OT 241: OTPF Domain & Process, OT 241: Ch 15 (H&B), OT 240: Chapter 2 (Thomas), OT 240 (Activity Analysis): UT-III & Body Functions, OT 240: Chapter 4 & 5 (Thomas), OT 241: Evaluation, OT 240: Chapter 7 (P), OT 241: PAMS and Joint Protection Techniqu...
occupational profile
1st step in evaluation in which the client is asked about their level of occupational performance prior to the disabling event and about what areas they'd like to address in order to regain optimal performance
figure ground (ex: finding something in a fridge, word-search games)
differentiating bw foreground and background forms and objects; ability to find a form when it is hidden among other forms
right-left discrimination
differentiating one side (of the body) from the other
sensory discrimination
difficulty processing stimuli
serial tasks
discrete components of a task strung together
work to the worker
do you fit the worker to the work or the work to the worker?
International Classification of Functioning, Disability, and Health (ICF)
document developed by WHO that emphasizes function versus disability and provides a common language for multiple health disciplines internationally, consisting of 2 domains (body functions and structures, and activity and participation) and consider social aspects of disability
uniform terminology (UT-III)
document providing a generic outline of the domain of concern of OT designed to create a common terminology for the profession and to capture the essence of OT succinctly for others
yes -role model -always be respectful to parents and their style
does the OT have a role in parenting styles? if yes, how so? if not, explain why. (2)
intrinsic motivation
drive to participate in particular activities because of the innate rewards experienced in the activity; in play, child is involved to have fun
analysis of occupational performance
during an _________________________________ (during the evaluation) the practitioner completes various assessments
formative
during periods of discourse or insecurity, groups can revert back to the _____________________ phase
advocacy
efforts directed toward promoting occupational justice and empowering clients to seek and obtain resources to fully participate in daily life occupations; supports health, well-being, and occupational participation at the individual or systems level
basic skills
elementary and purposeful actions (such as learning to manipulate eating utensils, a pencil, or a simple tool)
social demands
elements of the social environment and virtual and cultural contexts that may be required by the activity; influence on others directly or indirectly, including social norms and expectations; required in social environments, virtual environments, and cultural contexts; often influenced by the culture in which the occupation takes place
reflex
eliciting an involuntary muscle response by sensory input
bottom-up approach
emphasis on performance components with a disregard for the overall picture was a pitfall of the UT-III
activity-focused motor interventions
emphasize the need for practice and repetition of purposeful motor actions to increase the child's participation in daily routines; plan effective movement experiences that promote motor learning within the context of daily routines of the child or family
parental; therapist
emphasizing caring over competence in the patient-therapist relationship in OT yields a rather ____________, "for their own good," approach that reserves authority for the (client/therapist)
technian
emphasizing competence over caring in the patient-therapist relationship in OT results in a therapist who operates as a _________________
culture
encompasses all the learning about doing that people pass down to new members of a group of people
relaxed leisure (ex: listening to music, watching TV, playing videogames, surfing the internet, interacting on social media sites, or socializing with friends at a local mall or park)
encompasses those activities that are pleasurable but not challenging; require little physical or intellectual exertion; "time-out"
social activities
engagement in _________________ is reflected in interactions between 2 people, how their bodies move in relation to each other, and sharing the experience of engaging in an occupation together
peer/friend social interactions
engaging in activities at different levels of interaction and intimacy, including engaging in desired sexual activity
interaction with other people physical and social environment context within and surrounding a person
engaging in activities requires ______________, ______________, and ________________
sexual activity
engaging in activities that result in sexual satisfaction and/or meet relational or reproductive needs (i.e., does not have to involve genitals, nor does it necessarily involve two people; also includes activities necessary to meet reproductive needs/produce a child); unique for each individual
community social participation
engaging in activities that result in successful interaction at the community level (i.e., neighborhood, organizations, workplace, school, religious or spiritual group); social interactions that connect two or more individuals as a group
family social participation
engaging in activities that result in successful interaction in specific required and/or desired familial roles; involving family interactions embedded in culture and tradition; often surround daily activities such as meal prep, child rearing, and self-feeding
human development (facilitates development of cognitive, perceptual, and physical skills needed by a mature adult)
engaging in play is part of ____________________ (think: why is play necessary/essential to a child?)
rest
engaging in quiet and effortless actions that interrupt physical and mental activity resulting in a relaxed state; included are identifying the need to relax; reducing involvement in taxing physical, mental, or social activities; and engaging in relaxation or other endeavors that restore energy, calm, and renewed interest in engagement
social settings
environmental factor that includes support and relationships that a person has in his or her own environment and may be physical or emotional in nature; can include the support, nurturing, protection, and assistance from others or pets; relationships with other persons at home, work, or school or during play
physical settings
environmental factor that includes the natural or human-made products or systems of products, equipment, and technology in a person's immediate environment
attitudinal settings
environmental factor that includes the observable consequences of customs, practices, ideologies, values, norms, and religious beliefs
top down (puts person's occupations first, rather than a bottom up approach that focuses on underlying skills such as client factors and PS, etc.)
evaluation is a (top down/bottom up) progression (and describe how)
observation, natural context
evaluation process should include ______________ of the person's actual performance of an activity in the ____________________
self-care occupations
everyday life activities that people do to take care of themselves; fundamental to human existence and affect people's abilities to function
reflective practice
examination of why particular interventions and interactions are chosen, whether the choices were appropriate, and what they will do the next time they encounter a situation; what occurs when a seasoned professional, acting on intuition, stops to take the time to contemplate what s/he is doing while in the midst of doing it
top down
excellence in developing insight into the occupational nature of individual clients depends on (bottom-up/top-down) assessment
sequencing complex movement (ex: playing tag --> speeding up/slowing down, toe tapping, hand wringing, picking up a book)
executing movement patterns as a cognitive function; mental aspect of planning movements includes mentally planning how quickly to move, the timing of movements, and limited extraneous movements; the mental control over movements as they are being executed; regulating speed, response, quality, and time of motor production
domain
expertise/knowledge of OT; no one area is of greater importance than any other
process model
explains the determinants or factors that influence parenting and their subsequent effects on child development
unstructured play
exploratory and imaginative play
balance leisure activities (ex: travel abroad, go on camping trip, learn to sail, fish, or ski)
exploring new leisure activities together (as a family), thus breaking up their routine ways of interacting; facilitate family members' interacting and collaborating with each other in new situations and in new ways; typically requires time, financial resources, and planning
emotional domain of wellness in caregiver-care receiver relationship
expression of feelings, control of stress, problem solving, self-efficacy
pursuits (ex: watching or playing a sport, playing with a dog, or playing a video game)
eyes follow a moving object and keep it in focus
gatekeeper-expediter (group building role)
facilitates communication between members
screening
factors that may influence performance in desired occupations are considered during __________________?
shared occupations (ex: eating family dinner, watching a football game on TV with friends)
fall between co-occupations and solitary occupations; interactive occupations in a parallel way, social interaction is part of the conditions in which the occupation is taking place, but is not necessary to completing the occupation
personal factors
features that are integral parts of individuals and are brought to situations (e.g., gender, age, coping styles, social background, education, profession, past and current experience, overall behavioral pattern, character)
emotion (ex: displaying appropriate emotions when opening a gift from a friend even if you don't like the gift, participating in a spelling bee with the possibility of not winning or being embarrassed)
feeling and demonstrating the affective components of the processes of the mind
concentration (ex: taking a test, similar to sustained attention)
fixation of the mind on one subject or task
speech rhythm (ex: telling a joke)
flow and tempo of speech used to express the beginning and ending of statements, emotions, and emphasis on specific words
active impairment-level interventions
focused practice of a purposeful action to ameliorate impairments that limit task-specific critical components of movement; motor control emerges in the context of performing a purposeful task
analysis of occupational performance
focuses on collecting and interpreting info to more specifically identify supports and barriers related to OP and identify targeted outcomes
selective attention (ex: trying to read or study in a noisy environment, such as an airport; listening to lecture as cars are driving by; a child working with OT in a classroom or therapy gym is focused the activity they are doing with the therapist, or they could be focused on what other children are doing)
focusing in on one or more stimuli, while all other stimuli or info in the environment are ignored; requires actively discriminating bw what info and stimulus to absorb and what to disregard
divided attention (ex: cooking, talking on the phone while driving, talking while playing/doing a craft; listening to teacher as you're working on a craft)
focusing on 2 or more stimuli at one time, allowing for several tasks to be done at once
attention span
focusing on a task over time
home establishment and management
for all of the activities in this area of occupation, the person does not have to do the actual maintenance or repair but simply must know when and how to address it and obtain assistance when needed
low tech -secondary to failures (power, etc.) -cost
for any high tech device you need a _______________ option. why? (2)
no, although having a comfortable temperature may be preferred by the patient or clinician, but may not be required of the activity (think of what is absolutely necessary!) temperature may be needed for some activities such as skiing or hot yoga
for most activities, is temperature a requirement to complete the task?
aggressor (individual role)
forceful and outspoken in the group, often to the detriment of others or to the group
vascular dementia
form of dementia which occurs after a stroke; person experiences hallucinations; second most common type of dementia
-how we design interventions -how we interact with a client and their caregivers -how we introduce changes -method of education used -who we involve in the process
in what ways do cognitive changes influence how an OT practices? (5)
occupational profile
OT can avoid creating impersonal or generic goals (which may lead to impersonal or generic activities) by attending to the client's ______________________________________----
coaching
OT helps clients identify what knowledge or skills they need to learn to reach their personally identified goals
consulting
OT supports clients' participation by sharing observations and strategies with them and their caregivers and then guide clients in choosing strategies to implement; may design or provide materials as well as guide clients through implementation and monitoring of a plan for change
activity(ies)
OTs believe in the value of ____________ as an effective tool for facilitating change and growth. consequently, practitioners use _______________ to enhance people's ability to engage in the occupations that they need and choose to do. (same answer)
family; phsyical, phsychological, sensory, cognitive, and contextual
OTs bring expertise to ______________ intervention through their knowledge of _____________, ____________________, __________________, __________________, and _________________ elements that affect caregiving
psychosocial
OTs working in cognitive and behavioral health conditions require a core knowledge base in __________________ conditions
intervention implementation
Ongoing actions taken to influence and support improved client performance and participation directed at identified outcomes. Client's response is monitored and documented; based on FORs and appropriate occupations, activities, etc. are chosen
personal activities of daily living
PADL
augmented information
information provided by an external source to complement the intrinsic information that is naturally available to the learner through problem solving and performance of the task
equipment
instruments or appliances that serve to equip someone to complete an activity; often physically larger than the tools and may be a machine; can also be a set of objects that equip someone for a task; larger or mechanical in nature; extension of hand
complex skills
integrated sets of actions to follow rules and to sequence and coordinate movements
social conduct/social skills
interacting by using manners, personal space, eye contact, gestures, active listening, and self-expression appropriate to one's environment
transactional relationship
interconnectedness; if one thing is changed, it changes another
reductionistic thinking
interferes with the ability to establish a full understanding of the client in his/her narrative; oversimplifying a complex idea to fundamental components
monisitic thinking
interferes with the ability to establish a full understanding of the client in his/her narrative; perspective that things can be explained in terms of a single reality
pain response
interpreting noxious stimuli
sensory processing
interpreting sensory stimuli (tactile, proprioceptive, vestibular, visual, auditory, gustatory, olfactory); ability of brain and body to take in info through the sense, interpret into meaningful info, and generate an action/response
create/promote (health promotion)
intervention approach that does not assume disability is present or that any aspect would interfere with performance; designed to provide enriched contextual and activity experiences that will enhance performance for all people in the natural contexts of life
FOR
intervention is based on a ___________?
passive procedures
intervention that does not involve purposeful activity by the child but relevant to improving purposeful activities during daily routines; interventions directed toward reducing secondary impairments of joint limitations or soft muscle tissue contractures associated with muscle tone disorders
symmetrical bilateral integration (ex: jumping rope)
involves both sides of the body working in mirror-image unison
mobility
involves changing body positions or location by transferring from one place to another
action
involves the accomplishment of a task with the intention to realize a functional goal and a strategy to achieve the goal
knowing-in-action
involves the concept of tacit knowledge (form of knowing without knowing how one knows); certain practices become so automatic that they disappear from our awareness and become tacit knowledge; a practitioner may interact with or choose a purposeful activity with a client without being able to explain why a statement was made or an intervention chosen
higher level cognitive functions
judgment, concept formation, metacognition, executive functions, praxis, cognitive flexibility, and insight; allow us to adapt to situations, think abstractly, and plan for the future
eating
keeping and manipulating food or fluid in the mouth and swallowing it
recorder (task role)
keeps a record of the group's work, written or by memory
occupational profile
key element of the OT evaluation process; contains invaluable information to help choose activities; who the person is and why s/he is seeking services
tacit knowledge
kind of knowledge that is difficult to transfer to another person by means of writing it down or verbalizing it
safety and emergency maintenance
knowing and performing preventive procedures to maintain a safe environment; recognizing sudden, unexpected hazardous situations and initiating emergency action to reduce the threat to health and safety; examples include ensuring safety when entering and exiting the home, identifying emergency contact numbers, and replacing items such as batteries in smoke alarms and light bulbs; often incorporated within other occupations
work
labor or exertion; to make, construct, manufacture, form, fashion or shape objects; to organize, plan, or evaluate services or processes of living or governing; committed occupations that are performed with or without financial reward
fear of falling (FOF)
lasting concern about falling that can lead an individual to avoid activities that s/he remains capable of performing
cultural incompetence
leads to frustration for both the client and therapist, risk of not providing client-centered care, health disparity, denial, feelings of inadequacy
developmental groups
learn through sequential, stage specific activities; activities are graded simple to complex and short term to long term in order to provide progressive challenges; assist a person in developing group interaction skills in a sequential manner; serve as a structure for creating, organizing, and understanding the social interaction skills in other types of activity groups
experential learning
learning based on doing and reflection; reasons that people learn through dong and thinking about what they have done
behavior theory
learning theory that refers to procedures that change the consequences of behavior, to guide the shaping of skills for a person who has limited cognitive abilities
transitional leisure (ex: extracurricular school activities, individual hobbies such as playing an instrument, or developing high-level painting or dancing skills)
leisure activities that prepare an adolescent for the serious aspects of the adult world; promote concentration and challenge; also called achievement, influences mental health through enhancing competence
active leisure activities (hiking, shopping, gardening, bike riding, swimming)
leisure activities that require active movement within the environment or outdoors
quiet/sedentary leisure activities (reading, surfing the web, watching TV, knitting)
leisure activities that require little motor movement and may be done sitting or with small amount of walking
-provide a buffer for the stresses and negative events of other occupations (e.g., the practical) -develop relationships -lead to discovering a vocation or life purpose -emotional equilibrium through self-expression
leisure can... (4)
serious leisure (ex: reading a novel, knitting, gardening)
leisure occupations that engages the mind, uses certain skills for participation, and are considered relaxing; enhance the quality of life and can provide a person with a sense of achievement/accomplishment, an appreciation of simple things in life (beauty in nature or the arts), a feeling of identification with his or her community, or a sense of fulfillment in his or her potential; self-identity
intellectual domain of wellness in caregiver-care receiver relationship
lifelong learning, cognition, exploration
evidence-based practice
like a toolbox of methods to aid clinical reasoning, and, furthermore, it is a toolbox consisting primarily of methods designed to integrate research study evidence into the clinical reasoning process; these methods help the practitioner select the best assessments and intervention procedures from an array of possibilities; excellent intervention is demonstrated by the degree to which published evidence is used in making decisions regarding service provision
occupational-based activity analysis
an activity analysis from the client's perspective within their context; client defines the activity
client-centered practice
an approach to service which embraces a philosophy of, respect for, and partnership with, people receiving services
client-centered practice
an approach to service which embraces a philosophy of, respect for, and partnership with, people receiving services; emphasizes the rights of consumers to guide intervention
clinical reasoning
an awareness of the power that an OT has to affect destiny through the choices they make
properties
an essential quality or distinctive trait of a physical object in order to allow for success in the activity; descriptive; may be instrumental to how the activity is conducted, the time elements needed, and the skill set required
competence and caring
an even balance of ________________ and ___________ is the highest quality of therapeutic relationship and resembles friendship
fall
an event which results in a person coming to rest inadvertently on the ground, floor, or lower level; can impact the health and independence of elderly population
communication skills
an important part of increasing your cross-cultural competence is __________________________________
emic
an individual interpretation of an activity, influenced by personal experiences and perceptions
spirituality
an internal experience, a personal quest for understanding answers to ultimate questions about life, about meaning, and the sacred; occurs within the person as a result of engagement in occupations (is not an occupation itself)
maintain
an intervention approach designed to provide the supports that will allow clients to preserve the performance capabilities they have regained, that continue to meet their occupational needs, or both/performance that has been gained or that is at risk due to progression of a disease or illness
religion
an organized system of beliefs, practices, rituals, and symbols designed to facilitate closeness to the sacred or transcendent; used as a way to reach into the spiritual aspects of the self
activity analysis
analyzing an activity as it is typically done, without a particular person in mind; helpful in looking at how activities might be therapeutic
body structures
anatomical parts of the body such as organs, limbs, and their components
required body structures
anatomical parts of the body such as organs, limbs, and their components that support body functions and are required to perform the activity
assistive technology device (ATD)/adaptive equipment (AE)
any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities
play
any spontaneous or organized activity that provides enjoyment, entertainment, amusement, or diversion; freely chosen rather than engaged in because of requirements or expectations
generalization (ex: doing laundry at home and still being able to do it with different machinery at school; bathing at bedside, sponge bathing at sink, tub bathing)
applying previously learned concepts and behaviors to a variety of new situations
on-site industrial rehabilitation
approach in which clients with work-related injuries receive OT at their job sites; allows the therapist to observe the demands and context of the work, to enlist support from others, to recommend changes to the work context, and to see the client in actual interactions with the spaces, objects, rhythms, people, and culture of the worksite; barriers preventing the client's full return to his/her job responsibilities are more obvious; gradual recovery can be addressed through a graded re-entry into previous activities
compensatory FOR
approach to intervention influenced by the medical model and numbers of wounded veterans returning home which emphasizes environmental adaptation, adaptive equipment, and alternative strategies to promote an individual's level of independence; practitioner provides the client with various adaptive devices or compensatory strategies to complete a task
client-centered practice
approach to service that incorporates respect for and partnership with clients as active participants in the therapy process; approach that emphasizes clients' knowledge and experience, strengths, capacity for choice, and overall autonomy; collaborative process that requires knowing the client
toe-touching weight bearing (TTWB)
approx 10% of body weight may be placed on operated leg
disability rights movement
arose in direct opposition to the culture and values of medicine; PWD began protesting their situation as "patients for life" within the specialty of rehabilitation medicine; primary tenet was that disability is not a condition of an individual but is created by the way in which society excludes, discriminates against, and unfairly treats PWD; lead to independent living movement
social environment
availability and expectations of significant individuals; also includes larger social groups which are influential in establishing norms, role expectations, and social routines
person and self orientation (ex: being able to know one's own name)
awareness of one's own identity
place orientation (ex: person is in a bathroom and understands that s/he is in the bathroom in order to be successful in toileting; ordering food in a restaurant)
awareness of one's own location (understanding the type of place one is in)
awareness of client's social roles and social contexts
awareness of the client's _____________________ is necessary in determining the social demands of the activity
time orientation (ex: understanding what time of year it is in order to decide what to wear)
awareness of the current date, month, day of week, and year
orientation to others (ex: being able to identify mother from coworker or brother/sister or stranger)
awareness of the identity of significant people in one's life and one's relation to that person
sleep
base of the entire occupational pattern; without it, other aspects of the occupational pattern decline
eden alternative
based on the core belief that aging should be a continued stage of development and growth, rather than a period of decline
parenting styles
based on the parent's expressions of maturity, communication, discipline, and warmth when parenting; permissive, authoritative, authoritarian, and noninvolvement
program goals
because recovery can be unpredictable, as the OT, if outcome expectations don't match present level of functioning, then adjust...? (2)
action verb
beginning of statement in writing out a step that describes what the person participating in the activity must do; should be observable
discharge planning
begins at initial evaluation and continues through the delivery of OT services
visual acquity
being able to detect various shapes of objects; allows us to detect form and contour; see clearly both near and far; differentiate bw objects and discern details; visual discrimination of fine detail
orientation
being able to identify the person, time, place, and situation
self-concept (ex: a mother understanding that many of the activities she must engage in address her role as a caregiver towards her child)
being aware of one's roles and identity in the world; addressing who one is and understanding one's position in the environment; developing the value of the physical, emotional, and sexual self
initial meetings
between the occupational therapist and those s/he serves in order to: get to know each other, exchange information about what is needed and what the therapist can offer, and complete administrative requirements for intake procedures; focus mostly on info about the client's needs, current circumstances, and desired changes in occupational pattern; also addresses goals of intervention (get a sense of what the client is hoping to accomplish or change about his/her skills or life
balance
body's ability to maintain an upright position while standing, sitting, or moving; also related to functions of the inner ear
gustatory discrimination (ex: discriminating between tastes when preparing a meal or determining if something is too salty or has gone bad)
brain's ability to discriminate bw tastes based on input form taste buds
quality of performance
continuum of expectations set within particular activities and contexts; measured by the standards generated by both the individual and others in the social and cultural environments in which the performance occurs
moral contract with clients
contract to provide client-centered practice
parallel group
developmental group; work/play in presence of others; minimal conversation and minimal sharing of activities occur; OT encourages and reinforces appropriate behaviors and social interactions
prosthetics
devices that replace a limb or body functions
alternative communication devices
devices used by those who are unable to speak or hear
habit training approach
strategy developed by eleanor clarke slagle to establish daily routine skills which introduces routines to help individuals learn skills to be productive and maintain a balanced daily schedule
intactness
strengthening _____________________ is likely to shift intervention toward increased efficacy, greater holism, enhanced understandability for clients, and more community-based interventions
-QoL and quality of care for those living in nursing homes -improved staff satisfaction and retention -significant decreases in the overuse of medications and restraints
studies show that implementation of the eden alternative is a powerful tool for improving...(3)?
