Paediatrics - Disability Dynamic Online Independent Learning Module [ANSWERS]
3. The best practice approach for writing goals is using the SMART framework. From the goal below, what is the measurable part of the SMART goal? Whilst at home Sally will be able to use her right hand to independently finish a 50ml bowl of breakfast cereal and milk without spillage with the assistance of a shoulder sling and adapted cutlery by the end of 2 weeks. She will practice using adapted cutlery daily at each meal. Sally's progress will be reviewed by the Occupational Therapist at the end of week 1 and week 2.
"Independently finish a 50ml bowl of breakfast cereal and milk without spillage"
Now that a detailed assessment has been conducted, it is possible for Charlie and Airlie to work together to develop a Goal Attainment Scale (GAS) for the goal around standing without pain. What would be the best way to explain the purpose of the Goal Attainment Scaling (GAS) to Charlie?
'A Goal Attainment Scale is used to document where Luke is at now in terms of his goal around standing without hip pain and what level of achievement we expect him to get to. We can use this scale to measure his improvements over a defined period of time.'
20. In what order are the sequential steps of the Evidence Based Practice Cycle usually carried out?
*Option 1* 1. Assess a client and their situation. 2. Ask a relevant clinical or treatment question about the client and their situation. 3. Systematically acquire information that will answer the clinical question. 4. Critically appraise the relevance and quality of the information 5. Apply the evidence to the clinical situation
21. Within the disability sector emphasis is placed on developing partnerships between people with a disability, their families and the services that supports them. One way to approach the activities involved in developing partnerships and delivering services is to follow the process below:
*Option 1* 1. Engage with the clients and families 2. Understand their needs and goals 3. Intervene for a time defined period 4. Evaluate the outcomes of your service provision
Watch the video below then identify the level of attainment Luke achieved with his switching skills.
+1 Greater than expected Luke is able to independently activate a single head switch with >90% accuracy to turn the pages of an online book.
Luke has been working on his goals around standing, switching skills and language development for nearly 6 months. Next week Airlie will be meeting with Charlie to evaluate the outcomes of this episode of service. Before this happens, watch the video footage of Luke's skills now and use the Goal Attainment Scales below to rate his level of achievement for each of his goals.
+1 Greater than expected Luke is able to tolerate standing in his standing frame for leisure activities, for a period of 46 - 60 minutes before experiencing pain.
What did you notice about the way Airlie received feedback from Sarah?
- Airlie thanked Sarah for the feedback and took it on board - Airlie showed Sarah she was listening and interested - Airlie's body language and non-verbal signals demonstrated that she was comfortable with receiving feedback
Why do you think Charlie might have felt the way she did after this scene?
- Airlie took control of the situation and decided on the goals for Charlie. - Airlie did not give Charlie a chance to respond until the end.
5. This contemporary conceptualization of health and disability represents a biopsychosocial perspective. Different components of this model include:
- Biological factors - Personal factors - Environmental factors
19. Which of the following international and national initiatives actively supports the rights of people with disability and acknowledge the responsibility to provide quality services?
- Convention of the Rights of Persons with Disabilities - National Disability Agreement (NDA) - National Disability Insurance Scheme (NDIS)
7. What are Goal Attainment Scaling and Canadian Occupational Performance Measures example of?
- Criterion referenced instruments - Outcome measurement tools
6. What are 3 examples of different modes of service delivery?
- Direct therapy service - Indirect therapy service - Consultative service
After meeting with Charlie, the rest of the team have an opportunity to catch up with Airlie to hear about the goals and priorities for Luke and his family. Marion opens the team meeting with Airlie and Sarah. Listen to the way Airlie summarises the information she has learnt about Luke and his family. Why is it important for the team to meet together like this?
- Understanding what it is important to a client and family helps the team decide which therapist is best placed to address each need. - All members of the team will have an understanding of what needs Charlie and Luke would like support with. - The team have an opportunity to support each other's self reflection and ongoing learning by sharing feedback about the meeting.
