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Pediatric OT Exam 1

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anskorczewski12's version from 2018-02-11 21:21

Beginning Chapters

Question Answer
Which statement most closely reflects how using evidence-based practice (EBP) benefits occupational therapy practice with children and adolescents?The likelihood of positive outcomes is higher when therapists consider EBP guidelines to design intervention.
the role of the occupational profile when conducting a comprehensive evaluation?Analysis of the underlying reasons for limitations in performance and behavior
inclusive and integrated services: enabling the child and youth with disabilities to fully participate in the community
The International Classification of Functioning views human functioning at which three levelsBody function and structure, person, society
Which practice model is most useful for generalizing performance and transfer to natural environments?contextual interventions
Which statement most closely resembles the coaching model as used in occupational therapy practice?The therapist supports parents’ reflections about child’s behaviors and guides them in identifying solutions.
coaching: reciprocal process between a coach (occupational therapist) and learner (parent) comprising a series of conversations focused on child outcomes that allow the learner to discover his or her own solutions for achieving the agreed on outcomes.
Which founder of occupational therapy proposed that humans maintain rhythms of work, play, rest, and sleep that need to be balanced and that this occurs through actual doing and practice?Meyers
who posited that humans maintain rhythms of work, play, rest and sleep that need to be balanced and that “the only way to attain balance in all this is actual doing, actual practice.”Meyers
Which statement best reflects how occupational therapists work with children with disabilities and their families?Therapy is based upon the child and family system; the therapist helps the child engage in the family occupations.
family-centered care: a collaborative process with the therapist providing therapy that allows the child to engage in family occupations
Which type of parenting style is associated with children who rank higher on many measures of social and cognitive development?Warm, responsive, positive
Which approach is best when developing a home program regarding self-care?At the request of the parent, practice the new steps until the child is ready to carryover at home.
How should therapists communicate with parents and family?Share information with everyone who comes in contact with the child (family or not).
Why should an occupational therapist take time to get to know the things a family does together, their weekly routine, and an explanation of family membership?Involvement in family is central to best practice
school-based setting use what type of modelservice delivery model (and follow IDEA guidelines)
self-actualizationoccurs through successful coping with problems
practice strategies (from Cope's lecture)consultative services/role of consultant
consultative services/role of consultantexplain disorder, reframe problem, educate caregivers
ecologic assessmentconsider how environment influences performance
protective factors for riskstrong sel-esteem, communication skills, problem-solve, regulate emotions (easy-going), coping skills, nurturing family
risk factorsfamily-centered services
family-centered serviceshonor family's decisions about child, partnership with family, emphasized parent-education, intervention is based on family's vision
developmental theoriescognitive development, zone of proximal development, maslow's hierarchy of basic needs
behavioral theoriesoperant learning (using reinforcement to modify behavior), applied behavioral interventions (use operant conditioning), shaping, incidental teaching, pivotal response
shapingprogressively acquire new behavior through successful perforamnce (rewards/ breaks down complex behaviors and reinforces each component)
incidental teaching(naturalistic training) set up play environment and urge child to try new/challenging things and reward attempts (child initiates and paces session/loosely planned)
pivotal response(naturalistic training) teach behaviors central to learning (to increase motivation to learn, attention/initiation)
social cognitive theorieschild can learn by observing others, seek their own experiences to learn (trial and error), observe rewards and punishments, and learn social skills through group expeirences
dynamic systems theoryperformance depends on interactions of the child's inherent and emerging skills, characteristics of the desired tasks or activity, and the environment (self-organization is optimal if the task has a goal and outcome)
cognitive approachusing a problem-solving approach (task analysis, anticipation of difficulties, applying strategies)
CO-OP (Cognitive orientation to daily occupational performance)cognitive approach, focus on the occuaptoins the child selects, use a general problem solving framework, use process questions to increase awarenss of the use of strategies, plan for trasnfer/generalization (go-plan-do-check)
strength-based approachutilizing the child’s strengths to improve motivation, self-efficacy, and involvement (focus on what the child is good at, use this)
memorize