evaluator-critic (task role)
subjects the accomplishment of the group to some set of standards; questions the "practicality," the "logic," the "facts," or the "procedure;" one type is the devil's advocate
initiator (task role)
suggests new ideas to group, contributes frequently
orienter (task role)
summarizes to keep group organized and defines the position of the group with respect to its goals
physical endurance (ex: swimming, singing)
sustaining cardiac, pulmonary, and musculoskeletal exertion over time; involves continuous, efficient actions of the heart and lungs to provide oxygen to the body
true
t/f: FOF risk factors include being female, poly-pharmacy, a history of falling (either with or without injury), decreased performance of activities of daily living, activity restriction, physical deconditioning, social isolation, decreased quality of life, sedentary lifestyle, and depression
false; they are never used as stand alone treatment
t/f: PAMs are sometimes used as a form of treatment (without other occupation based activities)
false; do not bend down at the waist to pick items off the floor, instead use a long-handled reacher or other adaptive aid to pick items off the floor
t/f: a client with a hip fracture may bend at the waist to pick items up
false; do not twist torso inward
t/f: a client with a hip fracture may twist their torso when lying, sitting, or standing
false; do not do this
t/f: a client with hip fracture may cross their operated leg or ankle of their non-operated leg
false; do not turn operated leg inward in a pigeon toed stance, especially when standing and lying down
t/f: a client with hip fracture may stand pigeon toes
false; self-care occupations
t/f: a person's performance of work and sleep occupations is a major predictor of his or her dependence, morbidity, and mortality
true
t/f: according to the dynamic systems perspective, progress in motor skill development does not occur because of neurological changes alone; rather, a certain motor behavior emerges as the preferred or "natural" behavior in a given task and environmental context because of the interaction of multiple elements of a complex movement system
false; most occur in combination
t/f: activities are usually addressed individually and rarely in combination
false; areas of disability should be addressed during goal setting before implementing interventions
t/f: areas of disability shouldn't be addressed during goal setting, which occurs after implementing intervention
false; don't make this assumption
t/f: as a person ages, they will have cognitive changes
false; share them
t/f: as a practitioner, if you have concerns, you should keep them to yourself
true
t/f: as an OT, we have an ethical responsibility to address the occupation of driving
true
t/f: before beginning an activity, the therapist may discuss with the client how to arrange the space to optimize its use
true
t/f: being male or female is likely to result in involvement in certain activities and not in others
false; throughout their professional careers, practitioners continue to develop clinical reasoning skills and reflective practice
t/f: by the time a practitioner has worked for 1 year, they have fully developed their clinical reasoning skills and reflective practice
true
t/f: by using a highly intact intervention, the means and ends of the intervention will become less clearly distinguishable and will begin to closely resemble each other
false; care of others does not include children (that is the IADL, child rearing)
t/f: care of other encompasses people across the lifespan, including children
false; does not include care of child (this is its own separate category -- child rearing)
t/f: care of others includes both children and adults
false; circadian rhythms are influenced by factors from within the body, as well as environmental indicators
t/f: circadian rhythms are typically only affected by biological factors
true
t/f: client factors are features residing within the client that influence skill level but do not assure the skill level needed to be successful in an activity
false; safety is more important than client preference
t/f: client preferences should strongly influence the priorities for intervention and are more important than any other priority
false; family and caregivers as well
t/f: client-centered practice means providing care to only the client
true
t/f: cognitive remotivation accepts client/patient behavior, ideas and/or feelings as expressions of personal opinion
false; focuses discussion on concrete things and ideas rather than subjective feelings and emotions
t/f: cognitive remotivation focuses on abstract ideas and subjective feelings/emotions in order to help clients discover their root problems and find coping mechanisms
false; focuses on the patient's abilities rather than on their disabilities
t/f: cognitive remotivation focuses on the client's disabilities so that they can recognize their limitations and brainstorm strategies to live with such limitations
false; the field of OT is an ever-evolving and dynamic profession
t/f: concepts of OT have been fully defined and do not change according to documents such as UT-III and OTPF
true (if steps are dependent on certain conditions/decisions)
t/f: conditional statements can be used in completing sequencing and timing
false; should come to mind every time you enter the treatment setting
t/f: cultural sensitive treatment should typically only come to mind when you hear an unfamiliar accent or see a note on the patient history indicating the patient is a recent immigrant
false; face challenges in participating in their own leisure activities as well as in facilitating family-based leisure activities (greater demands on parents' time because of greater needs for parental assistance in academic and self-care activities than typically developing children)
t/f: despite the greater demand of their time, parents of children with disabilities are still easily able to participate in their own leisure activities
true
t/f: disability can be a result of socioeconomic or environmental health
false; a person's opinion is never corrected or commented upon in a critical manner (personal opinions)
t/f: during cognitive remotivation, a person's opinion may be corrected or commented upon if it is not right
false; never do this!
t/f: for a client who enjoys productivity, it is okay to provide experiences that might be boring, repetitive or lacking in value as long as there is still a product at the end of the activity
false; these are personal factors
t/f: gender, age, coping styles, social background, education, profession, past and current experience, overall behavioral pattern, character are all examples of environmental factors
false; setting priorities
t/f: identifying problem areas helps the therapist and client focus on the most critical areas to target first
true
t/f: if necessary, an OT can make referrals to a driver rehab specialist
false; both are essential
t/f: in OT, the emic perspective is more important than the etic
who the person; perceptions
occupation-based, client-centered practice begins with a comprehensive understanding of _____________ is that you are working with and their __________________ of what they want and need
emic
occupational experience is: emic/etic?
skills and routines; all persons in the caring relationship
our job as OTs is to promote _______________ and ____________ that preserve time for meaningful activities and promote QoL for ____________________________________________________
gravitational insecurity
over-responsiveness of vestibular systemfear of movement; avoid feet off ground
formal caregiving
paid care
generalized pain (ex: pained experienced when one has the flu)
pain that occurs in nonspecific areas and is focused in larger areas
authoritative parenting style
parents give children reasonable demands and consistent limits, express warmth and affection, and listen to the child's point of view; emphasizes autonomy and free will, values child's gifts/talents/individuality, sets clear expectations for standards; child is well-adjusted with the ability to regulate emotion and positive social skills
permissive parenting style
parents make few demands and rarely use punishment; governs children in an accepting, affirmative, and non-punitive manner; maximize child input; children may lack self-control and may struggle with the firm demands later placed on him/her in school
body functions
physiological functions of body systems (incl psychological functions) that reside within the client and can influence performance in areas of occupation
parathesia
pins and needles
disability status
place in continuum of disability, such as acuteness of injury, chronicity of disability, or terminal nature of illness
sequencing
placing information, concepts, and actions in order
hand
primary physical interface with the spaces and objects around us; feeling/sensation, extension of our body
child rearing
providing the care and supervision to support the developmental needs of a child, including biological, psychological, and social; also includes supervising and providing care when the primary caregiver is not available
knowing-in-action
requires tacit knowledge (kind of knowledge that is difficult to transfer to another person by means of writing it down or verbalizing it); ex: teaching someone to ride a bike
cognitive remotivation
small group therapeutic modality objective in nature, designed to help clients by promoting self-esteem, awareness, and socialization
personal rituals
smaller routines that individuals develop to transition from one mood to another, or from one part of their day to another; many center around self-care, rest, or the more routine and quiet aspects of work life
joint mobility (ROM) (ex: reaching up to hang a shower curtain, placing cups in a cupboard, playing tennis)
the ease with which a joint moves through motion; ability of joint to move smoothly
performance components
the elements of performance that occupational therapists assess and, when needed, in which they intervene for improved performance; fundamental human abilities that (to varying degrees and in differing combinations) are required for successful engagement in performance areas
outcome
the end result of the OT process; describe what clients can achieve through intervention; formal measures that are sensitive to change; marks progress towards goals
sensory/sensations such as smell and touch or pressure/light touch
the environment in which the activity takes place may generate other ____________ cues, such as ____________ (2)
clinical reasoning
the thought process that guides practice; "what if;" thinking about thinking; develops over time; requires reflection (knowing more practice than being able to describe)
clinical reasoning
the thought process that guides practice; asks why a client is having difficulty
asymmetrical bilateral integration (ex: opening a jar, cutting paper)
the two sides of the body are doing different movements
noise
the type or lack of this is often a key factor to an activity; also consider the level of this that is inherent and produced by the activity
moral contracts
the values of a client's approach and the practices of the therapist; what was right to address in treatment (morally right treatment); can be with reimbursers, employers, other professionals, clients, and themselves
high-quality intervention
the values of occupation based approach locate this in how well occupation was used and how much the resulting occupational pattern is valued by the client
retirement
the voluntary discontinuation of employment, or complete cessation of work, typically occurs age 65+; can also be a time in which skills can be gained or knowledge sought; look for new roles and occupations that provide enriching experiences to help support health
activities, occupation
the way each individual put the (occupations/activities/tasks) together becomes the (occupation/activity/task) and is grounded in personal meanings
strengths-based approach
theoretical approach that postulates that demonstration, practice, repetition, and positive reinforcement are essential elements for increasing the client's competency and mastery of skills
theoretical reasoning
theoretical rationales, hypothetical thinking; may take the form of a FOR, model, or paradigm; considers client's diagnosis, prognosis, and available intervention time and resources
occupation as a means
therapeutic medium is the client's actual occupation; use of real-life and community-based occupations; support the use of contextually relevant pursuits that facilitate a client's use of physical, cognitive, perceptual, and psychosocial skills to interact with his/her environment
handling techniques
therapeutic technique used by the change agent and delivered during the context of daily routines and activities that might help children to initiate movement or produce a difficult movement
objects or environmental aspects
things in step of activity being acted upon by action verb
metacognition
thinking about one's own thinking in an overarching manner
metacognition
thinking about the way you think; ex is examination of one's own style of learning new info; important in clinical reasoning because time spent examining the way in which your mind handles info and experiences can result in a substantial improvement in your ability to reason about activities
metacognition (ex: someone being aware of their learning strategies -- how one best learns and retains info)
thinking about thinking; awareness of one's own cognitive processes and the ability to manipulate an control one's own cognition
complex rotation (ex: flipping a pencil from writing end to eraser)
turning an object from end to end
domain and process
two parts of OTPF
gout
type of arthritis that is caused by a build-up of too much uric acid in the body causing hard, crystal-like deposits in joints
fibromyalgia
type of arthritis that makes you feel tired, causes muscle pain and "tender points"
lupus
type of arthritis that occurs when the body's immune system attacks healthy cells and tissues by mistake; can damage joints, skin, blood vessels, lungs, kidneys, heart and brain
creative play
type of constructive play using imagination and creative expression
space demands
type of physical environment typically required to perform an activity; includes size, arrangement, surface, lighting, temperature, humidity, noise, ventilation
play with rules (games with rules; checkers, card games, cooking/pet care, arts and crafts)
type of play with games that require social interaction and have consequences to action; can be structured or unstructured with social rules; requires following directions/rules in order to complete tasks
mentally processing the steps engage in the activity yourself talk to your client talk to someone who performs the activity watch someone perform the activity
what are 5 methods for determining key steps of an activity
procedural interactional conditional pragmatic ethical narrative
what are 6 types of reasoning about occupation and related activities?
-equitable use -flexibility in use -simple and intuitive use -perceptible information -tolerance for error -low physical effort -size and space for approach and use
what are 7 guiding principles of UD?
-being egocentric v. allocentric (concrete --> abstract) -spatial negotiation (topographical orientation) -visual sensation -spatial perception (understanding the world occupationally)
what are aspects of the occupational environment? (4)
time famine (work to afford leisure versus actually enjoying leisure we work to enjoy) stereotypes (cliques, people with disabilities, exclusion) personal factors (internal resources, social skills, negative habits/behaviors religious practices (sabbath) community resources (limited/decreased access) transportation
what are barriers to engaging in leisure activities? (5)
each activity be looked at individually but that engaging in the other activities is recognized
what does the analysis of nested occupations require?
provides solidarity and individuality
what is the significance of culturally accepted schedules?
no one is every truly independent; we rely on others want a healthy balance of interdependence
what is the significance of interdependence? (2)
evidence-based intervention
what new direction is clinical reasoning taking?
leisure
what people do in their spare time when they are not engaged in self- or family management, work, or educational activities; subjective; self-determined and autonomous; important for health and wellness across the lifespan
adolescents persons approaching retirement PWD elderly
what populations are at the most risk for disengaging from leisure activities? (4)
duplication of services
what should be avoided during group development?
-an action verb -how the action verb takes place -objects used or interacted with -time elements (if needed) -amounts used (if needed)
what should each step of the sequence of an activity include? (5)
communication social emotional regulation
what skills are necessary to all groups? (3)
who works well together safety if group member is having a bad day (still include in the group though)
what specific info is helpful to know in relation to group members?
nursing homes elders living at home
what two settings is the eden alternative prominent in?
therapeutic evidence based
what type of group protocol should be designed during group development? (2 qualities)
open-ended questions about occupational experience
what type of questions should you ask to gain an understanding of the client?
interactional
what type of reasoning is used for: -respecting the client as a person -supporting the client as an active participant in care -developing client-centered goals, interventions, and outcomes -knowing when to push the client beyond their comfort zone -monitoring for effectiveness
procedural
what type of reasoning is used for: problem identification goal setting based on D/C plans
those clearly and directly linked with the skills and abilities needed for the work, as long as they are set at an appropriate level of challenge
what types of activities will be the most appealing for those who have set goals of returning to work or entering a new type of work?
-eating and drinking can serve as intervention goals, as the primary activities within which eating and drinking abilities are addressed, as activities within which many other goals can be addressed, or as additions to another activity to enhance its enjoyment -self-care experiences can be used as activities within which to work on other goals -quiet-focus handwork and hobbies -nature-oriented activities or nature as a setting/to add appeal to a treatment setting -incorporating spirituality -intervention breaks -wind-down time at end of sessions (it is probably not possible to blend sleep into other therapeutic occupations to increase their appeal; sleep is a basic activity that you cannot easily combine with any other; rather, it is more of a direct goal)
what types of restorative activities might be appealing and effective in designing appealing interventions with restoration? (7)
20/200
what visual acuity is legal blindness?
20/40
what visual acuity is needed to be able to pass a driver's license test in all 50 states? (most printed material is at this level)
20/20
what visual acuity is normal vision?
process
what we do as therapists; includes evaluation, intervention and outcomes; fluid and dynamic
co-occupation
when 2 or more people share participation in an occupation physicality, emotionality, and intentionality
coregulation
when a person acts in response to another person's actions
purposeful activity
when a person engages in activities out of personal choice and values those activities; intervention selected by the therapist but motivating to the client
self-determination
when a person makes a decision for himself or herself without influence from others
reflective practice
when a seasoned professional, acting on intuition, stops to take the time to contemplate what s/he is doing while in the midst of doing it
how much what type the light inherent to the activity
when analyzing the lighting required of an activity consider _________ (3)
consider what is absolutely required in order to perform the activity, not what is "ideal" to the practitioner
when analyzing the space demands for an activity the practitioner should _____________________.
onset of therapy
when does an effective intervention address DC plans, outcome measures, and potential for referrals?
initiated at the onset of treatment/provides baseline data
when does the evaluation process begin?
it doesn't, it's a continuous process
when does the evaluation process stop?
clinical reasoning
when practitioners examine why particular interventions and interactions are chosen, whether the choices were appropriate, and what they will do the next time they encounter a similar situation
intentionality
when someone acts deliberately; implies choice
gross motor control (ex: throwing, jumping, kicking, bringing food to mouth without spilling, dressing, styling hair, washing a car, picking up a glass and placing it in a cupboard, swinging a bat to hit a baseball)
when the larger muscles of the body are used to coordinate movements (larger movements without demand for small and precise movement, but rather larger and less precise movements); also includes the speed of movement
just right match/challenge
when the treatment and how it is delivered address the client's need to facilitate positive change; occurs among the client, the FOR that guides the intervention, the context, the activity, and the service delivery model
false; a walker should not be used on steps
t/f: when a client with hip fracture is going up/down stairs, they should place the walker on the stair they are about to climb, and then push through their hands to take the step up/down the stair
universal design (UD)
the design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design
who we are and what we do how we do it (actions, how OT works)
the domain is the _________________ and ________________ as occupational therapists and the process is ______________
procedural reasoning
the dual search for problem definition and treatment selection; ex, thinking about the activities might use with a client to improve the client's functional limitations
transactional relationship
the dynamic interaction of all factors versus any one factor alone, and that a limitation to or interference with one aspect affects all others
occupation
occupation, activity, or task: self-care
seasonal affective disorder
"winter depression" tied to circadian rhythms, hypothesized to result from inadequate light cues in the environment; increased appetite for carbs, snacking and weight gain, daytime fatigue, anxiety, and inc sleep duration
teenagers; older drivers
(teenagers/adults/older adults) are more likely to kill someone else in a crash; (teenagers/adults/older) drivers are far more likely to kill themselves
serious transitional relaxed/casual
3 types of leisure occupations to relax?
cooking and eating (also combine well with productivity values)
2 activities to enhance pleasure and appeal through taste and smell
changing the strategy used to complete the activity adding adaptive equipment or technology
2 approaches involved in compensation for a permanent disability?
occupational profile analysis of occupational performance
2 components of evaluation
domain and process
2 major sections of OTPF
-intervention approach/type -service delivery setting
2 things outcomes and measures are dependent on?
formal informal
2 types of group membership
open closed
2 types of groups with formal membership
evaluation intervention targeting of outcomes
3 parts of the OTPF Process?
screening non-standardized assessments standardized assessments
3 types of evaluation (assessments)
play leisure sensory pleasure humor meaningful ritual
5 ways of designing appealing interventions with pleasure
reliable measurable sensitive to change consistent with client goals
4 characteristics of outcomes
-clear goals -feedback on relative success -focused attention within a limited stimulus field -match of perceived skill and perceived challenge
4 conditions of flow?
personal traits cultural factors environmental factors choices/technological factors (TV)
4 factors that affect leisure participation?
biotemporality sociotemporality subjective patterns orchestrating occupations developmental patterns
5 aspects of the temporal dimension
intervention plan
A plan that will guide actions taken and that is developed in collaboration with the client. It is based on selected theories, frames of reference, and evidence. Outcomes to be targeted are confirmed.
reliability
Ability of a test to yield very similar scores for the same individual over repeated testings and by different evaluators; "repeatability"
prevent (disability prevention)
An intervention approach designed to address the needs of clients with or without a disability who are at risk for occupational performance problems. This approach is designed to prevent the occurrence or evolution of barriers to performance in context. Interventions may be directed at client, context, or activity variables.
Establish, restore (remediation, restoration)
An intervention approach designed to change client variables to establish a skill or ability that has not yet developed or to restore a skill or ability that has been impaired
Modify (compensation, adaptation)
An intervention approach directed at "finding ways to revise the current context or activity demands to support performance in the natural setting, [including] compensatory techniques ...[such as] enhancing some features to provide cues or reducing other features to reduce distractibility"
activity analysis
Analysis of "the typical demands of an activity, the range of skills involved in its performance, and the various cultural meanings that might be ascribed to it"
Durable Medical Equipment (DME)
Any medical device, equipment, or instrument used in the care of a patient; can be used to improve mobility and decrease fall risk; used in bathroom (bath benches, grab bars), mobility devices (cane/walker)
basic activities of daily living
BADL
hypertension
BP too high/increased
hypotension
BP too low/decreased
low physical effort
Can be used efficiently and comfortably and with a minimum of fatigue
self-directed learning FOR
FOR that involves promoting an individual's self-initiation in identifying his or her learning needs, formulating learning goals, choosing and implementing appropriate learning strategies, and evaluating learning outcomes
employment seeking and acquisition
Identifying and recruiting for job opportunities; completing, submitting, and reviewing appropriate application materials; preparing for interviews; participating in interviews and following up afterward; discussing job benefits; and finalizing negotiations
employment interests and pursuits
Identifying and selecting work opportunities based on assets, limitations, likes, and dislikes relative to work
independent living movement
PWD demanded the opportunity to choose to live on their own as free adults; landmark legislation was rehabilitation act of 1973; honored principles of freedom, self-direction, and the de-medicalization of the lives of individuals with lifelong disabling conditions
authoritarian parenting style
Parenting style in which parents are demanding and unresponsive toward their children's needs or wishes; shape child's behavior through discipline, firm expectations, and a set code of conduct; parent is strict and may use external forces and rules; child may become anxious and withdrawn, and have poor frustration tolerance
job performance
Performing the requirements of a job, including work skills and patterns; time management; relationships with coworkers, managers, and customers; leadership and supervision; creation, production, and distribution of products and services; initiation, sustainment, and completion of work; and compliance with work norms and procedures
intervention review
Review of the intervention plan and progress toward targeted outcomes; continuous process of assessing effectiveness of the intervention, client's response to treatment, and progress towards goals
hurry sickness
Severe chronic feelings of time urgency that negatively affect one's lifestyle; feel "on" all the time; running from one thing to the next; example is a workaholic
occupational performance
The ability to perceive, desire, recall, plan and carry out roles, routines, tasks and sub-tasks for the purpose of self-maintenance, productivity, leisure and rest in response to demands of the internal and/or external environment
perceptible information
The design communicates necessary information effectively to the user, regardless of ambient conditions or the user's sensory abilities; pictorial, tactile, and verbal cues
simple and intuitive use
The design is easy to understand, regardless of the user's experience, knowledge, language skills, or current concentration level
analysis of occupational performance
The step in the evaluation process in which the client's assets and problems or potential problems are more specifically identified through assessment tools designed to observe, measure, and inquire about factors that support or hinder occupational performance and in which targeted outcomes are identified.
occupational therapy
The therapeutic use of everyday life activities (occupations) with individuals or groups for the purpose of enhancing or enabling participation in roles, habits, and routines in home, school, workplace, community, and other settings.
