Review for exam
transtheoretical model of change
1. precontemplation 2. contemplation 3. Preparation 4. Action 5. Maintenance
three key principles underlying free-market economies
1. supply and demand 2.competition 3. free choice
Balanced Budget Act
1997, brought SNFs under protective payment and dramatically changed the reimbursement to facilities. $1500 annual limit per person, or cap, was placed on occupational therapy services provided in outpatient settings or SNFs.
CQI
Continuous Quality Improvement, began in health care in 1980.
Indirect expenses (sometimes called operating expenses):
Costs associated with running an organization that may be spread across departments according to a predetermined rate or formula and that are not influenced by work volume, such as secretarial support, or overhead costs, such as electricity.
Direct expenses:
Costs such as salaries, services, contracts, and equipment directly related to operation of a department.
Medicare Administrative Contractor
MACs fiscal intermediaries process claims for Medicare beneficiaries
Ways that authority differs from power
Nature Flow Organizational charts Level of Management Legitimacy Position and Person
Capital equipment:
Nonconsumable equipment with a cost and life span over an amount set by the organization (e.g., any single piece of equipment costing more than $500 and with a life span of greater than 12 months).
stage of competency
Novice advanced beginner competency proficiency expert
SSA
Social security administration
Full-time equivalent (FTE)
The number of hours paid to a full-time employee during a designated time period, including payment of vacation or other benefit time. For example, payment for a typical 40-hour workweek multiplied by 52 weeks is 2080 hours.
Cost per unit of care:
The ratio of all expenses to total work volume such that the cost to produce one unit of care (e.g., 15-minute work unit, day of care) is represented and can be tracked over time or compared to costs of other programs or organizations.
Mission Statement
Why does the organization exist? What function do we perform? For whom do we perform the function or who are the primary beneficiaries of services? How do we fill this function?
reasons organizations efforts with change fail
allowing too much complacency failing to create a sufficient powerful guiding coalition underestimating the power of vision under communicating the vision permitting obstacles to block the vision failing to create short term wins declaring victory too soon neglecting to anchor changes firmly in the new organizational culture
Do
carry out process of improvement while collecting data. identify all parts of the process connected to the issue being reviewed. Flow charts work well.
types of competencies
equipment related specialized practice advanced practice
Phases of controlling
establish standards, measuring performance, correcting deviations.
business modeling
evaluating who does what and why; might need to reorganize to meet goals.
ecological model of health promotion
explains where to intervene once a particular challenge or health problem is identified.
consultants
external or internal, provide advice, expertise and project management
medicare
federal program for people over 65 years and some individuals with chronic disabilities.
three levels of analysis for organizational culture
first level-observable culture, or the way we do things around here, second level-shared values that link organizational members together... third level-common assumptions or taken-for-granted truths...
maintenance
health behaviors are successfully incorporated into daily routines so the behaviors become habitual
content theory
help managers understand WHAT will or will not motivate an employee; what will this employee value as a reward or as a need satisfier?
common reasons for resistance to change
increased stressed denial self-interest lack of understanding uncertainty motivation different assessments or perceptions Motivation
action
individuals attempt to incorporate health behaviors into their routine
process theory
instead of emphasis on what an employee needs; emphasis is on HOW to motivate employees.
legislative arena
laws influence scope of care
Change agency
leadership management consultants teams
novice stage
learners focus on applying the rules of a particular skill
advanced beginner stage
learners focus on applying the rules of a skill in specific situations that become increasingly dependent on the particular context of the situation.
expert stage
learners integrate mastered skills with their own personal styles.
proficiency stage
learners perceive situations as "wholes" rather than "aspects," and their performance is guided by intuitive behavior.
competency stage
learners see actions in terms of long-range goals or plans and are consciously aware of their skills
Activities grouped under directing
mentoring coaching performance planning supervision
management
middle-level managers
Productivity percentage
minutes billed /minutes worked
Victim behavior
missed work, lower productivity, complaining, missed workdays or sabotage
precontemplation:
persons are unaware or under aware of a health problem or the benefit of performing a health behavior.
Resistance:
persons express frustration or anger and may avoid helping to implement change or work against it • Continue to stress why change is occurring. • Allow opportunities to express concerns in writing and in person by using suggestion boxes or town hall meetings. • Make sure that communications includes details, and that persons are kept informed of steps as they happen. • Stress accomplishments.
Acceptance:
persons understand what change will occur and agree to support it even if it is not how they would act if acting alone • Celebrate accomplishments. • Recognize those instrumental in the change but thank all persons involved in the department or organization for their support. • Plan review of impact of change and to assure that the change is not temporary. • Review what went well and what did not go so well to help prepare for future changes.
Functions of Management
planning organizing and staffing directing controlling
Steps to Strategic planning
planning to plan Environmental assessment and monitoring review of organization mission establish goal business modeling performance audit and gap analysis action planning contingency assessment
factors that contribute to employee retention
potential for promotion part-time options autonomy job security competitive salaries flexible schedules vacation/holiday leave positive staff relations continuing education health benefits educational reimbursement
interpersonal
relationships and interactions with persons such as friends peers and family that influence behavior.
Management
the process of guiding an organization by planning for future work obligations, organizing employees into functional units, directing employees in the process of completing daily tasks, and controlling work process and systems to assure adequate quality of work output.
parallel group
18-24 months. Very little group interactions; leader provides essentially all needs of each member. (Mosey)
Titles XVIII and XIX
1965 established Medicare and Medicaid opened employment in nursing homes, related facilities, and home health agencies.
Section 504 of the rehabilitation Act
1973 Discrimination against people with disabilities when offering services is prohibited.
Complaints and appeals
8 basics of the Patient Bill of Right. You have the right to fair, fast, and objective review of any complaint you have against your health plan, doctors, hospitals, or other health care personnel.
Old Old
85 and older
IQ scores considered within normal limits
85 to 115
Cooperative group
9-12yr. longer-term projects; task accomplishments and socio-emotional needs met mostly by members. (Mosey)
Standard IV Outcomes
A COTA contributes to evaluating the safety and effectiveness of the OT processes and interventions within the practice setting.
Developmental sequence prewriting strokes: 3-4 y.o.
Cross, circles...then make shapes.
Context and environment
Cultural
CPT
Current Procedural Terminology. Revised annually calculated basis of a number of factors. Codes describe outcomes.
George Barton
Founded Consolation House in NY, in 1914, an early pro type of a rehabilitation center. Was a founding member of the National Society for the Promotion of Occupational Therapy. Focused on conditions of the discharged patient, need to return to employment after illness and occupation and education convalescents.
Areas of Occupation
Framework. Areas that are oriented toward taking care of one's own body, care of others. Obtaining restorative rest and sleep.
Performance patterns
Framework. Habits, routines, roles and rituals.
3- Fair minus
Part moves through incomplete ROM (more than 50%) against gravity.
2- Poor minus
Part moves through incomplete ROM with gravity decreased.
Developmental Stage of Mobility
Passenger Explores mobility Community Independence
Level C6
Pattern of weakness: absence of wrist flexion elbow extension, hand movement;total paralysis of trunk and lower extremities. Movement possible: Scapular protraction; some horizontal adduction, forearm supination, radial wrist extension. Moderate to Minimum Assitance
Osteogenesis Imperfecta
Congenital condition in which the bones do not develop correctly and become brittle. Prone to fractures with handling. Comorbidity-osteoporosis results from not weight bearing.
social skills training
improving interactive skills (e.g. communication, conflict negotiation skills)
discussion
information that will explain the main findings in great detail and discuss any methodological problems and flaws that the researchers discovered.
open system
input -throughput-output-feedback
dualism
involvement of both government and private industry in health care system
Teacher
is concerned with the individual's learning. Their expertise and experience in creating environments and activities that promote learning and understanding is essential to the development of children and adults.
resilience
is coping with adversity.
Praxis
motor skills planning
components of executive functioning
multitasking, planning, organizing, decision making
Isotonic active assisted exercise
muscle contraction is used as joint move through partial ROM, and the therapist or a mechanical device completes the range.
5 components of postural mechanism
muscle tone, postural control and stability, righting responses, equilibrium reactions and protective extension reactions.
developmental dyspraxia
neurologic disorder of motor coordination manifested by difficulty thinking out, planning out, and executing planned movements; difficulty with motor planning that is a result of sensory processing problems.
entry level
new graduate or an individual new to the practice setting
closed brain injury
non-penerating; trauma to the head by force. Brain tissue tear apart in skull
basic research type
objective is to discover new knowledge and to find out how things work or what they are made of, i.e: cellular structure of scar tissue.
asymmetrical patterns
paired extremities perform movements toward one side of the body at the same time.
Myocardial Infarction (MI) - What happens during an MI?
part of the heart muscle dies
Pt.
patient
0-6mo.
period of the most rapid physical growth.
reality orientation
person/place/time. Can be done in groups or one on one.
Pursed-lip breathing
prevent tightness in the airway by providing resistance to expiration
monopolist
probably the most common challenge is the person who dominates
price fixing
process of agreeing with another service provider to set costs together at a determined level
Planning
process of deciding what to do by setting performance objectives and identifying the activities needed to accomplish these tasks
life skills group
process of learning to satisfy one's needs in responsible ways. Organized around 3 content areas, values clarification, competency training and information classes.
the 4 p's of marketing
product price place promotion
institutional
programs and policies within an organization that influences behavior (weight loss program incentives) Smoking cessation.
step 1 in the 4 step intervention process
Problem; identify the specific issues in the group.Who is involved, what are the behaviors, and how is it affecting other group members and the group process?
Principle 5
Procedural Justice - OT personnel shall comply with laws and Association policies guiding the profession of OT.
3 types of clinical reasoning OT's use
Procedural reasoning
Grading
Process of performance being viewed step by step, from simple to complex. Builds upon what has already been accomplished. Example would be to add weights.
Activity Demands
Required body functions
Activity Demands
Required body structures
BOT (Bruininks-Oseretsky)
Testing of manual dexterity (stringing blocks), bilateral coordination (pivot thumbs and index fingers...itsy bitsy spider), upper-limb coordination (catching a ball or dribbling a ball).
Discrimination
The ability to detect a difference or distinction between one item or picture and another, for example, the ability to identify which picture is not like the others.
When is OT indicated for the treatment of patients with gout?
When resting splints are required, with decreased hand function and joint mobility, and when AE may be helpful.
Conditional reasoning
Where OP's place the Pt. in past, present and future social worlds to guide treatment decisions.
Mildred Schwagmeyer
Worked in Tuberculosis hospitals until recruited as assistant director of education at the AOTA national office in 1958. Became the most knowledgeable person on the subject of OTA's at the National Office in the United States.
Stage 3 Parkinson's Disease
Worsening of symptoms, impaired righting reactions, disability related to ADL, balance changes, may still maintain independence with interventions.
functional position
Wrist: neutral or 20 to 30 degrees of extension depending on person's tolerance, 15 to 20 degrees of metacarpophalangeal (MCP) flexion, and 5 to 10 degrees of ulnar deviation. Thumb: position of comfort in between radial and palmar abduction.
How could you modify activities to protect joints.
You could use splints, adaptive equipment/devices, give client rest breaks during the activity
Anemia
a pathological deficiency in the oxygen carrying component of the blood (red).
health
a state of complete physical, mental and social well being.
Lead pipe rigidity
a state of stiffness and inflexibility that remains uniform throughout the range of passive movement, associated with diseases of the basal ganglia.
Seizures
a sudden attack, spasm or convulsion; and intense, involuntary muscle contraction.
AKA
above the knee amputations
parts of research project
abstract introduction discussion methods results conclusion
Therapeutic activities
activities like knitting
anoxia
an absence of oxygen
symes amputation
ankle disarticulation
contextual inconsistencies
any aspect of a client's interpersonal or physical environment changes during the course of therapy. Interpersonal event that occur during group process.
help seeker
appears needy; seeks pity
primitive reflexes
are observed in the infant and are involuntary, helps to elongate muscle groups in preparation for voluntary control.
norms
are the established guidelines and expectations for behaviors
defense mechanisms
are unconscious and are used by the ego to control impulses and organize actions in a way that leads to compromise among the id, superego and the demands or reality.
specificity
art of stating things simply, directly and concretely
coordinator
assembles/organizes ideas
performing
at this point the gout members work together and begin to realize group and individual goals.
harmonizer
attempts to mediate differences of opinions
precautions and complications of spinal cord injury
autonomic dysreflexia,orthostatic hypotension, respiratory impairment, hypothermia/hyperthermia, sensory loss.
brain stem
breathing, heart rate, arousal & unconsciousness, sleep and wake cycles, attention and concentration
RLA V
confused, inappropriate, non-agitated. Appears alert and response to simple commands more consistently. Cognitive activities, group sessions, emphasize importance of ADLs.
Choreoathetosis (athetoid)
constant fluctuations from high to low and jerky movements.
introduction
contains information about the author's interest in the research, why they choses the topic, and their hypothesis
id
contains the drive to self-preservation and pleasure-present at birth-operates unconsciously.
superego
contains the standards for behavior based upon learned rules-operates unconsciously. It is our conscience-tells us right from wrong.
midlife 40-65
continued chronic problems, adjustment disorders, early onset dementia
normal muscle tone
continuous state of mild contraction or a state of readiness of a specific muscle.
Soft tissue injury
damage to muscle, nerves, skin, and/or connective tissues. Contusion, crush wound or injury, dislocation, sprain.
qualitative date
data that is represented in non-numerical forms, such as written descriptions, pictures, etc.
quantitative data
data that is represented in numerical form
eschar
dead epidermis and necrotic dermis that remains attached to the wound bed.
neglect
decreased awareness and attention of the affected side
anemia
decreased hemoglobin/oxygen in system, effecting activity tolerance
hypotonicity
decreased muscle tone. Floppy posture with difficulty performing movements against gravity and fatigues quickly.
warm water
decreases muscle tone
brazelton behavioral states
deep sleep; light sleep; drowsy or semi dozing;alert, actively awake; fussy; and crying.
hypoxia
deficiency in the amount of oxygen reaching the tissue
Aspergers
deficit in social interaction without a significant delaying communication skills. Has age-appropriate cognitive and self-help skills.
dyscalculia
deficit in the ability to perform calculations
abstract thinking
enable a person to see relationships between objects, events or ideas. To discriminate relevant from irrelevant detail. Recognize absurdities.
rehabilitation act
enacted in 1973. requires affirmative action hiring policies for federal agencies, nondiscrimination in hiring people with disabilities when the employer receives federal funding, and access to government buildings and services
omnibus budget reconciliation act
enacted in 1987. Sets requirements to improve and monitor the quality of life of residents in long-term care centers. Requires that long-term care facilities assist residents in maintaining independence, living as full a life as possible, and being free from restraints whenever possible.
american with disabilities act
enacted in 1990. provides for equal access for people with disabilities in employment, public transportation, private business, government services, and telecommunications
health insurance portability and accountability act
enacted in 1996. Privacy rules require written consent before disclosing information and put restrictions on electronic data transmission
individuals with disabilities education act
enacted in 1997, provides for free and appropriate education for children with disabilities in the least restrictive environment. Includes requirements for the states to develop early intervention programs
Duchenne's Muscular Dystrophy
pseudohypertrophic muscular dystrophy. Muscle mass replaced by fat and scar tissue. Progressive disease which ultimately affects the cardiopulmonary system, which can result in death. Comorbidity of scoliosis is common.
postural tone
refers to muscle tension in the neck, trunk, and limbs.
pull-out
remove the child for therapy outside of the classroom
indirect selection devices
requires intermediate steps in order to indicate a response. Maybe accomplished in one of two ways: scanning or encoding.
standard setter
sets expectations and ideals for the group
delirium
short term impairment of STM & LTM
NDT key points of control
shoulders, hips, elbows, knees, head, ankles, hand
dominator
shows inappropriate authority by monopolizing others
Phalen's test
sign is present if a person feels similar symptoms when resting elbows on the table while flexing the wrists for 1 minute
3 basic categories of learning #2
skills, actions or behaviors that are learned, the "doing" part of the activity
Pressure sores - Stage 2
skin broken; remove all pressure until skin heals
epidermis
skin growth cells are located here
sociocultural arena
societal values and beliefs about what is acceptable and expected are constantly shifting
technology arena
sophisticated new products are constantly introduced
inductive reasoning
starts with specific observations and uses them as a basis for generalizations or constructing theories.
SWOT
strengths weakness opportunities threats
sample
subjects, participants, units of study
Decerebrate posturing
sustained contraction and posturing of trunk and extremities in extension.
paraneoplastic syndrome
symptoms caused by the presence of the cancer cells in the bloodstream; often the first clinical sign of cancer.
procedural technician
takes on various duties and jobs
rehabilitative or educational technology
technology is only one aspect of rehabilitation or educational program (software program for teaching ABCs)
high technology
technology that is difficult to obtain and use (electric feeding machine)
components of IRM #1
the client
theory
the general principles or ideas that relate to a particular subject- it provides a way of understanding what is necessary for practice.
Programmed aging theory
the genetic "clock". Cells may lose the ability to replicate. Segments of DNA become depleted with advancing age. One of the genetic theories.
effects of disabilities and environment on children with disabilities
the impact of different family styles and environments on an infant, toddler, child, or youth with disabilities.
self-understanding
the insight one has into one's problems and the understanding of how one's behavior positively or negatively influences the problems
group dynamics
the interacting forces within a small human group.
components of IRM #3
the interpersonal events that occur
components of IRM #4
the occupation
Phenotype
the physical expression of the gene. A person's characteristics
immediacy
the practice of giving feedback right after the event to which it relates.
