SEM 4 - PEDS wk 1-2

You observe a child in a preschool who builds a tower next to peer but does not interact with them. What type of play is this?

Solitary play

Parallel play

Associative play

Cooperative play

parallel play

Which term best describes the concept of adapting tasks so children can accoss them in daily life?

A Developmendal delay

B Functional restoration

C Environmental modification

D Normative goal writing

C Environmental modification

In the school environments, a 6 year old child avoids recess due to mobility chaflenges. According to IDEA guidelines which goal would be most appropriate?

A increasing plantar flexor strength

B Building endurance on a treadmill

C Improving social and physical access to peer activities

D Measuring spasticity with the Ashworth scale

C Improving social and physical access to peer activities

According to IDEA Part C, which envorment is, most approprtate for PT

Outpatient clinic

Private PT clinic

Family's home during routines

School gymnasium

Family's home during routines

Which example represents an appropriate school-based PT intervention under IDEA Part B?

A Passive ROM to improve knee extension

B Climbing the stairs at the childs home

C Navigating the lunchroom to access meals independently

D Gait training on treadmill in a therapy gym

C Navigating the lunchroom to access meals independently

A PT selects the Peabody to assess gross and fine motor skills. Which age range is appropriate?

A Birth to 5 years

B 3 months to 3 years

C 6 months to 10 years

D 4 years to 21 years

A Birth to 5 years

What is the main benefit of using a routines- based interview like SAFER?

A replaces physical assessments

B It emphasizes caregiver narrative within functional activities

C It assigns percentile scores to child routines

D It provides age equivalent motor scores

B It emphasizes caregiver narrative within functional activities

According to Bandura's Social Cogritive Theory, a child using a block as a phone during play is demonstrating

A Practice play

B Sensorimotor behavior

C Modeling behavior

D Concrete reasoning

C Modeling behavior

A 9-month-old with no significant medical history is being screened for gross motor detay. Which tool is best suited for assessing this child?

A Bayley Scales

B AIMS

C вOT-2

D TIMP

B AIMS

A parent expresses concern about their child not keeping up with peers at preschool. Which part of the ICF does this concern best reflect?

A Impairment

B Activity limitation

C Participation restriction

D Environmental factor

C Participation restriction

A 6-year-old child is able to hop on one foot but struggles with bilateral coordination. Which test should be used that will provides a motor quadrant across multiple subdomains?

A AIMS

B Bayley Scales

C Peabody

D BOT-2

D BOT-2

A child is referred for early signs of developmental delay at 33 weeks gestational age, Which assessment is most appropitate?

A GMFM

B TIMP

C SFA

D BOT-2

B TIMP

A 5 year-old child with Down Syndrome is participating in therapy to improve mobility, Which intervention best supports developmentally appropriate?

A Treadmill welking anly

B Passive ROM stretching

C Play based motor games

D Orthotic assessment

C Play based motor games

Whichbof the following behaviors best reflects the use of postive reforcement in a pediatric PT session?

A - Allowing carly dsmissal tom therapy

B - Providing stickers after completing tasks

C - Ignoring non-compliance

D - Limiting play options for poor participation

B - Providing stickers after completing tasks

A 12-month-old child with hypotonia is being evaluated in their daycare setting. Which of the folloving best reflects a top down approach to thr evaluation?

A assessing lower extremily strength with MMT

B Observing the child's ability to participate in group story time

C Measuring ROM in supine and prone positions

D Conducting a sensory screen in a quiet room

B Observing the child's ability to participate in group story time

Which of the following is a primary goal of pediatric physical therapy across all practice settings?

A Reducing muscle tone

B Maximizing functional participation

C Teaching developmental milestones

D Administering standardized assessments

B Maximizing functional participation

Which of the following tools uses a computer adaptive model and measures caregiver perception of function?

A GMEM

B PEDI-CAT

C SFA

D Peabody

PEDI-CAT

A PT selects the BOT-2 for a child in 4th grade, What domain is this tool most appropriate for?

