability between atlas and axis causing instability of joint -diagnosed w x-ray -person is at risk of dislocation -should not play football, wrestling, some gymnastics, heading in soccer...
Risk factors of CP:
most causes is unknown!! -prenatal (majority), premature birth, low birth weight, infection, inadequate care -prenatal (not usually fault of gyno), neonatal seizures, low APGARs -postnatal (w/in 1st year), trauma, infection, accident *low SES and little access to prenatal care big factors
Invasive steps in diagnosis:
only after risk is determined as high -Amniocentesis (Sample of amniotic fluid to analyze chromosomes) -Chorionic Villus Sampling (Cells from placenta to analyze chromosomes) -Percutaneous Umbilical Blood Sampling •Umbilical cord blood to analyze chromosomes• (99% accurate in diagnosing before birth)
Developmental Period
period where development is still occurring, ceasing when adulthood is reached; generally considered 18 years and below (debatable).
Hard of hearing -
refers to a hearing loss that makes understanding speech through the ear alone difficult but not impossible (MOST PEOPLE ARE THIS NOT DEAF)
Deaf -
refers to a severe or profound hearing loss in which hearing is insufficient for comprehension or auditory information, with or without hearing aid
contractures:
shortening of muscle tissue due to severe tightening of the muscle• -Inhibits bone growth, bending of bones, causes joint deformities and dislocation
The most common misuse of behavior management is...
reinforcing an inappropriate behavior by mistake.
FAPE:
right to free and appropriate public education -guaranteed with the PL 94-142 -Special education & related services are provided at Public expense, Under public supervision & direction -No cost to the family -Meets the educational standards of the state -Includes an appropriate preschool, elementary, or secondary school education •Includes what is recommended on an IEP
Developmental Disabilities
term used to describe life-long disabilities attributable to intellectual and/or physical impairments, manifested prior to age 18
Which term refers to the most severe vision loss?
total blindness -legal blindness is several steps above -visual impairment refers to the least severe
Possible antecedents:
unable to communicate, lights, sounds, feelings/textures, clothes, health, what happened before they came, change in routine, weather, change in meds, attention seeking
ADA
•Americans with Disabilities Act •George H.W. Bush •ADA is most comprehensive Civil Rights Legislation •Equal opportunity law •Prohibits discrimination and guarantees individuals with disabilities have same opportunities as everyone else •Modeled after civil rights act
Hierarchy of the 4 main prompts:
•Physical Prompts (Ex: hand over hand) •Visual Prompts (Ex: demonstration, social story, picture cards, pointing) •Verbal Prompts (Ex: spoken directions) •Environmental Prompts (Ex: musical cues, bells, following the crow)
factors to maximize time on-task:
•Planning/preparation •Amount of adequate equipment •Ratio of staff to participant •Good behavior management •Minimize transition time (time between activities)