telehealth
Use of technology to deliver health-related services and information, including telemedicine
reflection-in-action
a characteristic of a professional who is practicing at the highest level of expertise; the ability to reason about what is going on as it is in the process; involves continued observation of and interaction with the client
play
a child-initiated occupation that an adult has not structured for teaching specific skills; child engages because s/he wants to and it is fun
individual differences
___________ account for complexity and multidimensionality of each occupation
self-care activities (ADLs)
______________ activities are a core set of occupations on which other occupations depend
approach and tone
______________ and _____________ is important as you share observations with the client and caregivers
occupational analysis
_______________ is key in determining the most effective means in providing care for individuals with cognitive changes
leisure; achievement; social
_______________ occupations promote a sense of competence and self-efficacy through individual _______________ and ____________ participation and have a powerful influence on the mental health of adolescents
personal identity
_________________ is a good example of how we negotiate the emic and etic perspectives in our lives
pragmatic
___________________ considerations do not always make using occupations as a means/as a type of intervention possible to achieve maximal participation in life
functioning and disability
____________________ and _______________ are the outcomes of the interaction between health conditions and the contextual factors (environmental and personal)
impression management
a PWD's attempt to minimize the negative social effects of their disabilities
culture
a broad term for shared meanings about traditionalized ways of living and working together; include activity ideas, language, symbols, a history of action, values, and typical material objects involved in everyday life; acquired through either immersion or creation through actions within a shared life world
behavioral change
a change in the preferred movement behaviors
geographical history
a client's current location that may be based on a treasured family tradition, the result of choices to change a way of life, or a result of loss and forced migration -- a client's _________________________ -- will influence the occupational patterns of clients and how they feel about their life opportunities
moral contract with reimburses
a contract to provide treatment that is reimbursable
temporal
a detailed understanding of the _____________ dimension in the single occupational experience of a client helps us to deal best with attention span, activity choice, appropriate pace, planning, reflection, and the creation of healthy habits and routines
activity limitation
a difficulty at the personal level
tacit knowledge
a form of knowing without knowing how one knows; basis for knowing-in-action
evolution
a framework within which humans create a variety of occupational patterns that fit today's cultural template; supports insight into why human occupations occur the way they do
group
a gathering of 3 or more people joined together for a joint face-to-face purpose for a continuous period of time
flow
a good match of skill and challenge will make the client more likely to experience ______________
organization
a group of individuals who share a common goal or effort, which tend to bring the occupations of individuals to an interdependent pattern; people share a general intent, which brings their occupational patterns into a broadly orchestrated and somewhat synchronous arrangement within time, space, and relationships
occupational justice
a justice that recognizes occupational rights to inclusive participation in everyday occupations for all persons in society, regardless of age, ability, gender, social class, or other differences; access to and participation in the full range of meaningful and enriching occupations afforded to others, including opportunities for social inclusion and the resources to participate in occupations to satisfy personal, health, and societal needs
sleep
a mental function that entails physical and mental disengagement from the immediate environment, accompanied by changes in breathing, HR, and brain activity; does not involve the amount and how it affects participation in an activity
leisure
a nonobligatory activity that is intrinsically motivated and engaged in during discretionary time, that is time not committed to obligatory occupations such as work, self-care, or sleep
expert stage
a person who uses intuition to make clinical decisions; don't solve problems or make decision, but do "what normally works;" being one with what one does; groups intuitive experiences into larger chunks so that thinking recedes and acting and living become one; will not make mistakes as long as things unfold as usual; do not think but at according to instincts they cannot identify
sensory integration
a person's ability to use sensory input from within the body and from external stimuli
body image (ex: choosing clothing (when shopping, knowing what size to get) or activities to participate in)
a person's awareness of the physicality and image of his or her own body (parts and shape, height and weight, what they look like)
openness to experience (ex: traveling to another country; a child with SPD might not be open to experiencing certain sensory stimuli)
a personality trait that allows a person to be accepting of new experiences and activities
sensory diet
a personalized activity plan that addresses a person's sensory needs so that s/he can stay focused and organized throughout the day
embodiness
a physical knowing, rather than an abstract reasoning process through years of physical action/experience; interacting with the spaces and objects around our bodies without a need for us to conceptualize those actions; knowing how to perceive, move through, and interact with the world
impairment
a problem in body functions or structures
ethnographic study
a qualitative research design that explores cultural phenomena
remotivation therapy
a set of concrete questioning skills that you can use to "motivate" and "engage" clients in healthy behavior that is self rewarding and long lasting
context
a setting in which an event occurs; changing this changes the activity
validity
a test's ability to measure what it is supposed to measure
programmatic
a therapist in a traditional clinical setting can make ___________________ changes that enhance the effectiveness of intervention by considering policies and practices, such as involvement of significant others, multidisciplinary sessions, an analysis of the balance of power between service recipients and providers, less clinical and more natural furnishings for intervention spaces, or offering interventions at times more appropriate or convenient for clients
activities
a wide range of actions that a person takes to accomplish or perform something; chosen as intervention for its own characteristics to meet therapeutic goals
part-task training
adaptation that grades the complexity or difficulty of motor task; practice on some component of the whole task as pretraining for performance of the whole task
occupation-based activity analysis
an activity analysis based on a particular client and how he or she engages in the occupation in his or her contexts
productive dreaming
adapting a clinical setting to approximate a more natural client context; envisioning an ideal intervention to get ideas for smaller changes that maybe within your reach within a traditional setting; ability to envision ideally intact interventions
cognitive flexibility (ex: planning on seeing a movie and then eating dinner, but the earlier move time is sold out --> change plans to eat dinner first and then see the later movie; a child coloring planned on using crayons, but when there are no crayons, the child realizes they can instead use markers or colored pencils)
ability to change strategies in confronting a problem or change
quality of vision (ex: getting into shower and seeing where supplies are)
ability to detect light, contrast, and color among visual stimuli
hearing functions (ex: crossing the street when you hear an ambulance, not paying much attention to noises during the activity of washing hair, discriminating between a child screaming urgently as if something were wrong or screaming playfully)
ability to detect noise and discriminate sounds; aware of location and distance of sound
vestibular functions (ex: knowing you are sitting upright or leaning to side even with your eyes closed, picking up a ball from the ground and maintaining balance)
ability to determine position and maintain balance based on inner ear functions
vestibular discrimination (ex: yoga (also proprioception), dancing)
ability to determine the position of the body in space
proprioceptive functions (ex: holding a bat while playing baseball and knowing where the bat is positioned)
ability to determine where one's body parts are moving/in which direction by the sensory receptors in tendons, muscles, and joints
independence
ability to direct one's own care; self-directed state of being characterized by an individual's ability to participate in necessary and preferred occupations in a satisfying manner irrespective of the amount or kind of external assistance desired or required
auditory discrimination (ex: differentiating between the sound of a fridge running and rain hitting pavement outside, understanding an alerting noise such as a scream, differentiating between a fire alarm and a ringing phone)
ability to discriminate bw different sounds, tones, and pitches
tactile discrimination (ex: shampooing hair, typing, buttoning buttons, turning pages of a book, feeling for belt loops to put on belt and looking for an object in a bag (also stereognosis))
ability to distinguish different textures by touch and perceive the differences in textures, understand dimensions and physical characteristics of objects, and determine if something is smooth or rough by touching
sense of forced applied to skin (ex: knowing how tight the fit of pair of pants is, if a watch band is strapped on too tightly)
ability to feel pressure against the body
flow
ability to function effortlessly
stabilization (of in hand manipulation skills)
ability to hold objects with the ring and pinky fingers while moving an object with the thumb, index, and middle fingers
pain
ability to identify when potential or actual damage may be occurring in a part of the body and where due to signals from receptors
visual attention
ability to maintain visual fixation on a stimulus
translation (ex: moving coins from the palm to the fingertips to place in vending machine or picking them up and moving them from fingertips to palm)
ability to move objects from the fingertips to the palm or the palm to the fingers
impulse control (ex: resisting the urge to scratch an itch in a private area of the body while out in public, resisting to belch while eating a meal with others)
ability to not act upon spontaneous needs or feelings due to social demands; controlling actions/physical urges
visual discrimination (ex: reaching for an object, setting a book down on a table so that it is not hanging off the edge, going to the bathroom and identifying which object is the toilet, differentiating between toilet paper and a towel; knowing the differences between types of silverware when setting table)
ability to perceive and interpret visual information; ability to discriminate between two similar forms
touch functions (ex: getting dirty, awareness of holding a book and it touching skin, knowing that there is a bug on you, knowing piece of clothing such as an unbuttoned sleeve or strap needs to be adjusted)
ability to perceive contact with the skin or mucous membranes and to differentiate different textures
visual stability (ex: riding a bike)
ability to perceive objects or our environment as stable even though our eyes are moving rapidly
anticipatory awareness
ability to predict or accept that a deficit will inhibit success or cause a problem
emergent awareness
ability to recognize limitations or strengths while they are occurring
self-control (ex: responding appropriately to feedback about performance, whether it be criticism or praise)
ability to resist the internal urges to do or say things; modifying behavior in response to environmental needs, demands, and constraints; controlling emotions/emotional reactions
thermal awareness (ex: feeling the temperature of bath water before stepping into it, placing gloves on hands when you sense it is very cold outside, determining if what we are eating is hot or cold, knowing that the sand on the beach is too hot to step on barefoot)
ability to sense heat and cold
smell functions (ex: being alerted of a situation that requires action, such as bad body odor or the smell of smoke)
ability to sense odors and smells in the environment
stamina
ability to sustain prolonged physical or mental effort
simple rotation
ability to turn an object around in the pads of the fingers and thumb
the occupation is viewed from the client's perspective the occupation occurs within relevant contexts
according to the research discussed, what are the 2 conditions required for using occupation in practice?
occupation awareness
acknowledging that some activities may be classified into several different areas of occupation based on how the client defines them
values
acquired beliefs and commitments, derived from culture, about what is good, right, and important to do
body scheme
acquiring an internal awareness of the body and the relationship of body parts to each other
learning
acquiring new concepts and behaviors; encompasses the skill areas of copying and rehearsing
occupational performance
act of doing and accomplishing a selected action (performance skill), activity, or occupation that results from the dynamic transaction among the client, the context, and the activity; improving or enabling skills and patterns leads to engagement in occupations or activities
occupational performance
act of doing and accomplishing a selected action, activity, or occupation that results from the dynamic transaction among the client, the context, and the activity; interaction of PEO; what OTs strive to improve
required actions and performance skills
actions required by the client that are an inherent part of the activity
progressive challenges
activities are graded simple to complex and short term to long term
education
activities needed for learning and participating in the educational environment
rest and sleep
activities related to obtaining restorative rest and sleep that supports healthy, active engagement in other occupations
activities of daily living (ADL)
activities that are oriented toward taking care of one's own body; the basic self-care skills required for daily living; fundamental to living in a social world; enable basic survival and well-being; often part of our routines
occupations
activities that are personally meaningful to the person who voluntarily engages in them out of personal choice or sociocultural necessity; unique to everyone, providing personal satisfaction and fulfillment as a result of engaging in them
occupations
activities that are personally meaningful to the person who voluntarily engages in them out of personal choice or sociocultural necessity; valued by the client
simulated (enabling) activities
activities that imitate real activities; provide opportunities for the client to practice motor, cognitive, or psychosocial skills; frequently involve practice and repetition
simulated activities
activities that provide clients with the opportunity to practice skills (not occupation based)
instrumental activities of daily living (IADL)
activities to support daily life within the home and community that often require more complex interactions than self-care; essential to living independently; not necessarily done by client (includes overseeing that the activities are completed and delegated to the appropriate people)
etic
activity is: emic/etic?
ergonomics
adapting a person's work environment to promote functioning; the scientific discipline that deals with the worker; the tools, equipment, and machines that the worker uses; and the environment in which the worker interacts and operates; concerned with the understanding of the interactions among humans and other elements of a system, and the profession that applies theoretical principles, data, and methods to design in order to optimize human well-being and overall system performance
component-focused practice (medical model approach)
addresses the problems of clients through intervention in a very specific area of functioning judged to be the primary barrier to a more desirable occupational pattern; the more traditional and most frequently used approach in OT; often considered to be nearly the opposite of client-centered and occupation-based practice; assumes the therapist can independently identify key limiting skill areas as well as important functional patterns to which the client should return; often described as the medical model approach; reduces the whole of the individual to components that can be separately addressed; "reductionistic;" excellence is demonstrated in the therapist's medical knowledge and intervention expertise regarding specific components
employment seeking and acquisition
advocating for oneself; completing, submitting, and reviewing appropriate application materials, preparing for interviews; participating in interviews and following up afterward; discussing job benefits, and finalizing negotiations
interactional reasoning
all of the ways in which a practitioner decides how to communicate with and listen to a client; an instinct for knowing how to speak with a client; allows practitioner to provide encouragement and motivation in a positive manner; ex, during eval the dialogue between practitioner and client is part of the intervention, and the way in which a practitioner interacts with a client can determine the efficacy of the entire course of intervention
BADLs
all the tasks a person must engage in or accomplish for personal care and self-maintenance
partial weight bearing (PWB)
allowed to put part of weight on operated leg, usually up to 50%
mental rest
allowing little to no mental processing of information or problem solving
physical rest
allowing muscle tension to reduce and the number of muscle contractions to decrease
olfactory discrimination (ex: being alerted by something that is burning, if something is rotten, if a baby needs their diaper changed)
allows for distinguishing differences in smells
digestive system (ex: eating/digesting)
allows for transportation of food or liquids through the body to be absorbed and broken down
metabolic system (ex: swimming)
allows our bodies to utilize food and convert it to energy, including breakdown and utilization of carbs, proteins, and fats
fluency (speech) (ex: calling 911 to efficiently convey an urgent message)
allows us to speak one word after another fluidly and smoothy
safety
although client preferences should strongly influence the priorities for intervention, what is more important than client preference at certain times?
play is a vital aspect of child development, while leisure is not related to human development in children or adults leisure is nonobligatory, which means it is not an activity that addresses other needs in life -- it is pursued simply for enjoyment or to meet other intrinsic needs
although how play is different from leisure is a topic of debate, name one vital difference between the two
care of pets
arranging, supervising, or providing the care for pets and service animals; different for each person depending on the animal, but at the very least includes providing food, water, safe shelter, and care of health needs; includes finding and supervising the care of if the primary owner is not available
effectiveness
as dementia progresses, the ___________________ of the strategies will change; be creative and sensitive to a person's specific needs
needs and abilities expectations and outcomes
as the OT, you have to match the client's current ______________ and _______________ with the _____________ and ______________
evaluation
asking culturally relevant questions are included in which step of the OT process?
spatial sense
aspect of physical body which encompasses our vision
spatial environment
aspect of spatial context including size, lighting, noise, safety factors, object affordances, and opportunities to negotiate space
body
aspect of spatial context; its perceptions and abilities are a basis of occupation-based intervention; embodiment of client's experience includes vision, the hand's interface with the physical world, awareness of social stigma due to physical differences, and the variety of activities in which the client engage to care for this
how the action should be completed
aspect of statement of step that describes the way the action is performed; descriptors placed at beginning of statement, at the end, or in both places
activity demands
aspects of an activity needed to carry out a particular activity; includes sequencing and timing, objects and properties, space demands, social demands, required actions and performance skills, required body functions, required body structures
temporal aspects
aspects of performance contexts that include chronological age, developmental age, place in life cycle, and health/disability status
environmental aspect
aspects of performance contexts that include physical, social, and cultural considerations
OT driving specialist
assesses fitness to drive and provide interventions to help patients get back behind wheel; can make recommendations to take away a person's license; designation provided through AOTA
shifting attention (ex: doing homework, looking up and seeing a dog and shifting attention towards the dog, and then returning to completing homework)
attending to one task for limited amounts of time and refocusing concentration from one stimulus to another
symbolic meaning
attribution of significance or representative or figurative association with an activity
personal care
caregiving that includes such tasks as assistance with bathing, grooming, dressing, and feeding
tactile sensation
can be provided through textures of foods, activity materials, objects with which the client comes into direct skin contact during activities, or therapist-provided brushing or massage
yes, unless: -inattentive to the task of driving (preoccupation, hallucinations, or delusions) -contemplation of suicide -excessive aggressiveness or disregard for the safety of self or others (or both)
can someone diagnosed with a mental illness drive? (3)
medical care
care that includes the daily activities that assist a person in meeting medical needs, such as wound care or medication administration
areas of occupation
categories defined by OTPF listing human activities that make up people's lives
process commentary
central therapeutic intervention that involves the giving of immediate feedback to the group on its current process; helps group members develop better insight and understanding of manifest behaviors; benefits of this type of unspoken communication include immediate feedback, gain understanding; but can cause resistance
heterogenous group composition
certain identified qualities of the group members are substantially different
homogenous group composition
certain relevant qualities of the group members are the same or very similar
occupational performance
changes in the person, environment, and/or occupation can influence __________________
activity synthesis
changing or modifying a specific activity so that person can engage in it successfully
introversion
characteristic of a person who is more focused on the self and internal thoughts and feelings versus those of others
extroversion
characteristic of a person who is very outgoing and readily engages with others
emotional stability (ex: in order to lead a relaxation group, the leader must demonstrate the ability to relax and must have a calm demeanor)
characteristic of a personality and temperament that is even-tempered, calm, and composed
noninvolvment
characterized by a lack of responsiveness to a child's needs; parents make few to no demands of their children and they are often indifferent, dismissive, or even completely neglectful
taste functions (ex: tasting food and determining it has spoiled, determine differences in ingredients)
chemicals reaching taste buds are broken into signals representing bitterness, sourness, saltiness, and sweetness
weight bearing as tolerated
client may put as much weight as client can tolerate on operated leg
occupation-based intervention
client-directed daily life activities that match and support or address identified participation goals within the client's natural context
meaning
clinicians should listen for ______________ during a narrative when using narrative reasoning
beliefs
cognitive content held as true to the client
something other than their illness; QoL
cognitive remotivation provides the opportunity for the individual to focus on ______________________________ to enhance _____________________
appeal, intactness
combining high __________________ (ex, high productivity) with high ___________________ (ex, actual workplace context) will produce much more powerful interventions than would have been possible in a clinical setting less natural to the life and goals of the client
decline in physical and mental health
common to many retirees, adjusting to the absence of the worker role can cause __________
standard setter (group building role)
communicates standards for performance in the group
interactional reasoning
communicating with and listening to your client; personal meaning of illness impacts commitment to therapy; understanding the lived experience of your client; "humanizes" the data that you identified through procedural reasoning; increase awareness and understanding of where client is coming from
executive functions (ex: planning a birthday party or wedding --> might also use concept formation?)
complex goal-directed behaviors (e.g. decision-making, abstract thinking, planning, mental flexibility, and action appropriateness)
decision making
complex process of reasoning and reflection; practitioner reasons about occupations and their related activities to make decisions about what course of intervention to pursue with a specific client
intervention plan
component of intervention that considers all findings from profile, assessments tools, etc.; the plan that will guide actions taken and that is developed in collaboration with the client; based on selected theories, FORs, and evidence; outcomes to be targeted are confirmed
praxis (ex: movements for brushing teeth (also LTM); purposeful movement)
conceiving and planning a motor act in response to an environmental demand; includes motor planning and sequencing, ideation, execution, and feedback and adaptation; primarily novel tasks
dynamic systems theory/perspective
concept that outcome of practice is influenced by the interaction of task, environment, and characteristics of the client
pluralistic
concepts such as clinical reasoning and reflective practice are not always defined the same and the ideas behind them are not necessarily uniform, inherently making them (pluralistic/holistic/monistic)
conditional reasoning
connection from meaning to action; synthesis of all the other forms of reasoning; ongoing revision of therapy, contingent on the client's response; glimpse into the client's world (current and future contexts)
muscle weakness balance and mobility deficits deconditioning social isolation depression anxiety self-imposed activity disengagement
consequences of FOF? (7)
adapt; occupations
considering the spatial dimensions of physical embodiedness, environmental qualities, and social meanings of space will enable a therapist to ______________ an occupation, specific to the spatial demands of an individual, to better assist that person in engaging in valued ______________
pragmatic reasoning
considers the contextual issues affecting the patient now and in the future, the practitioner's personal context, and the practice environment's culture; recognizes the integration of environmental and personal factors, as well as embraces the phenomenology of the practitioner, the input of the treatment team, and the political-economic factors of present-day health care
intervention planning
considers the performance areas that are of interest to the individual and the performance components within the individual's strengths and concerns; also considers performance contexts to determine the relevance of intervention
intuition
consists of a holistic understanding in which response to patterns occurs without having them deconstructed into component parts; it is knowing the right thing to do without thinking about why it is the right thing to do
moral contract with other professionals
contract to provide intervention in a biomedical way, rather than in terms of function, QoL, or re-engagement in lost occupations; to primarily address component-level problems; nurses, physicians, teachers, administrators, etc.
moral contract with employers
contract to provide intervention that meets a certain standard of quality in as profitable a way as possible
moral contracts with the profession and personal professional identity
contract to provide quality care that reflects the unique contributions to the client service that distinguish OT from other professions
bilateral integration (example depends on type of bilateral integration, but some include knitting or tying shoelaces)
coordinating both body sides during an activity; occurs when both sides of the body, arms, or legs, are used collaboratively to complete a task
oral-motor control
coordinating oropharyngeal musculature for controlled movements
visual-motor integration
coordinating the interaction of information from the eyes with body movement during activity
eye-foot coordination (ex: kicking a ball, pushing the brake in a car)
coordinating what is visually seen with what the lower extremities are doing
binocularity (ex: reaching for a cup)
coordination of the movement of the two eyes in exactly the same way in order to maintain view of an object
preparatory activities
create a state of optimal readiness for practice of a motor activity
rituals
cultural ______________ can be used to frame compelling interventions
-positive outcomes for the client -professional satisfaction for the OT -decrease health disparity
cultural competence is an ethical responsibility because it leads to...? (3)
health care beliefs, decisions, and behaviors interventions
cultural competency involves understanding how one's cultural identity influences...? (2)
cultural environment
customs, beliefs, activity patterns, behavior standards, and expectations accepted by the society of which the individual is a member
respiratory rhythm (ex: long-distance running, swimming, singing, delivering a speech, eating)
cycle of inspiration and expiration
egocentric-cooperative group
developmental group; members jointly decide on long-term activity and carry it through until completion
project group
developmental group; short-term task cooperatively or competitively
level of arousal
demonstrating alertness and responsiveness to environmental stimuli
coordinator (task role)
organizes info, clarifies relationships between various ideas
ethical reasoning
deals with values relative to human conduct, with respect to the rightness of wrongness of certain actions, and the goodness or badness of the motives, means, and ends of such actions; decisions practitioners make about what they do must be reasoned about in terms of whether they are the right things to do; ex, the mechanics of managed care and caps on reimbursement are often in conflict with both the needs of the client and desire of practitioner, and the practitioner must make the right (moral) decisions
visual reception
decoding stimuli through the eyes, including peripheral vision, acquity, and awareness of color and pattern
the client
defining which area of occupation is being analyzed requires the practitioner to gather information about how ___________________ defines the occupation
strength (ex: walking up a steep hill requires more strength than walking on a flat surface, consider how weakness could affect engaging in basic self-care skills involving a certain motion; pushing the body up in a wheelchair)
demonstrating a degree of muscle power when movement is resisted, as with objects of gravity; the force with which a body part must move or hold an object; muscle's ability to actively contract and create a force to respond to resistance (pulling, pushing, lifting, etc.); may be impaired by tone
muscle tone (ex: bringing a spoon to mouth, bending down to tie shoelaces, drinking from a cup; requires normal tone to allow for smooth movements, high tone in antagonist muscle might make it more difficult for agonist muscles to contract)
demonstrating a degree of tension or resistance in a muscle at rest and in response to a stretch; natural tension that is present in muscles when at rest; creates resistance when a body part is moved passively
health management and maintenance
developing, managing, and maintaining routines for health and wellness promotion, such as physical fitness, nutrition, decreasing health risk behaviors, and medication routines; includes observing and conducting any medical needs, taking vitamins or medications, and applying topical medications; varies from person to person
contrived activity in a clinical environment --> simulated activity in a clinical environment --> simulated activity in a real environment --> real activity in a simulated environment --> real activity in a real environment
describe the continuum involving activities and treatment environments involved in the process in which a client is reintegrated into his or her environment (5)
sorting coins to increase fine motor in a therapy gym --> practice buttoning, zippering, snaps, clasps, etc. in a therapy gym --> practice bed mobility in the client's hospital room practice laundry in easy street practice laundry/bed mobility in the client's home
describe the continuum involving activities and treatment environments involved in the process in which a client is reintegrated into his or her environment using the example of laundry, bed mobility, and fine motor skills (continuum includes: contrived activity in a clinical environment --> simulated activity in a clinical environment --> simulated activity in a real environment --> real activity in a simulated environment --> real activity in a real environment)
proficient uses intuition expert uses intuition and reflects in action
describe the difference between being a proficient therapist and an expert therapist?