Social emotional regulation

Fine and gross motor proficiency

Feeding and swallowing function

Daily caregiver burden

Fine and gross motor proficiency

After completing a SAFER interview, a caregiver reports satisfaction with mobility but significant concem about difficulty partipating i tamily meatine

A Priorize standardized testing before setting goals

B Develop goals addressing participation in mealtime routines

C Focus intervention on impairments identified by examination only

D Delay goal setting until age equivalent scores are obtained

B Develop goals addressing participation in mealtime routines

A 9 year old is learning things like reading, writing, math and history. In Enison's model, a child who is engaged in this type of learning is primarily in which stage?

A Intative vs. guilt

B Autonomy vs. shame

C Industry vs. inferiority

D Identity vs. confusion

Industry vs. inferiority

in your initial evaluation, a parent reports a rigid, rule driven home environment. The child presents with anxiety. Wiich parenting style is most likely present?

A Authoritative

B Neglectiul

C Indulgent

D Authoritarian

Authoritarian

A parent reports difficulty managing transitions from the home to the bus on school days. What is the PTs best course of action?

A Refer the child to psychiatry

B Recommend visual schedules and analyze routines

C Focus sessions on strength and range of motion

D Administer a gross motor assessment

Recommend visual schedules and analyze routines

Which of the following is an example of a school based goal that would be at the "participation" level according to the ICF?

A child will stand on one foot to be able to go up and down stairs

B child will engage with peers during recess tag game.

C child will perform 10 consecutive heel rises.

D child will walk from the classroom to the lunchroom independently.

B child will engage with peers during recess tag game.

In which setting is the natural environment most emphasized for pediatric PT services under IDEA Part C?

A Outpatient dinics

B Hospital settings

C Home and community settings

D School classrooms

Home and community settings

Why might a PT choose the AIMS over the Peabody in a 4-month-old infant?

A It includes caregiver satsfaction measures

B It evaluates fine motor control, gross motor control, early social and language skills

C It has fewer categories to administer and focuses on posture and motor milestones

D It provides higher standardized scores

C It has fewer categories to administer and focuses on posture and motor milestones

A child with cerebral palsy uses a walker to navigate uneven school terrain. Which standardized tool best montors progress in this context?

TIMP

SFA

Bayley

COPM

SFA

You ave evaluating a 14 month old child with mater detay t

A Inititive vs Guilt

B Autonomy vs. Share

C Trust vs. Mistrust

D Industry vs. Inferiority

Autonomy vs. Share

A 3-year old child uses a kitchen scrubbing wand to act out brushing her own hair during a PT sension. What type of play does this illustrate?

A Symbolic play

B Constructive play

C Practice play

D Parallel play

A Symbolic play

A PT selects the GMFM-66 to track a child with CP’s ability in roll and sit. What is a defining feature of this measure?

A it is norm refrencing and covers ages 0-3 only

B it is criterion-referenced and tracks change over time

C It measures caregiver satisfaction

D It provides a single percentile score

B it is criterion-referenced and tracks change over time

Which principle most distinguishes family-centered care in pediatnc physical therapy?

A The therapist leads care decisions

B Parents act as caregivers only

C Families are equal partners in care planning

D The child leads all therapy decisions

C Families are equal partners in care planning

A standardized tool returns a developmental quotient (DQ) of 0.5 for a child. What does this most likely indicate?

A. The child is developmentally advanced

B. Child is performing typical for age

C. Child is performing at half of their chronological age

D. The child is at the 50th percentile

C. Child is performing at half of their chronological age

To evaluate a toddler's development compared to age-matched peers, which assessment would offer the most relevant data?

A) Gross Motor Function Measure (GMFM)

B) Peabody Developmental Motor Scales

C) School Function Assessment (SFA)

D) Timed Up and Go Test (TUG)

B) Peabody Developmental Motor Scales

A physical therapist is selecting a test for a 3-month-old infant born prematurely. Which of the following assessments is most developmentally appropriate?

A) GMFM

B) Bayley Scales

C) TIMP (Test of Infant Motor Performance)

D) SFA

C) TIMP (Test of Infant Motor Performance)

In which situation might the GMFM-88 provide more useful information than the GMFM-66?