Sample
the subjects of the study.
isotonic concentric contraction
there is joint motion and the muscle shortens. May be done with or without resistance. Motion is done against gravity. Elbow flexing to bring food to mouth.
concrete thinking
thinking in a literal, manner, mental inflexibility, difficulty with problem-solving
Obsessive-Compulsive disorders
this category of disorder involves obsessive thoughts and compulsive behaviors that are uncontrollable and the client feels compelled to perform them.
transtheoretical model of change
this model suggest that behavioral changes occurs in a series of stages.
way to achieve service competency
through CEU courses
adapting activity
to accommodate residual abilities
Ataxia
uncoordinated movements is due to a muscle control problems that cause an inability to coordinate movements. It leads to a jerky, unsteady, to-and-fro motion of the middle of the body (trunk) and an unsteady gait (walking style) It can also affect the limbs.
Somatic mutation theory
unexpected chromosomal changes occur and result in replication mistakes. Mistakes result in progressive loss of function. One of the genetic theories.
codependency
unhealthy involvement of non-substance abuser in controlling the substance abuser
nystagmus
unintentional jittering of one or both eyes.
activity theory
unless contained by poor health or disability, elders have the same psychological and social needs as middle-aged persons.
electrotherapy
use of electric current to stimulate muscle contraction.
perception of vestibular input
what tells us what direction we are moving in, the speed of our movement, our head position, and the position of our body in space
Performance patterns
Habits
FIM score -4
Minimal Assist: Patient participates 75% -90% of the time
Mod@x2
Moderate assist with 2 persons
Intervention review
Monitoring progress towards outcomes.
Performance skills
Motor and praxis skills
Occupation based
Occupations have meaning and have a functional goal. (ADL's, IADL's, etc..)
Abnormal Hard End Feel
Occurs sooner in the ROM than is typical or in a joint that normally has a soft or firm end feel. A bony grating or bony block is felt.
Abnormal Soft End Feel
Occurs sooner in the ROM than is typical, or in a joint that normally has a firm or hard end feel. Feels boggy.
2 Poor
Part move through complete ROM with gravity decreased.
dyscalculia
disabilities involving math
Neoplasm
abnormal new growth of tissue
Progression of Parkinson's can lead to
drooling, dyspagia, monotone speech, disorders in bowel and bladder control.
self-regulation and interest in the world
during the first few months after birth, the infant is focused on organizing the internal and external worlds, and the job of the primary caregiver(s) is to help them regulate these influences.
NDT approach
dynamic techniques that guide movements to influence muscle tone and postural control and to trigger automatic movement responses.
continuity theory
elders adapt to changes by using strategies to maintain continuity in their lives.
edema reduction
elevation, contrast baths, retrograde massage, pressure wraps, Pam's, active range of motion.
Evidenced Based Practice
emerged in response to health care professionals efforts to be more conscientious and clear about the process of making clinical decisions for individual clients
fx
fracture
task-oriented group (Fidler)
group that allows for focus on both self-awareness and interactions with other group members during a structured activity
stereognosis
identification of an object without vision
cold water
increases muscle tone
ASIA impairment - E
indicates that motor and sensory functions are normal
enabling negative behavior
individuals permit or support behavior of another individual even though it is negative or potentially harmful.
Personality disorder cluster A
individuals seem bizarre or unusual in their behaviors and interpersonal relations.
Shaken baby syndrome
caused by infants being violently shaken. Various levels of severity. Can be diagnosed with Cerebral Palsy as a result of the brain damage in infants.
dermis
composed of highly structured and organized collagen, wandering cells, blood vessels, elastic fibers, and a glue-like substances of glycosaminoglycans. Does not regenerate and heals by scar formation.
gerontology
comprehensive study of aging and how it affects individuals-physically, socially, psychologically, and economically.
third stage in group formation (Yalom and Leszczll)
is cohesiveness and willingness to work within the group, but on their own issues. The group is more concerned about helping each other and maintaining a safe environment for growth.
group protocols
is the overall planning of the group
LTG
long term goals
sustained attention
requires maintaining concentration on one activity or stimulus for a sustained amount of time.
judgement
requires mentally examining the aspects of different options and discriminating the variation in order to form an opinion or belief
enabling activities
requires more active patient involvement. Are a step toward performing purposeful activities.
blocker
resists group progress
countertransference
response is when the leader's psychological world gets a reaction to the group process and the members (because you treat someone like grandma they begin to act like your grandma)
Physiatrist
responsibility is to treat any disability resulting from disease or injury. The focus is on the development of a comprehensive program for putting the pieces of a person's life back together after injury or disease -without surgery. They are MDs and can write prescriptions.
what should one do if angina is present?
rest and medication
akathsia
restlessness
limitations of therapy
restrictions on available or possible service, time, resource or therapist action. Interpersonal event that occur during group process.
neurodevelopmental treatment
retraining perceptual function through experiencing the sensation of normal movement and resulting sensory feedback
Normal muscle tone
right amount of tension inside of the muscle at rest, and that the muscle is inherently able to contact on command.
lever
rigid structure fixed at a point called the fulcrum and acted on at two other points by two forces, causing movement in relation to the fulcrum
parkinsonian
rigidity, tremors, drooling, mask like face, shuffling gait
calming scents
rosemary and lavender
initiator
provides ideas and new perspectives
Directive (Kaplan)
purpose of the group is to provide consistent and structured experience to increase adaptive functioning. FOR: MOHO Dx: acutely ill & minimally functioning
RET
rational-emotive therapy: We create our world through the way in which we interpret experience.
8 Stages of the Intervention Process in OT Stage 6
re-evaluation
protective extension
reaching forward, backward or to the side to catch self when equilibrium cannot be regained.
Ataxia Cerebral Palsy
small shifts in muscle tone. Typically, all extremities involved. Clumsy, with decreased balance and coordination. Decreased equilibrium reactions and lack of proximal stability.
purposeful communication
smiling is purposeful; they have learned that smiling causes adults to smile back.
Peck's stages of Psychological development in the second half of life Middle age -2nd
socializing vs. sexualizing
essential skills for successful intervention with families
solution-focused curiosity and interest collaborative goal setting acknowledgement continuity
backward chain
starting with the last step and having the client perform the process backward
Deductive reasoning
starts with a theory or hypothesis and proceeds to test it under specific circumstances to see if it holds true.
deductive reasoning
starts with a theory or hypothesis and proceeds to test it under specific circumstances to see if it holds true.
Inductive reasoning
starts with specific observations and using them as a basis for generalization or constructing theories., hypothesis.
condition
state the circumstances required for the performance of terminal behavior
medicaid
state-run program for people who have limited income and/or high medial expenses.
kinesiology
study of movement
Characteristics of Effective Supervisors
Solid foundation of technical knowledge desire to achieve high expectations of others Self confidence Ability to instill sense of value in others Communicate effectively
Activity Demands
Space demands
Cardiac risk factors
unchangeable - heredity, male, age changeable - cholesterol, smoking, sedentary contributing - diabetes, stress, obesity
way to achieve service competency
video taping
behavioral theory
1.All behaviors is learned. 2. Actions that have pleasurable consequences tend to be repeated. 3. Normal behavior is learned if "good" behavior rewarded (positive reinforcement) and "bad" behavior punished or ignored.
how an OTA can participate in EBP
1.participating in the review of literature 2.identifying problems of practice that are in need of study 3.assessing client satisfaction or quality assurance outcomes, 4.exploring the theoretical or historical basis for specific intervention practices
Why occupations?
1.sense of control 2. sense of accomplishments 3. go farther 4. transference 5. coordination of different skills 6. feedback
Principles of ergonomics
1.work in neutral postures. 2. reduce excess force 3.keep everything within reach 4.Work at Proper Heights 5.Reduce Excessive Motions 6.Minimize Fatigue and Static Load 7.Minimize Pressure Points 8.Provide Clearance 9.Move, Exercise, and Stretch 10.Maintain a Comfortable Environment
mature group
15-18yr. leader is co-equal.
RUGs Rehab Medium
150 to 324 minutes total therapy per week on any combination of 3 disciplines.
Standard III Intervention
An OT practitioner documents the OT services provided within the time frame, formats, and standards established by the practice settings, agencies, external accreditation programs, federal and state laws, other regulatory and payer requirements and AOTA documents.
Standard II Screening, Evaluation, and Re-Evaluation.
An OT practitioner educates current and potential referral sources about the scope of OT services and the process of initiating OT services.
Standard IV Outcomes
An OT practitioner facilitates the transition or discharge procession collaboration with the client, family members, significant others, other professionals, and community resource when appropriate.
Standard I Professional Standing and Responsibility.
An OT practitioner maintains current licensure, registration, or certification as required by laws or regulations.
Standard I Professional Standing and Responsibility.
An OT practitioner respects the client's sociocultural background and provides client centered and family-centered OT services.
Vocational Rehabilitation Counselor
Assists an individual in selecting appropriate and meaningful work or changing careers as a result of his or her illness or injury.
Minimal assistance
At least 25% assistance needed to complete task
Maximum assistance
At least 75% assistance needed to complete task
AAC
Augmentative and alternative communication. devices- use of switches to activate
1970's
Dr. Jean Ayers and Lorna Jean King; sensory integration for the treatment of chronic psychiatric disorders.
What happens if a pt. doesn't meet the allotted hours for their RUG level?
Dropped to the next lower level and hundred of dollars in therapy service can be lost.
Process
Dynamic occupation and client centered, both used in the delivery of OT services
Area of occupation
Education
Habit Training
Eleanor Clarke Slage developed for mentally ill- a re-education program designed to overcome disorganized habits, and construct new ones, with the goal of restoring and maintaining health.
Performance skills
Emotional regulation skills
Dignity (core value)
Emphasizes the importance of valuing the inherent worth and uniqueness of each person.
Titles of the ADA - Title 1
Equal Employment Opportunity for Individuals with disabilities. Designed to remove barriers that would deny qualified individuals with disabilities access to the same employment opportunities and benefits available to others without disabilities. Employers must reasonably accommodate the disabilities of qualified applicants or employees, unless an undue hardship would result.
Maslow's hierarchy of needs level 4
Esteem needs
Adult/adolescent sensory profile
Evaluate behavioral responses to everyday sensory experiences. Measures the effect of sensory processing, functional performance. Self questionnaire.
Altruism (Core Value)
Exhibits unselfish concern for the welfare of others
compliance
Explain the purpose and goals of the splint to the older adult and caregiver. •Provide simple written and oral instructions. •Use positive reinforcement for correct follow-through. •Listen to the older adult's complaints and make splint adjustments as necessary.
Separation anxiety disorder
Extreme anxiety when anticipating separation or separating from home or primary caregiver. May refuse to go to school or overnights with friends. Nightmares of separation. Somatic or physical symptoms: headache,dizziness, palpitations, stomachaches, nausea, and vomiting. Delayed social development and poor academic performance.
Symptoms of MS
Fatigue, depression, motor involvement, visual changes, sensory symptoms, tonic spasms, brainstem symptoms, cerebellar involvement, genitourinary symptoms.
What are three systemic signs of RA?
Fatigue, loss of appetite, fever, weight loss,
Social Skills Training #4
Feedback
Principle 7
Fidelity - OT personnel shall treat colleagues and other professionals with fairness, discretion and integrity.
Normal Firm End Feel
Firm or slightly springy feel at the end of the range as if it has some "give" to it.
Psychiatric rehabilitation
Forces the development of skills and resources and uses activities and environmental adaptions as a base for therapy. Atheoretical. 1. Stage 1 Rehabilitation diagnosis. Stage 2 Formulation of the rehabilitation plan. 3. rehabilitation intervention.
Context and Environment
Framework. Cultural, personal, physical, social, temporal and visual.
Activity demands
Framework. Objects and their properties, space demands, social demands, sequencing and timing, required actions, required body functions, and required body structures.
Client factors
Framework. Reside within the client and may affect performance in the areas of occupation.
Performance skills
Framework. The abilities clients demonstrate in the actions they perform.
Client factors
Framework. Values, beliefs, and spirituality. Body functions and body structures
Performance skills
Framework. sensory perceptual skills, motor, praxis skills, emotional regulation skills, cognitive skills, communication and social skills
Object relations theory
Gail Fidler utilized activities to evaluate the pt's psychodynamics(Freud). Mental health and mental illness are determined by our relations with objects, human and non-human. Our abilities to love and respond to others is seen as expressions of object relations. Activities are matched symbolically to psychic content.
NDT
General principles brain plasticity, key points of control, inhibition, facilitation.
What is recommended to strengthen the healthy part of the myocardium and improve cardiac output?
Graded exercise/activity
Area of occupation
Instrumental activities of daily living (IADL)
3 types of clinical reasoning OT's use
Interactive reasoning
step 2 in the 4 step intervention process
Interpretation: What are possible explanations for the behaviors? Given what you are observing, what do you think is really going on with the members at the center of the issue?
step 3 in the 4 step intervention process
Intervention: Consider the identified problem and proposed theory and the desired outcome of the intervention. Identify two or three possible approaches.
Prudence (core value)
Is the ability to govern and discipline oneself through the use of reason.
Procedural reasoning
Is thinking about the disease or the disability and deciding on which treatment activities they might employ to remediate the person's functional performance problems.
mature group
Leader is co-equal.
Area of occupation
Leisure
Cri du Chat
Lejoune's syndrome. Rare. Characteristics are weak, mewing cry; widely based, downward-slanted eyes.Cardiopulmonary anomalies, failure to thrive, intellectual disabilities and developmental delays.
Oppositional Defiant Disorders
Negative, hostile, and defiant behaviors. Outbursts of temper. Hostile toward authority figures, poor academic performance, few friendships. DOES NOT violate rights of others or ignore others' feelings.
Abnormal Empty End Feel
No end-feel is reached because pain or other symptoms limit the ROM before resistance is felt.
0 Zero
No muscle contraction
Titles of ADA- Title 3
Nondiscrimination on the basis of disability by Public Accommodations and in Commercial Facilities. This title prohibits discrimination on the basis of disability by private entities in places of public accommodation. Examples include hotels, restaurants, golf courses, private schools, day centers, health clubs, etc.
Titles of ADA - Title 2
Nondiscrimination on the basis of disability in State and Local Government Services. This prohibits discrimination on the basis of disability by public entities. The public entity is required to provide access to programs, services and activities provided by the state or local government,when viewed in their entirety.
Principle 2
Nonmaleficence - OT personnel shall take reasonable precautions to avoid imposing or inflicting harm upon the recipient of services or to his or her property.
Neurodevelopmental (NDT)
Normal movement is learned by experiencing/performing normal movement. Facilitation, inhibition, postural control affects limb control, key points of control.
Bulimia Nervosa
Normal to above average weight. Binging followed by purging but not on a regular basis. Psychosocial symptoms similar to anorexia.
What are the major difference between OA and RA?
OA does not involve inflammation and RA is an inflammatory arthritis and is considered to be an autoimmune disease.
Interactive reasoning
OP's employ when wanting to understand the Pt. as an individual. Helps OP decide what treatment works best, and to understand the experience of having the disability from the Pt. point of view.
Handicapped Amendments in 1986
OT has a direct role in early intervention with children birth through 2 years of age.
Autonomy and Confidentiality
OT personal shall respect the rights of the individual to self determination
Procedural Justice
OT personnel shall comply with laws and Association policies guiding the profession of OT.
Veracity
OT personnel shall provide comprehensive, accurate, and objective information when representing the profession.
Social Justice
OT personnel shall provide services in a fair and equitable manner.
Nonmaleficence -
OT personnel shall take reasonable precautions to avoid imposing or inflicting harm upon the recipient of services or to his or her property.
Fidelity
OT personnel shall treat colleagues and other professionals with fairness, discretion and integrity.
Education for all Handicapped Children act 1975
OT personnel were recruited as a related service by public schools, to assist children 3-21 years old.
OTA Levels of Practice - Advanced Level
OTA has 3 or more years of practice and has achieved the intermediate level. Has demonstrated advance level skills that may be clinical, education, or administrative.
OTA Levels of Practice - Intermediate Level
OTA has worked 1-3 years of practice. Competent to carry out entry-level tasks. May be developing additional, more advance skills in a special interest area.
OTA Levels of Practice - Entry Level
OTA has worked less than 1 year. Competent to deliver OT services. Close supervision is required.
way to achieve service competency
OTR instruction and on the job training
Activity Demands
Objects used and their properties
Abnormal Firm End Feel
Occurs sooner in the ROM than is typical, or in a joint that normally has a soft or hard end-feel.
Ego intergrity vs. death
Old age. Facing the prospect of death. Reviewing life choices.
OBRA
Omnibus Budget Reconciliation, focuses on elder's rights, quality of care, and quality of life in the nursing home setting.
Spina bifida
One or more vertebrae not formed properly. Occulta(hidden), meningocele, or myelomeningocele. Minimal to maximal functional impairment. Comorbidities possible-scoliosis, kyphosis, hydrocephalus
Intervention implementation
Ongoing actions taken to influence and support improved client performance.
The York Retreat
Opened by William Tuke in 1796. Used Pinel's idea of moral treatment with patients.
Stages of Group Process for lower functioning individuals. Stage 1
Opening the session, welcome members, stimulate senses, pass around scented items.
Beneficence
Ot personel shall demonstrate a concern for the well-being of the recipients of their services.
step 4 in the 4 step intervention process
Outcomes and reassessment: What was the effect of the intervention?
Domain
Outlines the profession's purview and the areas in which it's members have established body of knowledge and expertise
Model
Overarching concepts that guide the general approach to clinical practice.
5 Normal
Part moves through complete ROM against gravity and full resistance.