-get the client involved by giving them responsibilities and a purpose -shared responsibility between staff and clients to take care of the concepts built into the floor (e.g., dog, cat, bird, garden) -replace furniture to be more home-like -opportunity to give as well as receive care (antidote to helplessness) -provide variety and spontaneity by creating an environment in which unexpected and unpredictable interactions and happenings (antidote to boredom) -place the maximum possible decision-making authority into the hands of the elders or those closest to them
describe the eden alternative (how it works)/some of its principles
-improve the well being of elders and those who care for them -transform the communities in which they live and work -eliminate loneliness, helplessness, and boredom
describe the mission and vision of the eden alternative
occupational profile --> assessment of occupational needs, problems, concerns --> analysis of occupational performance
describe the overview of client-centered practice regarding the evaluation (the order in which the eval is completed)? (3)
novice advanced beginner competence proficient expert
describe the progression of professional growth (5)
pragmatic and ethical encompass the entire clinical reasoning practice narrative reasoning (obtained from the client) guides procedural, conditional and interactional reasoning conditional, procedural, and interactional work together to enable the OT to help the client reach their goals and plan effective interventions
describe the relation of the types of reasoning to each other (the dog picture)
role acquisitions --> role enactment --> role disengagement
describe the shifting of the OT's roles during transitions (3)
orthotic device
designed to control or correct a bony deformity or lack of strength or control of a part of the body, such as a splint; help support, control or correct
evaluation measures
designed to measure change over time within individuals often in order to evaluate treatment effects or indicate a change in client status
custom
designing for appeal is always a _________________ design, specific to the individual for which the intervention is being created, using the client's activity preferences, current and past occupational patterns, and present energy level and life challenges combined with his or her goals (so that it will be appealing and therapeutic, with just the right blend of productivity, pleasure, and restoration)
proprioceptive discrimination (ex: playing tennis)
detecting muscle lengthening and shortening and how fast and in which direction of a limb or body part is moving
outcomes
determinants of success in reaching the desired end result of the occupational therapy process; used to plan future actions with the client and to evaluate the service program
task-related parameters
determine the actual goal of the task that is practiced, the content of the practice, the rules for performance, and any implements used during practice
screening
determines whether further evaluation is necessary
retirement preparation and adjustment
determining aptitudes, developing interest and skills, and selecting appropriate avocational pursuits, and adjusting lifestyle in the absence of the worker role
volunteer exploration
determining community causes, organizations, or opportunities for unpaid work in relationship to personal skills, interest, location, and time available
topographical orientation (ex: knowing how to walk to the bathroom from your desk)
determining the location of objects and settings and the route to the location
spatial relations (ex: taking an object apart and putting it back together, estimating size of something, orientation of shapes, sizes, or designs)
determining the position of objects relative to one another and to one's self; the correct direction of forms
depth perception (ex: approaching a stop sign while driving; reaching distances to acquire objects)
determining the relative distance bw objects, figures, or landmarks and the observer and changes in planes and surfaces
position in space (ex: determining front, back, top, bottom, beside, behind, under or over; relationship between action and body; knowing where a pencil is on the table relative to the person reaching to grab it)
determining the spatial relationship of figures and objects to the self and other forms and objects; ability to perceive an object's position relative to oneself and the direction in which it is turned
cooperative group
developmental group; individuals have common interests, concerns, and values, and activity is of little importance
perceptual processing
organizing sensory input into meaningful patterns
mature group
developmental group; members are from different backgrounds, ages, interests, and ideas; take on roles for task development and group member satisfaction; members take on a variety of roles and a balance exists between the activity and member satisfaction; OT functions simply as a group member and provides mutual reinforcement of appropriate behavior within the group
heart rate/rhythm (ex: taking an exam, meeting someone you're attracted to)
how often the heart contracts is based on the need for blood and oxygen to areas of the body; challenged during activities that require a great amount of movement/varies amounts where it fluctuates
open with the right hand close with the left
how should a client open/close a screw top jar in order to prevent ulnar deformity?
-put the operated leg into the pant leg (on the floor) -put the non-operated leg into the other pant leg using a reacher or dressing stick -avoid bending forward and crossing legs -keep your back touching the back of the chair
how should a client with hip fracture put on pants? (4)
-identify several activities you think will appeal and then ask client to choose -be clear that of the activities you suggest, any choice is equally good, all of them will work, and choice is just a matter of personal preference -the one that is chosen has the most personal appeal
how is giving choices effective in strengthening occupational appeal for activities for the client? (3 steps)
moves at a different rate for everyone (can use this to make treatment move more slowly or quickly)
how is time subjective?
narrative reasoning
guides procedural, interactional, and conditional reasoning; helps with understanding how we think the client views health and wellness; considers what activities or roles are possible given the disability
while sleeping or lying in bed, keep a pillow between your legs to prevent hip dislocation (can also be done on side, just put pillows between legs)
how may a client with hip fracture sleep to prevent hip dislocation?
material culture
hallmark of human adaptation; using objects in treatment to restore or improve a person's occupational nature and capacities; offers everyday objects for use in the intervention (spaces dedicated to that activity, highly symbolic objects, spatial routines to which client is accustomed, activities focused on manipulations of particular objects); the raw materials of occupation and occupational therapy
hypertonicity
increased muscle tone
recognition seeker (individual role)
frequently acts in ways that draw attention to himself or herself
blocker (individual role)
frequently raises negative objections, opposition, or obstacles to group movement or group efforts
arguer (individual role)
frequently takes an opposing viewpoint for the purpose of disagreement to continue group discussion; may plead special interests or causes
joint stability (ex: carrying a heavy bag; if a dog pulls on leash while walking, you're arm won't fall out of its socket due to joint stability)
function of the joint's structural integrity to keep bones in proper alignment and maintenance of structural integrity
voice functions (ex: delivering a speech versus whispering to someone next to you)
functions that produce noise by sending air through the larynx
occupational profile
gaining an understanding of a client's interests, values, needs, occupational history, and priorities of outcomes is called...?
modifications to everyday client setting
general mode in the therapeutic use of context in which the therapist suggests changes in the client's usual settings to support his/her desired occupational patterns
new setting
general mode in therapeutic use of context that is a _______________________ might be a naturally occurring setting in the community that offers a specific challenge or a setting specifically designed to provide particular therapeutic activities
shopping provides items needed for survival (IADL) but is also a form of leisure and enjoyment for many people
give an example of how an occupation can fall into two different areas of occupation based on the client who is performing it
simulation
gives the appearance of being real but is not real
compromiser (group building role)
gives up a position or power to help resolve group conflict
reverse sequencing
going from forward to backward and vice versa
spoken and unspoken
group communication can be __________ and _________
open group
group in which anyone can join; allows new members to join throughout the group's lifespan
closed group
group in which membership is restricted to selected individuals; set membership and do not allow any new members to join
microcosm
groups are a ______________ of society in commonality and expectancy
individual
groups can often do the work that ________________ therapy cannot do
experiences thoughts ideas feelings problems
groups encourage sharing... (5)
naturally occurring groups
groups formed for a particular purpose unique to their environmental context and that function accordingly
skills behaviors
groups provide a comfortable environment to learn new ______________ and _______________
visual tracking
the ability to maintain fixation on a moving object through slow, smooth movements of the eyes
intentionality habits symbolic meaning (objects and words)
how do you make the connection from meaning to action, as in conditional reasoning? (3)
unstructured play --> structured play --> adolescent peer groups and peer cultures --> period of transforming leisure interests and creating relationships
how does leisure apply across the lifespan? (from infancy --> young adulthood; describe the progression of leisure across the lifespan)
-fulfill need to be altruistic through leisure (in ways that most work occupations do not meet) -help others and in doing so have self-gratifying feelings -increased civic and social involvement in later life
how does leisure cultivate social consciousness, altruism, and service? (3)
excessive media/internet usage can lead to depression, obesity, and addiction
how does technology affect leisure?
-access to environments (rural versus urban), materials, and equipment -financial resources -transportation means (or lack of)
how does the environment affect leisure participation? (3)
quality of life
health is judged in OT by ________________ a person finds in his or her patterns of occupation
leisure
helping clients to develop a rich and personally meaningful _______________ life may facilitate their achievement of all other goals of intervention that our society values more than ________________ (same answer)
point of grasp
hold object closest to the heaviest point; ex: hold a tray with an open palm under the center of the tray while grasping the side with other
-fosters enthusiasm for living and affirmation of the self -people get to know themselves more deeply and gain an awareness of what they value and appreciate
how are leisure occupations important in self-development?
-engaging in certain occupations and not others -express who we are to others -conform to expectations for our actions or choose not to conform
how are occupation and identity related? (3)
emphasize feelings of doing the right thing, craftsmanship (quality of materials and quality of production process), and pride in a product (supported through showing the product in a display case, at an open house or a benefit event, or by making a special effort to get the product out to show people)
how can a therapist use the protestant work ethic to create appealing therapy for someone who values productivity?
schedules and calendars
how can an OT help improve time management?
explore different options for future productivity (new type of employment, caring for a family, volunteering, household work, study; emphasize value of work even when a paycheck is not involved)
how can an OT help individuals who face unplanned retirement or inability to return to previous work?
maximize client participation
how can we justify working with the family of a client when the client is the person receiving occupational therapy services?
centrality of family unit (or lack of) values of productivity/usefulness gender and age (some cultures delineate appropriate activities by age, gender, or marital status) race
how do family and cultural factors affect leisure participation? (5)
-activities that help people develop, maintain, or strengthen relationships with others are most often leisure occupations -people sustain friendships with others with whom they have shared positive experiences that they associate with leisure -can provide a sense of belonging and identity across one's life -family leisure activities facilitate family communication
how do leisure activities satisfy a need for belonging and social engagement? (4)
provide opportunities for people to learn more about themselves, to explore their interests, and to develop skills in the activities that bring them pleasure without concern for their usefulness to others
how do leisure occupations promote cognitive, emotional, and physical invigoration?
-draw pleasure into the experience through the deep resonance the ritual holds for the individual (i.e., different types of seasonal, cultural celebrations, such as creating and displaying holiday decor, fixing or eating special holiday foods, or making holiday gifts; be care not to assume that the meanings traditions have for you are the same as those they hold for your client
how do meaningful rituals use pleasure in designing appeal for intervention?
people may choose to engage in leisure occupations that are completely opposite of how they spend their time outside of leisure (usually work) or it will be related to how they spend their time
how do people choose leisure occupations?
introverted v extraverted physical stamina temperament cognitive skill level
how do personal traits affect leisure participation? (4)
-ask broad --> specific questions -last question leads into the poem, which is objective in nature and can be read by the group members -use visual and audio aids to augment the group experience (linear questions or bounce questions)
how do you complete the 2nd step of cognitive remotivation, bridge to the real world? (3)
time cost policy
what are some common challenges to using standardized assessment tools at the organizational level?
the person's reaction time, the difference between how they drive now and how they drove when they were first learning, etc.
how might a person's unique "embodiness" affect a person's experience with driving?
re-evaluate the intervention plan for appropriateness modify plan continue, discontinue or refer client for additional services
if progress is not as expected or health status changes...? (3)
-remove the non-operated leg from the pant leg -remove the operated leg from the other pant leg using a reacher or dressing stick -avoid bending forward and crossing legs -keep back touching the back of chair
how should a client with hip fracture remove pants? (4)
-sit in a raised seat or on a raised toilet seat/commode with armrests -reach back for the armrests of the chair with both hands -bring the operated leg forward and slowly lower into the chair
how should a client with hip fracture sit? (the steps for sitting, 3)
-move the walker first -move the operated leg forward -push down on your hands when you step forward with your non-operated leg -do not turn/pivot operated leg; instead pick up feel and turn using several small steps -land on your heel and push off your toes when walking
how should a client with hip fracture use a walker to begin walking? (5)
-interpret data collected during initial and ongoing evaluation process (determine significance of body functions impact on desired occupations and relate to function) -use clinical reasoning -develop goals -choose service delivery model (direct, consult, monitor)
how should an OT develop an intervention plan?
-special equipment -platforms -take a client to the park and see if they can use it -signage
how would you (as an OT) know if a park/playground is accessible? (4)
hyperesthesia
hypersensitivity; finds some sensations noxious
occupation-based practice
identify the practice approach: excellence is defined as the degree to which occupation is used with reflective insight into how it is experienced by the individual, how it is used in natural contexts for that individual, and how much the resulting changes in the occupational patterns are valued by the client
evidence-based practice
identify the practice approach: excellence is defined by the degree to which published evidence is used in making decisions regarding service provision
client-centered practice
identify the practice approach: excellence is defined by the degree to which the goals for intervention are set by the client
component-focused practice
identify the practice approach: excellence is defined by the therapist's medical knowledge and intervention expertise regarding specific components addressed
coping skills
identifying and managing stress and related factors
employment interests and pursuits
identifying and selecting work opportunities based on personal assets, limitation, likes, and dislikes relative to work; can occur through deliberate investigation by taking competency and job matching assessments or job counselling; also occurs by finding out about a career spontaneously or by chance
play exploration
identifying appropriate play activities, which can include exploration play, practice play, pretend play, games with rules, constructive play, and symbolic play; investigating and choosing play activities
recognition
identifying familiar faces, objects, and other previously presented materials
visual closure (ex: you can figure out what a road sign says, even when the writing is partly hidden by graffiti, make sense of words on a smudged page, recognize an object even when you can only see part of it, find a missing item when it is partly hidden; seeing dog hiding under bed with its tail sticking out from underneath)
identifying forms or objects from incomplete presentations
values
identifying ideas or beliefs that are important to self and others
leisure exploration
identifying interests, skills, opportunities, and appropriate leisure activities; process of finding activities to meet intrinsic needs and that are not obligatory with regard to other aspects of living; seeking out a match of a person's interests, intrinsic needs, and abilities to leisure opportunities
stereognosis (ex: reaching into a pocket to find a coin)
identifying objects through proprioception, cognition, and the sense of touch (without vision)
categorization (ex: grouping a hand of cards based on numbers while playing a game of go fish, or in uno based on colors and numbers)
identifying similarities and differences among pieces of environmental info
kinesthesia
identifying the excursion and direction of joint movement
informal personal educational needs or exploration of interests (beyond formal education)
identifying topics and methods for obtaining topic-related information or skills
role performance
identifying, maintaining, and balancing functions one assumes or acquires in society
occupation-based activity analysis
individualized analysis of activity; looks at an activity that has meaning and contextual influences on a particular individual
stress (be sure goals set with client are not unrealistically high) (can cause clients to withdraw from intervention or abandon useful goals; can lower immunity)
if you are using high productivity to design appealing occupations for intervention, what might productivity result in if taken too far?
conditional statements
if/then statements created when sequencing an activity and the outcome of an action or an environmental situation has implications on the next action taken
copying
imitating or mimicking as a basic component of learning
casual leisure
immediately, intrinsically rewarding, relatively short-lived pleasurable activity requiring little or no special training to enjoy it
education
imparting of knowledge and information about occupation, health, well-being, and participation that enables the client to acquire helpful behaviors, habits, and routines that may/may not require application at the time of the intervention session; sharing knowledge, does not result in actual performance of an occupation
playfulness
important aspect of child's play that exists when a child is intrinsically motivated, internally controlled, and able to suspend reality
quality of life; adjustment
in addition to being essential for people's ______________, leisure participation is a powerful tool in supporting _____________ to an acquired disability (finding ways to participate in what were favored leisure activities before their disability may support the recovery and rehabilitation process beyond leisure participation)
work-focused evaluation
in addition to the typical assessment methods, the OT focuses on the worker's capacity to meet the unique demands of the job, and may need to conduct a thorough job site analysis to determine the demands of the job
client desired outcomes
in client centered practice, continually assess effectiveness of the intervention and the progress towards the __________________
means, ends
in client centered practice, plan and implement interventions using a variety of approaches and methods in which occupation is both the __________ and the ________
common culture
in conducting an activity analysis of an activity as it is typically done, you will need to determine the social demands within the ________________ of the activity
needs of the client (what would work best for the client)
in considering how the spatial, temporal, and sociocultural context may/may not support intervention, the ______________________ must supersede all other arguments
say; do; recap
in cross-cultural communication, it is important to __________ what you are going to do, _____ it, and then ________ what you did
occupation
in effective OT, you can always go back to your core knowledge of _______________ as a place to begin, refocus, assess, or bring closure to intervention, regardless of cultural difference
tender points
in fibromyalgia, places on the neck, shoulders, back, hips, arms, or legs that hurt when touched
body structures and body functions (by improving these, performance of self-care activities improves) (the relation of body structure/function to occupational performance, specifically its relationship to self-care, should be discussed so the client participates more fully in activities and occupations)
in many instances, at what level does it make the most sense to start intervention?
disability/illness/or injury to the client
in narrative reasoning, the focus shifts from ______________ to _____________
spatial perception
in occupational environment, understanding the world occupationally; knowing what to do in a bathroom versus a kitchen, for example
sundowning
in older adults, around late afternoon, become very confused and restless
within a real, nonartificial, and familiar context
in what type of context should the occupation being used/targeted as an outcome be experienced for the client?