A) When testing time is very limited

B) When capturing subtle functional changes is important

C) When evaluating adults with developmental delays

D) When screening speech-language development

B) When capturing subtle functional changes is important

In the context of IDEA Part B, what is the central purpose of school-based physical therapy services?

A) Providing clinical medical treatments

B) Helping students participate within their learning environments

C) Supporting acute care in educational facilities

D) Delivering wellness care during early childhood years

B) Helping students participate within their learning environments

Which element is a required component of an Individualized Education Program (IEP)?

A) A student’s extended family medical background

B) Diagnostic imaging reports

C) Descriptions of the student’s current academic and functional skills

D) Future employment preparation strategies

C) Descriptions of the student’s current academic and functional skills

What is one of the foundational goals of an Individualized Family Service Plan (IFSP) under IDEA Part C?

A) Preparing for high school graduation requirements

B) Ensuring readiness for the workplace

C) Enhancing child development in familiar settings

D) Decreasing long-term healthcare expenditures

C) Enhancing child development in familiar settings

You are working with an elementary school student with cerebral palsy. Which tool would most appropriately measure how they participate in classroom and playground routines?

A) Gross Motor Function Measure (GMFM)

B) School Function Assessment (SFA)

C) Bayley Scales of Infant Development

D) Pediatric Balance Scale

B) School Function Assessment (SFA)

According to IDEA guidelines, which of the following must be included in an IFSP?

A) Diagnoses provided by medical specialists

B) Objectives for participation and services delivered in everyday routines

C) Current academic achievement levels

D) Goals typically listed in an IEP

B) Objectives for participation and services delivered in everyday routines

In the top-down model, goal-setting begins with:

A. The child’s diagnosis

B. Strength assessment

C. Participation restrictions

D. Functional impairments

C. Participation restrictions

Which parenting style is characterized by high responsiveness and high demandingness?

A) Authoritarian

B) Permissive

C) Neglectful

D) Authoritative

D) Authoritative

Which of the following is a primary emotion observed in infants within the first six months?

Guilt

Pride

Joy

Embarrassment

Joy

According to Erikson, successfully navigating the stage of 'Autonomy vs. Shame and Doubt' leads to:

A) A sense of trust

B) Early independence

C) Mastery of knowledge

D) Formation of identity

B) Early independence

Piaget's 'Sensorimotor Stage' is characterized by:

A) Logical thinking and mastery of conservation

B) Use of abstract reasoning

C) Learning through movement and exploration

D) Development of symbolic thought

C) Learning through movement and exploration

In Bandura's Social Cognitive Theory, learning occurs primarily through:

A) Trial and error

B) Classical conditioning

C) Imitation and modeling

D) Operant conditioning

C) Imitation and modeling

'Constructive play' involves:

A) Repetitive physical activities

B) Creating or building something

C) Pretend scenarios and role-playing

D) Playing games with rules

B) Creating or building something

Family Centered Care requires:

1. Takes time and can take resources

2. Respect for all included- especially the family

3. Team approach

4. Collaborative decision making

5. Provide Education/Building self-efficacy

What does Family Centered Care look like?

Actionable Items:

1. Respect

2. Listen

3. Observe

4. Empathize

5. Support

Introduction to School-Based Physical Therapy

Specialized area of practice to support student access to education

2. Focus on participation rather than medical treatment

3. Collaborative role as part of an interdisciplinary team

Individuals with Disabilities Education Act (IDEA)

Federal law ensuring services for children with disabilities'

Guarantees Free Appropriate Public Education (FAPE) in the Least Restrictive Environment (LRE) aka a school or home which is not a hospital or clinic

Individuals with Disabilities Education Act (IDEA) part B vs part C

- Part B: Ages 3–21

- Part C: Birth–3 years

IDEA Part B: Ages 3–21

• Related services to support educational goals

• Requires development of an Individualized Education Program (IEP) - for part b

• Collaboration with interdisciplinary team: teachers, families, and therapists

for part B what does an IEP consist of?

