Pediatrics Final

Food thickness (low to high) A) regular, minced, liquidized, pureed, soft B) soft, liquid, minced, pureed, regular C) liquid, pureed, minced, soft, regular D) liquid, pureed, soft, minced, regular

C

Which medical conditions are commonly associated with feeding and swallowing disorders?

GERD and GER Food allergies

What are common types of intervention approaches for IADL participation? ________ - strengths based approach - enable participation - 4 guiding principles; situation coaching, understanding, foster deep thinking, explore resources

Occupational performance coaching (OPC)

What are supplemental diagnostic tests used to evaluate underlying causes for feeding disorders?

Pedi-EAT Early feeding skills assess Behavioral peds feeding asses scale Video fluoroscopic swallow study (VFSS) UMBSS

_____ _______ measures: gain insight into perception of skills and importance of ADLs ________: child describes his/her competence ________: assesses client's participation of ADL skills, productivity, and leisure over time; useful for assessment & reassessment

Self-rating COSA COPM

Developmental competences observed through play

TPBA

Form - Described through categories of _______: games, social play, sensorimotor play, sports, digital play - also includes study of the developmental nature: changes in preferences w/ different ages, gender, and ability levels - consider play _________ in children with various disabilities: time, forms, etc; although a child's play may not be typical it is important to understand what children with disabilities want to do

activities, differences

Choosing evaluation consider purpose collect data from multiple sources - measures of ________ behavior - _______ observation measures - _____-rating measures - measures of participation - measures of motor skills

adaptive, ecological, self

________ behavior measures - typically ______ --- vineland adaptive behavior scales --- adaptive behavior assessment system _________ observation measures - gather info in the typical or ______ setting --- performance during daily life -best measure of performance is in a _______ setting - standardized assessment or observation

adaptive, scales ecological natural natural

Establishing, restoring, and maintaining performance Identify skills or gaps Select ____-appropriate tasks and habits to target ________ ADL performance and patterns - consider age - plan tx according to _________ sequence - examine underlying body structures & functions If not possible: ________ or remediate abilities - by targeting underlying factors Use variety of approaches to remediate -NDT, BX, motor learning, etc

age establish developmental restore

Pharynx - mgmt of ______ -> respiration and control of food/liquid during swallowing

airflow

Chaining behavioral approach _________ chaining - OT performs most, PT does last step __________ chaining - child begins task & OT does remaining; OT gives varying level or cues prior to task

backward forward

Factors affecting performance - specific _______ ________ --- body structures and functions - performance ______ & _______ - interest level, self-confidence, motivation - _______ of ADL activities - control

child factors skills, patterns choice

Leisure intervention - allow ______ and ______ - parent education and training using ______ ______ - identify potential leisure opportunities, discover leisure interests - activity _______ or _________

choice, autonomy, activity analysis, adaptation, modification

What are common types of IADLs that are expected of children & adolescents?

chores, taking bus to school, packing lunch, religion

Friendships Prior to age of friendship dev. - interacting w mothers or CG - ___________: engagement of 2 ppl in an occupations such that each person influences the other First stage of friendship dev. - preferences for specific ______ - sharing and engaging in _______ behaviors as early as the first __ yrs High School -students w dis. often socially isolated - barriers - _______ friendships are not friendships

co-occupation playmates, prosocial, 2 incentive

Additional roles of OT - education of others -_________ - advocacy and focus on physical wellness, quality of life, and mental health

coaching

Intervention Strategies: Prevention/Educate problem solving: ________ approach ______ problem solving - prepare of unexpected events during ADLs; children should be part of this; reduce anxiety ________ orientation approach -CO-OP - child _____ a task they want to perform - talk about the task using goal-plan-do-check -review plan coaching and education

cognitive, anticipatory, cognitive, chooses

Modifying ___________ approach - OT enables or enhances independence w/o trying to change client factors Specific strategies: - mod of the ______ or materials - grading - mod of the _____ of completing task - AT and AE - mod of the _________

compensatory, task, method, environment

Activity demands task analysis - helps understand _____ and ____ of activity Analyzing - objects used, _____ & _____ demands, ______ and timing, required actions and _____ Activity demands ____ in clinic, home, school, and community