4 Good
Part moves through complete ROM against gravity and moderate resistance.
3+ Fair plus
Part moves through complete ROM against gravity and slight resistance.
2+ Poor plus
Part moves through incomplete ROM (less than 50%) against gravity or through complete ROM with gravity decreased
What is the AOTA PAC?
Political Action Committee, lobbyists that go to Washington to fight for laws that benefit OT/
Level of Management
Power does not depend on the level of management. Power can exist at any level of management. Even lower level manager or worker can have power in influence the behavior of a top-level manager.
Behavioral
Predict and shape behaviors. Positive and negative reinforcements.
Psychoeducation
Primarily focuses on training and development of skills. View educational approach, clients are viewed as students, environment is a classroom.
PPS
Prospective payment system rates established in advance, based on the anticipated resource usage by the Medicare beneficiary and are a pre-determined fixed amount.
Automatic Reactions
Protective Extension Reaction, righting reactions, equilibrium reaction
William Rush Dunton
Psychiatrist who devoted his entire life to OT. Founding member of National Society for the Promotion of Occupational Therapy forerunner of (AOTA). Served as President and Treasurer. Published in excess of 120 books and articles related to OT and rehabilitation. Elected president Sept. 1917.
Palmar Grasp Reflex
Pt. cannot release objects placed in the hand.
Symmetrical Tonic Neck Reflex
Pt. cannot support weight on hands and knees, maintain balance in quadruped and creep normally.
Suck/swallow reflex
Pt. has difficulty eating. Involuntary protrusion and retraction of the tongue make it difficult to keep food or liquids in the oral cavity.
Plantar Grasp Reflex
Pt. has difficulty keeping toes from curling in the shoes. Normal equilibrium responses in the foot do not develop if this reflex is not present.
Asymmetrical Tonic Neck Reflex
Pt. has difficulty maintaining the head in midline while moving the eyes toward or past midline. Pt. may be unable to extend or flex arm without turning head.
Positive Supporting Reflex
Pt. has difficulty placing heel on the ground for standing and walking. Balance compensated with other body parts.
Tonic Labyrinthine Reflex
Pt. has severely limited movements. Unable to lift head in supine position.
FIM score -5
Stand by/Prompting/Supervisor or Setup: the patient participates more than 90% of the time and requires prompting, cueing or coaxing less than 10% of the time.
pediatric intensive care unit (PICU)
Step-down nursery. address acute symptoms, wean pt. off external medical supports. OT can address sensorimotor stimulation as tolerated. Pediatrician as medical team leader.
What is the proper response if signs of cardiac distress are observed during Tx?
Stop the activity Have the patient rest Seek emergency medical help if symptoms do not resolve Report symptoms to team Modify future activity
Muscle spasms
Sudden involuntary contraction of a muscle or large groups of muscles.
What is the outstanding clinical feature that causes joint damage in RA?
Synovitis
Titles of ADA - Title 4
Telecommunications. This title requires telephone companies to have developed interstate and intrastate telephone relay services in every state.
Context and environment
Temporal
power dilemmas
Tensions arise in the therapeutic relationship because of clients' innate feelings about issues of power. Interpersonal event that occur during group process.
Visual Closure
The ability to identify a form or object from its incomplete appearance. This enables a child to figure out objects, shapes, and forms by finishing the image mentally, for example, finding a jacket when it is partially covered by others. This ability is required when a letter may not be completely formed.
Figure Ground
The ability to identify the foreground from the background. When looking at pictures, people, or items, it is essential to separate important visual aspects from the background. When writing, children identify written words on lined paper. An example of this is the game of finding hidden objects in a drawing.
Form Constancy
The ability to realize and recognize that forms, letters, and numbers are the same or are constant whether they are moved, turned, or changed to a different size. This means that a square is always a square no matter what size or color. A daily example of this is when a person recalls the shape of the "yield" sign.
Sequential Memory
The ability to remember a sequence or chain of letters to form a word. With handwriting, children need motor as well as cognitive sequencing. Therefore, they need the ability to remember how letters make words and sequence them according to their motor abilities to make those words. For example, when taking a spelling test, the child needs to be able to recall what the word "dog" looks like and remember that it is d - o - g and not g - d - o.
Visual Memory
The ability to remember a shape or word and recall the information when necessary. With handwriting, children must remember how to form letters, numbers, and shapes. In later school years, this skill is used when remembering how to form the letters to spell words or form multidigit numbers.
Gross revenues:
The aggregate, cumulative, or total sum of revenue before any deductions (e.g., the total work volume multiplied by billed charges before any deductions are made).
• Net profit
The amount of revenue that remains after deduction of all expenses, deductions, and allowances.
Net revenues:
The amount of revenue that you expect to collect after deductions, such as discounts for managed care payers, are applied.
Dyskinetic Cerebral Palsy
Typically abnormal tone distorted in all four extremities (quadriplegia)
Stage 1 Parkinson's Disease
Unilateral tremor, rigidity, bradykinesia, minimal or no functional impairment.
confrontation
a deliberate attempt to help another person examine the consequences of some aspect of his or her behavior
closed group
a group no new members join ion which membership remains the same over time
Define team
a group of individuals who are committed to a shared purpose to each other and to working together to achieve a common goal.
open group
a group that allows for new participants to join the group so membership is always changing
Frame of Reference
a guideline for practice that provides direction for evaluation and treatment of particular deficits in the occupational therapy domain of concern. If i do this, then this is what I can expect to occur.
culture
a learned, shared set of basic assumptions or shared way of coin things that is based upon the underlying values and beliefs
substance dependence
a maladaptive pattern of abuse leading to clinically significant impairment or distress.
substance abuse
a maladaptive pattern of substance use leading to clinically significant impairment or distress.
scaffolding
a method of grading an activity by providing assistance to the client at times that he or she might struggle or be unable to complete a task.
Multidisciplinary
a number of professionals conduct assessments and interventions independent from one another.
Power of Attorney
a person is appointed to make decisions on behalf of the Pt. in the event that the patient is physically unable to make the decision.
Social modeling
a person or a video demonstrates the acceptable behavior and the patient copies it.
declarative memory
a person's ability to recite or reproduce info
memory
a property that describes a material's ability to return to its preheated (original) shape, size, and thickness when reheated.
substitution
a realistic goal or object substituted for one that cannot be achieved.
cogwheel rigidity
a rhythmic "give" occurs throughout passive range of motion.
warmth
a sense of friendliness, interest, and enthusiasm the therapist conveys
paradigm
a shared vision- knowledge that specifically addresses the identity and perspective of the OT profession
Mental health
a state of being relative rather than absolute. Being successful at working, loving, and creating with the capacity for mature and flexible resolution of conflicts between instincts.
Frozen shoulder (adhesive capsulitis)
a stiffening and hardening of the glenohumeral joint capsule resulting in a loss of rotation and mobility of the shoulder joint
lifespan or life course theory
an age-graded sequence of socially defined roles and events that are enacted over historical time and place.
Variables
an attribute trait, or characteristic. Any attribute that can vary among individuals, objects or settings.
variable
an attribute, trait, or characteristic that can vary among individuals, object, or settings.
paraphrasing
an effective way to ensure that active listening has occurred and that an understanding of what the client has said is accurate.
approach-avoidance
an individual enters a relationship with an expectation that the other will fulfill certain (often unrealistic) needs.
Brachial Plexus Injury/ Erb's Palsy
caused by stretching or tearing nerves of the brachial plexus. 40% of cases signs go away. Variable severity of deficits.
claw hand
caused by ulnar nerve injury anatomically, this deformity occurs because the MCP joints of the ring and little fingers are positioned in hyperextension.
clinical pathway
certain way to treat a pt w/specific diagnoses, can be a good and bad thing at the same time.
grading
challenge the Pt.'s ability by progressively changing the process, tools, materials, environment to gradually increase or decrease performance demands.
cybernetic theory
changes in the neuroendocrine system result in organ changes.One of the genetic theories.
adaptation
changing the environment for improved performance.
challenge
characteristic that supports hardiness and resilience
commitment
characteristic that supports hardiness and resilience
connection
characteristic that supports hardiness and resilience
control
characteristic that supports hardiness and resilience
Automatic actions-level I
characterized by automatic motor responses and changes in the autonomic nervous system. Conscious response to the external environment is minimal
Postural actions-level II
characterized by movement that is associated with comfort. There is some awareness of large objects in the environment and the individual may assist the caregiver with simple tasks
Exploratory actions-Level V
characterized by overt trial and error problem solving. New learning occurs. This may be the usual level of functioning for 20% of the population
Goal directed actions-Level IV
characterized by the ability to carry simple tasks through to completion. The individual relies heavily on visual cues. He/she may be able to perform established routines but cannot cope with unexpected events
Planned actions-Level VI
characterized by the absence of disability. The person can think of hypothetical situations and do mental trial-and error problem solving
Somatic Symptom disorders
characterized by the experiencing of physical symptom without evidence of physical cause, thus suggesting a psychological cause.
COTE comprehensive occupational therapy evaluation
checklist or other structured format used to record observations of a client performing a task.
sensory integration dysfunction
children have difficulty processing sensory information (vestibular, proprioceptive, tactile)
Multiple Sclerosis
chronic, progressive, autoimmune disease that affects the central nervous system. Body's immune system attacks itself targeting the central nervous system.
extent of burn
classified as a percentage of total body surface area (%TBSA)
impulsivity
client begins a task before formulating a plan; safety issues.
boundary testing
client behavior violates or ask therapist to act in ways outside the defined therapeutic relationship.Interpersonal event that occur during group process.
KELS Kohlman evaluation of living skills
client must perform a task or respond to questions from a evaluator, assess several skills in the areas of personal care, safety and health, money management, transportation, use of telephone, and work and leisure.
enabling
codependent behavior characterized by making it easier for the substance abuser to continue to drink and/or drug
cryotherapy
cold therapy used for acute injuries
eclectic supervision style
combination of cognitive behavioral and developmental supervision styles.
Mixed Cerebral Palsy
combination of high and low tone. Hypertonic movement in extremities. Hypotonic flexor muscles in neck and trunk.
session plans
come out of the outlining group protocols
CARF
commission on accreditation of rehabilitation facilities
nonverbal cues
communications that do not involve the use of formal language. Interpersonal event that occur during group process.
Rehabilitation
compensatory and adaptive equipment. i.e. one handed dressing, showering bench, hearing aid and reachers
Rehabilitation
compensatory and adaptive equipment. i.e. one handed dressing, showering bench, hearing aid and reachers.
Speech Therapist
concerned with an individual's ability to communicate. This includes attention to his or her understanding of language as well as his or her expression of ideas. Also concerned with auditory (hearing) ability and work closely with audiologists.
Rehabilitative approach
concerned with restoration of a purposeful life. Focus is on abilities rather than disabilities to compensate for physical limitations.
Nurse
concerned with the health of the consumer as well as his or her comfort and care if ill. This involves evaluating and addressing the patient's physical, spiritual and emotional needs through established procedures and techniques.
middle childhood 6-12
conduct disorders, ADHD, learning disabilities, drug and ETO abuse, Tourette's syndrome, asperger's
conversion
conflicts turned into real physical symptoms.
RLA IV
confused and agitated. Heightened state of activity with severely decreased ability to process information. Safety during outbursts, shortened treatment sessions.
RLA VI
confused, appropriate. Goal directed behavior dependent of external input for direction. Time management activities, tasks to promote self independence (starting to get ready for discharge)
direct selection devices
considered faster form of device control. It is also considered less cognitively complex because it is more intuitive. Can be accomplished with or without physical contact.
lead pipe rigidity
constant resistance throughout joint range of motion: no give in ROM.
antianxiety medication
control anxiety in disorders
Antimanic
control mania symptoms
gatekeeper
control what health insurance companies pay for, how much they pay
protocols
conventional rehabilitative programs for certain diagnostic populations, can be standardized or non-standardized.
4 types/criteria for trustworthiness
credibility dependability confirmability transferability
normative life cycle events
critical stages can cause stress; stress leads to evolution or change.
family life cycle
critical stages of family life and parenting
Strabismus
cross eyed (eso or exotropia)
wear and tear theory
cumulative damage to vital parts of the body leads to death of cells,tissues, organs, and finally the organism. Nongenetic theory.
CPT
current procedural technology; timed codes, 15=1 unit
aggressor
demeans and attacks the status of others by expressing negativity
Late adulthood and aging 65-death
depression, alzheimer's
ethnographic studies
describe an intact cultural group in its natural setting.
depth of burn
described as superficial, partial, or full thickness injury
occupation-based functional outcomes
describes the "real-life" occupation that the client will be able to engage
Beery-VMI
designed to assess the extent to which individuals can integrate their visual and motor abilities (eye-hand coordination). Drawing test.
Task roles
develop in relationship to group goals. Initiator-contributor, opinion seeker, opinion giver, energizer.
frame of reference
develop methods to apply existing theory to practice - a structure for guiding practice specific to OT.
Gary Kielhofner
developed a term Model of Human Occupation or MOHO using the concepts of occupational behavior theory in 1985.
health belief model
developed by US Public Health Service in the 50's. Ours choices to behave a certain way are based on a set of beliefs and our knowledge on the subject
Anxiety disorders
diagnosed by identifying a general or specific cause of unease or fear. This fear is considered significant when it is excessive and persistent over time.
Paraphilic disorders
diagnosed when a client is sexual aroused to circumstances that deviate from traditional sexual stimuli and when such behaviors result in harm or significant emotional distress.
ICD 9 codes
diagnosis codes used for billing service to insurance company
transdisciplinary
different groups with a common scientific goal
equifinality
different initial states can lead to similar ends states, and families can change in a infinite number of ways to meet goals.
dyslexia
difficulties with accurate word recognition, decoding and spelling
orthopnea
difficulty breathing while lying down which is relieved during sitting or standing
Right-left discrimination
difficulty distinguishing between right and left.
Figure ground discrimination
difficulty finding objects as they may blend into the background
perseveration
difficulty moving from one idea or movement to the next
dyspraxis
difficulty with motor planning
close supervision
direct and daily
minimum supervision
direct and indirect as needed or as mandated by state regulatory board.
routine supervision
direct and regularly scheduled
prescriptive role
direct service
8 Stages of the Intervention Process in OT Stage 8
discontinuation of service
Four Stages of Change and Related Strategies
discovery denial resistance acceptance
special interest pleader
disguises own prejudices through social positions
Disruptive, Impulse control and conduct disorders
disorder characterized by socially unacceptable or otherwise disruptive and harmful behaviors that are outside of the individual's control.
Cerebral Palsy
disorder of movement. Head, neck, trunk, arms, and legs affected. Impairments possible in fine motor, gross motor, language and communication skills, or overall adaptive functioning.
Neurocognitive disorders
disorders are diagnosed when one's decline in cognitive functioning is significantly different from the past and is usually the result of a medical condition.
Elimination Disorders
disorders can include enuresis which is the inappropriate elimination or urine, and encopresis, which is the inappropriate elimination of feces.
Feeding and eating disorders
disorders describe clients who have severe concerns about the amount of food they eat to the point that serious health problems, or even death, can result from their eating behaviors.
Trauma and Stressor Related disorders
disorders emphasize the pervasive impact that life events can have on an individual's emotional and physical well-being.
Bipolar disorders
disorders in this category refer to disturbances in mood in which client cycles through stages of mania or mania and depression.
Substance-Related and Addictive Disorders
disorders include disruptions in functioning as the result of a craving or strong urge.
Dissociative disorders
disorders indicate a temporary or prolonged disruption to consciousness that can cause an individual to misinterpret identity, surroundings, and memories.
sexual dysfunction disorders
disorders related to problems that disrupt sexual functioning or one's one ability to experience sexual pleasure.
Schizophrenia spectrum disorders
disorders that belong to this section all have one feature in common: psychotic symptoms, that is, delusions, hallucinations, grossly disorganized or abnormal motor behavior, and/or negative symptoms.
Sleep-Wake disorders
disorders where one's sleep patterns are severely impact, and they often co-occur with other disorders (e.g., depression or anxiety)
Open-chain movement
distal aspect of extremity moves freely and is not fixed to an object. Examples seated leg extension, leg curl, bench press, dumbbell biceps curl and lat pull-down
dynamic
distinctive quality, emotional tone and specific interpersonal events that compose an interaction between individuals
Rule of 9's
divided body surface in areas of 9%
Activities
do not have meaning or a functional goal.
Limitations of manual muscle testing
does not test muscle endurance or muscle coordination
Altruism
doing for others without expecting anything in return.
neurotransmitters
dopamine, norepinephrine, serotonin
remotivation
draws on LTM. Nostalgia group-music from the 50's, first job or first automobile. Sing a longs to motivate depresses or confused pts.
Obesity
dysfunctional eating patterns.
4 main arenas for a manager to be aware of
economic arena, legislative arena, technology arena, demographic arena
economic arena
economy influences organizational future plans
compensation
efforts to make up for personal deficits
Peck's stages of Psychological development in the second half of life Old age- 1st
ego differentiation vs. work-preoccupation
Erickson's theory Late adulthood
ego integrity vs. ego despair
Peck's stages of Psychological development in the second half of life Old age - 3rd
ego transcendence vs. ego preoccupation
dichotomous thinking
either or thinking, black or white, good or bad
developmental model supervision
employees evolve through developmental stages; continually growing, learning; supervisors role is to identify needs for growth of employee.
social microcosm
enactment of one's typical interpersonal style.
forward chaining
encouraging the client to initiate the first step and complete as much as possible before the OT completes.
universal design
equal access for all.