What kinds of activities might Luke be able to participate in at this point in time?
- Use a switch to turn on or off the radio - Use a switch to turn the pages of an online book - Use a switch to start a toy - Use a switch to gain the attention of his classroom teacher
Watch the video and read Sarah's progress notes to identify the level of attainment Luke achieved with his language development.
0 Expected outcome Luke spontaneously generates 2 word combinations during conversation with a familiar communication partner 9% of the time using either spoken language of AAC.
Beginning Steps
1. Go to: http://trainingalliance.edu.au 2. Click online Learning Login 3. Login (username = uni email i.e. [email protected], password = Learning-1) 4. Click "My Courses" 5. Click "Disability Dynamic" 6. Click and Complete "Working with Clients" - just keep clicking NEXT over and over again until you finish. 7. Complete "Working with Clients Quiz" - Answers below
Have a go at taking a measurement yourself of Luke's left knee. Flex Luke's foot as far as it will go and then take a measurement of his range of movement at this joint.
135°
8. What is a Multidisciplinary team?
A team of therapists acting within their own professional domains and interacting only formally with other team members.
18. When using Evidence Based Practice to guide clinical decision making, what factors need to be considered?
All of the above
1. "Sophie will reduce the number of times she falls." This statement is and example of:
An aim
4. The Canadian Occupational Performance Measure (COPM) is an example of:
An outcome measure
This section of video will show Airlie and Marion taking measurements of the range of motion in Luke's joints. As you watch the process, take notice of the different role that each person has in the assessment process. Why do you think Airlie asked Charlie to record the measurements during this assessment?
Because she perceives Charlie as member of the team who has a valued role in the assessment.
16. What would you hope to achieve in the "ENGAGE" phase of service delivery?
Build a relationship with the client and their family.
2. Jack is a physiotherapist and he has received a referral for 6 year old Claire to increase her independent mobility. Claire has cerebral palsy with spasticity in her lower limbs. If you were Jack, what would you do next?
Find out what daily tasks or activities Claire needs to be able to participate in.
"I thought it would be a great place to start by giving you an opportunity to tell us about you and about Luke and tell us the story of what has been happening over the last 6 years. What do you think?" Why do you think Airlie choose this way to start the interview?
It empowered Charlie to talk about her experiences.
9. What is an important feature of Person Centered Practice?
It places the person with a disability at the centre of decision making regarding the support and service they use.
After welcoming Charlie you are ready to sit down together and start an interview. How would you open the interview? Choose the best opener to encourage conversation and build trust and rapport.
Thank you for coming to meet with me today. How has your morning been so far?
14. What is the main premise of the International Classification of Functioning Disability and Health (ICF)?
The ICF is an integrated model that enables clinicians, researches and policy makers to understand disability using internationally, common language.
17. When liaising and sharing information with other people and professionals, who remain at the centre of the team?
The client
We have just seen a less than optimal approach from Airlie, now it's time for you to choose what you would have done. Remember, Charlie has just spent some time sharing her story and describing what her needs are for Luke. What would be a good way to demonstrate that you have understood what Charlie has just discussed?
The main area you have spoken about is helping with Luke's pain in his hip? I can hear that this is really important for you to address right now.
15. What is the purpose of a service plan?
The service plan is the place where important information about decisions and actions are captured.
10. What is characteristic of Family Centered Practice?
The strengths and needs of all family members are considered.
11. What is the main aim of the "EVALUATE" phase of service delivery?
To evaluate the outcome of a treatment of intervention.
12. What is the main aim of the "INTERVENE" phase of service delivery?
To select and provide an appropriate intervention process, strategy or technique that will address an identified goal.
13. What is the main aim of the "UNDERSTAND" phase of service delivery?
To understand the needs, goals, hopes, dreams and wishes of people with a disability and their families.
The purpose of this switch assessment is to see how well Luke is able to use a head switch to activate cause and effect toys.
Untimed, repeated purposeful switch activation (Switch Building)