Present Levels of Academic Achievement and Functional Performance: A statement describing the student's current strengths, weaknesses, and areas for improvement.

• Annual Goals: Specific, measurable objectives that outline what the student will achieve during the school year.

• Accommodations and Modifications: Adjustments made to instruction or assessment to support the student's needs.

• Least Restrictive Environment (LRE): The placement of the student in a general education classroom with supplementary aids and services, when possible.

• Special Education Services: A list of related services, such as speech therapy, occupational therapy, or physical therapy

IDEA Part C: Birth–3 Years

• Early intervention services for infants and toddlers

• Family-centered approach with Individualized Family Service Plan (IFSP) - for part C

• Services provided in natural environments (home, community)

Goals of Early Intervention:

• Prevent disability in infants and toddlers

• Support early childhood development

• Enhance family functioning

• Progress to Preschool

Part C: IFSP

Key Components:

• Child: A statement describing the child's developmental needs, goals, and progress

• Family: A plan outlining how the family will be involved and supported in the early

intervention process

• Interventions: A list of specific services and supports to be provided to the child

• Evaluation: A schedule for periodic assessments and re-evaluations to monitor the

child's progress

IPE vs IFSP

for part b vs part c

Part B:

Focus: Educational outcomes and school participation

1. Ages: 3–21 (IEP)

2. Setting: School-based

Part C:

Focus: Developmental progress and family support

1. Ages: Birth–3 years (IFSP)

2. Setting: Natural environments

Role of the Physical Therapist in Schools

Educational- to support learning and education

• Assessment and evaluation of motor skills

• Development of functional, goal-oriented interventions

• Collaboration with IEP team for individualized goals

• Advocacy for accessibility and barrier removal

• Training for staff and families to support goals

Outcome Measurements norm vs criterion

Norm Referenced Assessments: (examples) - compared to the norms of those in the same age group

• Peabody Developmental Motor Scales (PDMS-2): Ages birth–6 years

• Bayley Scales of Infant and Toddler Development (Bayley-4): Ages 1–42 months

Criterion Referenced Assessments (examples) - based on specific criteria and can monitor over time.

Tools for activity assessment:

• Gross Motor Function Measure (GMFM): Ages 5 months–16 years

• Timed Up and Go (TUG): Ages 3 years and older

Outcome Measurements functional vs participation

Functional assessments:

• Pediatric Evaluation of Disability Inventory (PEDI-CAT): Ages birth–21

years

• School Function Assessment (SFA): Ages 5–12 years

Participation assessments:

• Children’s Assessment of Participation and Enjoyment (CAPE): Ages 6–21

• Participation and Environment Measure (PEM-CY): Ages 5–17

top-down approach

prioritizes a patient's real-life activities and social participation over isolated physiological impairments

Video as an Assessment Tool

Things to consider:

HIPAA (icloud, cloud storage issues, etc) - sending to a phone is NOT hippa compliant

Institution Policy and Procedures

Parent/child comfort

SAFER model

The Scale for Assessment of Family Enjoyment within Routines (SAFER) is a routines-based family interview used in early intervention and pediatric rehabilitation to understand how a child functions during daily routines and identify family priorities.

Families rate satisfaction with routines (waking up, meals, bedtime, outings, etc.) on a 1–5 scale, where 1 = not at all satisfied and 5 = very satisfied, helping guide functional goals and interventions

9 routines • Waking up • Diapering/dressing • Feeding/meals • Getting ready to go/traveling • Hanging out/watching TV • Bath time • Nap/bed time • Grocery store • Outdoors

Natural environment in pediatric evaluation

A natural environment is the child’s everyday setting (home, school, daycare, playground) where they typically live, learn, and play. Evaluating children in these settings helps therapists observe more realistic behaviors and functional performance.

Natural vs. non-natural environment

A natural environment reflects the child’s usual daily context and routines, while a non-natural environment (such as a clinic or lab) is more controlled and structured. Natural environments often provide a more accurate picture of real-life function, whereas non-natural settings allow standardized testing.