complexity, aspects space, social sequencing skills vary

Facilitating Playfulness - shared negotiations of _______ and decision making - demonstration and _______ - may need to specifically _____ how to play

control, imitation, model

Physical environment Inaccessible buildings rooms ______ with furniture objects used may help or hinder ADLs consider aspects of: clothing items, grooming, bathing -> may motivate or _______ the child

crowded distract

What are some of the intervention approaches that OTs use to improve children's and adolescents feeding/eating? _________ for oral hypersensitivity deep _____ and proprioceptive experiences AE self directed touch to face (distal to prox touch) behavioral intervention strategies ________ reinforcement manage expectations ________ schedule

desensitization pressure positive visual

TPBA (Transdisciplinary Play-Based Assessment) A play assessment which focuses on child's _________, _________ style, interaction patterns, and _________ to determine need for services.

development, learning, behavior

Modern theories - psychoanalytic: cope with and manage their ______ - arousal modulation theory: stimulation of _______ system - metacommunication theory: learn to perform on 2 levels at once- ______ and make believe - cognitive theories: foster cognitive development

emotions, nervous, reality

Social environments Family, other caregivers, peers, etc. provide _______ shape _______ Parents with ID or MH problems - _____ how to help child Parents w physical probs - training in using specific techniques/AD Analyzing social routines - may differ across _________

encouragement expectations training environments

Play deprivation: delayed development, difficulties with social interaction, difficulties with mental health, limited _________ and mvmt, impaired ______ span, limited ________

endurance, attention, resourcefulness

Older theories - surplus energy theory: release excess ______ - recreation or relaxation theory: replenishes ______ and used to relax - practice or pre-exercise theory: practice ______ or practice ____ for future - recapitulation theory: play development mimic the ________ of the species

energy, energy, skills, roles, development

What are the major components of a comprehensive intervention plan for peds feeding, eating, and swallowing problems? _________ adaptations: mealtime structure (30-40 mins) Positioning: _______ feet, ______ pelvis, ______ head and trunk Adaptive equiptment _______ diets Sensory Behavioral

environmental supported, neutral, vertical, modified

Play and leisure assessment Consider: - what, why, how play and leisure occur - use multiple methods, observation, interview, and assessment tools - attitudes, preferences, and playfulness - _________ competencies expressed through play

everyday

Cultural context __________: diff levels of concern ab children meeting milestones Culture also influences: type & _______ of tools and materials Economic conditions Location ________ for education and employment Economics - if water gets shut off

expectations availability opportunity

How does performance and participation in IADLs contribute to positive skill development of children and adolescents? - opportunities for being part of ______ and _______

family community

"Function" of play - way in which it serves the person & influences health and well-being Theories attempt to understand the ________ of play Ex) physical activity found to reduce __________ and ________ area for more investigation

function, depression, anxiety

Play as a ______ - little evidence that play goals are included in intervention plans - for many fams, play/leisure is a desired area for goals

goal

prosocial behavior encouraged as early as:

helping behavior 18-24 mo

Sleep ________: bedtime routines and habits

hygeine

Developing ADL occupations - foundation begins in ________ - ADL _______ & _______ influence engagement in other occupations ---children benefit from _______ participation in ADLS --- mastery of ADLs lead to _______ and ________

infancy habits, routines active self-esteem, autonomy

Child Occupational Self-Assessment (COSA) - find out from the child what he or she finds ______ and ______ - a structure to determine how a child ________ his/her competency - identify interest occupation and rate how well they _________ it

interesting, meaningful, percieves, perform

Self determination: -encompass many life skills that are innate and learned - devel. supported by providing children opportunities to identify ______, make _____, take _____ - Example: Head start; help children identify _____ they need help and guiding them to solve problems

interests, choices, turns, when

Performance Environment & Contexts - _____ and _____ to the child ---_______ - age, gender, education & SES ---Physical - 4 primary environments: ____,_____,_____,______ ---social environments -Personal and ______ contexts: family life cycle & developmental stages

internal, external Personal home, school, community, work temporal

________: defined as nonobligatory activity that is intrinsically motivated and engaged in during discretionary time, that is, time not committed to obligatory occupations such as work, self-care, or sleep - important for development and quality of life - preference, desire, and motivation are critical

