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OTA 140 - Pediatrics > Pediatric Practice > Flashcards

Flashcards in Pediatric Practice Deck (36)
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1
Q

OT Code of Ethics

A
  • Beneficence (well-being of pt.)
  • Nonmaleficence (do no harm)
  • Autonomy (confidentiality)
  • Justice (comply with laws)
  • Veracity (exhibit truthfulness/accuracy)
  • Fidelity (treat others with fairness/integrity)
2
Q

Concerns of OT in pediatric practice

A
  • Typical development in children
  • Treating the child and family
  • Pediatric diagnoses
  • Practice models
  • Assessments for children with disabilities
  • Age-appropriate activities
  • Practice settings
  • Assistive Tech
3
Q

Pediatric Areas of Focus

A
  • Physical (Motor/Sensory)
  • Emotional
  • Social
  • Environmental
  • The Whole Child (include child’s family, etc.)
4
Q

Areas of Pediatric Practice (settings)

A
  • Clinics
  • Schools
  • Home
  • Community Settings
5
Q

Role of OTA in Screening/OT Process

A
  • Collects evaluative data, observational data and client info.
  • Can participate in screening
  • May administer some screening tests such as WOLD and CHES (with service competency)
  • Ideally, collaborates with OT for development of intervention plan
6
Q

WOLD

A

Sentence copying test created by Bob Wold, an optometrist, in 1970. Timed test to evaluate speed/accuracy/handwriting when copying a sentence from top of page to lines on rest of page. Can observe posture, grasp, etc.

7
Q

CHES

A

Children’s Handwriting Evaluation Scale. Manuscript (grade 1-2) or Cursive (grade 3-8) versions. Copy 2 sentences; checks speed, letter accuracy. To remediate handwriting problems and prevent further difficulties.

8
Q

Levels of Performance

A

Functional Independence: completion of age-appropriate activities with/without use of assistive devices or human assistance.

Assisted Performance: Child requires some assistance to perform/participate in age-appropriate task.

Dependent Performance: Child unable to perform age-appropriate task; Caregiver gives max assist.

9
Q

Tools for Pediatric Intervention

A
  • Occupations (*Play)
  • Purposeful activities (goal-directed; voluntary participation; meaningful)
  • Activity Analysis (task-focused, child/family focused)
  • Activity Synthesis (adaptation, gradation, configuration)
  • Therapeutic Use of Self
10
Q

“RUMBA”

A
What long-term goals should be:
R=Relevant
U=Understandable
M=Measurable
B=Behavioral
A=Achievable
11
Q

Reevaluation/Discontinuation process for pediatrics

A
  • Clinic reevaluates according to billing guidelines
  • Schools reevaluate every three years
  • OTA contributes work samples, data, admin of assessments if competent; OT conducts reeval.
12
Q

Assessment vs. Evaluation

A

Assessment is an actual/specific test, while Evaluation is a broader process.

13
Q

Purpose of Assessments

A
  • Determine eligibility for services
  • Monitor progress (and for discharge)
  • Make decisions regarding treatment intervention
14
Q

Norm-Referenced vs. Criterion-Referenced

A

NORM=Compared to other children; Standardized (comparing/relating performance to others)

CRITERION=Based on task performance (actual correct answers important)

15
Q

Purpose of Standardized Assessments

A
  • Provide precise measurements of performance in specific areas
  • Report performance as a standard score
  • Composed of a fixed # of items
  • Fixed protocol for administration
  • Fixed guide for scoring
  • Can administer these in un-standardized way (adjust to child’s need), but this MUST be reported in results! Means comparative data is not as precise.
16
Q

Reliability vs. Validity in Standardized Assessments

A

Reliability = Consistency of scores overall

Validity = Test measures what it says it will (ie: is child’s score poorly reflected due to stress/time/fine motor?)

17
Q

Screening Tools

A

(To determine need for services)
Ex:
• Denver Developmental Screening Test
• Developmental Indicators for Assessment of Learning
• First STEP (for evaluating Preschoolers)
• Miller Assessment for Preschoolers

18
Q

Developmental Assessments

A

(To determine developmental disabilities)
Ex:
• PDMS II-Peabody Developmental Motor Scales
• Bayley Scales of Infant Development
• BOT-2-Bruininks-Osteretsky Test of Motor Proficiency 2
• HELP-Hawaii Early Learning Profile
• PEDI-Pediatric Evaluation of Disability Inventory
• School Function Assessment (*Very long! Takes hours.)