-client may want to immediately discuss goals of intervention of indicate through statement a willingness to work hard toward goals -work ethic evident in that the client will not want to do things that do not produce objects or engage in activities that seem frivolous -sense a pride in, or conflict around, work identity
in what ways might a client indicate values of productivity in occupational experiences (and will thus work best with therapeutic occupations high in productivity; i.e., design interventions with productivity)? (3)
personal hygiene/grooming (NOT bathing/showering)
in which subcategory of ADL is washing and drying hair included?
distractibility
inability to focus one's attention
performance areas
include activities that the occupational therapy practitioner emphasizes when determining functional abilities; broad categories of human activity that are typically part of daily life
mediums
include liquids, solids, and gases; offers special characteristics in terms of breathing, locomotion, transmission of light and sound, chemical diffusion, and gravity
natural (intact) intervention contexts
include the places, times, and sociocultural conditions in which clients would usually undertake the activity being used as treatment
time elements
included in writing the steps of an activity if the timing of certain steps or the length of an action is essential to the task; also includes repetitions
work
includes activities needed for engaging in paid employment or volunteer activities; involves employment interests and pursuits, employment seeking and acquisition, and job performance
dynavox-augmentative and alternative communication (AAC)
includes any strategy used to express thoughts, needs, wants, and ideas; individuals with communication challenges use this to supplement their existing speech that is not functional; ex: sign language, picture communication boards, voice output communication devices
household care
includes assistance with daily tasks such as cooking and cleaning
temporal context
includes biotemporal rhythms; sociotemporal calendars, schedules, and values; subjective construction of an occupation and its rhythm and speed; orchestration of occupational experiences through memory, temporal horizon, routines, and narratives; and typical human and lifespan patterns in occupation
sociocultural context
includes concepts such as the differences in viewing an occupation from the emic (subjective) and etic (cultural) perspectives; personal identity; continuum of solitary, shared, and co-occupations; relationships and organizations; the culture within which the individual is acting and its rituals and traditions; communicating effectively with persons of diverse backgrounds; gender differences; and the unique cultures of medicine, rehab, the disability rights movement, and OT
parenting
includes familiar activities of daily living and the development of performance patterns that incorporate the addition of a child into the family's daily life
occupational profile
includes info about the client's needs, problems, and concerns about performance in occupations
emotional care
includes providing support by spending time with, talking to, or praying with the care receiver
care of others
includes selecting and supervising caregivers; arranging, supervising, and providing the care for other; includes caring for adult family member, spouse, or friend outside of a work setting; can include providing assistance with any self-care activity
reproductive system (ex: sexual activity, self-care activities)
includes sexual functions, menstruation, procreation, and sensations associated with genital and reproductive functions
home based care
includes specialized in-home services in addition to education of the caregiver and family to maximize QoL for all and to decrease caregiver and care receiver stress
-with the ability to perform reasoning about occupation, occupational therapy practitioners should be able to solve treatment problems that exist outside of their experience or training -and learn how to think about a profession, which improves the ability to engage meaningfully in that profession
including clinical reasoning and reflective practice in professional standards and direct experience is based on what premise?
respiratory rate (ex: sleep)
increased breaths to meet oxygen demands from increased movements
rheumatoid arthritis
inflammatory type of arthritis that causes the immune system to attack parts of the body, especially the joints that leads to inflammation, which can cause severe joint damage; can affect organs of the body (heart, muscles, blood vessels, NS, and eyes)
primary impairments
limitations directly resulting from the pathology associated with the disorder
secondary impairments
limitations that develop over time
contrived simulated real
list 3 types of activities
clinical (structured) real (natural) simulated (structured)
list 3 types of treatment environments and whether they are structured or natural
-occupational performance -adaptation -health and wellness -participation -prevention -self-advocacy -quality of life -role competence -occupational justice
list outcomes (9)
-ethnicity/race -SES -educational status -language -values/beliefs related to healthcare and illness -religion -healthcare delivery systems -cultural identity of others
list some influences that shape culture identity? (8)
develop activity-related goals and objectives (collaborate with family and intervention team) plan activity-focused interventions (opportunities for practice of functional actions adapted to meet individual learning strengths and needs of client) integrate impairment-focused interventions (reduce secondary impairments)
list the 3 steps for planning motor interventions according to the article "Activity-focused Motor Interventions..."
procedural interactional conditional narrative pragmatic ethical
list the types of reasoning in practice
empathy
listening to others with the third ear, which is attuned to the feelings of others and the meaning of the feelings for others so that the leader can describe what it is like to be in the situation of another group member
flaccidity
low muscle tone
-use a sharp knife to lower the risk of the blade slipping -wear shoes to protect feet from falling sharp objects -don't wear sleeves that could accidentally catch on fire -never preheat the oven to prevent burning your arms when you go to open it
low vision cooking tips? (4)
contrived activities
made up activities that are done in relation to the client's occupational goal
thought control and content (ex: writing a shopping list, thinking about the topic during a lecture)
maintaining a stream of thoughts that appropriately relates to the activity or issue
soft tissue integrity
maintaining anatomical and physiological condition of interstitial tissue and skin
sustained attention (ex: taking a test, similar to concentration)
maintaining concentration on an activity/stimulus for a sustained amount of time
observer-commentator (group building role)
makes comments on observations of events in the group
ethical practice
making and defending judgments about about the quality of service based on what would work best for the client in determining therapeutic intervention; the responsibility and right of the therapist to advocate for the best possible mode of service provision for each client
therapeutic environment
making efforts to provide intervention for the client in the most ________________________________ possible is an ethical obligation of service provision
formal
many therapy groups are (formal/informal) in membership
etic
meaning derived from a cultural classification; culturally interpreted, idea of how something is usually done and what it usually means
emic
meaning from an individual interpretation; personally experienced and interpreted
unspoken group communication
meaning of what was said, why and how it was said; includes process commentary and interpretation
mental models
means of making practice more efficient; a person's representation of the real world upon which s/he anticipates actions and consequences and prepares action; posits that people use a small-scale model of reality to be able to predict events and explain phenomena
health
measured by the quality of life a person finds in his or her patterns of occupation
physician
medicine places ultimate authority in the hands of the (patient/physician/insurance company/caregiver) and award to the recipient of care a more passive, trusting, and compliant sick role
judgment (ex: deciding whether to answer a phone call during a movie at a theater, how important is the call?)
mentally examining aspects of different options and discriminating the variation in order to form an opinion or belief; right versus wrong
spatial operations
mentally manipulating the position of objects in various relationships
abstraction
mentally processing and coordinating ideas that are outside of concrete instances; used to understand and apply theories and intangible concepts
mentally process the steps
method for determining key steps of an activity in which the practitioner mentally visualizes each step of an activity; takes very little time or expense
engage in the activity yourself
method of determining the key steps of an activity in which the practitioner participates in the activity, allowing them to "feel" what it is like to participate and pick up on steps and elements that may not be detected through other methods; gives perspective not possible with other methods; allows to determine timing elements that may be difficult to determine using other methods; allows clinician to gather a broader understanding of an activity, allowing for more accurate analysis
task
occupation, activity, or task: opening the toothpaste cap, putting toothpaste on the toothbrush, brushing the teeth, rinsing the mouth
watch someone perform the activity
method to determine the key steps of an activity in which the practitioner gathers information regarding the strength, range of movements, coordination, and duration of movements required for a given activity through careful observation; can give information on the physical actions required as well as the timing and sequence of steps; works well in situations where the experience of the clinician is a limiting factor or the context does not lend itself to analysis in other ways; includes video information (more cost and time effective method)
talk to someone who performs the activity
method used to determine key steps of an activity when talking to the client is not feasible or does not provide enough information; use a list of questions for the person you are talking to in order to gather all information regarding the activity at one time
preparatory methods
methods that prepare the client for occupational performance, used as part of a treatment session in preparation for or concurrently with occupations and activities or provided to a client as a home-based engagement to support daily occupational performance; modalities, devices, and techniques to prepare the client for occupational performance (eg splints, assistive tech, wheeled mobility, PAMS, ROM, exercise)
physical guidance
mode of augmented information that helps provide infants and young children a general "feel" for a movement that will achieve an action
four-quadrant model of facilitated learning
model of learning that uses teaching-learning approaches to enhance clinical reasoning and help organize choice of intervention with clients; uses learning that is initiated by the facilitator to learning that is initiated by the learner, from direct teaching methods to indirect teaching methods, and from teachers moving from leading learning to fading from them; outlines a gradation of ability
ecological models
models that address the relationship between the human (all physical, mental, and spiritual aspects) and the physical (objects with which we interact while we are involved in activities or occupations) and social environment
M-time
monochronic time schedule, emphasizing efficiency of time use, doing one thing at a time, and being strictly observant of time commitments
follower (group building role)
more passive than the other members and goes along with group decisions
formal groups
more structured groups, such as families, classrooms, school sports teams, special interest clubs, scouting organizations, volunteer community task forces, political action groups, and workplace teams and committees
learning theories
most common dynamic theories used to address facilitating ADL competencies; explain how the practitioner should provide instruction to bring about positive outcomes or to shape a specific behavior; an example is behavior theory
rites of passage (ex: weddings, graduations)
most formal rituals; one time events that mark turning points in a person's life; often experienced by a person as a sort of test or change; complete with expected sequences of actions, special clothing, particular spaces in which they should occur, and changes in how the person is treated and addressed after the transition
ulnar deformity
motions of the hand should be in the direction of the thumb to prevent ______________________
intrinsic motivation
motivation comes from within; there is an emotional reward from doing something (enjoyment, entertainment, amusement, diversion)
oculomotor control (ex: following a running dog)
motor control of eye muscles that allows for the detection of visual information in the environment and requires multiple types of coordination
range of motion
moving body parts through an arc
swallowing
moving food from the mouth to the stomach
functional mobility
moving from one position or place to another (during performance of everyday activities), such as in-bed mobility, wheelchair mobility, transfers (wheelchair, bed, car, tub, toilet, tub/shower, chair floor); includes functional ambulation and transporting objects
crossing the midline (ex: using right hand to brush left side of head, picking up a cup on our left side with our right hand)
moving limbs and eyes across the midsagittal plane of the body; occurs when the right side of the body crosses over into the left side's territory or vice versa
fluctuating muscle tone
muscle tone too loose at times (hyptonic) or too tight at others (hypertonic)
hypotonia
muscles slow to initiate a contraction against an outside force and are unable to sustain a prolonged muscle contraction
one part prepares the body and mind for sleep while another aspect prepares the environment for sleep
name the 2 categories of sleep preparation
ADL IADL rest/sleep education work play leisure social participation
name the areas of occupation (8)
areas of occupation client factors performance patterns performance skills context and environments
name the areas of the domain (5)
cultural personal temporal virtual physical social
name the contexts and environments in the domain of the OTPF (6)
appetite (ex: desire for food or water, longing for touch as a desire for certain sensory stimuli (sensory diet), smoking)
natural desire for things
involuntary movement reactions (ex: maintaining an upright position during skiing when the skier goes over bumps and different terrains; sitting up after lying in bed)
natural reactions of body that are designed to protect us and allow us to restore our bodies to a natural upright position; automatic reaction to restore alignment of trunk (keeping us from falling)
social control
necessary for people to maintain order and function every day in society; people need to fulfill certain roles and put aside their own wishes and impulses for immediate gratification
ethical reasoning
negotiates pragmatic issues in favor of quality care
neuropalliative conditions
neurological conditions that result in limited life expectancy; important to develop sensory diet activities to provide relaxing, casual leisure
proprioceptive input
neurological info about joint position and traction; can be provided through jumping, hanging by the arms, pulling or carrying things, being overlaid with weighted covers, doing heavy work, and other activities that exert significant forces on the more proximal joints and surrounding muscles of the neck, shoulders, arms, and legs (joint compression and decompression); most people find very pleasurable and calming
consultation
no direct intervention or responsibility for outcome
simply ask the individual to tell you about himself/herself, either as a prelude to intervention or while working together
no matter what the source of diversity may be, the best route is to _________________________
non-weight bearing (NWB)
no weight should be placed on the operated leg
speech
noise that is produced from voice functions; primary mode of communication
osteoarthritis
non-inflammatory type of arthritis that causes stiffness and pain
physical environment
nonhuman aspects of contexts; includes the accessibility to and performance within environments having natural terrain, plants, animals, buildings, furniture, objects, tools, or devices
dementia
not a specific disease, but an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to interfere with a person's ability to perform everyday activities
boredom, loneliness, unhappiness, passivity, and a disconnect
not actively pursuing leisure interests leads to __________? (5)
stimulated activity
not as purposeful but generalized to functional - Peg board to simulate fine motor skills
affordances
objects in the environment that provide opportunities for action
visual field (ex: safely navigating in a grocery store, playing baseball)
objects we can see close to or far away from our body as well as the periphery
occupations
observable acts that a person wants or needs to do in order to participate in life
non-standardized evaluations
observation, interview, proxy reports, checklists, rating scales, chart review
home establishment and management
obtaining and maintaining personal and household possessions and environment (e.g., home, yard, garden, appliances, vehicles), including maintaining and repairing personal possessions (e.g. clothing, household items) and knowing how to seek help or whom to contact; includes finding and obtaining a place to live, maintaining the household environment, and maintaining and repairing objects that are personal possessions
personal hygiene and grooming
obtaining and using supplies; removing body hair (use of razors, tweezers, lotions); applying and removing cosmetics; washing, drying, combing, styling, brushing, and trimming hair; caring for nails (hands and feet); caring for skin, ears, eyes, and nose; applying deodorant; cleaning mouth; brushing and flossing teeth; and removing, cleaning, and reinserting dental orthotics and prosthetics
bathing and showering
obtaining and using supplies; soaping, rinsing, and drying body parts; maintaining bathing position; and transferring to and from bathing positions; safe and complete cleaning of the body
toileting and toilet hygiene
obtaining and using toileting supplies; clothing management; maintaining toileting position; transferring to and from toileting position; cleaning body; and caring for menstrual and continence needs (incl. catheters, colostomies, and suppository management) as well as completing intentional control of bowel movements and urinary bladder and, if necessary, using equipment or agents for bladder control
individual, therapist, client
occupation as either the means or the ends of intervention has to be viewed as it was valued and perceived by the ____________________ experiencing it, rather than from the perspective of the _________________, along with the assumptions that the _______________ might hold about a particular activity (who? therapist, client, insurance company, family, nursing staff at the setting??)
means and ends
occupation is used as both a _______________ and an ______________ of intervention in OT
co-occupation
occupation that implicitly involves two or more people
activity (the various components of self care)
occupation, activity, or task: combing hair, expressing sexuality, brushing teeth, toileting, eating
occupation-based/purposeful activity intervention
occupations and activities selected as interventions for specific clients and designed to meet therapeutic goals and address the underlying needs of the mind, body, and spirit of the client; considers activity demands and client factors in relation to the client's therapeutic goals, contexts, and environments
tasks
occupations are made up of smaller ___________
co-occupations
occupations that involve more than one person; includes occupations in which social interaction is required or that rely on another person's actions
stretch reflex (ex: yoga)
occurs when a muscle is stretched to the point at which an involuntary contraction of the muscle is induced; protects body from injury due to overstretching
constructive play (baking cookies or stringing beads, coloring with crayons and paper
occurs when the child begins to utilize objects to build and create; creative play; occurs in children 4-7
purposeful activity as a means
occurs when the client selects an activity that has a meaningful outcome to achieve therapeutic goals; require a complex interplay of physical, cognitive, perceptual, and psychosocial skills and have the potential to produce change in a person
accommodation (ex: looking down at notebook to take notes and back up at professor; driving)
occurs when the eye muscles must coordinate to allow for looking at objects near and far or when an object is changing distance from near to far (or vice versa); accommodate to changing distance by refocusing
active mechanisms for volunteer exploration
occurs when the potential volunteer seeks out volunteer organizations and opportunities based on his or her skill set and the time s/he is willing to contribute
activity as a means
occurs when the practitioner selects an activity on the basis of its characteristics to achieve therapeutic goals
passive mechanisms for volunteer exploration
occurs when volunteer opportunities present themselves in the communities or organizations in which potential volunteers already participate
opinion giver (task role)
offers beliefs or other opinion-based ideas
information giver (task role)
offers facts or other info
symmetrical tonic neck reflex (STNR)
often called crawling reflex; primitive reflex that is helpful only in infants and recedes after the first year of life; when the head flexes, the upper extremities flex and lower extremities extend; when head extends, upper extremities extend and lower extremities flex
informal groups
often occur spontaneously in settings such as playgrounds, schools, workplaces, religious centers, and health clubs and on the internet
dominator (individual role)
often tries to control the events or members in the group
less likely to speed, drive drunk, or text while driving
older drivers are often safer, why?
reciprocal bilateral integration (ex: walking, climbing ladder)
one side of body is doing the opposite movement of the other side
intervention implementation
ongoing actions taken to influence and support improved client performance and participation; directed at identified outcomes
intervention implementation and review
part of process in which we continuously monitor for changes in client needs, skills, and context
evaluation
part of process in which we identify client's desired outcomes for what they want and need to do daily
formal education participation
participating in academic (e.g., math, reading, degree coursework), nonacademic (e.g. recess, lunchroom, hallway), extracurricular (e.g., sports, band, cheerleading, dances), and vocational (prevocational and vocational) educational activities
informal personal education participation
participating in informal classes, programs, and activities that provide instruction or training in identified areas of interest
older adults
participating in leisure occupations is the most important predictor of well-being among which age group?
play participation
participating in play; maintaining a balance of play with other areas of occupation; and obtaining, using, and maintaining, toys, equipment, and supplies appropriately
religious and spiritual activities and expression
participating in religion and engaging in activities that allow a sense of connectedness to something larger than oneself or that are especially meaningful, such as taking time out to play with a child, engaging in activities in nature, and helping others in need
holistic
paying attention to a person's physical and mental health concerns, as well as the interaction among body, mind, and spirit; contributes to the intricacy of reasoning about occupations, activities, and purposeful activities
job performance
performing the requirements of a job, including work skills and patterns, time management; relationships with co-workers, managers, and customers; leadership and supervision; creation, production, and distribution of products and services; initiation, sustainment, and completion of work norms and procedures; remaining employed; may require engaging in activities involving a variety of skills, including motor movements, cognitive processing, and social interaction
volunteer participation
performing unpaid work activities for the benefit of selected causes, organizations, or facilities; often done in efforts to increase the well-being of humanity or improve conditions in what one believes to be an issue or charity in need
procedural technician (task role)
performs routine tasks related to group functioning (gathers supplies)
spatial context
perhaps the most easily observable dimension of occupational context; includes the embodiment of our experiences, their physical environment, interactions with material culture, and the social meanings of spaces
solitary occupations (ex: keeping a journal, taking a bath, worrying, writing, thinking)
person engaged perceives his or her experience ad completely uninvolved with others; does not necessarily mean that there are not other peope around during the occupation, only that the individual does not perceive them as privy to or participating in the occupation in which he or she is engaged
physical domain of wellness in caregiver-care receiver relationship
physical needs, fitness, nutrition, life-style, health and medical
required body functions
physiological functions of body systems (incl psychological functions) required to support the actions used to perform the activity
therapeutic activity groups
planned groups that are held in a particular setting or treatment environment context, designed for a therapeutic purpose with a specific, selected population of participants; OTs design these groups around members' interests, common needs and problem areas, or treatment goals
motor planning
planning and executing functional movements
driving and community mobility
planning and moving around in the community and using public or private transportation, such as driving, walking, bicycling, or accessing and riding buses, taxi cabs, or other public transportation systems
time management
planning and participating in a balance of self-care, work, leisure, and rest activities to promote satisfaction and health
leisure participation
planning and participating in appropriate leisure activities; maintaining a balance of leisure activities with other areas of occupation; and obtaining, using, and maintaining equipment and supplies as appropriate
meal preparation and cleanup
planning, preparing, serving well-balanced, nutritional meals and cleaning up food and utensils after meals; process of deciding what to prepare and what items and ingredients are needed, concerning only well-balanced, nutritional meals; includes preparation of food, and serving it in the appropriate dish, bowl, or platter; washing dishes and utensils, putting away any unused food, and wiping up the surfaces that were used
intrinsic
play activities are engaged in for (extrinsic/intrinsic) rewards
social play
play conducted with others; exploration requires collaborating with other children or adults to determine the play activities
pretend play (pretending to be a superhero, playing with dolls, pretending to cook or prepare a tea party)
play during ages 2-7; involves the child imitating or mimicking actions that may or may not occur in the real world; also often imitate sounds that they believe are created during the action that occurs
symbolic play (playing with dough, finger painting, puzzles, tumbling, riding a tricycle, or playing on swings, art activities)
play from ages 1-5 in which the child begins to understand how objects are used and how they can control and manipulate objects to create action or change; learn how to move and formulate concepts about the world around them; might also include interactions with others, assisting with language development and understanding human relations
"doing"; end result
play is focused on the process or the ____________ of the activity versus an ___________
structured play
play organized by rules
practice play
play that typically occurs from infancy to age 2 years; includes activities that are conducted fro the sake of experiencing the effect
limbic arousal and relaxation
pleasure sensations most strongly seen in thrill seeking, entertainment suspense, competitive games, and activities that require strong physical exertion
P-time
polychronic time; encourages doing multiple things at once, values being with people and involved in events important to them, and is experienced as more fluid and adjustable
sensory-based motor disorders
postural problems and difficulty stabilizing when moving
traditional/physical disabilities/biomechanical approach
practice that emphasizes physical change; using valued occupations to produce therapeutic changes in the physical body
proficient stage
practitioner functions without a conscious reach for rules, situations, or hierarchies; uses intuition; functions effortlessly (flow)
preparatory methods
preliminary techniques that are used to prepare a client for a specific treatment and are appropriate and effective occupational therapy interventions
physical agent modalities (PAMS)
preparatory activities used to help clients engage in meaningful occupations; examples include superficial thermal agents, deep thermal agents, electrotherapeutic agents, and mechanical devices
shopping
preparing shopping lists (grocery and others); selecting, purchasing and transporting items; selecting method of payment; and completing money transactions; included are Internet shopping and related use of electronic devices such as computers, cellular telephones, and tablets
asymmetrical tonic neck reflex (ATNR)
primitive reflex that is present in infants and disappears by 3 to 4 months of age; prevents infant from rolling over before it is motorically and neurologically ready; when the head i turned to one side, the extensor tone on the side toward which the person is facing increases and the flexor tone on the opposite side increases (so turn head right, right arm extends and left arm flexes); not normal in adults
sequencing and timing
process required to carry out the activity (e.g., specific steps, sequence of steps, timing requirements)
clinical reasoning
process used by practitioners to plan, direct, perform, and reflect on client care; being able to analyze, observe, and interpret what the situation is in order to best help the client
clinical reasoning
process used by practitioners to plan, direct, perform, and reflect on client care; clinical practices used to choose interventions for and interactions with clients
energizer (or expeditor; task role)
prods the group to action to maintain forward progress
increased independence in problem solving and task completion (generate change)
progressive challenges lead to
collaborative effort (participation) ability to complete (just right challenge)
progressive challenges require? (2)
immunological system (ex: lymphedema management, playing on a playground with other children)
protects body against infection and other pathological organisms and actions; challenged depending on the environment of activity
protective functions of skin (ex: shoveling dirt in a garden, hitting a ball during volleyball)
protects us from physical, chemical, and biological elements that might cause harm to our bodies and shields us from elements of the environment (wind, heat, cold, and sun); presence/absence of wounds, cuts, or abrasions
flexibility in use
provide choice in method of use; used by right and left handed people
self-care intervention
provided by OT practitioners to increase a client's ability to participate in activities, in this case, self-care; developed to remedy impairments in body structures and body functions, to maximize facilitating contextual factors, and to eliminate or lessen barriers
elaborator (task role)
provides further explanations
pragmatic reasoning
provides the framework for the entire clinical reasoning process; guided by the practical aspects of treatment including: setting, time constraints, clinic environment, insurance coverage, financial status of client, barriers to recovery, social supports, therapist knowledge/skill level/values/referral options
encourager (group building role)
provides verbal encouragement and support to group members
culturally competent
providing ______________________________ intervention for persons with diverse backgrounds is an ability required in any OT setting
spiritual domain of wellness in caregiver-care receiver relationship
purpose in life, morals and ethics, self-determination, love, hope, faith
donning
putting on clothing
talk to your client
quickest, easiest, and often the most feasible method to determine the key steps of an activity by asking the client to explain an activity step by step to get an overall idea of how a task is done and the objects and equipment needed; must ask probing questions to gather all of the pertinent details
saccades (ex: reading)
rapid eye movements
contrived activity
real setting, real timing - buttoning shirt with the client when getting ready in the morning
phenomenological
reality is what the client perceives
logical and coherent thought (ex: balancing a checkbook, shopping for groceries, driving, choosing what clothes to wear, reacting appropriately when being surprised at a surprise party)
reasonable thought processes capable of being explained in words or symbols and used for reasoning
pragmatic reasoning
reasoning about the contextual issues affecting clients now and in the future, the practitioner's personal context, and the practice environment's culture; another variable affecting the activity synthesis and activity choice process
medical reasoning
reasoning in which the goal is to postulate a diagnosis; engaged in by physicians
cognitive figure-ground
reasoning to determine what is important and needs to be attended to an what to ignore; can be used by practitioners to sort and sift the info gathered while speaking with and observing a client; practitioner pushes aside what s/he reasons to be irrelevant and extraneous to determine what is meaningful and worthy of attention
memory
recalling info after brief or long periods of time
sensory awareness
receiving and differentiating sensory stimuli
problem solving
recognizing a problem, defining a problem, identifying alternative plans, selecting a plan, organizing steps in a plan, implementing a plan, and evaluating the outcome
form constancy (ex: cartoon cow represents a living cow, they're the same thing, just appear differently)
recognizing forms and objects as being the same in various environments, positions, and sizes
communitas
refers to a community in which a strong feeling of equality, solidarity, and togetherness exists
participation restriction
refers to a societal-level impediment
shift (ex: repositioning the pencil in the fingers to position for writing)
the ability to move an object in a linear manner with the fingertips
hematological system (ex: delivery of electrolytes to muscles during a physically strenuous activity)
refers to blood and blood-forming tissues of body (bone marrow and spleen); challenged during activities that require efficient delivery of elements
internal control
refers to the child's having primary control over what occurs in the [play] activity
second shift
refers to the childcare and household work that awaits women when they arrive home after a day on the job
occupational justice