Top-Down approach to the ICF model:

• The Top-Down approach starts by identifying participation restrictions and functional goals that matter to the child and family, then examines activity limitations and body structure/function impairments contributing to them. This focuses care on meaningful daily participation rather than isolated impairments first.

Routines-based interview and benefits

A routines-based interview is a structured conversation with families about the child’s participation and performance during daily routines such as meals, play, and bedtime. It helps identify family priorities, improves family-centered care, and creates functional goals that fit everyday life.

Pediatric vs. adult examination

Both pediatric and adult examinations assess function, impairments, and participation, but pediatric evaluations place greater emphasis on development, family involvement, and play-based observation. Adult evaluations are usually more symptom-focused and rely more heavily on direct self-report and standardized testing.

Developmental Quotient

Relationship of Development Performance Age and Chronological age

Imaginary Test: Scored Age = 2 years / Chronological Age = 4 years = 0.5

Percentile Rank

Percentage of where the child being scored, is above other children their age. aka, the percentage of children that will score below the child who is being evaluated.

Canadian Occupational Performance Measure

Structured Interview- Capturing self perception of performance in everyday living.

1. Family’s Goals

1. Performance

2. Satisfaction in areas

1. Care

• Leisure

• Productivity

3. Criterion-Referenced Assessment

Test of Infant Motor Performance (TIMP)

1. Pre-term infant assessment

2. Test Type: Motor Function

3. Ages- 34 weeks post conception through 4 months

corrected age

4. Excellent Test-retest reliability

5. Norm-Referenced Assessment

Alberta Infant Motor Scale (AIMS)

Test Type: Motor Function

2. Ages- 40 weeks post-conception (full term) to 18

months.

3. Assess skills in:

1. Prone

2. Supine

3. Sitting

4. Standing

4. Norm-Referenced Assessment

has a ceiling affect at about walking

Bayley Scales of Infant and Toddler Development (4th edition)

1. Test Type: Comprehensive Developmental Assessment

2. Ages: 16 days to 42 months

3. Areas of Test:

1. Cognitive

2. Language

3. Motor

4. Social-Emotional

5. Adaptive Behavior

4. Norm Referenced Assessment

Peabody Developmental Motor Scale

1. Type: Motor Function

2. Ages: Birth - 5 years

3. Areas of Test:

1. Gross Motor: Reflexes, Stationary Skills,

Locomotion, Object Manipulation

2. Fine Motor: Grasping, Visual Integration

4. Norm-Referenced Assessment

entire test does not need to be completed

Bruininks Oseretsky Test of Motor Proficiency

. Type: Motor Function

2. Ages: 4-21

3. Testing Areas of Interest:

1. Fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance,

running speed and agility, upper limb coordination, and strength

2. Also has a Short Form of 14 item to gain overall Gross Motor Quotient

4. Norm-Referenced Assessment

GMFM

Type: Gross Motor Function

2. Ages: 5 mo- 16 years

3. 2 versions— GMFM-88, GMFM-66

4. Specifics: Created for individuals with cerebral palsy,

however, GMFM-88 has been validated in children with

Down syndrome

5. Items are also appropriate for typically developing

children up to 5 years

6. Criterion-Referenced Assessment

School Functional Assessment

Type: School based function

2. Ages: Grades K - 6th grade

3. Type: Function in the school setting.

4. Criterion-Referenced Assessment

Pediatric Evaluation of Disability Inventory (PEDI-CAT)

1. Based on Function rather than Development

2. Ages: Birth to 20 years

3. Testing Areas:

1. Questionnaire looking at self-care, mobility, and

social function assessing for functional skill,

caregiver assistance and any modifications

4. CAT = Computer Adaptive Test

Which of the following tools is a criterion-referenced assessment?