19
Q

Handwriting Assessments

A
  • CHES-Children’s Handwriting Evaluation Screening
  • WOLD-Handwriting Test (from our lab)
  • ETCH-Evaluation Tool of Children’s Handwriting (manuscript and/or cursive)
20
Q

Visual Motor Tests

A
  • TVPS-Test of Visual Perception Skills
  • DVPT-Developmental Visual Perception Test
  • Beery VMI-Beery-Buktenica Developmental Test of Visual Motor Integration, 5th ed.
21
Q

Sensory Tests

A
  • Sensory Profile

* Sensory Processing Measure

22
Q

Advantages vs. Disadvantages of Standardized Testing

A

ADVANTAGES: Well-known tests; allow professionals to speak same language; monitor developmental progress; can be used to justify OT services

DISADVANTAGES: Tests performance components, rather than full occ performance; only brief picture of perf.; rigidity of testing procedures (may not work well for all kids)

23
Q

Formal Interview Methods

A

(Standardized interview tools; structured “script” and goals; can use to measure progress later):
• Canadian Occupational Performance Measure (COPM)
• Pediatric Evaluation of Disability Inventory (PEDI)
• Sensory Profile
• Vineland Adaptive Behavioral Scales

24
Q

ABA

A

Applied Behavioral Analysis
• Therapy for kids with special needs, esp. ASD.
• Repetition until generalization
• Positive reinforcement
• To improve communication, attention/academics, decrease problem behaviors

25
Q

Interview Goals

A
  • Gather medical info (history, services, reason for referall)
  • Build rapport with child/family
  • Learn family’s interests/values
  • Identify goals, expectations
  • Begin observation of child/interaction w/environment and family
  • Clarify your role/services/skills
26
Q

Medical Info to gather at Interview of child

A
  • Complications during pregnancy/birth
  • Developmental milestones (what age did they occur)
  • Allergies
  • Current meds
  • Frequent ear infections/colds
  • Recent hospitalizations
27
Q

What to observe while child plays

A
  • How long does child stay with one activity
  • Choice of activities
  • Social interactions
  • Gross/fine motor skills
  • Balance and posture
  • Imagination/creativity
  • Activity level; emotional expression
  • Compare child’s performance to typical expectations for age
28
Q

Levels of Assist

A
Dependent = needs A with >75%
Max A = A with >50-75%
Mod A = A with 25-50%
Min A = A with up to 25%
Independent = no A needed
29
Q

Common Structured Observations

A
  • Muscle Strength (MMT)
  • Muscle Tone (response to passive mvmt)
  • Supine Flexion (curling into ball residual reflex)
  • Prone Extension (superman residual reflex)
  • Co-contraction (shoulders/legs residual reflexes)
  • Visual Pursuits (tracking with eyes, etc.)
30
Q

Motor Coordination Observations

A
  • Rapid alternating movements
  • Thumb/finger touching (serial opposition)
  • Imitation of postures
  • Standing balance on one foot
  • Hopping
  • Skipping
  • Running
  • Jumping
31
Q

Serial Opposition

A

Ability to touch thumb to all fingers.

32
Q

Sequence of observing through intervention process

A

Observation > identify/monitor problem > adjust activity for needs/engagement/challenge > solve problem

33
Q

Gross Motor Skills to Observe in Child

A
  • Balance
  • Gait
  • Sitting/Prone
  • Reaching while in different positions
  • Playing in different positions
  • Jumping, walking, crawling, climbing
34
Q

Fine Motor Skills to Observe in Child

A
  • Left/Right hand use
  • Grasp/prehension patterns
  • Developed (thumb opposition), or Gross (fisted hand)
35
Q

Psychosocial Items to Observe in Child

A
  • Attachment to parent (ventures from parent? Plays with parent?)
  • Social play (play with others? Alone? Beside others?)
  • Emotional expression (crying, laughing)
36
Q

Language Items to Observe in Child

A
  • What are verbal skills? (speak to anyone, only familiars?)
  • Do they engage with language min/mod?
  • Are they verbal, using language in appropriate manner?
  • Using sign language?
  • Is level of language use affecting behavior?