refers to the client being able to decide what they need or want to do; activities person desires, wants, or needs to do and participates in; recognizes occupational rights to inclusive participation in everyday occupations for all persons in society, regardless of age, ability, gender, social class, or other differences
caregiver burden
refers to the emotional, financial, and physical strains resulting from a caregiving situation; profound feelings of guilt and sadness leading to a sense of failure when having to make a choice (or forced) in deciding if long-term care is the best option
person-activity-environment fit
refers to the match among the skills and abilities of the individual, the demands of the activity, and the characteristics of the physical, social, and cultural environments; the interaction among the performance areas, performance components, and performance contexts that determines the success of the performance
prehension
refined movements of the thumb, index, and middle finger to pinch and grasp
orchestration of occupation
regardless of age or ability, orchestrating our own day/life is something we must go; with clients who are disorganized by the effects of their disabilities, this is a critical area of need and goal setting
endocrine system
regulates hormone levels within the body through secretions of glands, including growth and metabolic hormones
sexual functions
related to mental and physical aspects of performing sexual acts
gait patterns (ex: walking in a grocery store or during the preparation of a meal, hiking up a mountain, walking down a runway)
related to movements used to walk; normally includes use of both legs interchangeably, shifting body weight from one leg to the other; considered in relation to how they affect ability to engage in occupations in daily life
sleep preparation (self)
related to preparing the body and mind for the occupation of sleep; engaging in routines that prepare the self for a comfortable rest, such as grooming and undressing, reading or listening to music to fall asleep, saying goodnight to others, engaging in meditation or prayers; determining the time of day and length of time desired for sleeping or the time needed to wake (consciously deciding/mentally processing when to sleep and wake, sleep-wake cycles); and establishing sleep patterns that support growth and health (patterns are often personally and culturally determined)
sleep preparation (environmental)
related to preparing the environment for sleep; preparing the physical environment for periods of unconsciousness, such as making the bed or space on which to sleep; ensuring warmth/coolness and protection; setting an alarm clock; securing the home, such as locking doors or closing windows or curtains; and turning off electronics or lights
egocentric
relating object location to one's own body as the center; typically in children
social domain of wellness in caregiver-care receiver relationship
relational; respect for self and others; interaction with the environment, people, pets, and community; social cause
sociocultural dimension
relationship between social and cultural aspects of occupations
catharsis
release of emotions/deep seeded problems that hinder OP
urinary system (ex: riding in a bicycle race, using the bathroom, giving a urine sample while visiting the doctor)
release of urine from body and controlling release; ability to refrain from releasing urine at inappropriate times
rehearsing
repeating a sequence of events or symbols as a basic component of learning
allocentric
representing space in terms of a layout of the environment unrelated to the individual; abstract, cognitive maps
muscle endurance (ex: carrying grocery bags from the car to the inside of the house, kayaking for a long time, painting a house)
required when the contraction of a muscle must be maintained for a prolonged period of time (such as standing for long periods, holding an extremity in a static, isometric contraction, or in repetitive muscle contractions)
occupation-based intervention
requires practitioners to use occupations from the person's life as a part of the intervention
active listening
restatement of the problem, a statement of reflection on it, and a statement clarifying it
working memory (ex: writing a letter/email, creating a strategy in a game based on recalling the opponent's moves and actions)
retains info while we are using it during a task; allows problem-solving and processing tasks that don't involve physical cues to the info
intervention review
review of the intervention plan and progress toward targeted outcomes; status of client is re-examined
spasticity
rigid/high muscle tone
role acquisition
role focuses on caregiver education, identifying supports, and anticipating future needs (D/C)
role enactment
role focuses on direct care skills training, training DME, home modification, compensatory techniques, and discussing/exploring future placement options
role disengagement
role focuses on supporting family during transition or loss, providing resources for support groups, and identifying new roles
group building (maintenance) roles
roles that focus on the functioning of the group process
individual roles
roles that focus on the individual members and their own issues and needs; these roles frequently disrupt or impede progress with the group
task roles
roles that related to facilitating completion of the group's tasks
core leisure activities (ex: family dinners, watching TV, or playing games as a family unit)
routine and home-based leisure activities that draw family members together and support cohesion and stress reduction
"context free"
rules that can be recognized without a need to be aware of anything else that is happening are ______________
information seeker (task role)
seeks clarification of issues in terms of their factual adequacy
opinion seeker (task role)
seeks opinions from others, rather than facts
dressing
selecting clothing and accessories appropriate to time of day, weather, and occasion; obtaining clothing from storage area; dressing and undressing in a sequential fashion; fastening and adjusting clothing and shoes; and applying and removing personal devices, prosthetic devices, or splints
leisure occupations
self-directed, non-obligatory occupations that promote self-determination and improve physical health, mental wellness, and relationships with family, peers, and community; supports development and is unique to each individual
communication management
sending, receiving and interpreting information using a variety of systems and equipment including writing tools, telephones (cell phones/smartphones), keyboards, audiovisual recorders, computers/tablets, communication boards, call lights, emergency systems, Braille writers, telecommunication devices for the deaf, augmentative communication systems, and personal digital assistants
position
sensory function of the inner ear that helps to determine the position of body
forensic settings
service delivery sites that work with and include clients who are at risk for offending or who have a history of offending
skills
sets of actions that a person has learned and is able to apply in given situations
nested occupations (ex: listening to music and surfing the internet, driving while talking on the phone
several occupations are conducted at the same time and co-occur; may be distinct occupations that occur together or separate occupations
relationship (ex: coworkers, friends, lovers, family)
shared understanding of how two individuals are related to each other within their lives and actions; exert a powerful shaping force on occupational experiences; vary in length, importance to individuals, intimacy, effects on individuals, degree to which they are equal or unequal between individuals, and types of feelings they evoke
communication boards
simple one-dimensional pieces of paper or boards with the alphabet or common words or objects printed on them; user will point to or indicate which object or letter s/he is trying to convey to another person
performance contexts
situations or factors that influence an individual's engagement in desired and/or required performance areas; consist of temporal and environmental aspects; the features of the environment that affect the person's ability to engage in functional activities
vocational domain of wellness in caregiver-care receiver relationship
skill development, work, volunteerism, personal interests
culture
social demands are often influenced by the ___________ in which the occupation takes place
culture and social environment
social rules and expectations are shaped and determined by __________________ in which the activity takes place
conscientiousness
someone who is very careful and particular and governed by principles and a strong sense of what is right
spirituality
source of energy that comes from inner beliefs about life's meaning; can be a set of activities existing within the framework of a religious community, or can be meditation/prayer/ritual without belonging to a larger group, or regularly doing things that are personally renewing
social space
space that carries social meaning; therapist must be sensitive to the social meanings of space in the eyes of each client in order to avoid alienating a client as well as to enhance the success of intervention; can be public or private, sacred or profane, social density, indications of social status through space use, interpersonal body space and eye contact
devil's advocate
special evaluator-critic who tests and evaluates the strength of the group's ideas
client factors
specific capacities, characteristics, or beliefs that reside within the person and that influence performance in occupations; include body functions, body structures, and values, beliefs, and spirituality that reside within the person
P-E-O (and related) models (or FORs)
state that occupational performance is influenced by the interaction of elements within the person, environment, and occupation
playboy/girl (individual role)
stays on the periphery of the group; offers little to the group, as if above or different from the rest of the group; and often jokes off topic
termination of activity
stopping an activity at an appropriate time
long-term memory (ex: recalling how to ride a bike even after years of not having done so, brushing teeth (also praxis), driving home)
stores info about past events, language, and sensory experiences for a long period of time; allows for the utilization of past experiences in order to deal with current ones
short-term memory (ex: remembering a phone number long enough to dial it, remembering that one looked both ways before crossing the street)
stores info temporarily (for about 30s) for immediate use; usually lost if not stored in LTM
false; focuses on what is healthy and right about the client/patient and does not discuss personal problems or make feelings the subject of discussion
t/f: in cognitive remotivation groups, clients discuss their personal problems and feelings while focusing on the client's limitations so that they can work through them with a group
false; level of stimulation and arousal must be high and the demand for performance must also be high (don't want them to get bored)
t/f: in creating designs that are appealing for people driven by productivity values, the level of stimulation, arousal, and demand for performance should be low
false; do not worry too much about creating the perfect blend, just focus on the one that you think is most appealing to your client (match your client's preferences with an activity that offers high levels of that characteristic; later you can try blending just the right combination of the 3)
t/f: in early years of designing appealing interventions, an OT should focus on creating the perfect blend of pleasure, productivity, and restoration
true
t/f: interactional reasoning requires that a practitioner know himself or herself well, and be able to observe the effect of his/her behavior on others and adapt or alter it when needed
false; evaluation
t/f: intervention helps to identify problem areas
true
t/f: it is thought that many people do not develop beyond the competence stage/level of skill because to do so would entail moving into intuitive levels of thought and action
false; do not address it unless the life-balance problem is so extreme that his or her immediate safety is at risk
t/f: occupational therapists should still address occupational balance even if the client does not wish to change it
true
t/f: often a disparity exists between the client's vision and the reality of the course of treatment
true
t/f: outcome monitoring is a continuous and dynamic process
false; continuous throughout the entire process
t/f: outcome monitoring is the third step of the process
true
t/f: outcomes can be applied to measure progress and modify goals and interventions, if needed
false; regardless of your personal beliefs, it is unethical to allow your own values to interfere in the quality of care you provide
t/f: personal beliefs/values may affect how a therapist provides care
false; while play is the primary occupation of children, it is an occupation that can be engaged in across the lifespan
t/f: play is engaged in only by children
false; preparatory methods generally do not stand alone at OT for billing purposes or for the integrity of the profession
t/f: preparatory methods can be used as stand alone treatment
false; does not take place without interactional and conditional reasoning
t/f: procedural reasoning can occur without interactional and conditional reasoning, but requires pragmatic reasoning to occur simultaneously
true
t/f: reductionistic and monistic thinking leads to applying rote techniques and exercises that may not address the client's desires
true
t/f: starting something new is much more difficulty/stressful that continuing with an activity once it has been started
true
t/f: the OT must consider the presence of other people when planning activities
false; use the client's preferred communication style
t/f: the OT should use whichever communication style is the easiest and clearest
false; promote well-being and a better QoL for individuals with cognitive disabilities and the staff who support them
t/f: the benefits of the eden alternative are directly targeted toward the patients only
false; there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies. thus, we should not assume that a person's symptoms are permanent dementia, but that it may be a reversible factors
t/f: the causes of dementia are irreversible
false; there is no correct balance between pleasure, productivity, and restoration, there is only the question of whether the client and family are finding the balance that suits their values
t/f: the correct life balance for each individual includes an even distribution of pleasure, productivity, and restoration
false; medical treatment should be the servant of genuine human care, never its master
t/f: the eden alternative suggests that medicine should be at the focus of treatment, and is more important than the aspects of treatment involving "genuine human care"
false; combines all the approaches
t/f: the highest-quality practice is the client-centered practice
true
t/f: the key to a successful combination of opposing approaches was to always keep the goal-setting process oriented to the occupational priorities of the client, and to keep assessment and intervention at a broad occupational level
true
t/f: the most powerful and meaningful intervention is one that allows the client to determine what goals are important to him or her
false; always disrupts the natural contexts to some degree
t/f: the presence of the therapist in the usual setting of the occupation does not typically disrupt the natural context
false; nonlinear/fluid and dynamic/evolving
t/f: the process is linear
true
t/f: the questions that facilitate discussion in cognitive remotivation are geared to the vocabulary, literacy, IQ and/or cognitive ability of the client/patient making it an effective approach with all types of persons
true
t/f: there is a point at which attempting to reclaim a particularly valued occupation in an area in which one is no longer competent could actually degrade self-concept and should therefore be avoided
false; do not include these!! it should be completed based on how the activity is typically done
t/f: when completing procedural task analysis and the sequencing and timing of activities, the therapist should include "could be" situations or special circumstances so that the client knows how to proceed in the activity if they complete it in a way that is different from the way the activity is typically done (i.e., the social norm of how the activity is completed)
true
t/f: when people feel socially accepted and supported in leisure environments, they are more likely to demonstrate the motivation for participating in available leisure occupations
sleep participation
taking care of personal need for sleep such as ceasing activities to ensure onset of sleep, napping, dreaming; sustaining a sleep state without disruption; and performing nighttime care of toileting needs and hydration; also negotiating the needs and requirement of and interacting with others within the social environment such as children or partners, including providing nighttime caregiving such as breastfeeding and monitoring the comfort and safety of others who are sleeping; disengagement from environment
doffing
taking off clothing
mirroring
taking on the same posture of another individual; a particularly potent indicator of engagement and interest in another person
creating occupational opportunity and community
targeting occupations that residents showed interest in and identified as important to them; residents increasingly recognizing each other in terms of what each other did, or had done, due to sharing of occupational narratives, reflections, and experiences
standardized evaluations
task specific; have reliability and validity; ex ROM, MMT, interviews, FIM
related tasks
tasks that focus on shared movement components; play an increased role in motor learning by young children with neurological disorders, who have a limited coordination repertorie
IADLs
tasks to support daily life within the home and community that often require more complex interactions than personal care and self-maintenance
culture
teaches the individual what is valued, how things are usually done, what to expect, how families are constructed, what certain activities mean, and so on
procedural task analysis
technique used by OT practitioners to help determine the sequence of steps for an activity; accurate description of the essential steps that leads to precise analysis of the activity demands and greater ability to explain or to teach a client or caregiver
rituals (ex: birthdays, religious holidays, patriotic observances)
temporal structures of occupations that carry a recognized cultural and personal meaning, which is about the transition of the primary person(s) engaged from one status in the culture to another; marked by predictable, seemingly scripted series of symbolic actions or objects
lifestyle diversity
term describing how people live life in all kinds of ways
discretionary time
term referring to our spare time
procedural reasoning
the "how to" or "doing" of the therapeutic process; evaluate what is wrong, barriers to OP, draw from knowledge of disability/illness/or injury, decide how to "fix it" treatment planning, sort through relevant versus irrelevant info, develop goals
reasoning
the 5 stages from novice to expert, along with the concept of reflective practice, provide a structure for the discussion of the different types of ___________________ about occupation and related activities OTs use
universal design
the ______________________ concept increases the supply of usable housing by including universal features in as many houses as possible, and allows people tp remain in their homes as long as they like
client's perspective occupational profile
the ___________________________ about what is meaningful to them, what problems they are experiencing, what supports or hinders occupational performance, their priorities, and the things they are able to do is a key aspect of the ____________________________
awareness of reality (ex: knowing we cannot fly like a superhero by simply owning a cape, knowing that the events that occur in a TV show are not real, knowing we cannot make snowballs during the middle of summer)
the ability to distinguish bw thoughts and what is truly occurring; requires separating realms, imaginations, delusions, or hallucinations from what is occurring in the actual environment
self-expression (ex: an artist using their feelings to design meaningful works of art, conveying true feelings during a disagreement with another person (a child might throw a temper tantrum to express their emotions); or a child may draw to express their feeling)
the ability to express one's feelings and emotions during activities; using a variety of styles and skills to express thoughts, feelings, and needs
visual fixation
the ability to fixate on a stationary object
in-hand manipulation
the ability to hold and move an object with one hand; essential to the handwriting process
psychosocial skills and psychological components
the ability to interact in society and to process emotions
concept formation (ex: concept of love; if a child was asked to decorate the room for Fall, could they understand that symbols of Fall may be leaves, pumpkins, etc.?)
the ability to organize a variety of information to form thoughts and ideas based on the common qualities of objects or situations; tied to abstract thought and categorization
conditional reasoning
the ability to place thinking in an environmental context at the same time that thinking takes place in a context that is beyond the bonds of strict linear cognition; provides the connection from meaning to action; phenomenological, creative, and imaginative
scanning
the ability to rapidly change fixation from one object in the visual field to another
visual memory (ex: recognizing letters and numbers)
the ability to recall visual images and information, or details of a single form
sensorimotor component
the ability to receive input, process information, and produce output
sensory modulation
the ability to respond appropriately to incoming stimuli; behavioral responses are inconsistent with the sensory stimuli (underrespond, overrespond, overly seek particular sensations)
intellectual awareness
the ability to understand what abilities and weaknesses are present before engaging in the activity; able to verbalize deficits
cognitive integration and cognitive components
the ability to use higher brain functions
gender and culture
the activities required for personal hygiene and grooming are often determined by the individual's _____________________ (2)
appropriateness and range of emotion (ex: controlling reactions when playing a game if the person loses)
the affect and display of feelings during engagement in occupations
blood pressure (ex: riding a roller coaster, running a marathon, interviewing for a job)
the amount of pressure exerted by blood on walls of vessels
surfaces
the areas of the environment at which most perception and action occur
spirituality
the aspect of humanity that refers to the way individuals seek and express meaning and purpose and they way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred
performance environment
the augmented information provided during the learning situation by the change agent
novice stage
the beginner who is learning a new skill is taught to recognize certain features and rules that are based on features of the task at hand
performance stage of clinical reasoning
the behavior after having made a decision; the way in which you or anyone else knows that a decision has been made by the behavior you engage in after having made the decision
confidence (ex: interviewing for a job promotion, speaking to the manager of a department store about getting a return for a purchase; a child who knows an answer in class might display confidence by raising their hand high in the air to answer)
the belief in oneself, or being self-assured
pluralistic
the belief that there is more than one basic principle to a concept
circadian rhytm
the biological clock; regular bodily rhythms that occur on a 24-hour cycle; biotemporal aspect of the temporal dimension
reflection-in-action
the capacity to reflect on action so as to engage in a process of continuous learning; learn new and different ways of thinking; highest level of expertise
motor development
the changes in motor behavior over the lifespan and processes that accompany these changes
ventilation
the circulation of air and the process of providing fresh air; should be considered when the activity uses objects that have potential for emission of fumes, gases, odors, and other elements that may become dangerous if inhaled
fatigability
the condition of becoming easily tired or exhausted
open task
the conditions of the task change on each trial, so there are many solutions along with increased processing demands
etic
the culturally interpreted meaning of an activity; somebody else's perception
intactness
the degree to which a therapeutic occupation occurs in the usual spatial, temporal, and sociocultural conditions in which it would usually occur for that client if it were not being used as an intervention; the naturalization of therapeutic occupation through the use of typical context
intervention appeal
the degree to which an intervention is attractive to the person for whom it was designed because of its blend of productivity, pleasure, and restoration
equitable use
the design is useful and marketable to people with diverse abilities
tolerance for error
the design minimizes hazards and the adverse consequences of accidental or unintended actions; fail safe features
procedural reasoning
the evaluation process (focusing on the relationship between performance in daily life and the barriers to engagement and participation in daily activities), as well as the connection between evaluation and the creation of an intervention plan requires ______________ reasoning
aerobic capacity (ex: hiking, long-distance biking)
the extent to which a person can exercise without getting out of breath
perform meaningful occupations that are needed and/or desired by the individual
the focus of an OT evaluation must be the individual's ability to _______________________
needs and progress
the four general modes in the therapeutic use of context are dependent on ____________________ and _______________
meaning-making
the framework for the jump from meaning to action; the ways that therapists think about which of the actions that the patient takes have potential for meaningfulness
grasp patterns
the gross movements of the hand involving fingers and thumb used to hold objects (include hook, cylindrical, spherical, three-jaw chuck, lateral pinch, tip-to-tip pinch)
interpretation
the group leader's offering of an understanding or insight that s/he has reached during the group activity or the interactions around the activity; hypothesize what was said in a form of a question
interests
the identifying mental or physical activities that create pleasure and maintain attention
time
the impact of sudden disability often imposes tremendous distortions of daily life spaces by increasing the amount of ________ required for routine activities
temperament
the inborn style with which people approach and respond to the environment; affects activity level, approach and withdrawal tendencies in new situations, adaptability to change, sensory threshold, quality and intensity of mood states, persistence, and attention span
activity tolerance
the individual's ability to sustain a purposeful activity over time
develop goals and outcome measures
the information gathered during an analysis of occupational performance is used to (2)
motivation (ex: obtaining a degree, engaging in any activity that is beyond basic needs)
the internal incentive to behave in a certain way or take action
social participation
the interweaving of occupations to support desired engagement in community and family activities as well as those involving peers and friends; involvement in a subset of activities that involve social situations with others and support social interdependence; can occur in person or through remote technologies such as the telephone, computer interaction, and video conferencing
competence stage
the learner has amassed so many context-free rules and situational experiences that s/he can feel overwhelmed; so much is known that extracting important info from irrelevant info is difficult; adopts or is taught a hierarchy of decision making to assist them in navigating this confusion; begins to have a sense of responsibility for the outcome of a decision and this emotional involvement is critical to this stage; the practitioner has an emotional stake related to both empathy for the client and a desire to make the right choice in activity with the client
advanced beginner stage
the learner of a new skill or profession is continuing to gather more context-free facts; the context the learner perceives is becoming larger because of the experienced gained through practicing in concrete situations; beginning to gather a "database" of past situations with which current experiences can be compared; begins to use situational cues for reasoning and practice
level of tolerance
the level of noise that an activity produces influences _____________________ to sounds required by the activity (e.g., an activity with a high level of noise requires a higher level of sensory processing ability and vice versa)
natural
the more that OTs work within ____________ intervention contexts, the more powerful will be the results
culture
the most effective OT is provided in settings in which OTs can operate from their true _____________, which values the subjective experience and perspective of the client over their own as experts
planning stage of clinical reasoning
the thought process of making a decision; a decision is nothing more than what you think until you begin to take action based on that decision; ex: deciding to become an OT
co-occupations (ex: teaching, caregiving, playing tennis)
the most highly interactive types of occupation, in which the occupational experiences of the individuals involved simply could not occur without the interactive responses of the other person or persons with whom the occupations are being experienced
knowing-in-action to reflection-in-action
the movement to full professional status of an artful practitioner involves progressing from _______________________ to _________________
biotemporal rhythms of human occupation
the natural rhythms of the client
toys
the objects and spaces of childhood play; support and advance development
professional optimism
the occupational therapist's encouragement, consistent support, and firm expression of belief that people can make changes in their lives; used to reclaim lost occupations and occupational identity
environmental affordances
the opportunities that an environment provides to a particular individual; the specific opportunities that a surface provides to an animal or a human; benefits or positives of an environment; allows an individual to perform an action
subcomponent skills
the parts of the whole that contribute to the whole skill when combined
materials/supplies
the physical articles needed to make or do something; substance(s) out of which things are made; those objects consumed or expended during an activity; may need to be replenished at the end of an activity or after a certain amount of time
environmental factors
the physical, social, and attitudinal settings in which people live and conduct their lives
body functions
the physiological and psychological actions of body systems
reflection-in-action
the positive outcome when the professional is confronted by a situation that falls outside of the applied science of technical rationality, the experience of knowing in action, and catapulted into a world of problem solving in which s/he must entertain new thinking and actions
occupation as an end
the practitioner's use of a purposeful, meaningful activity that, when completed will provide the client with the capacity to perform an occupation
vision
the primary sense of spatial perception
-assessment -interpretation of data -developing and refining a hypothesis -creating goals in collaboration with the client -identifying specific intervention approaches -implementing the plan of care (continuously monitor the effectiveness of the plan; change as needed)
the process involves...? (6)
cultural competence
the process of actively developing and practicing appropriate, relevant, and sensitive strategies and skills in interacting with culturally different persons
health promotion
the process of enabling people to increase control over, and to improve, their health; to reach a state of complete physical, mental, and social well-being, an individual or group must be able to identify and realize aspirations, to satisfy needs, and to change or cope with the environment
feeding (self-feeding)
the process of setting up, arranging, and bringing food (or fluid) from the plate or cup to the mouth
interdependence
the reality that in human society people are never completely independent but rather rely on each other for the satisfaction of many of their needs
norms
the rules guiding the behaviors and actions within, and at times outside, the group
technical rationality
the simple application of learned techniques of practice
the setting in which the client usually does the activity; temporal and sociocultural
the simplest way to think of intactness is to have the therapist and client do the therapeutic intervention in _______________________________________, including keeping the ________________ and _______________ conditions for the occupation as close as possible to their natural features when that activity is not being used therapeutically
social time
the social construction of time; calendar, holidays, weekdays, weekends; expectations, depending on culture, about factors such as pace, length, and punctuality of interventions
consciousness (ex: required by most activities, it is the level of arousal that varies depending on the function; sleep does not require this function, as we are unconscious during sleep)
the state of awareness and alertness, including the clarity and continuity of the wakeful state
narrative
the story a person tells of illness and wellness and how the practitioner fashions a view of the client's future world
proxemics
the study of body language and proximity; use of space/body language; can express mood, receptivity, engagement, level of comfort, and many other feelings important to the success of an intervention session
epistemology of practice
the study of knowledge based on the premise that most practicing professionals know more in practice than they can verbalize, which represents the strongest argument for professionals to participate in the training of occupational therapy students as they think about choices made in practice
closed task
the task remains the same from one practice trial to another
religious occupations
those activities surrounding involvement in organized rituals or practices that are used to demonstrate beliefs through which many hope to reach a greater understanding of the spiritual self and gain a sense of something greater than themselves
intact interventions
those interventions that are designed within the contexts in which they occur
tools
those objects used to perform an activity/helps complete an activity; those objects that are not disposable and are reusable (not expendable); manipulated or used by hand to assist in a task
co-occupation
those occupations that occur when two or more people physically, emotionally, and intentionally share participation in an occupation
change agent
those people who support positive changes in motor behaviors, such as a PT, OT, or parents; intervenes with practice strategies related to the task and the environment to support the learning of new functional activities
rites of passage
those special rituals which mark important milestones in a person's life
three-track mind
three tracks of reasoning -- procedural, interactional, and conditional
2-4
throughout which steps can you use sensory aids (scents, pictures, tangible items, etc.)