Bayley Scale of Infant and Toddler Development

Pediatric Balance Scale

Gross Motor Function Measure (GMFM)

Peabody Developmental Motor Scales

Gross Motor Function Measure (GMFM)

2. What is the primary focus of school-based physical therapy under IDEA Part B?

• Physical rehabilitation in hospital settings

• Participation and inclusion in the educational environment

• Family-centered wellness care in early childhood

• Cure of medical conditions

Participation and inclusion in the educational environment

3. A 2-year-old child with developmental delays needs crawling interventions at home. Which plan supports this under IDEA?

• Individualized Health Plan

• Individualized Education Plan (IEP)

• Individual Development Curriculum

• Individualized Family Service Plan (IFSP)

Individualized Family Service Plan (IFSP)

4. A PT builds a plan that includes caregiver education to promote a parent’s confidence in managing the child’s condition. This best demonstrates:

• Adherence to discharge planning protocols

• Diagnosis-driven therapy

• Building parental self-efficacy

• Direct-to-patient intervention focus

Building parental self-efficacy

What is a primary goal of the IFSP under IDEA Part C?

• Achieving full independence in the workplace

• Reducing healthcare costs for schools

• Preparing the child for post-secondary education

• Promoting development in natural environments

Promoting development in natural environments

When modifying uneven terrain on a playground for a child using a walker, what is the therapist promoting?

• Accessibility and participation

• Medical rehabilitation

• Diagnostic testing

• Academic instruction

Accessibility and participation

Which of the following best describes the core goal of pediatric physical therapy?

• Supporting a child's ability to engage in life across different environments

• Focusing only on developmental milestones

• Maximizing insurance reimbursement through medical necessity

• Teaching children how to perform ADLs independently

Supporting a child's ability to engage in life across different environments

A 14-month-old child presents with delayed motor skills and had a known anoxic brain injury at birth. What best explains the presentation?

• Exclusive focus on the child’s impairments

• This is a progressive diagnosis

• This is a congenital condition whose effects are just now emerging

• This is a stable disorder that does not change

This is a congenital condition whose effects are just now emerging

Freud

• developed Psychosexual Stages

• pioneered psychoanalytic theory

Id

• instinct - doesn’t necessarily include morality

2. Ego

• Personality based off of experiences of demands/constraints

• Executive branch

• Involves reasoning

3. Super ego

• Moral branch of personality

• Determine right from wrong

Erikson

developed Psychosocial Stages

People motivated by social experiences

Trust vs Mistrust

Age birth to 1 (Infant)

Autonomy vs Shame and Doubt

Age 1-3 (toddler)

Initiative vs Guilt

Preschool 3-5

Industry vs Inferiority

Elementary School

Identity vs Identity Confusion

Adolescence: 10-20 years old

Intimacy vs Isolation

Early Adulthood: 20's and 30's

Generativity vs. Stagnation

Middle Adulthood 40's and 50's:

The Contributions of the Psychoanalytical Theories: important vs critisms

Important:

• Play

• Family relationships

• Relationship between development and personality

• Subconscious thought

• Lifespan of changes/ not just in childhood

Criticisms

Theories hard to test

Heavy emphasis on memory/recall

Too much sexual context (Freudian)

too much reliance on subconscious

Negative spin

Too much culture and gender biased –

• western driven

• male driven

Piaget's Cognitive Developmental Theory (what are in all the stages not neccasiliy the stages)

4 stages of development

Organization:

• Organize the world around us

• Important vs not important

• linking ideas/experiences

Adapt: change to environmental demands

Schemes:

• baby schemes:_________________________

• older child schemes: ________________________

• adult schemes: ex. have created a huge number of schemes allowing us to perform complex tasks (driving a car), and complex ideas (balancing a budget) (concept of fairness)

4 Stages of Piaget’s Cognitive Development Theory stages: stage 1

ages of birth - 2 years of age

• repetitive to complex movements

• variability

• thoughts of images and words

4 Stages of Piaget’s Cognitive Development Theory stages: stage 2

preoperational stage

• ages 2-7

• symbolic thought forming

• lack of conservation

4 Stages of Piaget’s Cognitive Development Theory stages: stage 3

concrete operational stage

• 7-11

• no longer seeing lack of conservation

• concreate logical thinking but difficulty with abstracts