8 Stages of the Intervention Process in OT Stage 3
evaluation
OT philosophy
every person is born with a drive to act on the environment, to change things, to produce things, to work, and to use the hands and the mind.
elaborator
expands on suggestions
three levels of motivation for occupation or action
exploration motivation, competency motivation and achievement motivation
Protective extension reaction
extending arms to protect head and face when falling or off balance
credibility
extent data reflects what researchers actually observed, heard, read, or perceived.
confirmability
extent that results are free from the researcher;s biases, values, assumptions and can be confirmed by others.
transferability
extent that results can be transferred, generalized, to persons/settings outside of the study.
dependability
extent to which results would be comparable if study was repeated
expression of strong emotion
external displays in internal feelings. Interpersonal event that occur during group process.
3 keys to active listening
eye contact; nonverbal cues; paraphrasing
saccadic movements
eye moving rapidly and accurately from item to item
tardive dyskinesia
facial movements, writhing of the tongue and fingers.
visual agnosia
failure to recognize common items that can be seen
morphogenetic principle
families have the capacity for change
intimacy vs. isolation
finding a partner to share life.
multimodal
flexibility to match those modes to the client and the situation or to change modes as needed.
developmental groups (Mosey)
focus on teaching group interaction skills that are considered developmental stage-specific
psychoanalytic groups
focused on increasing insight into self and increasing understanding of personal behavior; use therapeutic media as a means to understanding behavior
sensorimotor approach
for treatment of upper motor neuron disorders. Focus is sensory perception and movement patterns. Balance, posture, tone and reflexes are considered. Central nervous system dysfunction.
non-nomative life cycle events
frequent hospitalizations, not reaching developmental milestones, multiple doctor visits and other appointments.
Fx
function
regression
functioning at a more primitive developmental level than previously
RLA level II
generalized response. reacts inconsistently and non purposefully to stimuli. Total assistance. Increase Pt.'s level of response.
Theoretical research
generates new knowledge by using cognitive process to analyze and synthesize ideas and information. This information or idea can come from a book, article, conversations or individual observation and experiences.
theoretical research
generates new knowledge using cognitive processes to analyze and synthesize ideas and information from many sources.
conceptual practice model
generates theory and the methods used by therapists to apply that theory.
generation y
generation born from the early 1980s to the late 1990s.
generation x
generation following the post-World War II baby boom, especially people born in the United States and Canada from early 1960s to the late 1970s.
Fragile X syndrome
genetic condition that causes limited brain development, abnormal skull, prominent jaw and forehead, lax joints and flat feet. As well as various degrees of intellectual disabilities.
extrinsic feedback
given by the therapist
rationalization
giving reasons for drinking/drug use, blames on another
storming
group is likely to highest level of disagreement and conflict. The leader must take on a negotiator and supporting role.
adjourning
group members may adjourn at different times.
splitting
group members will go to one leader in hopes they will get what they want (children use this tactic)
Azimos
group model that increases self-awareness & promote self-understanding to encourage interpersonal change. Recognized therapeutic value of art, music poetry, dance, clay/sculpting.
Integrative (Ross)
group model to facilitate organized sensory, motor, affective and or cognitive responses to increase function. FOR: sensory integration Dx: limited sensorimotor dev who require stimulation and cueing (head trauma)
involuntary
group participation is required
task-oriented group
group that allows for focus on both self-awareness and interactions with other group members during a structured activity.
functional group
group that result in end products or help members achieve desired skills and abilities.
heterogeneous
group with multiple,or different issues
sub-grouping
groups break into smaller groups ( high school clicks)
evaluation group
groups that allow for assessment of both interpersonal and activity skills
Habituations
habits and roles of the Pt.
power grasp
handle or object tight in the palm, and shoulder produce movement (e.g., using a hammer)
secondary brain damage
happen as a result of brain injury; hematomas, edema, hydrocephalus, infection, seizures
hypertrophic scar
hard, red, collagenous bundle of connective tissue raised above the surface of the burn wound, usually visible 6-8 weeks after wound closure.
Dynamic splints
have one or more movable parts [Malick 1982] and are synonymous with splints that employ elastics, springs, and wire, as well as with multipart splints.
insight and awareness
having an understanding on one's strengths and weakness. This means having a realistic concept of one's physical and mental capabilities.
tertiary circular reactions
he or she repeatedly attempts a task and modifies the behavior to achieve the desired consequences.
Group roles
help the group towards its goal
Role of occupational therapy
helping families assess their concerns and priorities for intervention; the use of self-reporting instruments in OT.
hypertonia
high muscle tone; limbs feel rigid and inflexible
spasticity
high tone; too much stability.
intermediate level
higher level of skills gained by experience, continuing education, and involvement in professional activities.
executive functioning
higher order of reasoning and planning functions
body scheme
how a person perceives the position of the body and the relationship of the body parts.
Group process
how the group went; the manner in which the occupational activity is conducted and the emotional tone of the verb and nonverbal content that occurs during group
ADHD - attention deficit/hyperactivity disorder
hyperactive, impulsive, excessive energy and motor activity, and ADD symptoms.
secondary prevention
identification and treatment of persons with early, minimally symptomatic disease to improve outcomes and maintain health. Importance of health screenings.
graphesthesia
identification of numbers and letters when they are written on the skin
evidence based practice steps
identify/define practice-related problem formulate a question around the problem seek out and evaluate info to help answer the question
downward comparison
identifying a situation that is worse than your own
passive appraisal
ignoring a problem and hoping it will go away.
Ataxia
impaired gross coordination and gait. Pt. may have visible tremor like movements. Problems with calibration, step length, postural, and stability.
brachytherapy
implantation of radioactive seeds into tumor bed; while seeds are in place Pt. is radioactive.
development of socializing techniques imitative behavior
improve and develop appropriate social skills through the process of modeling or practicing
meta-cognitive training
improve fundamentals by enhancing self-awareness and improving skills, such as time management, self-control, and self-monitoring.
Role of OT in Educational environment
improve the child or adolescent's performance in the school or educational environment. advocate within the context of the educational setting and the federal laws that mandate services being provided.
Truth
in documentation and billing
Tranquilizers are introduced
in the 1950's. They allowed those with bizarre and psychotic to participate in OT.
Constructional Apraxia
inability to copy, draw or construct a design
Astereognosis
inability to identify familiar objects through touch, proprioception and cognition
Ideomotor apraxia
inability to plan or perform a motor skill
apraxia
inability to plan out movements despite having the necessary range of motion, strength, and coordination
somatodyspraxia
inadequate processing of tactile, proprioceptive, and kinesthetic information that causes difficulty in motor planning.
ADD - attention deficit disorder
inattentive, restless, and distractable
Neurodevelopment disorders
include intellectual disabilities, communication disorders, autism spectrum disorders, ADHD, specific learning disorders and motor disorders.
postural mechanisms
includes postural tone, muscle tone, integration of the primitive reflexes and mass pattern movements, righting reactions, equilibrium reactions, protective extension, and selective voluntary or intentional movement.
Normal phases of swallow 1 Oral preparatory phase,
includes seeing, smelling, reaching for the item, bringing it to the mouth, and putting it in the mouth.
Postural mechanism
includes the righting reaction which maintains the head in midline wight the trunk
Persons
including families, caregivers, teachers, employers, and relevant others
psychostimulant medications
increase mental and physical activity.
hypertonicity
increased muscle tone; increased resistance to passive stretch.
ASIA impairment -A
indicates a complete lesion; there is no motor or sensory function preserved.
ASIA impairment - B
indicates a incomplete lesion; sensory but not motor function is present below the neurological level
ASIA impairment - D
indicates an incomplete lesion; motor function is preserved below neurological level, and at least half of the key muscles below the neurological level have a muscle grade of 3 or more.
ASIA impairment - C
indicates an incomplete lesion; motor function is preserved below the neurological level and more than half of the key muscles below the neurological level have a muscle grade less than 3
general supervision
indirect as needed and direct once each month or as designated by state law.
blood pressure
indirect measure of the force exerted by the blood as it flows through an artery.
divided attentional deficit
individual cannot process all the information for task completion
help seeking-help rejecting
individual establishes a pattern of asking for assistance and hen explaining why it would not work.
intrapersonal
individual factors or beliefs that influence behavior
reluctance-reassurance
individual is consistently anxious, skeptical, or self-doubting about engaging in occupation and others reliably attempt to bolster, entice, and reassure them, a dynamic of reluctance and reassurance is occurring.
demonstrative-voyeuristic
individuals become involved in elaborating on, embellishing, or dramatizing their reactions or hardships, they often have a need for their hardships, they often have a need for their hardship to be recognized and validated.
idealizing-devaluing
individuals can be consistently idealizing of one another, consistently idealizing of one another, consistently devaluing, or they can change between the two states.
helpless-rescuing
individuals fall into a pattern of recruiting assistance when it is not necessary.
enmeshment
individuals have close ongoing contact. It is expected that individuals share information readily, even if it is highly intimate or personal.
manipulating-conceding
individuals may be accustomed to getting their needs met through manipulation, particularly when they perceive that there may be an obstacle to getting what they want.
competitive
individuals often compete to obtain an interpersonal need or a valued resource, particularly if it is perceived to be in short supply.
Personality disorder cluster C
individuals tend to appear anxious, worried, or fretful in their behaviors.
secondary circular reactions
infant begins to use voluntary movements to repeat actions that accidentally produced a desirable result.
Postnatal causes of intellectual disabilities
infections, trauma, and toxins
long term memory
information about past events, language, and sensory experiences that are stored for long periods of time. These memories are retained for years.
methods
information about the techniques and assessment instruments used for the research.
frontal lobe
initiation, problem solving, judgement, inhibition of behavior, planning and anticipation, self-monitoring, motor planning, personality, emotions, awareness of abilities and limitations, organization, attention and concentration, mental flexibility, speaking-expressive language
adaptive approach
intact skills are used to compensate for skills that are deficient. Involves engagement in client's occupation of interest.
fluid intelligence
intellectual processes that impact numerical reasoning and logic.
preparation
intention to begin performance of a health behavior is combined with criteria for action that include a time frame to begin acting
3 aspects of self awareness #2
interests
ICD-9
international classification of disease
organizational
interrelationships between organizations that influence behavior (YMCA and Summa hospitals or ADM board)
8 Stages of the Intervention Process in OT Stage 5
intervention
8 Stages of the Intervention Process in OT Stage 4
intervention planning
orthopedic conditions
involves bones, joints, and muscles. Muscles activated by the nervous system to create movements at joints. Can be congenital or acquired.
active listening
involves reflecting back to the client (group) what was heard and how it was understood
Cystic fibrosis
involves the exocrine glands. Think mucous build up in the lungs. Scarring and cyst build up in the pancreas.
precision grasp
involves the thumb and fingertips used to position or move an object.
Dementia
irreversible impairment of STM & LTM
Caresource
is Medicare
Theory
is a description of a set of phenomena and the relationships among the concepts in those phenomena. Provides the foundation for developing the frames of references and treatment ideas.
Dystonia
is a faulty muscle tension or tone. Tend to involve large portions of the body and produce grotesque posturing with bizarre writhing movements.
conformability
is a performance characteristic that refers to the ability of thermoplastic material to fit intimately into contoured areas.
transference
is a phenomenon characterizers by unconscious redirection of feelings from one person to another.
neurolysis
is a procedure performed on a nerve that has become encapsulated in dense scar tissue, which compresses the nerve to surrounding soft tissues and prevents it from gliding.
sensory processing intervention
is aimed toward the organization of multiple sources of sensory input. The focus is also on the lower brain processing of vestibular input integrated with proprioceptive and visual inputs, making it important to identify the target sensory platforms.
cancer
is an abnormal tissue that grows and spreads or may metastasize throughout the body.
first stage in group formation (Yalom and Leszczll)
is characterized by getting to know each other hesitant participation; searching for a meaning to the group and participation; and a dependency on the leader and other members for structure, for approval, and for an understanding of their role within the group
memory
is closely linked to other cognitive and sensory factors, in that the brain stores information on sensory experiences
Strategic Planning
is determining the long term goals of a site/company/organization and using the goals to accomplish goals. Often useful to review or create a vision or mission statement.
selective attention
is focusing in on one or more stimuli, while all other stimuli or information in the environment are ignored.
transference
is group members projection of their inner world ( treating someone like your grandma because they remind you of your grandma)
metacognition
is having awareness of one's own cognitive processes and the ability to manipulate and control his other own cognition. This is self-awareness of one's cognitive ability and is often defined as thinking about thinking
chaotic-organizing
is one in which one aspect of the systems irresponsible, disorganized, slovenly, undisciplined, or lacking in emotional self-control.
visual discrimination
is our ability to perceive and interpret visual information. It is what allows us to discriminate between different shapes, objects and colors.
sensation
is the ability to identify a sensory modality, its intensity, and its location.
visual perception
is the ability to organize and interpret what is seen.
concept formation
is the ability to organize information and develop ideas based on common qualities of objects or situations
praxis
is the ability to plan and perform purposeful movement
anticipatory awareness
is the ability to predict or accept that a deflect will inhibit success or cause a problem
visual perception
is the cognitive processing of what our eyes detect.
intrarater reliability
is the degree of agreement among multiple repetitions of a diagnostic test performed by a single rater.
interater reliability
is the degree of agreement among raters.
drapability
is the degree of ease with which a material conforms to the underlying shape without manual assistance.
coordination
is the harmonious interaction of muscles throughout the limb that allows for the production of accurate controlled movement.
multisensory processing
is the integration of sensory information from different sources.
role aquisition
is the learning of all daily life, work and leisure skills that enable one to participate in social and productive roles.
perception
is the mechanism by which the brain recognizes and interprets sensory information received from the environment
second stage in group formation (Yalom and Leszczll)
is the most challenging for a leader. During this stage, members begin to let their guards down, become more familiar with their peers, and try to establish their position within the group structure. Some members feel a need to dominate in the group or to impress others.
Access
is the point of contact between the user and the aid or device that he or she needs to control
Dynamic tripod grasp
is the preferred mature grasp. The pencil is held between the thumb and the index and middle fingers; the index finger is placed on top of the pencil, with the thumb in full opposition. The ring and little fingers are flexed to stabilize the grasp. The wrist and fingers are used to move the pencil with greater digital control. The arm simply positions the hand for the appropriate manipulation of the pencil by the fingers. This grasp is typically present by 6 to 7 years of age.
critical appraisal
is the process of judging the quality of a piece of information and determining its applicability to practice.
sensory integration
is the way the brain organizes sensations for engagement in occupations
Flow
is total engrossment in activity to the point where you lose track of time.
challenging
is used when the group is experiencing difficulties with one or more members, or is stalled or moving in a less than therapeutic direction.
divided attention
is utilized when a person must focus on two or more stimuli at one time.
Occupation
is viewed as behavior that is internally gratifying and used to fulfill a variety of cultural and socially accepted roles.
Progress notes
justify interventions justify continued interventions used for discharge planning
gate keeper and expediter
keeps lines of communication open and flowing
recorder
keeps notes on group and recalls information
crystallized intelligence
knowledge accumulated through the life span
empirical research
knowledge based on information gained from experience or observation. most common
Splinting requires
knowledge of occupation, pathology, physiology, kinesiology, anatomy, psychology, reimbursement systems, and biomechanics to best design splints for persons
3 basic categories of learning #1
knowledge, acquired information, facts about reality
brown-sequard syndrome
lateral damage to cord. Pt. loses postural control and motor control on ipsilateral side; pain and temperature changes on contralateral side.
dysgraphia
learning disability that affects writing
Profound intellectual disability
less than 25. accompanying physical disabilities require constant support in all areas of occupation. May learn to communicate and to perform routine self-care activities.
Thriving
lifespan theory. Three interacting factors person, human environment, nonhuman environment
Facilitation used with hypotonia
light moving touch tapping, sweep tapping, brush tapping, and/or alternate tapping fast vestibular input heavy joint compression weight bearing and weight shifting quick and variable movements stimulating enviroment
Facilitation used with hypotonia
light moving touch tapping, sweep tapping, brush tapping, and/or alternate tapping fast vestibular input heavy joint compression weight bearing and weight shifting quick and variable movements stimulating environment
homogeneous
like issues,deficits or problems
aging in place
living where the elders have lived for years, typically not in a health care environment, using products, services, and conveniences that allow them to remain home as circumstances change. Elders continue to live in the home of their choice safely and independently as they get older. Livability can be extended through the incorporation of universal design principles, tele care, and other assistive technologies.
RLA level III
localized response. Reacts specifically but inconsistantly to stimuli.Total assistance. ADLs, orient pt., education of family continues.
marketing
looking at the market,listen to market needs, and design a program that meets the "needs, resources, and limitations of potential customers."
basic sitting position in a regular chair
looking for 90-90-90.
disuse syndrome
loss in the ability to preform ADL functions as a result of a sedentary lifestyle disability
Maslow's hierarchy of needs level 3
love and belongingness needs
Hypotonia
low muscle tone (increased flexibility at joint)
flaccidity
low tone; too much mobility.
Athetoid
movements without stability are slow wormlike, arrhythmical movements that affect the distal portions of the extremities. Not present during sleep.
transitional movement
moving from one position to another. Involves weight shifting, unloading and loading of the body.
isotonic active exercise
muscle contraction is used as joint moves through available ROM against no outside resistance.
Isometric exercise
muscle or group of muscles is actively contracted and relaxed without producing motion of the joint. Purpose is to maintain muscle strength when active motion is not possible.
Brunnstrom's stages of motor recovery
no motion, spasticity, synergy, normal movement.
