NBCOT Study Pack: Domain 3 Flashcards

wound healing: inflammatory phase

Initial stage of wound healing that includes:
• clot formation
• blood vessel dilation allowing neutrophils and monocytes to initiate debridement and attack bacteria
• changes in skin color, temperature, pain, swelling and function

wound healing: proliferation phase

second stage of wound healing that begins by day three after injury, includes:
• wound revascularization
• scab formation
• wound re-epithelialization (new skin layer)
• fibroblasts initiating contraction
• erythema and beginning of scar formation

wound healing: maturation phase

Final phase of wound healing that may continue for months or years that includes: 
• collagen remodeling  
• scar softens while its tensile strength increases
• erythema lessens

debridement

A procedure performed to facilitate wound healing and involves removal of damaged or nonviable tissue

Types include:
• surgical
• mechanical
• chemical
• autolytic

surgical debridement

A type of debridement that involves surgically removing damaged or nonviable tissue with a sharp instrument

mechanical debridement

A type of debridement that involves actively removing damaged or nonviable tissue

Types include:
• hydrotherapy
• wet-to-dry dressings
• wound irrigation followed by suction

chemical debridement

Type of debridement that uses fast acting enzymes to slough nonviable tissue from a wound

autolytic debridement

Type of debridement that uses the body's own enzymes to breakdown nonviable tissue

alginate dressing

Primary wound care dressing that can absorb large quantities of exudate

transparent film dressing

Semi-occlusive wound care dressing that can be used as a primary or secondary dressing and act as a waterproof barrier

hydrogel sheet dressing

Wound care dressing that hydrates the wound and promotes autolytic debridement

scar management

Technique best used six to 12 weeks after wound closure to minimize the risk of adhesions, contracture, hypertrophy or hypersensitivity

scar management interventions

Interventions include:
• mobilization orthoses (e.g., applying sub-maximal stretch)
• massage (e.g., graded vibration, manual)
• compression (e.g., gloves, tubular gauze)
• desensitization (e.g., graded touching, textures)
• ROM (e.g., active exercise and passive stretch)
• thermal modalities (e.g., ultrasound, moist heat)

conduction

Transfer of energy between two connected surfaces of contrasting temperatures, examples include:
• paraffin wax
• cryotherapy
• hot pack

convection

Transfer of energy from a circulating source in contact with a body part, examples include:
• Fluidotherapy®
• whirlpool

evaporation

Physiological response resulting from the topical application of a vapocoolant, examples include:
• cold spray
• cooling cream

electrotherapeutic physical agent modalities

Physical agent modalities (PAM) that require essential knowledge of electrical principles, electrode selection and placement, indications, and contraindications, examples include:
• neuromuscular electrical stimulation (NMES)
• functional electrical stimulation (FES)
• transcutaneous electrical nerve stimulation (TENS)

hot pack

Superficial, moist heat, conduction modality

Requires taking precautions to prevent:
• overheating of the client
• localized burns to the body part being treated
• discomfort from the weight of the pack
Recommended for use as an adjunct to other occupation-based interventions

fluidotherapy

Superficial, dry heat, convection modality that involves inserting a distal extremity into a thermostatically-controlled machine of circulating particles, typically used for:
• desensitization
• edema and pain reduction
• improving range of motion
Recommended for use as an adjunct to other occupation-based interventions

paraffin therapy

Superficial, conduction, heat modality that involves use of thermostatically controlled, warmed wax and mineral oil, methods include:
• immersion
• dip immersion
• pouring
Recommended for use as an adjunct to other occupation-based interventions

cryotherapy

Superficial, conduction, cold modality that may be used to address:
• spasticity
• pain
• edema
Recommended for use as an adjunct to other occupation-based interventions

neuromuscular electrical stimulation (NMES)

A type of physical agent modality that provides electrical stimulation to a peripheral nerve

Potential uses include:
• strengthen a muscle
• increase ROM
• decrease spasms
• manage edema
Recommended for use as an adjunct to other occupation-based interventions

functional electrical stimulation (FES)

Form of electrotherapy to:
• maintain muscle mass
• gain range of motion
• facilitate voluntary movement
• manage spasticity
Recommended for use as an adjunct to other occupation-based interventions

transcutaneous electrical nerve stimulation (TENS)

Form of electrotherapy used as a component of a comprehensive pain management program Techniques of application include:
• subsensory
• sensory
• motor
Recommended for use as an adjunct to other occupation-based interventions

ultrasound

Mechanical acoustic modality that uses energy conversion to influence:
• tissue length
• pain
• inflammation
• tissue healing
Recommended for use as an adjunct to other occupation-based interventions

social competence

Mastery of a complex interaction of social, cognitive, emotional, and behavioral skills needed for social adaptation, includes demonstration of effective:
• interpersonal communication
• social communication
• social skills

play space

Designated social or physical environment designed for children to foster:
• exploration
• development
• socialization

applied behavioral analysis (ABA)