leisure

Youth with disabilities report ____ levels of civic engagement

low

What is play? - spontaneous, fun, joyful - intrinsically ________ and internally _______ - emphasis on ______ - imaginative - nonliterality - often ______ Changes with __________ levels

motivated, guided, process, developmental

attitudes of children when they play -> playfulness (intrinsic _______, internal ______, ability to suspend _______) -> each occur on a continuum -> framed so that all players understand the context

motivation, control, reality

Play as an occupation Examining play in ______ environments OTs may consider the occupation through the substrates of _____, _______, ______, and _______

natural, form, function, meaning, context

Assessing IADLS

occupational profile analysis of occupational performance COPM card sort CAPE/PAC

Promoting or creating supports Create environment & _______ Team or system _______ Examples: PK center activity, free time box for K, community building committee

opportunities supports

Contexts Cultural - perceptions of importance, use of time, etc Temporal - seasons, time of day, consider SES Virtual contexts - the digital realm Intersection of contexts and impact on play - less free play, particularly ______ free play

outdoor

ADLs are key in supporting _________ Motor skills are a part of activity _______ & part of participation in ADLs Explicitly determine the relationship of motor skills to ADL performance

participation sequences

IADL performance is closely linked to ________ IADL is relevant from infancy to teens IADL is addressed across multiple practice contexts Person, environ., occupation factors -> IADL Variety of ______ and ______ approaches

participation, evaluation, intervention

________ context: playgrounds, play spaces, toys and materials, barriers _________ context: interactions w parents and peers, sibling play, changes in play with adult present, gender, proximity of a teacher

physical, social

What factors are essential to consider when the OT completes an assessment of feeding, eating, and swallowing? Context - _______, ______, _______, _______ ____ _____ function ______ issues (____ high prev. of feeding difficulties)

physical, social, temporal, cultural oral motor sensory, ASD

The Test of Playfullness (ToP): assesses degree of _________ (4 elements) - intrinsic ___________, internal _______, ability to suspend ________, and ___________ - the child is rated - scored from direct __________ or video

playfulness, motivation, control, reality, framing, observations

Steps to Activity Analysis - occupational _____ -choose an ________ method - team evaluations

profile, evaluations

Phases of swallowing - oral prep, oral, pharyngeal, esophageal Oral prep: _______ in young, ______ in older children Oral: ____ in young, ______ in older children Pharyngeal: primarily _____ Esophageal: _______ (hint: reflexive or voluntary)

reflexive, voluntary reflexive voluntary reflexive reflexive

3 areas related to sleep and rest

rest, prep for sleep (sleep hygeine), participation in sleep

_______ play: child can play at great heights, high speeds, with harmful tools, or near dangerous elements of the environment - rough and tumble play - in natural environments without boundaries - adventure playground; "cast off" objects and scraps to build with, climb on, etc

risky

__________: process of setting up, arranging, bringing food to mouth _______: ability to keep/manipulate food or fluid in the mouth and swallow _________: travel from mouth to stomach

self-feeding, eating, swallowing

Takata's Taxonomy of Play - Birth to 2 year: ____________ - 2-4 years: ________ and ______ constructive - 4 to 7 years: ________, _______ constructive, and ____________ - 7 to 12 years: __________ - 12 to 16 years: __________

sensorimotor, symbolic, simple, dramatic, complex, pregame, game, recreational

Oral cavity - management of food/liquid - newborns = ______ oral cavity - 4-6 months = ______ oral cavity, ______ tongue, _______ mobility

small larger, thinner, increased

What are the relevent factors of an OT to consider when evaluating IADL performance? When and where - from early childhood through adolescence - children first engage in IADL skills as _______ - _________ behaviors Factors: ______, ______, _______

toddlers prosocial person, environmental, occupational

3 ways to use play: As a ________: specific skill may be developed by play As a ______ As an _________: focus on play itself and dev. of play performance, playfulness, intrinsic motivation and exploration of play preferences AKA as a _______

tool, reward, occupation, goal

The quality of the experience, a person's state of mind, and the value that the play experience has It is the individuals "_____" of play Ex) losing oneself in an activity, experiencing a flow - difficulty had to be ______ _____

why, just right

Meyer - ______, ______, ______, ______ = 4 rhythms that shape human organization

work, play, rest, sleep