client
to be an effective OT, it is necessary to believe that the (caregiver/client/therapist/insurance company) is the final authority and expert on what is needed, valued, and useful in intervention
time to hear the story; is not
to engage in meaningful narrative reasoning requires ___________________; this (is/is not) a reimbursable service
-decide what is necessary for a client to reach their goals for engagement in life through an occupation-based, holistic perspective -know, understand, and respect a person for who they are and from this knowledge plan effective interventions using multiple strategies to improve a client's level of functioning
together procedural, interactional, and conditional reasoning enable an OT to...? (2)
agreeableness
trait characterized by being easily pleased and conforming to other's needs
harmonizer (group building role)
tries to smooth over conflicts in groups and maintain peace
exploratory play (rattles, balls, blocks, mobiles, squeeze toys, and small puzzles)
type of practice play that encompasses cognitive development and more, and is a means by which a child seeks to understand his or her environment and sensory experiences; strictly intrinsically motivated, as this is how the child comes to understand how to move his or her body to create actions or have an effects on his/her environment; creates understanding of sensory characteristics
sensorimotor play
type of practice play that includes exploring sensations and how the body moves
social rules
typical norms and expectations of how one should act and communicate during the activity
functioning
umbrella term encompassing all body functions and structure, activities and participation
disability
umbrella term for impairments, activity limitations, or participation restrictions; applies in cases in which a person has problems at different levels or problems at combined levels
process
under which section of the OTPF is activity demands included in?
reflective
understanding another's experience of doing required high developed _______________ skills that go beyond activity analysis or even empathy, and a determination to remain within that perspective
insight/awareness (ex: an amateur skier deciding not to ski a double black diamond based on his/her awareness of own skiing abilities)
understanding of one's strengths and weaknesses; realistic concept of abilities
objects and space
understanding the ____________ (2) required allows for a greater understanding of the needed skills and body functions for an activity as well as how the client will interact with his or her environment
informal caregiving
unpaid care
poly-pharmacy
use of >4 medications
purposeful activity
use of simulated and contrived activities to support the development of performance skills and patterns to enhance occupational engagement; often components of occupations and always hold meaning, relevance, and perceived utility for clients at their level of interest and motivation
call lights/emergency systems
used by those who are in bed, on a commode, or unable to move from a given location to notify others that they need assistance; used in hospitals and medical settings, as well as within homes; often activated by pulling a cord or pushing a button, which in turn creates a noise or flashing light to signal others that help is needed
work performance testing
used to determine the client's potential for returning to work; the client performs a battery of tests that simulate his/her work or may even observe the client performing actual work tasks following an eval of underlying client factors
self-care evaluation
used to develop an appropriate intervention plan by identifying areas of limited participation and how impairments limit participation; assessment of client's potential capacity, functional status, and actual abilities, as well as a client's physical, psychological, sensory, perceptual, and cognitive functions, and their performance of BADLs (and IADLs, if appropriate)
role of simulation
used to improve or practice subskills (motor, cognitive, social); improve PS; improve OP; practice to develop confidence in one's skills/abilities; improve body mechanics and efficiency in work skills; is a tool for any age, gender, ethnicity, or cultural background; can control intensity and environment; motivating and fun (but not to all)
evaluation
used to show progress
narrative reasoning
uses phenomenological process where the meaning of therapy is gained through stories; each client's story is unique and carries the seed of intervention
self-confessor (individual role)
uses the group to get personal issues off his/her chest
laterality
using a preferred unilateral body part for activities requiring a high level of skill
use it to guide the rest of the evaluation (what assessments, what to analyze, what's important)
what do you do with all the information gathered from an occupational profile?
financial management
using fiscal resources, including alternate methods of financial transaction and planning and using finances with LTM and STM goals; planning and saving for the future; managing investments, alternative income, or savings; and filing income tax
gross coordination
using large muscle groups for controlled, goal-directed movements
occupation-based practice
using occupation as the framework for intervention
postural control
using righting and equilibrium adjustments to maintain balance during functional movements
fine motor coordination (dexterity) (ex: threading a needle, grasping a doorknob, dressing using buttons and zipper, holding a key, playing an instrument)
using small muscle groups for controlled movements, particularly in object manipulation; those movements that utilize the smaller muscles of the hand, fingers, and thumb, allowing for precise movements used to manipulate smaller objects
motor control
using the body in functional and versatile movement patterns
occupation's related activities
using therapeutic activities that are associated with an occupation; enhances the applicable and efficacy of the intervention
interpersonal skills
using verbal and nonverbal communication to interact in a variety of settings
personal device care
using, cleaning, and maintaining personal care items, such as hearing aids, contact lenses, glasses, orthotics, prosthetics, adaptive equipment, glucometers, and contraceptive and sexual devices
eye-hand coordination (ex: reaching for toothbrush, placing toothpaste on toothbrush, grabbing toilet paper, scooping up food in a spoon, washing our hands, catching a quickly moving ball, threading a needle)
utilizing what is visually perceived in the environment to contract and control muscle groups to move hands in a coordinated fashion
control parameter
variable that provides conditions for change when it takes on a critical value; factors that influence change in behavior; also called constraints (because they constrain, or limit, the possible outcomes for emerging motor behaviors)
size and space for approach and use
variations for seated and standing users; accommodate for different hand and grip size
algorithm
visual diagram of the steps of a task based on information collected during the activity, and then specific options are given for the next step based on that information; helps to clarify the sequence of steps based on conditional aspects
alternative vocalization (ex: singing, humming, chanting, yelling, laughter)
vocalization produced for activities outside of those involving speaking; yelling, singing, humming, chanting, or crying or laughing
respiratory depth (ex: climbing a tree, reading a book, singing, playing a musical instrument, blowing bubbles)
volume of air inhaled/exhaled
-public transportation -taxis -bike -uber -walking -using a w/c -scooters -golf carts -supplemental transportation systems
what are some different forms of community mobility other than driving a car? (9)
grade; emotional, physical, and cognitive; just right challenge
we have to tailor (_____________) activities to the _______________, _________________, and ________________ abilities of the client in order to reduce undesirable behaviors and create a _____________________ to support engagement in life
approach stage of recovery
what 2 things will guide the focus of intervention?
-understanding the importance of social and cultural influences on a client's health beliefs and behaviors -considering how these factors interact at multiple levels of the health care delivery system -devising interventions that take these issues into account to assure quality healthcare delivery to diverse patient populations
what 3 things does cultural competence entail?
theoretical reasoning clients needs and desires influence of activity choices on the therapeutic relationship pragmatic considerations cultural considerations
what 5 variables must be considered when planning occupations, purposeful activities, and activities for an OT session?
life goals
what a person hopes to have accomplished in life; assessment of these can lead to finding meaningful occupations to pursue during the retirement years
-environmental/contextual factors -medication -alcohol and drugs
what additional factors may impact a person's ability to safely operate a car? (3)
teenagers and adults
what age group has the highest fatal crash rate?
-activities that are personally interesting and engaging and in which a person invests time, energy, and serious attention -activities a person engages in casually or passively to relax or distract him/herself from the stresses of daily living
what are 2 broad types of activities leisure is divided into?
BADLs IADLs
what are 2 categories of self-care occupations?
boredom and loneliness
what are 2 common leisure concerns for people with disabilities (and are thus important to address in the assessment process)?
environmental factors (external) personal factors (internal)
what are 2 components of contextual factors?
-residents were afraid/cognitively unable to assume the direction of their own interventions -therapist and client disagreed regarding goal priorities
what are 2 difficulties that might be encountered during goal setting using the client-centered approach?
active listening empathy
what are 2 effective strategies to model appropriate group behaviors?
-do not lean forward (shoulders should stay behind hips) -do not raise knee higher than hip when sitting, sit down with the operated leg forward
what are 2 precautions a client with hip fracture should follow when sitting?
planning stage performance stage
what are 2 stages of clinical reasoning?
-do not bend operated hip beyond 90 degree angle -do not turn operated leg inward in a pigeon-toed position (internal rotation) -do not cross operated leg or ankle (adduction)
what are 3 hip precautions to take to avoid dislocating the hip after surgery for hip fracture?
occupations purposeful activities activities
what are 3 interventions to enhance a client's occupational performance
-to make use of these activities in intervention (if they are valued by clients) -to effectively set goals addressing a client's abilities to engage in caregiving and household work -to work successfully with caregivers of clients during intervention
what are 3 reasons why OTs must be knowledgeable about unpaid work in the home?
physical social attitudinal
what are 3 type of settings categorized as environmental factors (of context)?
embodiness task analysis physical environment or context social meaning
what are 4 components of just right challenge?
body function body structure environmental and personal factors
what are 4 elements that influence participation in self-care?
self report proxy report direct observation (ideally where clients live) performance based measures that use tasks in a clinic setting
what are 4 examples of self-care evaluation measures?
permissive authoritative authoritarian noninvolved
what are 4 parenting styles?
-formal -informal -by occupational tasks -by wellness of caregiver-care receiver relationship
what are 4 ways of categorizing caregiving?
-improved occupational performance -perceived happiness -belief in oneself -hopefulness for life and abilities
what are 4 ways to measure outcomes?
-be willing to compromise -don't be afraid to use bribery (reward system to elicit yes) -use the "three tries" rule (ask in 3 different ways) -don't take 'no' personally -make it easy to cooperate by offering choices and remember that a lack of cooperation is not the end of the world! :)
what are 5 creative ways to turn a "no" into a "yes"?
the activity OT's use of self as a leader group members as participants group process or interactions group culture and physical context
what are 5 major components of designing therapy groups?
-become aware of limitations and abilities -develop functional capacities through concrete task achievement -sharing responsibilities and accomplishments -behavioral trial and error -problem solving -immediate feedback -graded to allow progressive learning/experiences -new skill development -reality testing -interactions with nonhuman environment and objects
what are benefits of using groups?
-leisure occupations in which a person invests time, energy, and serious attention -leisure occupations to relax -leisure for cognitive, emotional, and physical invigoration -leisure for self-development -leisure for social consciousness, altruism, and service
what are categories of leisure occupations? (5)
-stress, anxiety, fatigue -cancer treatments -heart disease -brain surgery -hormone therapy -medications (!!) -infections -insufficient vitamins and minerals -untreated vision problems -other brain or NS disorders (MS) -dementia
what are causes of cognitive changes? (11)
-remembering to take medications (the more they take the more they forget to take) -getting timely refills -adverse side effects (unwanted results of medication; temporary, may just stop taking medication altogether) -adverse drug interactions with other medications, supplements, or food -fear of asking questions -high cost -not taking medication properly (chewing/cutting pills, dosage errors)
what are challenges people with cognitive decline may have with medication? (7)
-severe circulatory obstruction disorders (i.e., arterial, venous, or lymphatic disorders) -systemic infectious diseases -malignancies -open wounds -epilepsy -metal implants -pacemaker -severely impaired skin sensation
what are contraindications/precautions for using PAMS? (8)
-persistent fatigue -loss of energy -loss of interest in socializing (!); foot pain can be a contributing factor -drastic mood changes -wandering
what are emotional signs of cognitive decline? (5)
-spoiled food in the fridge -dirty dishes on the countertops -tripping hazards on the floors -clutter under the tables -unpaid bills
what are environmental clues that signal cognitive decline? (5)
-role balance -community accessibility (!) -respite care -stress mgt -behavior mgt -telehealth -energy conservation -referrals
what are examples of intervention that would occur in community-based settings? (8)
-education -compensatory strategies -safety -dressing -behavior mgt -medication mgt -stress mgt -referrals
what are examples of interventions that would occur in a clinic? (8)
-role balance -leisure -medication mgt -environmental modification (!) -safety -stress mgt -behavior mgt -telehealth -community resources -energy conservation -referrals
what are examples of interventions that would occur in home health? (11)
-therapy occurs in the client's usual life settings -modifications are made to life settings -an activity setting new to the client is selected for its therapeutic qualities -changes are made in the traditional clinical setting to more closely approximate intactness for the client (a mixture of these can also be selected, or a gradual transition from one to another, based on needs and progress)
what are four general modes in the therapeutic use of context?
logical-mathematical linguistic musical spatial bodily-kinesthetic interpersonal intrapersonal
what are gardner's 7 dimensions of intelligence?
-loss of independence -memory loss -communication and language difficulties -visual perception -emotional -physical -loss of attention -environmental clues
what are general signs of cognitive decline? (8)
-optimize performance -enhance meaning and QoL -reduce agitation or confusion
what are goals when working with cognitive and behavioral health conditions? (3)
-control pain -promote tissue healing -increase muscle flexibility -scar reduction -wound healing -decrease edema
what are indications for when PAMs should be used? (6)
-client may leave out essential details, assuming that you already know about certain aspects of the activity or because s/he is unsure of how much detail to give you -some clients may be unable to verbally give you the info needed (due to cognitive or speech impairments) -must be sure to gather information regarding all aspects of the activity (incl objects and properties, space demands, and social demands)
what are limitations of talking to your client to determine the steps of an activity? (3)
-balance issues (difficulty getting up from a seated position; look in bathroom for clues; loosening towel bars, torn shower curtain) -change in gait -loss of or change in appetite (junk food and easy to prepare, non-nutritious meals) -weight loss
what are physical signs of cognitive decline? (4)
everyday life activities that people do to take care of themselves
what are self-care occupations? (try to define)
-appearance, such as personal hygiene and daily grooming, is not attended to as much -driving (response time, missing turns, braking quickly, rolling through stop signs) -concentration (poor judgment, deciding not to go to the doctor because they were "just there last week," however it was a different doctor; getting repeated phone calls; missed appointments)
what are signs of cognitive decline dealing with loss of attention? (3)
-grading (just-right challenge/adaptability) -forum for observation of behaviors! -opportunity for giving natural feedback! -obtain peer feedback and benefit from group problem solving -support and hope - allows patients to interact with others who may share similar problems and goals (catharsis) -share knowledge and learn from each other -improved functional outcomes -physical/emotional safety
what are some benefits of OT groups? (8)
-sustained engagement/stimulates interest -focus on goal -works on social participation
what are some benefits of focusing on the activity? (3)
-sustained attention -cognitive flexibility -judgment (decision making, following driver etiquette)
what are some cognitive body functions needed for driving? (3)
-time -knowledge -resources -competence -attitude
what are some common challenges to using standardized assessment tools at the individual level? (5)
bathing/showering bowel and bladder management dressing eating feeding functional mobility using, cleaning, and maintaining personal care items (hearing aids, contact lenses, glasses) personal hygiene and grooming sexual activity toilet hygiene (hint: bADL; these are essentially all the ADLs listed in the OTPF)
what are some examples of BADLs? try naming at least 5 (there are 10 total)
care of others (including selecting and supervising caregivers) care of pets child rearing communication management community mobility financial management health management and maintenance home establishment and management meal preparation and cleanup religious observance safety and emergency maintenance shopping
what are some examples of IADLs? try naming at least 6 (there are 12 total)
-seat sliders -convex mirrors -key holders (arthritis) -gas cap grabber -handibar for window (and helps for transferring into/out of car)
what are some examples of adaptations to cars? (5)
-personal care -medical care -household care -emotional care
what are some examples of caregiving categorized by occupational tasks? (4)
-physical -emotional -social -spiritual (doing creative, meaningful activity that expands thinking beyond that activity) -intellectual -vocational
what are some examples of caregiving categorized by wellness of caregiver-care receiver relationship? (6)
-avoid pressure that pushes knuckles or wrist toward the little finger (preventing ulnar deformity) -avoid strong grasp and pinch (adapt daily tasks) -use stronger, larger joints that are close to the trunk -maintain or increase strength -maintain or increase endurance -maintain or increase skill in functional tasks with the use of AE -preparatory activities
what are some examples of joint protection techniques? (7)
-stress management -consistent bedtimes -increase sleep (decreases hunger)
what are some examples of lifestyle changes to address sociotemporal rhythms? (3)
waiting turn responding when someone is talking to you culturally sensitive sharing craft supplies
what are some examples of social demands?
-exercise programs (balance, gait, strength training like tai chi or PT) -adaptation/modifications of home environment (reduce hazards, tailored to the individual with appropriate follow-up provided) -provision of vitamin D supplements -medication reviews by a physician or other medical provider to minimize number/type taken
what are some fall prevention recommendations? (4)
-head up -eyes looking forward most of the time -shoulders relaxed -back erect and supported -only moderate pressure at the front of the seat cushion/butt is far back in chair -feet firmly on footrest or chair is at appropriate height so you can keep both feet flat on ground -hands in line with the forearms (can use armrests to support forearms) -reference material is easy to look at (e.g., paper holder) -monitor is approximately at eye height and an arms distance away -use hands, a headset, or speakerphone to avoid holding a telephone between head and shoulder
what are some guidelines for good ergonomics? (10)
-use an interpreter -pictures -apps -handouts -demonstrate -awareness of body language
what are some methods to communicate with a client who does not speak english? (6)
-eye hand coordination -gross motor coordination -eye foot coordination -saccades -pursuits -accommodation -muscle endurance
what are some motor body functions necessary for driving? (7)
-use on the road assessments and training -suggest appropriate vehicle modifications and adaptive equipment -improve flexibility and ROM -undo bad habits -recommend if a person should continue, modify, or stop driving
what are some of the unique roles of an OT driver rehab specialist? (5)
-parent's social support system -how they were treated as children -characteristics of the child -contextual factors (marriage, work, etc.)
what are some other factors that influence the parental process? (4)
-anxiety about starting a task -extra mental energy to start
what are some possible reasons people experience starting a task as more challenging than continuing a given task? (2)
-include preparatory and cleanup tasks in the steps if absolutely necessary (otherwise they can be separate activities) -listed in correct sequence, as they normally occur (construct steps according to sociocultural norms) -steps should be simple and concise (keep out unneeded details and avoid including multiple instructions in one step), and succinct and specific -be specific as to the amount of a certain material that is needed or used -avoid indicating using the right/left hand unless absolutely necessary -do not list physical or mental requirements -include precautions and warnings in parentheses -do not include proper nouns or specifics in regard to objects and properties unless absolutely necessary -be careful not to create special circumstances or "could be" situations
what are some protocols for sequencing steps of an activity? (9, not including what each step should include)
-emotional regulation -self confidence
what are some psychosocial body functions needed for driving? (2)
home safety balance transfer abilities strength gait training exercise medication review and reduction
what are some recommended areas of intervention for fall prevention? (7)
-meditating -listening to calm music
what are some relaxation techniques to lessen sleep disturbances? (2)
-vestibular -auditory discrimination -proprioception (hands steering, feet working pedals) -vision -touch
what are some sensory-perceptual body functions needed for driving? (5)
-limit eating before bed (nothing heavy 2 hours prior) -limit fluids before bed (no caffeinated drinks or alcohol) -level of activity -reading a book
what are some suggestions for sleep prep/bedtime routines to lessen sleep disturbances? (4)
sequencing and timing objects and properties space demands social demands required actions and performance skills required body functions required body structures
what are the different activity demands delineated in the OTPF? (7)
occupation is both the modality and the goal
what does it mean to say that occupation is both a means and an end?