Assessments and Data analysis

full term in weeks: 40 weeks
Question Answer
Which standardized test would be most appropriate for a high-risk clinic where you are evaluating an infant who is 2 months old?PDMS- 2
Peabody age range and what does it measurefor children 1 to 84 months of fine and gross motor development. (Table 6-1)
What is the meaning of a Z-score of −3.00?Child's score falls below the majority of his peers on this test.
Which statement is not referring to a criterion-referenced test? a. No score distribution needed; a child may pass or fail all items.\\ b.Items chosen for functional and developmental importance \\ c.Compares child’s performance with a list of skills \\ d. items chosen for statistical purposesd: Criterion-referenced tests compare a child’s performance with a defined list of skills that are chosen based upon importance, not for statistical purposes.
difference between assessment vs. measurement vs. evaluationassessment (gathering information to monitor progress and make decisions), measurement (set of procedures for how to complete assessments, provides objectives), evaluation (provedures used to determine whether the subject meets a criteria, the bigger process of combining all information)
criterion-referenced tests(may or may not be standardized) Performance is compared with particular criterion of a particular skill; Measures performance on specific tasks rather than to compare to peers
norm-referenced testsPurpose: to determine how a child performs in relation to the average performance
standard deviations + or - 1 from the meannormal development typically (68%)
z-scoresconsidered indicative of delay/deficit when less than 1.5 usually
t scoresmean is 50 (normal range being 40-60)
standard error of measurement (SEM)expected range of error for the test score of an individual (depends of reliability level)
extent to which a test measures a particular theoretical construct (e.g. fine motor, visual-perceptual, etc.) construct-related validity
extent to which the items on a test accurately sample a particular behavior domain (i.e. does the sample of behaviors encompass the performance on the entire domain) content-related validity
ability of a test to predict how an individual performs on other measures or activitiescriterion-related vallidity
how well test scores reflect current performance concurrent validity
identifies the relationship between a test given in the present and some measure of performance in the future predictive validity
rasch analysisused to develop item scaling for tests; Generates hierarchy among the items of the test (easiest to hardest), which allows the OT to see where the child is at along this process
ethical concerns associated with standardized testingexaminer competency; client privacy; communication of test results; cultural considerations when testing
mean of Peabody and Bayle scoring100
Is M FUN performance or skill-basedperformance-based
GASaddresses uniquely individualized nature of expected outcomes (used to prioritize goals, not standardized)
Age-range of MFUN2.6-3.11, 4-7.11
Age-range of GOAL7-17
Age-range of BOT-24-21.11 (tests fine and gross motor)
Educational Assessment of School Youth (EASY)forms are preschool, K2, elementary, high school), for ages 4-18, assesses school-related Fine Motor, Gross Motor, Visual-Perceptual, Visual Motor and Self-Help.
PEDIdone by caregiver generally, from birth-7 (computerized option), tests self-cares, mobility, social functioning
age-range of short form sensory profile3- 14.11
Peabody (PDMS-2)not as functional as MFUN, but fast; has basal and ceiling for scoring
memorize