RLA level I
no response to stimuli. Total assistance. Increase Pt.'s level of response and overall awareness
dominance-submission
nondemocratic system that is characterized by a clear power differential that involves the consistent oppression of some individuals by others.
primary aging
normal gradual changes in organ systems. experienced by everyone. Not associated with disease, impairment, or disability.
Psychologist
not a medical doctor; although they may have a PhD. Functions in 3 areas: diagnosis, psychotherapy, and research. Administers diagnostic tests and conducts interviews.
action research type
objectives are to document and improve the quality of individual practice or the function of an organization in a specific setting.
applied research type
objectives are to find answers to practical problems or to test the finding of basic research under real world conditions. Most of research by OT is this type i.e.: cognitive function with different sensory losses.
sidetracking
occasionally a group member will take great interest in a topic that is of little interest to other members and he or she lacks the ability to notice this fact.
purposeful activity
occupational performance and occupational roles.
occupational form
occupational situations including environmental context of the individual's life
co-occupation
occupations by two or more individuals.
diffuse axonal injury
occurs from shearing forces corpus collosum and brainstem are most affected
instilling hope
occurs in a group when a member is encouraged by another member who has dealt with a similar problem or issue
Normal phases of swallow 2 Oral phase
occurs once the bolus is prepared and formed by the tongue.
occupational deprivation
occurs when factors beyond themselves limit the individual's choice or opportuntiy.
interpersonal learning
occurs when group members become more aware of their behavior and their interaction skills
corrective recapitulation of the primary family experience
occurs when group members identify the therapist with members of their own family
disengagement
occurs when individuals have little contact and do not share personal information readily.
Normal phases of shallow 4 Esophageal phase
occurs when the bolus passes into the esophagus and is propelled to the stomach.
Normal phases of swallow 3 Pharyngeal phase
occurs when the bolus passes over the base of the tongue and enters the pharynx.
emergent awareness
occurs when the person is able to recognize limitations or strengths while they are occurring
validity
of manual muscle test, depends on examiner's knowledge and skill in using correct testing procedure.
MMSE
offers a quick and simple way to quantify cognitive function and screen for cognitive loss. It tests the individual's orientation, attention, calculation, recall, language and motor skills.
evaluator critic
offers standards used to measure accomplishments
opinion giver
offers values and attitudes to others
contralateral
on or relating to the opposite side of the body.
ipsilateral
on or relating to the same side of the body
Intradisciplinary
one or more members of one discipline providing treatment to an individual.
Tourette Syndrome
onset at 6 to 7 years of age, genetic disorder. repetitive, involuntary motor and vocal tics.
urostomy stomas
opening between the body surface and the organs that produce and collect the urine.
stomas
opening from the surgically resected site to the outside of the body.
morphostatic principle
order is maintained through daily family rhythms
components of the marketing process
organizational assessment environmental assessment market analysis marketing communications
idealization
overestimating someone or valuing him or her more than the real personality or person seem to merit.
free radical theory
oxidation of lipids, proteins, fats and carbohydrates. Low-level free radical damage occurs over time resulting in age associate decline of function in major organs. Genetic theory
Anterior Cord
pain, temp, and touch are lost; proprioception is preserved.
dystonia
painful sudden muscle spasms
symmetrical patterns
paired extremities perform like movements at the same time
reciprocal patterns
paired extremities perform movements in opposite directions at the same time.
resistance and reluctance
passive or active refusal to participate in some or all aspects of therapy. Interpersonal event that occur during group process.
follower
passively goes along with members
Freedom
patient has the right to refuse treatment.
disengagement theory
people withdraw from roles or activities and reduce their activity levels or involvement .
mood lifting scents
peppermint and lemon grass
remedial approach
perceptual retraining. focus is on repairing impairment through potential reorganization of the central nervous system.
Psychotherapy based supervision style
person and relationship centered
early adulthood 21-40
personality disorders, anxiety disorders, alcohol and substance abuse.
contemplation:
persons are aware of a health problem and are considering taking action but have not committed to any specific action or to begin performing a health behavior.
types of qualitative research design
phenomenology studies ethnographic studies case study design
Biomechanical
physical motion, stress and rest the body. Used in OTA preparatory. 1. ROM 2.Strength 3. Endurance
Maslow's hierarchy of needs level 1
physiological needs
definition of play
pleasurable, self-initated activity controlled by the child.
Public policy
policies of the state, federal and local bodies to influence or regulate behavior (Let's move! campaign-Michelle Obama)
visuodyspraxia
poor processing of visuospatial information and performing visual construction tasks.
wrist drop
position whereby the wrist and MCP joints are unable to actively extend. Caused by radial nerve dysfunction
8 Stages of the Intervention Process in OT Stage 1
referral
assistive technology services
refers to any service that assists an individual with a disability in selecting, acquiring, and using an assistive aid or device. (Communication Aid)
assistive technology
refers to anything that helps a person be more functional in daily life.
cohesiveness
refers to how the members bond or interact
denial
refusing to believe something that causes anxiety
ego
regulates behavior by compromising the demands of the Id, the superego and reality.
sensory modulation
regulatory process of the nervous system that controls the perceived intensity of incoming sensations through the raising or lowering of neuronal thresholds to that sensory input.
Types of MS
relapsing-remitting secondary-progressive primary-progressive progressive-relasping clinically isolated.
imparting information
related to accessing services, obtaining products, or learning new skills
antidepressant medication
relief from depression and the risk of suicide
orientor
reminds the group of its intent and purpose
Individual educational program (IEP)
required for children 3 to 21 years old who receive special education services. written plan and process. Goals, objectives, methodologies.
cognitive flexibility
requires changing strategies when confronting a problem, or changing a set of thoughts. This means when a person is presented with two or more concepts, the person can shift from one to the other.
quadruped
requires head and trunk control coupled with shoulder and pelvic stability.
Social Worker
role is to act as a liaison between consumer and the community in order to make the best use of resources available.
Social role supervision style
role of the supervisor changes based on needs of employees
torque
rotary or twisting force.
elopement
running away from an inpatient treatment facility without being discharged
Maslow's hierarchy of needs level 2
safety needs
8 Stages of the Intervention Process in OT Stage 2
screening
Developmental sequence prewriting skills: 14 months
scribbling
phenomenology studies
seek to understand individual experiences and the meanings people make of their experiences
information seeker
seeks clarification and factual information
case study design
seeks to understand the experiences of one specific individual/group/context.
3 aspects of self awareness #3
self concept
Prudence
self governing; knowing right from wrong
paranoia
self- avoid approaching suddenly, from behind or in a manner that might be perceived as threatening. Do not whisper in these pts. presence because they will believe your are talking about them. environment-stable and reliable as possible. Prepare client in advance for any changes. Do not forces social contact. activity-should be ones that person can control. Structured activities involving controllable materials (e.g., leather work)
anxiety
self- encourage talking, do not criticize behavior,avoid extended discussions of physical symptoms. environment-calm, comfortable, familiar, avoid noise and too many people activity- repetitive motor sequence (woodworking kits, simple cooking tasks) deep breathing
Maslow's hierarchy of needs level 5
self-actualization needs
depression
self-allow them to talk. redirect to positive approaches. environment-safe and subdues, little stimulation, provide choices activity- simple structured, successful, repetitive. don't push socialization at first work-up to it.
cognitive deficits - confusion-impaired memory
self-approach as individual, consider level of functioning, remind pt of where they are and who you are environment-control to maximize safety, use to cue desired behaviors activity-simple, structured,short-term. Simplify known activities instead of introducing new ones. carry notebook, organization, orientation skills
delusions
self-avoid talking about delusion. environment-relatively stimulating. provide opportunities for the person to get involved in real-life activities. activity-should be suited for intellectual level. board games, current event discussions, crossword puzzles, word games.
intrinsic motivation
self-initiation or drive to action that is rewarded by the activity
cognitive deficits -attention deficits-disorganiation
self-may need to be loud, may need to touch firmly but gently on the arm or shoulder. environment-reduce distractions, work alone. classical and/or favorite music played in background. activity-simple craft projects, self care task, training in safety, coping and stress management, computer games.
seductive behavior
self-nonjudgemental manner, avoid any physical contact, stop/explain therapeutic relationship. environment-avoid crowded situations. Pt. should have personal space, protected from touch, smell and warmth of others. activity- instruct masturbation, gross motor activities, social skills training, sports, physical exercises.
mania
self-remain calm, matter of fact, firm. environment- eliminate distractions, may start person out by working alone. activity-short term, immediate gratification. 3 steps or less and predictable. Gross motor exercise.
hostility
self-sensitive to client's feelings. Alert to signs that client is feeling tense threatened or suspicious. Get them to talk. environment-private environment to avoid embarrassment. 4 or 5 foot distance. door left open for safety. activity- art and dance
hallucinations
self-talk to them in a calm, firm, natural, rhythmic, soothing manner. Acknowledge hallucinations and how they make the pt. feel but focus them on neutral topic. environment- low stimulation, do not allow them to isolate themselves. activity- interactions with small selective groups. music or sing along, bright colors.
leadership
senior management and executives at the top
phantom sensation
sensation still seems to come from missing limb and feels as though its movement can be controlled.
Parietal lobe
sense of touch, differentiation of size-shape-colors, spatial perception, visual perception
Piaget's stages of cognitive development
sensorimotor, preoperational, concrete operational, formal operational
intrinsic feedback
sensory stimulation as a consequence of task performance
Egocentric group roles
serves the needs of the individual but interferes with group process. Aggressor, blocker, dominator
Interdisciplinary
several disciplines agree to collaborate for decision making. Evaluations are still performed independently defined within each other's expertise. Formal communications such as treatment planning meetings occur.
coordination of secondary schemata
several significant changes take place. Infant readily combines previously learned schemes and generalizes them for use in new situations
Autism
severe and complex impairments in reciprocal social interactions and communication skills; stereotypical behaviors, interests and activities.
neutropenia
severe impairment of immune response with decreased resistance to infection
Complete spinal cord injury
severing of the spinal cord. Does not regenerate, everything below that level has no voluntary control
group observer and commentator
shares views and interpretations
failure to thrive
sharp decline in physical health with no real physical or illness-related reason.
STG
short term goals
cognition
skill of understanding and knowing. the ability to judge and make decisions. Overall awareness of an individual's surroundings. Allows individuals to use and process sensed and perceived information.
Pressure sores - Stage 1
skin intact reddened for 20 minutes, warm to the touch
operant conditioning
skinner box
Open brain injury
skull has been penetrated or cracked
pursuit tracking movements
slowly following an object with the eye.
ataxia
small shifts in muscle tone with decreased equilibrium cannot be regained
Mosaic Down Syndrome
some cells have the trisomy (extra chromosome) and some do not. Intelligence level will be 10 to 30 pts. higher compare to downs syndrome.
advanced level
specialized skills with expertise in a particular area of practice.
purposeful activity
specifically selected, goal-directed activities that allow the client to develop skills that enhance occupational engagement.
statement of terminal behavior
specifies the physical changes, types of behavior, or performance skill that the Pt. is expected to display
isokinetic contraction
speed is set and will stay the same. Done with special equipment like the cybex or universal system in a gym.
norming
stage is characterized by the recognition of individual differences and shared expectations
criterion
states the degree of competence or the performance standard by which the patient's behavior is to be measured
results
statistical analyses are explained that led to the authors conclusions.
dsyphagia
stiffness in jaw, mouth, neck, shoulders
short term memory
storage of information temporarily, very limited time frame
primary prevention
strategies that reduce risk for disease before its onset. Facilitation of lifestyle changes.
COPM Canadian Occupational Performance model
structured interview that measured a client's own perceptions about his or her own occupational performance
statics
study of forces acting on objects at rest.
kinetics
study of motions of objects and the forces acting on them.
Act
study the results and make lasting changes with decisions based on data. Root cause analysis to make sure you truly identified the cause of the problem.
medical informatics
study, invention, and implementation of structures and algorithms to improve communication, understanding, and management of medical information.
OT treatment for UE Amputation
stump care/skin hygiene, stump wrapping, ADL/IADL training, ROM exercise, desensitization, wear schedule and use schedule, prosthetic skill training.
denial
substance abuser ignores the disease
Dynamic splint can
substitute for loss of motor function (example is the tenodesis splint.)This splint helps persons with spinal cord injuries at the cervical level of six or seven grasp objects using a tenodesis grasp pattern.
Organizations
such as businesses, agencies or industries
existential factors of life
such as the meaning of life, acceptance of mortality, and recognition of personal responsibility in one's life can be addressed in the group process
conclusions
summarizes the findings, as well as discusses what value the research has on a real-life application public knowledge. It may also offer suggestions for future research, and issues that may have come up during the study.
encourager
supports others in a positive ways
arthrokinematics
surface movement of the joint (small movement, involuntary with the joint surface, usually invisible to the naked eye.)
autograft
surgical transplantation of person's own skin from unburned area (donor site)
Decorticate posturing
sustained contraction and posturing of BUEs in flexion and trunk and BLEs in extension
concentration
sustained focused attention for a period of time
Inhibition used with hypertonia
sustained pressure on tendon slow rocking, rolling, or stroking rotation weight bearing and weight shifting heavy joint compression wrapping and swaddling hand vibration calming enviroment
Inhibition used with hypertonia
sustained pressure on tendon slow rocking, rolling, or stroking rotation weight bearing and weight shifting heavy joint compression wrapping and swaddling hand vibration calming environment
Dystonia
sustained twisted postures, triggered by movement.
neuromas
swelling or tumor along the course of a nerve or at the end of a divided nerve.
the three categories of group membership
task (worker) roles, maintenance roles, and individual (blocker) roles
compensation
teaching alternative strategies or methods
Role acquisition
teaching of "all" daily life roles.
social skills training
teaching of interpersonal skills needed to relate effectively to other people.
Social skills training
teaching of interpersonal skills needed to relate to other people effectively.
forward chain
teaching step by step; client performs the process in order
low technology
technology that is easy to obtain and use (reacher)
medical technology
technology used to sustain life (respirator)
isotonic eccentric contraction
tension in the muscle increases or remains constant as the muscle lengthens. Motion is done with gravity. Lowering arm place napkin next to a plate on the table.
Validity
that the measurement actually represents; what it is suppose to represent.
Reliability
that the measurement remains consistent and free from error.
therapeutic reasoning
the ability to anticipate, identify and cope. determine if a mode shift is required, choose a response mode. Draw on relevant interpersonal skills. Gather feedback and review.
hardiness
the ability to bounce back quickly from adversity or illness.
praxis
the ability to plan and perform purposeful movement.
empathy
the ability to share and understand feelings of another.
flow
the act of doing without thought-effortless action. This is experienced with active leisure vs. passive like reading
Supervision
the control and direction of work of one or more employees in a manner that promotes improved performance and a higher quality outcome.
scapegoating
the entire group may "gang up" against one member. May blame failure to meet group goals.
altruism
the experience of being able to help another person
catharsis
the experience of relief from emotional distress
internal control
the extent to which the child is in control of the actions and to some degree the outcome of the activity
primary circular reactions
the infants repeats the reflexive movements and patterns simply for pleasure.
universality
the realization that other members have similar concerns and feelings and may have very similar experiences
recapitulation of ontogenesis
the stage by stage repeating of development
components of IRM #2
the therapist
family ecology
the way family operates in society, including the immediate community and the state and federal systems
instructing
therapist carefully structures therapy activities and is explicit with clients about the plan, sequence and events of therapy.
empathizing
therapist continually strives to understand the client's thoughts, feelings and behaviors while suspending judgement.
advocating
therapist ensures that the client;s rights are enforced and resources are secured.
collaborating
therapist expect the client to be an active and equal participant in therapy, and ensures choice, freedom, and autonomy to the greatest event possible.
problem solving
therapist facilitates pragmatic thinking and solving dilemmas by outlining choices, posing strategic questions and providing opportunities for comparative or analytic thinking.
empathic breaks
therapist is perceived by the client as hurtful or insensitive. Interpersonal event that occur during group process.
encouraging
therapist seizes the opportunity to instill hope in a client and celebrate a client's thinking or behavior through positive reinforcement.
therapeutic use of self
therapist's planned use of his or her personality, insights, perceptions, and judgement as part of the therapeutic process.
hypotonia
there is not enough tension in the muscle when it is at rest. The muscle may have a slightly mushy or floppy feel to it, and there is a lack of graded control of the muscle hen it is being used.
hypertonia
there is too much tension in the muscle at rest. The muscle is tight and tense even though it is not doing anything.
Personality disorders
these disorders all involve a pattern of experiences and behaviors that are persistent, inflexible, and deviate from one's cultural expectations.
Depressive disorders
these disorders describe conditions where depressed mood is the overarching concern.
Personality disorder cluster B
these individuals seem overly emotional, are melodramatic, or unpredictable in their behaviors and interpersonal relations.
cognitive behavioral supervision style
thinking changes behavior, begin by changing thinking. 1. establish trust 2. analyze employees skills 3. set goals 4. implement strategies 5. follow up assessment
Basic research
to discover new knowledge. How things work and what they are made of.
Applied research
to find answers to practical problems or to test the findings of basic research under real world conditions. This is the most common type.
functional groups
to incorporate the use of purposeful activity and meaningful occupation into the process and dynamics of group work
sanction
to preserve their integrity a group may "punish"a member who violates the norms.
interventions of new means through mental combinations
toddler begins using trial and error to solve problems
anosognosia
total inability to recognize deficits
RUGs extensive services
tracheostomy care OR ventilator or respirator OR isolation for infectious disease AND ADL score greater than or equal to 2.
classical conditioning
trail and error
projection
transfer onto others of one's own feelings
forming
transition from a group to a functioning team; members build confidence and trust in each other as well as their leader
8 Stages of the Intervention Process in OT Stage 7
transition planning
push-in
treat child in the classroom.