-do not respond emotionally (!) -approach the person from the front -approach at optimal speed (1 step/sec) -address the person directly -speak at a normal rate of speed -explain who you are/why you're there (even to family) every! time! (they may not remember you) -catch their attention when outside arm's reach -use short verbal cues, one question at a time, one step instructions -support and reassure, pos feedback -offer a hand, but be cautious that you are not in a position where you can't break away from the grip (grab from underneath) -move to the same level as the person
what are some tips for communication with persons with cognitive declines? (11)
-instrumental panels with larger symbols and adjustable lighting -automatic dimming rearview mirrors to reduce headlight glare -rear-window wipers -blind spot reducing mirrors and doors
what are some universal designs for cars?
-wider more reflective pavement markers to delineate lanes clearly at night and in bad weather -raised pavement markers that reflect headlight beams -larger, brighter letters and symbols on traffic signs with more contrast between figures and backgrounds -better lighting on city streets and highways -left-turn lanes with traffic signals -larger traffic-signal heads and "all read" periods to allow a margin of error at intersections
what are some universal designs for roads and signage? (6)
-approach each client as a new experience (because they are); avoid becoming habitual -think about your thinking -know what type of learner you are/strengths -practice mindful self-awareness techniques to become a better intuitive thinker (journaling, meditation)
what are some ways to develop skills in clinical reasoning? (4)
activity demands
what are specific features of an activity that influence the type and amount of effort required to perform an activity?
occupational profile analysis of occupational performance
what are the 2 major aspects of evaluation?
motor process social interaction
what are the 3 categories of performance skills
values, beliefs, spirituality body functions body structures
what are the 3 client factors
-intervention plan -intervention implementation -intervention review
what are the 3 components of intervention?
intervention plan intervention implementation intervention review
what are the 3 components of intervention?
spatial temporal sociocultural
what are the 3 dimensions of context considered in the structuring of intact interventions
-home safety assessment by OT with modifications -provision of vitamin D -programs for balance, strength, gait training
what are the 3 most highly recommended interventions for fall prevention?
formative phase (getting to know each other) turbulence cohesion and productivity
what are the 3 phases of group formation?
person occupation environment
what are the 3 primary areas that can be changed, modified, or adapted during therapy?
appeal intactness accuracy
what are the 3 primary sources of the therapeutic power of occupation?
procedural, interactional, and conditional
what are the 3 types of reasoning in the three-track mind?
intentionality habits symbolic meaning
what are the 3 ways in which meaning making connects with activity?
-therapy occurs in the client's usual life setting -modifications are made to life settings -an activity setting new to the client is selected for its therapeutic qualities -changes are made in the traditional clinical setting to more closely approximate intactness for the client
what are the 4 general modes in the therapeutic use of context?
habits routines rituals roles
what are the 4 performance patterns
-create, promote (health promotion) -establish, restore (remediation, restoration) -maintain -modify (compensation, adaptation) -prevent (disability prevention)
what are the 5 intervention approaches?
novice advanced beginner competence proficient expert
what are the 5 stages a person may pass through during growth in the ability to reason about activities as a function of time and experience?
1. climate of acceptance 2. bridge to the real world 3. sharing the world in which we live 4. appreciation of the work world 5. climate of appreciation
what are the 5 steps for leading a cognitive remotivation group?
-occupation-based -purposeful activity -preparatory methods -consultation -education -advocacy
what are the 6 types of interventions?
-expert/leader -role model (model appropriate group behavior) -helper/facilitator -select members -logistic coordinator -oversees group rules/norms (guide behavior and actions in the group)
what are the OT roles in the development and running of a therapeutic group? (6)
ADLs IADLs rest and sleep work education play leisure social participation
what are the areas of occupation? (8)
-improved cognition -reduction of risk fall -reduction of behavioral and psychological symptoms of dementia -aerobic exercise leads to improvement in spatial memory -resistive exercise improves executive function and gait speed (indicator of mortality rate and reduced fall risk) -combo of resistance and aerobic routines reduces agitation and aggressive behaviors in moderate and severe stages of dementia
what are the benefits of exercise on cognitive decline? (6)
-self expression -feeling of connectedness with others -relaxation -cognitive, emotional, and physical growth -self development -altruism
what are the benefits of leisure occupations?
-can control for safety -address problems -gain insights
what are the benefits of providing OT in a safe and controlled clinic environment? (3)
creates a tunnel vision that negates the possibility of entertaining other possible explanations about the way in which a client functions
what are the dangers in the habituation to tacit ways of applying clinical knowledge? (1)
-people who create mental models make very little explicit (because they focus on the implicit info in their models) -creates an environment in which the possibility of considering alternatives that lie outside the mental model is diminished
what are the hazards of reasoning using a mental model? (2)
-not always possible -not always enough time to experience all the occupations our clients do -contexts in which the occupations occur also limit participation -special equipment may be required -some activities require a certain amount of skill to be able to engage in (limitations because of safety and knowledge)
what are the limitations of engaging in the activity yourself to determine the steps of an activity? (5)
-used with simple, everyday tasks -not possible if the practitioner is not familiar with the task/activity
what are the limitations of mentally processing to determine the steps of an activity? (2)
-person may leave out essential details, assuming that you already know about certain aspects of the activity or because s/he is unsure of how much detail to give you -coordinating time between the clinician and the experienced person -cultural or language barriers
what are the limitations of talking to someone who performs the activity to determine the steps of an activity? (3)
-timing, sequencing, and actions used by another person may not always be the same as those used by your client -need to find someone willing to do the activity for you -time might become an issue (unless using video information)
what are the limitations of watching someone perform the activity in order to determine key steps? (3)
safety dignity of the group members maintenance of the group's cohesion and functioning
what are the norms of the greatest importance in a group? (3)
-move operated leg forward -push off the armrests of the chair to stand up -once balanced, reach for walker
what are the steps a client should take to standing with a hip fracture? (3)
client's perspective (life story) practitioner's perspective (stories we create about our clients)
what are the two levels of narrative reasoning?
objects/materials and their properties space demands social demands sequencing and timing required actions/performance skills body functions body structures
what are the types of activity demands? (7)
hand spatial sense embodiness
what are three aspects of the physical body?
environmental physical body social meaning
what are three components of the spatial dimension of occupation?
-the life story of the client as it unfolds during eval and continues in treatment -narrative constructed by the practitioner as intervention is designed and implemented
what are two levels of narrative reasoning?
-patient and family edu -assure them that steps backwards do not equal failure
what are two things to address with the client regarding the unpredictability of recovery?
explicitly state them writing and displaying them on a bulletin board
what are two ways to establish group norms
functional activity task social other (developmental)
what are types of OT groups? (5)
-qualitative data from both the care-receiver and caregiver perspectives -observation of care-receiver and caregiver interactions -caregiver identity - occupational profile -environmental assessment
what are types of assessment? (4)
-behavioral -biological -environment -modifiable -nonmodifiable
what are types of fall risk factors? (5)
acuity visual fields contrast sensitivity (light and dark) conditions (macular degeneration, cataracts, diabetic retinopathy, glaucoma)
what are vision related factors that may affect driving ability? (4)
-visual cues -repetition -journal new info -sticky notes -physical exercise -mental exercise -redirect during challenging behaviors (sidetrack them from what is upsetting them) -use life story as a guide -quiet books -sensory stimulation
what are ways to manage cognitive problems? (10)
-rest so the pain can subside -warm bath/shower/soak can ease pain and stiffness -after exercise/exertion, cold therapy (frozen pack of peas wrapped in a towel or a gel freezer pack) -topical OTC ointments -oral meds
what are ways to schedule therapy around pain so you can exercise/treat a client with painful joints? (5)
no one area is more important than another
what area of the OTPF Domain is the most important?
goal setting (needs to be function related)
what aspect which uses procedural reasoning is documented most for reimbursement
we can begin to look at what can be changed in order to allow for greater independence; how we can change the objects used to allow for greater independence
what can OTs begin to do after gaining an understanding of what is used to perform an activity?
-proper positioning -respect privacy during activities such as dressing
what can we do to make our patients more comfortable?
accepting the role of caregiver unconditional positive regard (sincere concern) for care receiver
what caregiver behavior is essential in supporting a productive caregiving relationship regardless of whether the caregiving is informal or formal? (2)
setting, OT's experience, condition, etc.
what determines which FOR is used to guide the evaluation process?
alzheimer's
what disease accounts for 60-80% of dementia cases?
-theoretical perspectives -activity analysis -clinical reasoning skills -knowledge of a client's ability to perform occupations that are wanted and desired
what do occupational therapists use to help guide the OT process? (4)
consider what, when, where, why, how questions related to the topic
what do you do during the 3rd step of cognitive remotivation, sharing the world in which we live?
consultation
what is the role of an OT in creating accessible parks/playgrounds?
-treatment should be individualized (and focus on the specific client's strengths and weaknesses and the context in which they perform their daily routines with their family) -motor behavior/skill does not have to be normal -- just has to be functional
what does the article "Activity-focused Motor Interventions..." emphasize about intervention for children with neurological impairments? (2)
-temporal: experience, time of day -spatial/physical: obesity, weather -virtual -social: driving etiquette, passenger in car -personal: age, gender, medications, etc. -cultural
what environmental/contextual factors may impact a person's ability to safely operate a car? (6)
FOR
what guides the group development process?
-low vision -arthritis (dec mobility and pain) -after a stroke -seizures -narcolepsy -parkinson's -diabetes (peripheral neuropathy and passing out due to lack of insulin)
what health conditions can affect one's ability to drive safely? (7)
whether an adult chooses to marry or remain single or to have children
what influences how an individual uses leisure time during middle adulthood?
-respite services -personal care aids -positive coping strategies -caregiver mastery (self-confidence) -social support -education
what internal or external factors have been shown to mediate perceived stress caused by caregiver burden? (6)
-work hardening (time efficiency) -lifestyle changes -time management -consulting with caregivers -consulting with care facilities for environmental design options that support sociotemporal patterns -advocating at a system level -advocating for undisturbed sleep
what is OT's role in addressing sociotemporal rhythms? (7)
-respect where clients are in learning new tasks or restoring previous level of function (complete one step at a time) -some people move slower/faster -some take more time to process info -analyze lifestyles that may have contributed to an illness or injury -overall, be patient
what is OT's role in addressing subjective time experiences? (5)
-time analysis -sleep logs -sleep prep/bedtime routines -education -relaxation techniques -advocating for undisturbed sleep
what is OT's role in sleep disturbances? (6)
-daily routines -medication adherence -self-mgt -stress mgt techniques
what is OT's role when treating the client in cognitive and behavioral health conditions (4)
training and education (appropriate cues and support for patients with cognitive limitations and behavioral health conditions)
what is OT's role when working with the caregiver in cognitive and behavioral health conditions?
-sun flare -foggy weather -heavy rain -dawn -snow
what is a good example of a driving condition that requires good contrast sensitivity? (5)
get it done whenever versus need it done by
what is an example of M-time versus P-time?
context/environmental factors activity demands
what is changed in the modify approach? (2)
IADL -out in community; connectedness to other things, people, services, occupations -all the ways in which people move about
what is community mobility?
has advanced education and expertise
what is different about the OT specialist in driver rehab?
-consider what, when, where, why, how questions centered around the work of the topic -completion of activity
what is done during the 4th step of cognitive remotivation, appreciation of the work world? (2)
caregiver burden
what is especially important to address with caregivers of individuals with cognitive declines?
relevance and importance to client objects and properties space demands social demands sequencing and timing required actions and performance skills required body functions required body structures
what is included in activity demands under the OTPF? (8)
health participation engagement in occupations
what is looked at during outcome monitoring? (3)
grouping; for example, teach client UE dressing and then LE dressing (instead of both at same time)
what is meant by "chunking" in regards to occupational experience?
healthy balance of occupation
what is needed in engaging in occupations lest you risk health problems?
the activity
what is often the focus of OT groups?
give them a teaching role
what is one possible way to deal with a client who takes over the group session?
re-direct unsettling behavior with familiar or enjoyable concrete activities
what is one tip for caregivers when the care recipient's behavior is unsettling?
try to reason with them and give them reminders
what is one way to address concentration in a client with cognitive decline?
-measurable goals -intervention approach(es) -type(s) of intervention
what is selected in the intervention plan? (3)
educate patients
what is the 1st step in addressing an imbalance in leisure occupations during the intervention process?
occupational awareness and profile
what is the 1st step in an OB-AA
-consider the FOR -identify specific info about potential members of group -conduct a program assessment to identify the setting's existing services -prepare/design an appropriate protocol for the group
what is the 4 step process for the clinical decision making that leads to developing a group protocol?
-pain management -preparing them or their family members -leisure/reflection (ex: scrapbooking) -daily routines -dignity (give choices) -DME -education and training family on how to care
what is the OT's role for clients at the end of life stage? (7)
associated with meaning
what is the significance about the objects (tools, toys, symbolic objects) filling the spaces of humans engaging in various occupations?
-educate caregiver on condition, AE, and environment, and introduce coping mechanisms/respite services -environmental modifications to make safer -suggest putting out clothing night before or clothes that are easy to put on
what is the OT's role to support aging in place? (3)
direct observation
what is the best method for a self-care evaluation?
direct observation because it depends less on client's insight and cognitive ability (other methods include self-report, proxy report, and performance-based measures that use tasks in clinical settings)
what is the best method for gathering information about self-care occupations during a self-care evaluation? why?
trying to meet goals of all the different clients
what is the biggest challenge OTs face when designing a group?
boredom
what is the biggest problem of productivity-loving clients?
client needs and desires
what is the center of the OT process?
works against the group
what is the commonality among individual group roles?
solitary --> shared --> co-occupations
what is the continuum of the social nature of occupations (begin with occupations requiring no/minimal social interaction)
concept of occupation
what is the core of OT?
-AE is made specifically for people with disabilities -UD is for all people
what is the difference between AE and UE?
OBAA is based on a client performs the activity AA is based on how the activity is typically performed within the cultural and social norms
what is the difference between OBAA and AA?
activity demands are based on a particular activity and include conditions external and internal to the client (are observable) client factors are identified regardless of the activity and are internal to the client (reside within the client)
what is the difference between activity demands and client factors?
-group: clients have a certain level of independence and have similar goals; groups also emphasize the social nature of people, fostering physical and emotional supports among clients -individual: OT practitioners work with clients when one-to-one attention and assistance are required
what is the difference between group vs individual treatment?
watching television
what is the favored way to rest among americans?
immobilize the painful joint with a splint
what is the first line of action for treating painful joints?
get to know your client (need to know what is attractive to the person for whom you are designing an intervention for appeal) -requires an understanding of the client's activity preferences, current and past occupational patterns, and present energy level and life challenges (in a family-centered approach in which goals are set for the family as much as for the individual, need to get to know the whole family)
what is the first step in designing for appeal?
occupational profile
what is the first step in the evaluation of client centered process?
determine what is being analyzed and if you will be conducting an activity analysis or occupation-based activity analysis
what is the first step of activity analysis? (2 parts)
Achieving health, well-being, and participation in life through engagement in occupation
what is the goal of OT?
discuss and develop the patient's healthy aspect no matter how repressed they may be
what is the goal of cognitive remotivation?
grade an activity that is minimally challenging to meet a client's level of functioning (flow)
what is the goal of the just right challenge?
actively listening because the client's story emerges through his/her storytelling
what is the key task/most crucial element for the OT using narrative reasoning?
ability to participate in ADLs (complete self-care occupations)
what is the major predictor of dependence, morbidity, and mortality following an illness or injury?
qualitative data from both the care-receiver and caregiver perspectives (carers' checklist)
what is the most beneficial form of assessment?
provides enjoyment or pleasure (primary motivator toward engagement)
what is the most essential characteristic of play?
parental personality and psychological well-being
what is the most powerful determinant in supporting parental function and child development?
support QoL for all person's involved in the caring relationship
what is the overall goal during transitions?
achieving health, well-being, and participation in life through engagement in occupation
what is the overarching statement describing occupational therapy's domain and process?
striving for intactness
what is the primary way in which OTs use context effectively in treatment?
provide a appropriate tool so the client can perform an occupation (not to change a client's physical abilities)
what is the purpose of a compensatory intervention approach?
for people to engage in activities together
what is the purpose of a group?
design and implement effective fall-prevention programs to enable the elderly to stat active and enjoy productive lives
what is the role of OT in fall prevention?
-home safety eval -help create plan for accessing things used most frequently -recommend installing railings and grab bars; putting nonslip strips or rubber mat on the floor of tub/shower to prevent slipping -suggest adding lighting to potentially unsafe areas -safely increase physical conditioning by focusing on enjoyable activities/occupations
what is the role of OT in fall prevention? (5)
-long term care -assisted living -adult day care settings -psychiatric settings (in-patient and out-patient) -schools and alternative learning settings
where is cognitive remotivation used? (5)
life-space
where one or more roles change or end as a result of acquired physical disability, the individual may be unable to find new meaningful activities and roles to fill the _________________ (temporal dimension) formerly occupied by old ones
occupational environment
where to treat, the conditions of the environment, the objects that need to be available or that present barriers, and the social meaning of the space to the individual that play a critical role in the success of the intervention; the spaces in which occupation occur
pleasure, productivity, or restoration
which 3 characteristics of what will be most attractive in therapeutic experiences lay the foundation for designing highly appealing, and thus effective, occupational therapy? (by determining which of these characteristics the client finds most motivating)
procedural interactional and conditional
which 3 types of reasoning work together?
activity demands
which area of the domain was moved to the process?
intactness
which aspect of therapeutic power (appeal, intactness, or accuracy) aligns with context and environments?
individual; once a client has mastered a certain level of independence in her or her newly acquired skill, s/he can be treated in a group setting with others who have similar goals
which comes first: group or individual treatment?
no one is more important than the other
which dimension is more important or more frequently considered?
personal factors
which influence how a person experiences a disability: environmental factors or personal factors?
authoritative
which parenting style is the most effective?
eye contact physical/personal space
which two features of proxemics are closely correlated with one's culture and are primary indicators of comfort and attentiveness between individuals?
conditional reasoning
which type of reasoning is the synthesis of all of the other forms of reasoning, some of them beyond what is known explicitly?
steps or timing elements essential (what is absolutely necessary)
while each person, may complete an activity differently than another person, it is important to understand which _____________________ for successful performance of an activity
-depression -medication side effects -excessive use of alcohol -thyroid problems -vitamin deficiencies (vitamin D) -UTI (refer to nursing staff for urinalysis)
while most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by what conditions may improve when the condition is treated/addressed? (6)
the client (gives them meaning to determine which area they fall under; for example, art can be work for one person but leisure for another)
who defines occupations?
-dementia -need more sensory stimulation -non responsive individuals -maintain or improve physical and cognitive abilities -need re-socialization skills -passively introduces the correct answer as one of many possible answers
who is cognitive remotivation used with? (6)
others who will support the client
who is especially important to involve in the process when working with a client with cognitive declines?
care recipient AND the caregiver
who is the primary client in caregiving?
child or adult participating in them, as well as the environment or culture that surround them
who/what defines play activities? (2)
-not actively pursuing leisure interests leads to boredom, loneliness, unhappiness, passivity, and a disconnect -leisure may be the key in achieving all of the other client goals that our society values more than leisure
why do OTs need to address leisure? (2)
-to modify a specific client factor when neurological, musculoskeletal, or skin conditions are present that may limit occupational performance -in preparation for and in conjunction with purposeful or occupation based activities (used prior to occupational performance)
why do OTs use PAMS? (2)
-aging in place, family members may be living with them
why is caregiver burden becoming a focused area for OTs?
-you're going into the client's space -want to make client comfortable
why is it important for an OT to be sensitive to the social meanings of spaces? (2)
-will affect how they approach care-taking -66% of caregivers are female and experience more stress -age; younger caregivers experience increased burden (have to manage other additional responsibilities) -relationship dynamics might be different -increased level of care over time
why is it important for occupational therapists to consider a caregiver's cultural background, gender, sexual orientation, geographic location, socioeconomic status, etc.? (5)
leisure will potentiate change in ADLs prevent secondary health issues participate in things they enjoy contribute to balanced lifestyle supports mental and physical health opportunities for personal growth and competency
why is leisure a critical aspect of life (6)
provide ready access to a range of leisure activities that would otherwise be unavailable
why is the internet important for engaging in leisure occupations for persons with disabilities?
leads to seeking pleasure in non-productive things (not channeling energy positively, which can also lead to drugs, graffiti, etc.)
why should we not have too much relaxed leisure?
sense of efficacy, avenue for socialization, and self esteem
work provides _____________ (3)
repair functions of skin (ex: rowing, developing blisters)
wound healing; capacity of skin to heal itself when damage occurs through tearing, ripping, cutting, or burning; required of activities in which maintaining skin integrity is important