Sensory Integration

Question Answer
what is the therapist's role when using SI approachset up the environment and activities so the child will choose to select activities that enhance his/her ability to make an adaptive response. The therapist leads the child but does not control the child’s action. The goal is to allow the child to be inner directed and make adaptive responses that promote organization (ensure physical safety, present sensory opportunities, establish a therapeutic alliance)
assumptions of SIInput can be used to elicit an adaptive response; Registration of meaningful sensory input is necessary for an adaptive response; Adaptive responses enhance the child’s behavioral organization.
Amelia is learning to ride a bike for the first time. She begins to understand how to balance, hold the handlebars, and pedal. How would sensory integration theorists describe this?adaptive response
adaptive responseorganizing a successful, goal-directed action; comes from within and allows the child to integrate sensations from a variety of systems (vestibular, proprioceptive, vision) to accomplish a given task (e.g., riding a bicycle).
Ayres definition of sensory intregrationthe "organization of sensation for use." She emphasized that sensory integration involved more than neurological synapsis, but also the ability to register, process, and act upon sensation.)
sensory modulation disorderdifficulty responding to sensory input with behavior that is graded relative to the degree, nature, or intensity of the sensory information (overresponsivity, underresponsivity, sensory seeking)
sensory discrimination disorderdifficulty interpreting qualities of sensory stimuli and similarities and differences among stimuli
sensory-based motor disorderpoor postural stability, with poor balance and hypotonic muscle tone (subtypes: postural disorder or dyspraxia)
core elements of sensory integration intervention1.provide sensory opportunities, 2.just-right challenge, 3.collaborate on activity choice and guide self-organization, 4.support optimal arousal and arrange room to engage child, 5.create play context, 6.maximize child's success, 7.ensure physical safety, 8.foster therapeutic alliance
sensory nourishmentsensory input is needed for brain functioning
sensory dietintervention of individualized sensory input to optimize functioning
Dunn's Model of Sensory processingresponding/self-regulation can either be passive or active, and reactivity can either be low or high (creates low registration, sensory seeking, sensory avoiding, or sensory sensitivity)
gravity insecurityover-responsiveness to vestibular sensations (fearful of movement/uneven surfaces, playgrounds are difficulty), different than postural insecurity
Types of Sensory modulation problemssensory registration problems, sensation-seeking, over-responsiveness (tactile, gravitational insecurity or other senses)
types of sensory integrative problems1.sensory modulation problems, 2.sensory discrimination and perception problems, 3.vestibular-proprioceptive problems, 4.praxis problems
sensory discrimination problemsfine motor is affected, may relate to visual perceptual problems (hand-eye coordination), affects balance/cognition, may be clumsy/awkward, may seek firm pressure
vestibular-proprioceptive problemspostural and bilateral integration, vesitublar-bilateral integration, bilateral inegration and sequencing, or projected action sequences
somatodyspraxiasenosry integration deficit that involves poor motor planning and tactile/proprioceptive processing (aspect of praxis that is sensory intregration in origin)
ideation dyspraxiadifficulty generating ideas of what to do in novel situations
types of praxis problemsdevelopmental dyspraxia, somatodyspraxia, ideation dyspraxia
gold standard standardized test for sensory integrationsensory integration and praxis test (takes 2 hours)
memorize

Behavior

Question Answer
functional behavioral analysisa systematic analysis of a child’s behaviors conducted through interview and observation of the child’s behavior. Occupational therapists participate in this process by contributing their observations of behavior and its relationship to occupational performance and contextual factors for the child.
Which strategy is most effective in preventing existing challenging behaviors?Individualized interventions targeting specific behaviors and contexts are most effective in preventing existing challenging behaviors
Which strategy is most likely to promote positive behavior in children?(Improving child’s competence and creating positive environment); creating contexts that support positive behaviors and intentionally managing consequences.
Which statement best reflects the role of the therapeutic relationship in regards to positive behaviors in children?It may be used as an intervention strategy to help a child with positive behaviors.
behavioran expressive act that can have many different forms/meanings
purpose of behaviorobtain item, avoid situation, escape undesired object/event, sensory function
how to prepare for problem behaviorrule out pain/illness, establish predictability/consistency (routine, same activities), create a calm atmosphere (organized/clean), attend to appropriate behaviors (praise, reinforce), use "do" statements, keep perspective
how to prevent challenging behaviorminimize aversive events, share control, promote success, increase communication effectiveness (physical gestures, pictures), clarify expectations, support self-regulation, match demands to abilites
contingency methodsoffer rewards after engagement (supporting positive behavior)
token economicssystem of earning tokens for desired behavior (support positive behavior)
steps of functional behavioral analysis1.team building/goal setting, 2.functional assessment of behavior, 3.hypothesis development (what triggers? function?), 4.develop comprehensive support plan, 5.implement and monitor
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