Equality
treating everyone equal.
undoing
trying to reverse the effects of what one has done by doing the opposite
Leukemia
tumors of the bone marrow.
Rotation:
turning the pencil from the lead end to the eraser end without putting the pencil down on the table or using the chest to stabilize the pencil while turning it.
scapegoating
two or more individuals collude to influence, criticize,or otherwise control another individual.
groups
two or more people who meet to address a specific task or goal
milieu treatment approach
type of treatment that involves changing the environment in hopes it will encourage a client to develop new coping strategies.
sublimation
unacceptable wishes channeled into socially acceptable activities
crisis points
unanticipated, stressful events can clients to become distracted or temporarily interfere with client's ability for occupational engagement. Interpersonal event that occur during group process.
inhibition
used for hypertonia to decrease abnormal muscle tone and patterns of movement.
biomechanical approach
used in the treatment of lower motor neuron and orthopedic dysfunction. Emphasis of activity analysis is muscles, joints, and motor patterns. All voluntary movements.
playboy
uses joking and provocative behavior to distract attention onto self
quantitative approach
uses methods that can define, measure, collect, and analyze data in numerical formats. This method looks at variables.
qualitative approach
uses methods that can identify, collect, and analyze data that exists i a non-numerical format. Researchers pose a questions that need to be answered with words or visual displays. Is non experimental.
isotonic resistive exercise
uses muscle contraction against a specific amount of weight to move the load through certain ROM. Primarily used to increase fair plus to normal muscles.
Recreational Therapist
uses play, leisure, exercise, and other activity to meet individual needs.
Sensory integration
uses the patient's ability or inability to process sensory information to promote change.
Translation:
using only the fingers, the student "walks" his or her hand from the lead end of the pencil to the eraser end without the aid of items for stabilization
use of spiritual beliefs
using philosophical or spiritual beliefs to make sense of and find meaning in a situation
Developmental sequence prewriting strokes: 2-3 y.o.
vertical and horizontal lines
Occipital lobe
vision
Post Traumatic Amnesia (PTA)
waking up after the injury and not remembering injury. The longer the PTA the worse the injury
opinion seeker
want clarification of values and attitudes
What are the clinical signs of joint inflammation?
warm, swollen, tender, red, painful to move
Performance capacity
what Pt. can achieve
Etiology
what is the cause? the syndrome or disorder may be a result of some behavioral, and/or psychological condition, or related to a secondary physical condition, or illness.
Plan
what process could be improved and how would that lead to increased efficiency and ability to meet customer requirements? Decide what you are going to focus on-what are the issues?
group content
what the group did; what is said, written or produced during the course of the group.
Asthma
wheezing, coughing, chest tightness. Chronic inflammation of the airways. Treat with inhalers-corticosteriods.
Unskilled services
would be exercises that are a repetitive in nature, or passive exercises to maintain range of motion or strength that do not require the involvement of skilled rehabilitation.
Pressure sores - Stage 3
wound is in deeper areas of skin
Advantages of prefabricated splints
• May save time and effort (if the splint fits the person well) • Immediate feedback from client in terms of satisfaction and therapeutic fit • Variety of material choices • Some clients prefer sports-brace appearance
Moderate assistance
At least 50% assistance needed to complete task
3 types of clinical reasoning OT's use
Conditional reasoning
3 Fair
Part moves through complete ROM against gravity.
Standard II Screening, Evaluation, and Re-Evaluation.
A COTA contributes to the screening, evaluation, and re-evaluation process by implementing delegated assessments and by providing verbal and written reports of observations and clients capacities to the OTR in accordance with federal and state laws, other regulatory and payer requirements, and AOTA documents.
Standard IV Outcomes
A COTA contributes to the transition or discontinuation plan by providing information and documentation to the supervising OTR related to the client's needs, goals, performance, and appropriate follow-up resources.
Standard I Professional Standing and Responsibility.
A COTA is responsible for providing safe and effective OT services under the supervision of an in partnership with the OT and in accordance with laws or regulations and AOTA documents.
Mental Illness
A behavioral or psychological syndrome that causes significant distress or disability or a significantly increased risk of suffering death, pain or an important loss of freedom. Impaired functioning in one or more areas.
William Tuke
A coffee merchant and Quaker who came from a wealthy family who had a long history of philanthrophy.
neurapraxia
A condition in which a nerve remains in place after a severe injury, although it no longer transmits impulses.
Cost centers:
A manner of referring to the grouped costs associated with a set of activities within the organizational structure (e.g., the occupational therapy department, the behavioral health day treatment program, or the human resources department).
Physician
A medical doctor who practices the science and art of preventing and curing disease and preserving health.
Allowances or deductions
A percentage of fees that is negotiated with a payer to be deducted or discounted from the gross charge for services.
neurotmesis
A peripheral nerve injury in which laceration or traction completely disrupts the nerve.
Standard II Screening, Evaluation, and Re-Evaluation.
An OT practitioner uses current assessments and assessment procedures and follows defined protocols of standardized assessments during the screening, evaluation and re-evaluation process.
Standard III Intervention
An OT practitioner uses professional and clinical reasoning to select the most appropriate types of interventions, including therapeutic use of self, therapeutic use of occupations and activities, consultation, education, and advocacy.
axontomesis
An interruption of the axon with subsequent degeneration of the distal nerve segment.
What is point of service?
As you perform the treatment you write it down.
Stage 5 Parkinson's Disease
Confided to a bed or wheelchair, maximal assistance required.
early childhood birth to 5
ADD/ADHD, pervasive developmental disorder, autism, mental retardation, failure to thrive, reactive attachment disorder, separation anxiety disorder
Area of occupation
Activities of daily living (ADL)/Basic activities of daily living (BADL) or Personal activities of daily living (PADL)
Gullian-Barre Syndrome
Acute inflammatory condition that affects spinal roots, peripheral nerves, and some select cranial nerves. Following a viral illness, immunization, or surgery.
identity vs role confusion
Adolescence. Parental rebellion. Vocational choices and gender identity.
Living Will
Advance Health Care Directive, is set instructions to give an appointed individual the right to make decisions concerning the health care actions to be taken when the person is no longer able to make the decisions.
Arthrogryposis
Affects joints of the lower and upper extremities but not the spine. May or may not be genetics. Splinting as an infant can help with the deformities. Curving of the joints, abnormal fibrosis of the muscle tissue
Rett Syndrome
Affects only females. Characteristics microcephaly, seizures, intellectual disabilities. Progressive disorder.
Neuroscientific theory
All mental processes, including behavior and emotion, originate in biochemical and electrical activity in the brain.
Freedom (core value)
Allows the individual to exercise choice and to demonstrate independence, initiative and self-direction.
Standard III Intervention
An OT practitioner collaborates with the client to develop and implement the intervention plan, on the basis of the client's needs and priorities, safety issues, and relative benefits and risks of the intervention.
Standard II Screening, Evaluation, and Re-Evaluation.
An OT practitioner communicates screening, evaluation and re-evaluation results within the boundaries of client confidentiality an d privacy regulations to the appropriate person, group, organization, and or population.
Standard III Intervention
An OT practitioner coordinates the development and implementation of the OT intervention with the intervention provided by other professionals, when appropriate.
Flow
Authority flows downwards in the organization. This is because it is delegated by the superiors to the subordinates. Power can flow in any direction. Even subordinates have power over their superiors, if they can influence their behavior. So power can flow upwards, downwards or horizontally.
Legitimacy
Authority is always official in nature. So it is legitimate. Power need not be official in nature. So it need not be legitimate.
Position and Person
Authority is given to a position or post. the manager get the authority only when he holds that position. Power resides (lives) in the person who uses it.
Nature
Authority is the formal right given to a manager to make decisions or to command. Power is the personal ability to influence others or events.
Organizational Charts
Authority relationships (superior-subordinate relationships) can be shown in the organization chart. Power relationships cannot be shown in organizational charts.
Principle 3
Autonomy and Confidentiality - OT personal shall respect the rights of the individual to self determination
Stages of Alzheimer's Disease - Early/Mild impairment
Average 1to 3 years, possibly longer.Memory loss, especially with recent events. Difficulty with complex cognitive tasks. Difficulty with decision making and planning. Decreased attention span and concentration. Lack of spontaneity and lessening of initiative. Impaired word-finding skills. Preference for familiar settings.
Cognitive disabilities
Claudia Allen 6 levels of cognitive development used focused on the effects of impaired cognition on task performance.
Stages of Group Process for lower functioning individuals. Stage 5
Closing the session. Emphasize the positive. Familiar and relaxing activities. Examples repeat stage 1, candy, refreshments. Say goodbye to each person.
Social Skills Training #1
Coaching- motivation
Performance skills
Cognitive skills
Adolph Meyer
Coined the term "Psychobiologic approach" to mental health; indicating the human is an indivisible unit of study, rather than a composite of symptoms. Established the foundation of what is now know as occupational behavior, the model of human occupation and occupational performance.
Generalization
Cole's 7 steps of group process. Address cognitive learning aspics of the group.
Sharing
Cole's 7 steps of group process. Clients share experiences. Leader acknowledges each member.
Application
Cole's 7 steps of group process. How does this apply to everyday life? Ask members how they might use skills from the group in other settings and in their daily lives.
systolic
BP at time of the contraction of the left ventricle
diastolic
BP at time of the rest period of the heart
Cognitive Rehabilitation
Balance of the entire brain. What the Pt. can and can't do
Define MET
Basal Metabolic Equivalent
Object relations theory
Based on psychoanalytic theory. Mental health and mental illness is determined by our relations with objects in our environment. These objects are physical (non human) or human. Our abilities to love and respond to others is seen as expression of object relations.
Social Skills Training #2
Behavior modeling-demonstration
Social Skills Training #3
Behavior rehearsal- practice
Prader-Willi Syndrome
Behavioral manifests - overeating and self-mutilations. Various degrees or intellectual disability.
Susan Tracy
Believed "the patient is the product, not the article he or she makes". She coined the term occupational nurse. She was a nurse who worked to apply moral treatment principle to acute medical conditions.
Principle 1
Beneficence - Ot personel shall demonstrate a concern for the well-being of the recipients of their services.
Stage 2 Parkinson's Disease
Bilateral tremor, rigidity, bradykinesia, with or without axial signs such as facial involvement, independent with ADL, no balance impairment.
Client factor
Body functions
Client factor
Body structures
Normal Hard End Feel
Bone contacting bone resulting in a hard yet painless end-feel.
Sensory Integration
Brain plasticity-can be rewired. Sensory feedback allows for continued normal response. 7 senses.
Fractures
Breaks, ruptures, or cracks in bones or cartilage. Immobilization for healing.
Processing
Cole's 7 steps of group process. Members express feelings about experience and others.
Summary
Cole's 7 steps of group process. Review goals, content, and process.
activity
Cole's 7 steps of group process. timing and therapeutic goals. Physical and mental capacity of members. Knowledge and skill of the leaders. Adaption of the activity.
introduction
Cole's 7 steps of group process. warm-up setting the tone of the group.
Performance skills
Communication skills
FIM score -7
Complete independence: Patient participates 100% of the time without helper and without an assistive device.
CMS
Center for Medicare and Medicaid Services is a government agency that oversees the program and interprets the laws developed by Congress.
Cognitive-Behavioral
Changing irrational thoughts to rational thoughts. How you think is how you behave.
Juvenile Rheumatoid Arthritis (JRA)
Characterized by exacerbations and remissions-75% have remission by adulthood permanently. Interventions-education about joint protection, energy conservation, assistive technology devices, PAMs, orthoses.
Spastic Cerebral Palsy
Characterized by hypertonia and spasticity. Distribution of abnormal tone variable. Initiation of movements leads to increases in abnormal tone.
What is COPD and the diagnosis involved?
Chronic Obstructive Pulmonary Disease -- Damage to the alveolar wall and inflammation of the conducting airways
Athetosis
Fluctuation of muscle tone from low to normal, with little or no spasticity and poor co-activation.
Total assistance
Dependent with task completion
What are two psychological symptoms common in COPD clients?
Depression and Anxiety
Plan
Determine and set forth the specific treatment that will be used to achieve the occupational goals. Document follow up required. What you plan on doing next session. Recommendations for family or caregiver. How much longer the pt. will be seen for treatment. Can document goals in this section: measurable, objective and in behavioral terms. The plan allows another practitioner to carry out tx. if you are unable at the next session.
Medical 203
Developed by the war department in 1943 first formal classification system
DRG
Diagnosis-related group. A group of patients classified for measuring delivery of care in a medical facility; used to determine. Medicare payments for inpatient care.
DSM V
Diagnostic Statistical Manual
Developmental sequence prewriting strokes: 4-6 y.o.
Diagonal lines.
Discovery:
when and how persons learn about the change • Plan communication carefully so that all hear the same information at the same time. • For large-scale changes, develop a formal and written communication plan. • Put any facts, dates, or other concrete information that will help staff understand and be clear on what is to happen in writing.
occupational alienation
when people are unable to meet basic occupational needs or use their particular capacities because of intervening sociocultural factors.
Denial:
when persons don't really believe that a change will occur or believe that, after a time, things will return to the way they were • Continue wide communication in writing and in person. • Offer "town hall" meetings or allow time for questions and answers at a staff meeting. • Continue to express why the change is occurring and when. • Include persons in planning and implementing change so that they see that it will indeed occur.
Evidence based practice
when practitioners locate, review, and interpret research literature related to a specific problems to gather evidence to support their clinical decisions.
extrinsic rewards,
which are rewards given by another person, often a manager or supervisor (Braveman 158)
intrinsic rewards,
which are rewards received as a direct consequence of a person's actions.
falling-in-love stage
which the he or she forms strong attachment to the primary caregiver(s). Responds to the facial expressions and vocalizations of the caregivers with smiles and coos.
action planning
who will do what by when.
compromiser
will accommodate and trade off own position for the good of the whole
Peck's stages of Psychological development in the second half of life Middle age -1st
wisdom vs. physical powers
Populations
within a community such as refugees, veterans who are homeless, and people with health disabling conditions
Shifting:
working items from the palm of the hand to the tips of the fingers without dropping items
consultative role
working with the family (most important role)
Pressure sores - Stage 4
wound has gone into muscles. May be life threatening
Defining contribution of OT is the application of
Core Values - Knowledge - Skills
What is CABG?
Coronary Artert Bypass Grafts
What is CHF?
Coronary Heart Failure
CQI process
Plan Do Check Act
Area of occupation
Play
Young Old
65-75
When considering technology ask...
"What is it the user wants to do? and/or "What is it the user needs to be able to do?
According to ASHT what are the purposes of a splint?
(1) mobilization, (2) immobilization, (3) restriction, and (4) torque transmission.
To have a strong functional grasp, the hand uses the following three arches
(1) the longitudinal arch, (2) the distal transverse arch, and (3) the proximal transverse arch
State Children's Health insurance program
(SCHIP) federal-state partnership wight he goal of expanding health insurance to children whose families earn too much money to be eligible for Mediciad, but not enough money to purchase private insurance
Crepitation
- Seen by RA and OA and occurs as the joints degenerate - Characterized by grating, crunching, or popping sensation that occurs during joint or tendon motion
Treatment objectives for arthritis
- maintain and increase joint mobility, strength, and endurance - prevent/correct/minimize deformities - maintain/increase I with ADLs - educate
Gout
- metabolic disease with a sudden onset and severe inflammation - occurs when there is an excess of uric acid in the body
Context and environment
Personal
AFO
ankle foot orthosis
PT
physical therapy
Responsibilities Stemming from Evidence-Based Practice
• Staying up to date with the sources of information in your area of practice • Communicating with others about what you have learned from synthesizing information • Using good judgment about the information you have gathered by critically evaluating its quality • Recognizing that translating evidence into everyday practice will not be easy and will require creativity
Frames of reference
1. Biomechanical 2. Neurodevelopmental 3. Rehabilitation 4. Role Acquisition 5. Behavioral 6. Sensory Integration 7. Psychodynamic 8. Cognitive-Behavioral 9.Cognitive Rehabilitation
developmental theory
1. Humans mature through a series of stages that occur in a fixed sequence. 2. Problems occur when developmental tasks are not sufficiently mastered developmental lag. 3. A developmental lag can be corrected by exposing the person to s situation that will encourage growth in the deficient area.
developmental theory
1. Humans mature through a series of stages that occur in a fixed sequence. 2. Problems occur when developmental tasks are not sufficiently mastered developmental lag. 3. A developmental lag can be corrected by exposing the person to s situation that will encourage growth in the deficient area.
When establishing goals for the individual users, OT practitioners consider the following:
1. Is this goal rehabilitative or functional? 2. Is the goal shared by the student/user, the family, and other members of the team? 3. Does the goal make sense; is it logical?
Identify 5 principles of joint protection.
1. Respect pain 2. Maintain muscle strength and joint ROM 3. Avoid positions that put stress on involved joints 4. Avoid saying in one position for a long time 5. Distribute the workload over several joints
Education for all handicapped children act (renamed education of the handicapped act (EHA))
1975 All children have the right to free and appropriate public education. 1986 Part H added extended service from birth to threes services should be equal in all states and counties. Renamed in 1990 Individuals with Disabilities Education Act (IDEA)
Technology-Related Assistance for Individuals with Disabilities Act
1988 allocated a considerable amount of dollars to support efforts of the states to increase the awareness of the benefits of technology for people with disabilities, funding for the provision of AT devices and AT services and coordination among state agencies and public and private entities to deliver AT devices and AT services.
Americans with disabilities Act
1990 In areas of public services, discriminatory practices against individuals with disabilities by employers are prohibited
autonomony vs shame and doubt
2 to 4 yr. Bowel and bladder control. exploring enviroment. Their sense of motivation will be shaped by the parents' reaction to this.
project group
2-4yr. Short term task emphasis; group cooperation is encouraged; leader provides for member needs. (Mosey)
No Child Left behind
2001 stresses the use of scientifically based or evidence-based programs and practices.
Severe intellectual disability
25-39 Requires regular support in all areas of occupational performance. May learn habitual self care skills. May have physical disabilities.
initiative vs. guilt
3 to 5 yrs. Imitate adult roles, terry out new ways to do things.
RUGs Rehab High
325 to 499 minutes total therapy per week AND 1 discipline 5 days/week.
Moderate intellectual disability
40-54 Writes name in cursively. reads simple text and emergency words. Works in sheltered workshops or community- supported employment setting. Successfully lives in supervised living situations.
RUGs Rehab Low
48 to 149 minutes total therapy per week and at least 3 days of any combination of 3 disciplines.
When are the assessment periods for RUG levels?
5, 14, 30, 60,90 days
egocentric-cooperative group
5-7 yr. Moderately long term projects with more personal interaction among members; leader provides for needs but less so. (Mosey)
RUGs Rehab Very High
500 to 719 total therapy per week AND 1 discipline 5days/week.
Mild intellectual disability
55-69. Reads at 4 or 5 grade level. Writes simple letters or lists. Performs simple mathematical functions, such as multiplication and division. Uses the computer and internet to perform simple research or communicate with others. Lives alone or with minimal supervision.
Ramps
5ft. at the top and 10ft at the bottoms.
industry vs. inferiority
6 to 12yrs. Teachers and parents attitudes towards them. Compares self to peers.
Borderline IQ
70-84
RUGs Rehab Ultra High
720 minutes expected or actual therapy per week AND one discipline 5 days/week AND a 2nd discipline 3 days/week.
Mid Old
75-85
Confidentiality of health information
8 basics of the Patient Bill of Right. HIPPA. Protects all "individually identifiable health information"
Access to emergency services
8 basics of the Patient Bill of Right. If you have severe pain, an injury, or sudden illness that makes you believe your health is in danger, you have the right to be screened and stabilized using emergency services.Even if they are out of your network, without needing to wait for authorization and without finical penalty.
Consumer responsibilities
8 basics of the Patient Bill of Right. In a health care system that protects consumer or patients' rights, patients should expect to take on some responsibility. Patients are expected to do things like treat health care workers and other patients with respect, try to pay their medical bills and take responsibility for their lifestyles to help improve their health.
Information for patient
8 basics of the Patient Bill of Right. You have the right to accurate and easily understood information about your health plan, health care professionals, and health care facilities.
Taking part in treatment decisions
8 basics of the Patient Bill of Right. You have the right to ask about pros and cons of any treatment, including no treatment at all. You have the right to refuse treatment.
Choice of providers and plans
8 basics of the Patient Bill of Right. You have the right to choose health care providers who can give you high-quality health care when you need it.
Respect and non-discrimination
8 basics of the Patient Bill of Right. You have the right to considerate, respectful care from doctors, health plan representatives, and other health care providers that do not discriminate against you based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation or source of payment.
Standard III Intervention
A COTA contributes to the modification of the intervention plan by exchanging information with and providing documentation to the OTR about the client's responses to and communications throughout the intervention.
Standard III Intervention
A COTA selects, implements, and makes modifications to therapeutic interventions that are consistent with the COTA's demonstrated competency and delegated responsibilities, the intervention plan, and requirements of the practice setting.
1 Trace
Contraction can be felt, but no motion or slight twitch observed.
ADA is modeled after
Civil Rights Act of 1964 and Rehabilitation Act of 1973
Amputation
Congenital or acquired. Thumb and below the elbow most common.
Domain and Process framework
Direct OT practitioners to focus on performance of occupations that result from the dynamic intersection of the client, the context and environment, and the client's occupations.
Congenital Hip Dysplasia
Dislocation of one or both hips. Genetic or environmental. Medical treatment consists of surgery, casting or bracing. Intervention- infant wears cast to promote proper alignment, can result in gross motor development.
Closed chain movement
Distal end of the extremity is fixed, emphasizing joint compression and, in turn, stabilizing the joint. Examples squats, wall slides, lunges, elliptical training, stair stepper, push-ups.
Sickle cell anemia
Hematological disorder that occurs in people of African descent. Crescent shaped red blood cells.
cognitive-behavioral theory
Human behavior is based on what we think and believe. What we think determines how we act. We create our own experiences of the world and can change it by becoming aware of how we think and feel.
Occupational Science
Human beings are viewed as complex multilevel systems who participate in their environment.
Cardiac Rehab - Phase 1, 2, 3
I - Inpatient - monitored low level activity II - Outpatient - Exercise is advanced with close monitoring III - Community Based Exercise Program
static tripod grasps
In this grasp, the implement is held with the thumb and the index and middle fingers. For the first time, the thumb is in full opposition to the index finger. Can be fatiguing or painful but offer more stability and power. Tight grasps limit the variety of movements and make smooth, flowing motions difficult. The hand moves as a whole unit, with very little or no finger action.
IEP
Individual Education Plan-specific goals developed jointly by the teacher, therapy, medical and family
Acquired Musculoskeletal Disorders
Injury or trauma to the skeletal or muscular system, or both. Soft tissue injuries and fractures. Care by orthopedist.
Conduct Disorder
Long standing behaviors that violate the rights of others and rules of society.Physical aggression toward others. Participation in mugging, shoplifting, burglary. Destruction of others' property. Breaking rules. Impaired school performance, skipping school and suspensions from school.
Cooperative group
Longer-term projects; task accomplishments and socio-emotional needs met mostly by members. (Mosey)
FIM score 2
Maximal Assistance: Patient participates 25%-49% of the time.
What is the largest funding source for OT services?
Medicare
Team
Member recognize their interdependence and understand both personal and team goals are best accomplished with mutual support. Time is not wasted struggling over "turf" or attempting personal gain at the expense of others.
Team
Members contribute to the organization's success by applying their unique talent and knowledge to team objectives.
Team
Members feel a sense of ownership for their jobs and unit because they are committed to goals they helped establish.
Team
Members practice open and honest communication. They make an effort to understand each other's point of view.
Team
Members work in a climate of trust and are encouraged to openly express ideas, opinions, disagreements, and feelings. Questions are welcomed.
generativity vs. stagnation
Middle adulthood. Making contributions through work. Child-rearing.
Titles of ADA - Title 5
Miscellaneous Provisions. The final title contains a variety of provisions relating to the ADA as a whole, including its relationship to other laws and its impact on insurance providers and benefits.
MOHO
Model of Human Occupation. Habituations, performance capacity, volition.
FIM score -3
Moderate Assistance:Patient participates 50% - 74% of the time.
egocentric-cooperative group
Moderately long term projects with more personal interaction among members; leader provides for needs but less so. (Mosey)
FIM score -6
Modified independence: Patient has mild difficulty but self-corrects without prompting from a helper. May use an assistive device or require extra time (3x normal).
Stages of Group Process for lower functioning individuals. Stage 2
Movement phase, increases non-verbals, match movements to abilities. Shaking hands, clapping, ROM, dance.
Brunnstrom's theory
Movement therapy. Syneries, reflexes and other abnormal movement patterns as a part of the process through which an individual with CNS dysfunction must go before normal voluntary movement can occur.
Proprioceptive Neuromuscular Facilitation (PNF)
Multisensory, focusing on mass movement patterns that resemble normal movement. All movement has a diagonal or spiral pattern.
Level T1-9
Patterns of weakness: lower trunk paralysis; total paralysis of lower extremities. Movement possible:upper extremities fully intact; limited upper trunk stability; endurance increased secondary to innervation of intercostals. Independent with most tasks.
Level T10-L1
Patterns of weakness: paralysis of lower extremities. Movement possible: fair to good trunk stability. Independent with modification.
Level C7-8
Patterns of weakness: paralysis of trunk and lower extremities; limited grasp and dexterity secondary to partial intrinsic muscles of the hand. Movement possible: elbow extension, ulnar/wrist extension; wrist flexion; finger flexions and extensions; thumb. Minimum Assistance
Level C4
Patterns of weakness: paralysis of trunk, upper extremities, lower extremities. May be able to breath without a ventilator. Movement possible:neck flexion, extension,rotation, scapular elevation;inspiration. Mostly total assistance.
Level C1-3
Patterns of weakness: total paralysis of trunk, upper extremities, lower extremities; dependent of ventilator. Movement possible: neck flexion, extension, rotation Total assistance
Level C5
Patterns of weakness:absence of elbow extension, pronation, all wrist and hand movement; total paralysis of trunk and lower extremities. Movement possible:shoulder flexion, abduction,and extension; elbow flexion and supination; scapular adduction and abduction. Moderate Assistance.
Level L2-S5
Patterns of weakness:partial paralysis of lower extremities, hips,knees, ankle, foot. Movement possible: good trunk stability; partial to full control of lower extremities. Independent with adaption.
Level 4 - Goal Directed Actions
Person able to copy demonstrated directions presented one step at a time; can visualize the goal of making something; is interested in doing simple two-dimensional projects, however does not plan for details; tends to rely on prior learning and finds it easier to imitate a sample than follow a diagram or picture; cannot recognize errors and may not be able to correct them when pointed out; does not understand that objects can be hidden from view; does not notice glue sticking to bottom of tray [Imitated motor actions: copy or reproduction of an example, rote learning; Attn to sensory cues: visible - what is not visible is ignored i.e. color, size, discomfort]
Level 6 - Planned Actions
Person appreciates relationships between objects even when they are not obvious; able to anticipate errors, reasons why they may occur, and plan to avoid them; associated with higher levels of education, occupational background and socioeconomic status [Imitated motor actions: often unnecessary; Attn to sensory cues: symbolic - abstract or intangible i.e. evaporation, electrical, current, heat, time, gravity]
Level 3 - Manual Actions
Person is interested in what is going on; easily distracted by objects in the environment, enjoys touching and manipulating them; engages in simple repetitive craft or activity but is likely to be surprised to see something has been produced; has difficulty understanding cause and effect except in his own simple actions; easily disoriented and may get lost [Manual or manipulative imitations of motor actions; Attn to sensory cues: Tactile i.e. texture, shapes]
Psychodynamic
Person is valuable and unique. People give meaning to objects and things. ID, ego, super ego.
Level 1 - Automatic Actions
Person seems mostly unaware of what is going on; pays attention for only a few seconds but carries out automatic habitual motor routines (self-feeding when food is presented); very slow to respond to request or cue (may respond by rolling over or holding up hand) [no imitated motor actions; Motor actions: sniffing, withdrawal from noxious stimuli, swallowing; Only dimconscious awareness of sensory cues i.e. hunger, thirst, discomfort]
Level 2 - Postural Actions
Person seems to be aware of movement and position and of effects of gravity; sits and initiates some gross motor actions; not aware of social context and may wander off; may assume bizarre positions or perform strange-looking movements [Approximate imitations of motor actions; Attn to sensory cues: proprioceptive i.e. posture, gesture, motion]
Level 5 - Exploratory Actions
Person shows interest in relationships between objects, however relationships must be concrete and obvious; interested in effects that can be produced using the hands and may vary the pressure or the speed of hand motions, can generally perform a task involving three familiar steps and one new one; new steps must be demonstrated; may appear careless because of inability to anticipate the possible consequences of actions; may benefit from social skills training to improve attention to nuances of expected social behavior; may function in community but may not take ordinary and reasonable care regarding rights of others [Imitated motor actions: new steps initiated; Attn to sensory cues: related - between 2 visible cues i.e. overlapping, color mixing, spatial relations]
Context and environment
Physical
Neonatal intensive care unit (NICU)
Physiologically unstable: unable to maintain body temperature or heart or breath rate. Neonatologist as medical team leader. OT does not work in this area.
PECS
Picture Exchange Communication System
Eleanor Clark Slagle
Pioneer of OT. Worked for 2 years at Hull House as a staff member. Established first training program for Occupational Workers (forerunner of OT personnel). Went on to work with William Dunton. She is consider on to the founding members of the national professional organization. Considered the most distinguished 20th century OT, she held every major office.
Objective
Place where you record all measurable, quantifiable, and observable data obtained during your client's occupational therapy treatment sessions: any social interactions. Judgement and problem solving behaviors, appearance and work skills.
Justice (core value)
Places value on the upholding of such moral and legal principles as fairness, equity, truthfulness, and objectivity.
subacute setting
Pt. more medically stable but not ready to go home for medical or family reasons. Continue to monitor and treat acute symptoms. wean off external medical supports. OT provides developmentally appropriate interventions. Pediatricians as medical team leader.
Volition
Pt. motivation
Independent
Pt. performs activity without assistance.
RLA VIII
Purposeful appropriate. Alert and oriented. Pt may drive. Stand-by-assistance. Community reentry, any ADLs or IADLs that have not been mastered
Which form of arthritis is symmetrical?
RA
Symptoms of Gullian-Barre Syndrome
Rapid onset and patient decline; then rapid recovery. Pain and tenderness of muscles, weakness, and decreased deep tendon reflexes occur; trouble walking then may not be able to move then on vent. Most recovery is within a few weeks to few months. May continue to recovery for up to 2 years.
Most common type of MS
Relapsing-remitting shows clearly defined relapses with some amount of recovery in between and no progression in-between
Activity Demands
Required actions
Supervision
Requires direct supervision for safety.
Stage 4 Parkinson's Disease
Requires help with some or all ADL, cannot live alone without assistance, able to walk and stand.
Equality (core value)
Requires that all individuals be perceived as having the same fundamental human rights and opportunities.
Truth (core value)
Requires that we be faithful to the facts and reality.
Area of occupation
Rest and Sleep
Primary symptoms of Parkinson's Disease
Resting temor Rigidity Bradykinesia Postural instability
Anorexia Nervosa
Restrictive: limits food intake and uses activity,exercise to control weight. Intense fear of being overweight.
intimate self disclosures
Reveal too much personal information. Interpersonal event that occur during group process.
Common diagnoses for a resting hand splint
Rheumatoid Arthritis,hand burns,Dupuytren's disease,contractures,trauma, and crush injuries of the hand.
Public law 99-457 (1986)
Rights of families. Central role of families in intervention with young children. Families as co-leaders on state-level advisory boards. Families' concerns, resources, and priorities important to the development of an intervention plan. Added Part H (now know as Part C) to EHA, mandating early interventions for birth to age 3 population. Included identification and referral, evaluation, determination of eligibility, development of individual family service plan (IFSP), and transition plans.
Performance patterns
Rituals
Performance patterns
Roles
Performance patterns
Routines
Stages of cancer
STAGE I-may be localized to one region, usually early stage. STAGE II-cancers spreads to another adjacent local region of the body ( a tumor and metastasia). STAGE III-disease spreads to another organ. STAGE IV-disease is wide spread and multiple systems /organs are involved.
Performance skills
Sensory perceptual skills
Activity Demands
Sequencing and timing
Traumatic Brain Injury (TBI)
Serious injury to the brain, can cause motor, cognitive, and emotional changes.
project group
Short term task emphasis; group cooperation is encouraged; leader provides for member needs. (Mosey)
Narrative notes
Similar to SOAP notes but one big paragraph. Allows for more flexibility all data is included in a smooth flowing descriptive note.
Parkinson's Disease
Slow,chronic progressive disease of the nervous system. Caused by a reduction of dopamine in the brain.
What is the leading cause of COPD?
Smoking
Context and environment
Social
Principle 4
Social Justice - OT personnel shall provide services in a fair and equitable manner.
Area of occupation
Social participation
Client-centered therapy
The client has the ability to freely choose and act because one is aware of one's feelings and the possible consequences of an action no matter how psychotic or disorganized the behavior may be. Techniques: the therapist takes a non directive approach. Active listening very important. There is an open invitation to talk, minimal response, reflection of feelings, paraphrasing, withholding judgment.
Tinel's test
The first method involves gently tapping over the suspected entrapment site to help determine whether entrapment is present. The second method consists of tapping the nerve distal to proximal. A positive sign if he or she experiences tingling or shooting sensations in one of two areas: at the site of tapping or in a direction distally from the tapped area.
Normal Soft End Feel
The range is limited by soft tissue compression.
Family systems theory
The way families operate as units, the impact of diverse cultures and child-rearing patterns on family life, and difference in child rearing.
Adult/adolescent sensory profile- Sensory Sensitivity
These individuals have low neurological thresholds that cause them to respond readily to sensory stimulus. They are distractible and are uncomfortable around intense stimuli. They tend to notice each stimuli as it presents itself. They are able to discriminate and attend to detail.
Adult/adolescent sensory profile- Low Registration
These individuals tend to miss or take longer to respond to stimuli that others notice. This person may be the last to understand a joke or the last one to smell an odor. These individuals are more flexible and more comfortable in a wide range of sensory environments.
Adult/adolescent sensory profile- Sensory seeking
These individuals will create additional stimuli or seek out environments to get more sensory stimuli. These individuals will listen to music while they ares studying or eat at a restaurant that have unfamiliar foods. They enjoy exploring the environment and regard sensory experiences as pleasurable. They become bored easily and find low stimulating environments intolerable.
Adult/adolescent sensory profile- Sensory Avoiding
This individual is overwhelmed or bothered by sensory stimuli. They purposely avoid stimuli in their environments and engage to reduce the stimuli. This individual may use rituals to increase predictability. They enjoy being alone.
faded assistance
This involves providing assistance for all, or a portion, of the activity. Could occur in the form of physical assist or grading of the activity in the form of adaptations or accommodations to the size of objects, speed, frequency or duration of the activity, height and angle at which the activity is performed, number of steps, complexity, and sensory components of the activity.
Subjective
This is the section that OTA will document the patient's concerns and comments. It is the client's perspective. Any reports of pain or discomfort from Pt. goes here. Any reports from the caregiver or family member goes here also. Should specifically pinpoint a specific issue rather than noting general comments.
Assessment
This section consists of the occupational therapy practitioner's skilled appraisals of the client's progress, functional limitations, pertinent issues and expected gains from rehabilitation. Rehab potential in Areas of Occupation. Progress or regress report here. Justify why the patient needs to continue OT Tx. Not for new information, reiterates what was documented in the O and S sections.
Adaptation
To modify the activity. Changing the components that are required to complete the task. It allows Pt. to experience success in task accomplishment at his or her level. An example would be using a vice to stabilize needlepoint or wood project for a patient that has only one arm.
Adaptation
To modify the activity. Changing the components that are required to complete the task. It allows the patient to experience success in task accomplishment at his or her level of functioning.
Domain of OT
To support health and participation in life through engagement in OCCUPATION.
FIM score 1
Total assistance: Patient participates less than 25% of the time or not at all, requires more than one helper, or 1:1 supervision.
Contact guard assistance
Touching Pt.
William's motor learning principles
Transfer of learning Feedback (modeling or demonstration) verbal instruction knowledge of result/ knowledge of performance distribution and variability of skill practice whole versus part practice mental practice
sensory diet
a carefully designed activity plan for sensory input a person needs to stay focused and organized
Lazarus Project
Used in long-term care facilities it involves empowering individuals by creating communities which govern themselves by drawing on diverse strengths of members to address common problems.
What is therapeutic use of self?
Using your personality, insights, perceptions and judgements as part of the therapeutic process.
3 aspects of self awareness #1
Values
Client factor
Values, beliefs and spirituality.
Principle 6
Veracity - OT personnel shall provide comprehensive, accurate, and objective information when representing the profession.
Stages of Group Process for lower functioning individuals. Stage 4
Verbal and Symbolic activities, enhanced cognition. Examples making fruit salad, memory games.
parallel group
Very little group interactions; leader provides essentially all needs of each member. (Mosey)
Context and environment
Virtual
Stages of Group Process for lower functioning individuals. Stage 3
Visual motor perceptual activities, increases demands on members to respond. Incorporates; sensory stimulation, movement, cognition, Simon says, relay races, pantomime games.
VOCAs
Voice Output Communication Aids. High-tech devices are able to store information and produce auditory communications.
BMI calculation
Weight (lb)/[Height(in)]2 × 703
Role Acquisition
What roles did they have? What roles can they have?
Area of occupation
Work
Describe how energy conservation techniques can be applied to daily activities.
You can plan ahead, remove yourself from stressful situations, and include daily rest periods and breaks
whose covered under ADA Act
You must actually have what is considered to be a "physical or mental impairment". The impairment must "substantially limit one or more of your major life activities."
mental illness
a behavioral or psychological syndrome that causes significant distress or disability or a significantly increased risk of suffering death, pain or an important loss of freedom. Impaired functioning in one or more areas.
genuineness
ability to be oneself openly
initiation
ability to begin a task, generate ideas, responses, and problem-solving strategies
working memory
ability to hold information in mind for completing a task.
Stereognosis
ability to identify common objects through touch
organization of materials
ability to impose order on work, play, and storage spaces
judgement
ability to make realistic decisions based on environmental information
planning and orientation
ability to manage present and future-oriented tasks
self-monitoring
ability to monitor self-performance and measure against a standard of what is needed or expected
sequencing
ability to organize an activity in logical and timely steps
freedom to suspend reality
ability to participate in make-believe activities or pretend play.
form discrimination
ability to perceive or understand what they see
graphesthesia
ability to recognize numbers, letters, or forms written on the skin. Tracing letters on hand vision occluded.
emotional control
ability to regulate emotional responses
motor control
ability to regulate or direct movement
Inhibition
ability to stop actions and thoughts at appropriate time.
Shift
ability to think freely and move from one situation to another
empathy
ability to understand how the other person feels
secondary aging
abnormal changes in organ systems. Experienced by some individuals but not all. Associated with disease, impairment, or disability. Frequently preventable through lifestyle changes.
Anorexia Nervosa
abnormally low body weight, refusal to gain weight, disturbed body image
Therapeutic exercise
activities like stationary bicycle
emotionally charged therapy tasks and situations
activities or circumstance that can lead to the client to become overwhelmed. Interpersonal event that occur during group process.
Self care training
activities that focus on ADL's and IADL's
Neuromuscular re-ed
activities that involve the brain and muscles working together.
primary brain damage
actual damage done to the brain; contusion or diffuse axonal injury
identification
adopting the habits or characteristics of another person.
normal range for resting heart rate
adult: 60 to 100bpm
Dietician
advises individuals about understanding complex nutritional needs and planning and preparing special diets.
Justice
advocate for the patient so they are getting the treatment they need.
JRA-Pauciarticular
affects 4 or fewer joints.
JRA-Polyarticular
affects 5 or more joints.
JRA-Still's disease
affects internal organs and joints. Can lead to death.
demographic arena
age, socioeconomic status, racial mix, and other characteristics of local and national populations change
assistive appliance
aid/device that is beneficial without development of skill (foot orthotics)
assistive tool
aid/device that requires development of skill to be useful (switch-adapted toy)
sensitivity
alertness to the patient's needs and awareness of your affects on him or her
perceptual skills
allow interpretation of and meaning of sensory input.
olfactory discrimination
allows for distinguishing differences in smells
adapting
allows for greater participation and independence 9 compensatory techniques are adapting)
auditory perception
allows for the ability to discriminate between different sounds, tones and pitches
Mobility
allows learning by moving and exploring the environment. Helps to develop spatial awareness.
activity analysis
allows the OT practitioners to understand and address the skills and external components needed for performance of the activity. Addresses the typical demands of an activity, the range of skills involved in its performance, and the various cultural meaning that might be ascribed to it.
tactile discrimination
allows us to distinguish different textures by touch. It is our ability to perceive the difference in textures, not just the body's ability to sense touch.
working memory
allows us to hold information and use it during a tasks. It is theorized that our working memory can handle seven pieces of information at one time.
Antipsychotic medications
also know as neuroleptics. help control hallucinations and delusions
Down Syndrome
also know as trisomy 21-extra chrome. On the 21 chrome making it 3. Diagnosed shortly after birth. Characteristics include facial features, cardiac anomalies, and low muscle tone.
Temor
an involuntary trembling or shaking of the body or limbs.
evidence based practice
an never ending process of gathering appropriate clinical evidence from clinically relevant research to enable accurate, efficient, and safe decisions about patient care.
successful aging
an optimal state attained by avoiding disease and disability maintaining high cognitive and physical functioning, and continuing to be actively engaged with life.
splint
an orthopedic device for immobilization, restraint, or support of any part of the body
respect
and recognition as a unique individual with personal interests and values
What are the eight signs and symptoms of cardiac distress?
angina, dyspnea, orthopnea, neausea/emesis, diaphoresis, fatigue, cerebral signs, orthostatic hypotension
contingency assessment
answers the "what if's".
health promotion
any planned combination of educational, political, regulatory, environmental, and organizational supports for actions and conditions of living conductive to the health of persons, groups, or communities.
thermotherapy
application of thermal agent used to increase cell metabolism, blood flow, soft tissue elasticity.
Rood's theory
appropriate sensory stimulation can elicit specific motor responses. Normal muscle tone is a prerequisite to movement. Movement occurs in a developmental sequence, each skill build upon the other.
long term goals
are broad, observable outcomes that will be achieved at the end of the group program
occupational therapy groups
are formed to address invention goals; they consist of content and process.
intrinsic muscles of the hand
are located within the hand itself. They are responsible for the fine motor functions of the hand.
Group maintenance roles
are needed to promote closeness among the group members. Encourager, Gatekeeper, Follower.
leukemia
arises from blood-forming organs such as bone marrow
lymphoma
arises from cellular components of lymph nodes.
sarcoma
arises from connective tissue (tissue that supports and connects other tissues and parts of the body including adipose, fibrous, elastic, cartilage, and bone.
carcinoma
arises from epithelial tissue (skin, epidermis)
Achondroplasia or dwarfism
arrested or stunted growth. Is a disorder of the growth cartilage.
backward chaining
assist the patient until the last step. Then allows the client to try to finish the last step on their own. This is repeated to include the second to last step then so on..
exchange theory
assumes people attempt to maximize their rewards and minimize their costs in interactions with others. Elders continue with interactions that are beneficial and withdraw from those perceived as having no benefit.
3 basic categories of learning #3
attitudes, learned feelings, values or beliefs
self confessor
attracts attention by inappropriate disclosures
recognition seeker
attracts attention to self
Peck's stages of Psychological development in the second half of life Middle age -3rd
cathectic flexibility vs. impoverishment
RLA VII
automatic appropriate. appears oriented within hospital and home setting. Complete daily routine automatically. Community mobility and awareness, support groups, develop plan to return to work, coping skills for family. Do not let them drive.
tactile defensiveness
aversion to touch
body scheme
awareness of the position of the body and its parts in relation to themselves and the environment.
cerebellum
balance, coordination, skilled motor activity
Glasgow Coma Scale
based on a 15 point scale for estimating and categorizing the outcomes of brain injury on the basis of overall social capability or dependence on others. The test measures the motor response, verbal response and eye opening response.
development of adaptive skills
based on developmental model. Developmental stages within each skill. There are 6 areas of adaptive skills
3 types of research
basic applied action
informed consent
before providing any form of treatment, the caregiver must orient the patient. Caregiver should greet and identify the patient and clearly state his or her name and professional or technical status. Patient should be informed why he or she has been referred to the service unit, the type of treatment to be received, and any serious risks or adverse affects associated with the proposed treatment.
organized sense of self
begins to realize how behaviors can be used to get different reactions from others.
Manual actions-Level III
begins with the use of the hands to manipulate objects. The individual may be able to perform a limited number of tasks with long-term repetitive training
social cognitive theory
behavior is determined by expectancies and incentives interacting together. Also the impact of self efficacy is crucial. The patient has to believe he or she can make the change or perform the behavior. This is achieved through performance accomplishments, vicarious experiences and verbal persuasions. The clients physiological state also will influence his or her own readiness to change behavior.
reflexive stage
behavior is dominated by reflexes such as sucking and the palmar grasp/
behavioral FOR
behaviors that elicit or inhibit functioning in the area of ADL, work, and play/leisure. There is an emphasis on the stimuli that act as cues to the behavior and the reinforcers for specific behaviors.
projection
believing that an unacceptable feeling of one's own belongs to someone else
BKA
below the knee amputation
colostomy stoma
between colon and the body surface
Development of fine motor skills, elements that make up the foundation
bilateral motor control, reaching/grasping, object manipulation and implement usage.
bulimia nervosa
binge eating followed by self-induced vomiting, average or above average weight
basic trust vs. mistrust
birth to 18 mo. Nurturance from mother.
sensorimotor stage
birth to 2yr. infant develops the ability to organize and coordinate sensations with physical movement and actions
Two types of prostheses
body powered and externally powered.
Peck's stages of Psychological development in the second half of life Old age - 2nd
body transcendence vs. body preoccupation
NDT General principles
brain plasticity, key points of control, inhibition, facilitation.
abstract
brief summary of the research questions that are targeted and the methods that are used to answer those questions
What adaptive equipment would be useful for patients with arthritis?
build up handles, button hooks, washing mitts
heterotopic ossification
build up of calcium in the joint; you can not stretch the joint once this happens
Set up only
can leave area
way to achieve service competency
can perform the same or equivalent tasks and obtain the same results.
Skilled Therapy
care is covered if performed under the supervision of a professional and ordered by a physician and provided on a daily basis. Care must be reasonable and necessary for the treatment of a patient's illness or injury and reasonable duration and quality.
geriatrics
care of elderly people based on the integration of knowledge of gerontology and chronic disease.
Hospice/palliative care
care to help alleviate suffering while maintaining the elder's dignity. All services provided should be coordinated to be ever-mindful of maintaining the emotional adjustment and support of the entire family.
Gender dysphoria disorders
category includes those individuals who experience significant distress with the sex they were born with and with associated gender roles.
Equililbrium reactions
maintains and restores a person's balance in all activities.
Righting reaction
maintains or rights normal position of head in space and in relationship with trunk and limbs
adolescence puberty -21
major psychiatric disorders, schizophrenia, substance related disorders, eating disorders, identity issues
compensation
makes client aware of a problem and teaches compensatory measures to improve performance.
rationalization
making excuses for unacceptable behavior or feelings
Empirical research
making observations and collecting data. Evidence based practice. Knowledge based on information gained from experiences or observations using the senses.
teams
management and employees at all levels and consultants
multidisciplinary
many different groups each with different goals, each group works independent.
Interdisciplinary
many different groups with different goals, groups compare findings
hand rails
max load 250 lbs.
client-centeredness
means that goals are discussed with the clients and that the language used is straightforward
force
measurable influence acting on a body
Check
measure the impact of the improved process. Analyze the data
Monkey hand
median nerve injury, loss of the ability to abduct the thumb.
Tricare
medical insurance for military.
Transdisciplinary
members are committed to ongoing communication, collaboration, and shared decision making for the patient's benefit. Evaluations and treatments are planned cooperatively. There is usually a primary interventionist but treatment is often shared. Consultations among disciplines are important.
voluntary
members attend based solely on their personal desire to attend the group, they will be more invested in engaging in the process
confabulate
memory deficit. fill in memory gaps with imaginary material. Unaware of adding information, confused regarding past events.
procedural memory
memory for a skill or series of actions
Temporal lobe
memory, hearing, understanding language, organization, sequencing.
grading activity
modifying to obtain the patient's maximal performance; provide the "just right" demand for performance.
central cord
more paralysis and sensory loss in UE than LE; usually from tumor or infection
energizer
motivates the group to decide and/or take action
Social skills training session phases
motivation, demonstration, practice and feedback
peripheral neuropathy
motor and sensory impairment of extremities
Developmental coordination disorder
motor coordination is significantly below chronological age expectation and intellectual ability. Impairments in occupational performance.
metastasize
move and start in new sites
osteokinematics
movement of bones around a joint axis. (big movement of the joint, voluntary movement, can be seen.)
contralateral
movements are the forerunner of the arm/foot opposition inherent in most locomotion.
Choreiform
movements are uncontrolled, irregular, purposeless, quick, jerky and dysrhythmical movements; may also occur during sleep.
self-disclosure
practice of revealing things about oneself when appropriate - for the patient's benefit
perceptual skill remediation
practicing skills during meaningful tasks. Examples lighthouse strategy and constraint-induced therapy
transfer of training approach
practicing skills in skill-based training.
National Society for the Promotion of Occupational Therapy
preceded the American Occupational Therapy Association
stages of transtheoretical model of change
precontemplation contemplation preparation action maintenance
ageism
prejudice or discrimination against a particular age group, particularly the elderly.
adjunctive methods
prepare the person to engage in activity.
anti-deformity position
preserves a balance between extrinsic and intrinsic muscles, and provides localized rest to the tissues of the fingers, thumb, and wrist
tertiary prevention
prevention of the progression of existing conditions. Relates to the function assessment and rehabilitation both to reserve and prevent the progression of the burden of illness.
Psychoeducation
primarily focuses on training and development of skills
play
primary occupation of children. critical to the development and refinement of skills. Opportunities for problem solving, communication, understanding nonverbal communication, and socialization.
Dignity
privacy and respect of the patient at all times.
Role of OT in Pediatrics
promote active engagement in developmentally appropriate occupations. (Play, ADL's, school, self-care, socialization
home care
promote caregiver and child bonding. Medical services on an outpatient or home delivered basis. Community based supports and resources vary with the child's age. OT should continue to facilitate the acquisition of developmentally appropriate skills.
dynamical systems theory
proposes that movement is a function of interactions among the neuromuscular system, environment, cognition and task itself.
Sensory Integration
proprioception, kinesthesia, and vestibular treatment focus on the outcome of the activity rather than the movements used.
Long-term care facility
provide the necessary medical care. OT should provide appropriate therapeutic interventions.
Principles of positioning as a therapeutic tool
provide variety, promote function, avoid restricting movements, consider safety, promote skeletal alignment and symmetry, and provide proximal stability to promote distal mobility.
Principles of positioning as a therapeutic tool
provide variety, promote function, avoid restricting movements, consider safety, promote skeletal alignment and symmetry, and provide proximal stability to promote distal mobility.
smaller height wedge
provides more difficulty head control.
Physical Therapist
provides treatment for patients with disabilities resulting from disease or injury. Purpose of treatment may be to relieve pain, to increase function of the body part by improving muscle strength and joint ROM.
RLA Level X
purposeful and appropriate. modified independent
RLA Level IX
purposeful and appropriate. stand by assist with request
Ballism
rare symptom produced by continuous, gross, abrupt contractions of the axial and proximal musculature of the extremity. Causes the limbs to fly out suddenly and occurs on one side of the body.
information giver
readily provides facts as needed
reframing
redefining the situation i ways that make it more manageable
countertransference
redirection of a therapist's feelings toward a patient, or more generally, as a therapist's emotional entanglement with a patient.
akinesia
reduction in movement, fatigue and weakness