Therapeutic approach used to enhance school function, positive behaviors, and socialization through intensive therapy consisting of reinforcement and daily structure

least restrictive environment

Academic context allowing students with disabilities to receive their education and all academic and related services in the same setting as children who do not have disabilities

behavioral modification

An intervention strategy used to shape behavior; typically associated with providing a combination of positive or negative reinforcement

reality orientation

Intervention method used for persons with cognitive impairment that includes routine and consistent reminder of:
• time, date, and weather
• current location
• familiar names
• roles of people in their support network

temperament

Behavioral attributes of a personality that influence social interactions in nine areas: activity level, rhythmicity, approach or withdrawal, attention span, threshold of response, distractibility, adaptability, intensity of response, and quality of mood

activity pacing

Energy conservation technique that includes:
• integrating regular rest breaks into daily activities
• establishing daily habits and routines
• maintaining adequate sleep hygiene

activity planning

Energy conservation technique that involves looking ahead days, weeks or months to develop a strategy for organizing and scheduling tasks based on occupational roles, priorities, task demands and expected energy expenditure levels and includes time for rest and recovery

activity modifications

Adaptations to activities or tools to:
• promote a lifestyle change
• facilitate independence
• reduce injury or health-related risk

just right challenge

Top-down task analysis approach that involves identifying client-centered activities that:
• are meaningful and contextually relevant
• provide the greatest opportunity for success
• maintain motivation and arousal

task simplification

Method of grading activity to allow the capacity of the client to match activity demands, may involve:
• breaking an activity into smaller parts
• eliminating steps of an activity
• modifying objects used during the activity

incremental gradation of occupation

Gradual increase or decrease in activity and/or environmental demands to optimize a client’s performance, typically started from where the client will be successful

client education

Collaborative client-centered teaching approach used to advise a client on:
• plan of care and goals
• resources
• discharge planning
• home programs

Includes assessing the ability to carry out health care recommendations

automaticity

Ability to perform activities using an automatic response or habit, involves less attention to details of the procedural steps

automaticity intervention

Intervention strategies may include:
• linking a new activity with an existing one
• ensuring consistency in instruction, steps, and environment

generalization of skills

Ability to transfer a newly learned skill across a variety of contexts and activities, facilitated by:
• maintaining client motivation
• contextually relevant practice
• direct exposure to a task

home program

Set of recommended activities provided to support carryover of skills learned in a therapeutic setting to the natural environment

group leader

Role in a therapeutic group that includes:
• facilitating participation and process
• defining expectations and norms
• teaching needed skills
• guiding actions toward achieving desired outcomes

group leadership style: authoritarian

Style of group leadership that involves a high level of control

Features include:
• leader directs group members
• members minimally contribute to the group decision-making process

group leadership style: facilitative

Style of group leadership used with group members who are functioning at a higher cognitive level

Features include:
• group leader acts as an educator and a resource
• group members contribute to group decision-making process under the guidance of the leader

group leadership style: advisory

Style of group leadership used when members in the group are functioning at a high level

Features include:
• groups typically occur in community (e.g., health and wellness group)
• group members responsible for the functioning of the group
• leader offers guidance and direction as needed

group leadership style: co-leadership

style of group leadership that includes two or more practitioners from the same or different discipline

Benefits include:
• leaders can support each other
• greater objectivity when measuring performance of group members
• knowledge of the group leaders can be combined
• group leaders can take on different roles

group norms

Implicit and explicit rules that govern accepted behaviors and processes in a group

Can be established by the group leader or by the members themselves

group task roles

Roles that individuals in a group assume to accomplish tasks related to the overall objective for the group

group task roles types

Types include:
• information provider
• information seeker
• energizer
• recorder
• leader/facilitator

group maintenance roles

A type of role in the group process where members contribute to the overall performance of the group

group maintenance role types

Types include:
• harmonizer
• compromiser
• follower

group dynamics

Internal and external factors that influence functioning of a group and its outcomes

parallel group

A type of group in which members work or play independent of each other with little to no interaction

project group

A type of group in which there is a specific, outcome-based activity or project
• group members have some interaction through sharing and cooperation

egocentric cooperative group

A type of group in which members focus on completing a project or activity over several sessions
• group members choose level of interaction with each other, which is often based on the need to complete various aspects of the project

social skills group

Group intervention approach with focus on interactive activities that may address:
• empathy development
• relationships with others
• nonverbal and verbal communication skills
• social interactions

sensorimotor group

Intervention used primarily in pediatric and geriatric settings, includes the provision of sensory experiences through movement or play in a therapeutically structured group

life skills group

Group intervention approach to address acquisition of or barriers to specific skills that promote participation in occupation, may include practical exercises related to:
• daily living tasks
• conflict resolution
• anger management
• communication skills
• time management
• clarification of values

discussion-oriented group

A type of group in which peers interact and engage with each other while learning skills for personal growth

Types include:
• stress management
• sleep hygiene education
• advocacy training
• caregiver support

group termination

A therapeutic process that brings closure to the group process and ends a group

sensory-seeking behavior

Actions characterized by craving input from a variety of senses and experiences, typically associated with:

• altered sensory processing ability
• challenges with regulation of arousal level
• atypical praxis
• hyper- or hypo-responsivity

sel-management education

Therapeutic approach that involves:
• enabling and empowering the client to independently identify issues
• problem solving meaningful and realistic solutions/actions plans

self-determination

The action or process of making an informed, personal decision on how to solve a problem, overcome a barrier, make a choice, or plan for the future

self-verbalization strategies

Cognitive strategy where an individual learns to talk out loud to regulate or control behaviors

therapeutic sensory diet

Customized program designed to help regulate responses to a variety of sensory input

Typically used as an adjunct intervention for children with:
• autism spectrum disorder
• sensory modulation disorder
• sensory seeking behaviors
• attention deficit hyperactivity disorder

sensory re-education

Active training strategies used in the presence of a peripheral nerve injury or after a brain injury to enhance sensory awareness or compensate for lack of sensation, distinct categories include:
• protective sensory re-education
• discriminative sensory re-education

protective sensation

Ability to accurately perceive sensory input necessary to prevent personal injury or harm (e.g., pain and temperature)

diplopia

Visual impairment secondary to a neurological event, also referred to as double vision, may cause loss of depth perception and increase risk of falls.

diplopia intervention

Interventions for managing symptoms may include:
• prism correction
• full occlusion eye-patching
• partial visual occlusion

oculomotor dysfunction

Visual impairment characterized by lack of efficient eye movements and eye-tracking skills due to a cranial nerve lesion or neural disruption of the extraocular muscles, functional deficits may include difficulties with:
• reading speed
• copying skills
• writing skills

unilateral spatial neglect

Neurobehavioral deficit characterized by the inability to interact with stimuli on the contralateral side to a brain lesion (e.g., bumps into walls with the affected side of body)

unilateral spatial neglect interventions

Interventions may include: awareness training, limb activation, lighthouse strategy, partial visual occlusion, scanning techniques, videotaped feedback, and environmental adaptation

hemianopsia

Visual impairment secondary to a brain lesion that results in loss of vision to half the visual field

hemianopsia intervention

Compensatory strategies may include:
• visual anchoring
• scanning training
• environmental modification

desensitization

Systematic intervention for decreasing hyper-responsiveness to aversive stimuli, may be used in:
• mental health interventions for anxiety disorders
• hand therapy for nerve hypersensitivity

visual skills training

Interventions for impairment of the peripheral or central visual field (e.g., visual strategies and visual scanning training) and for central visual field defects (e.g., eccentric viewing training)

magnification

The process of enlarging an object’s appearance using an optical device or lens, commonly used in low vision therapy to enhance vision
Categories include:
• low power (e.g., hand-held magnifier, reading glasses)
• high power (e.g., closed-circuit television)

anchoring technique

Strategy used in visual scanning training where a visual cue (e.g., a solid line or a bright colored, thin strip) is placed in the impaired field of view and the client is encouraged to scan to the visual cue

attention

Cognitive process of being able to focus on specific stimuli, task, and/or task component while disregarding irrelevant distractors, types include:
• selective
• sustained
• alternating
• divided

awareness deficit

Lack of insight into a person’s own functional deficits

memory

Cognitive process of retaining information, types include:
• working, short term, and long term
• procedural, declarative, and episodic
• semantic, explicit, and implicit
• prospective and metamemory

distractibility

Disruption in the cognitive process of attention that manifests itself with inability to maintain focus on desired performance due to distractions caused by external stimuli

metacognition

Self-awareness of one's own cognitive performance ability and capacities and the need for strategy use

Frequently impaired in clients with executive dysfunction

executive function

High level cognitive process that includes:
• planning and organizing
• regulatory control
• problem solving and working memory

environmental adaptation: contrast

Solution to enhance safety and performance for client’s with low vision, that includes a distinct color gradient, may be used for:
• visual presentations/educational materials
• placemat during meal time
• edge of stairs

video detective

An intervention technique that addresses social skills used with individuals who have autism spectrum disorder by presenting a mute video clip to the client, who must identify and interpret the emotions expressed through nonverbal behaviors

emotions charades

An intervention technique that addresses social skills used with individuals who have autism spectrum disorder by having a person role-play an emotional expression and asking the client to identify the emotion

power card

An intervention technique that addresses social skills used with individuals who have autism spectrum disorder by listing the steps of a desired behavior on a card with a picture that shows the client's special interest or hero

scales and thermometer

An intervention technique that addresses self-regulation skills that can assist a client in recognizing, quantifying, and describing energy level and emotion

social autopsy

An intervention technique in which the client is asked to reflect on a social event to consider behaviors and motivations associated with the situation

privacy circle

An intervention technique that addresses social skills by teaching the client about social boundaries through use of concentric circles (e.g., family and close friends are identified in an inner circle to the client and a customer at a grocery store are placed in an outer ring to the client)

video modeling

Intervention technique frequently used to teach a specific motor or social skill by having a client/child watch a video of the skill being performed then attempting to imitate the task

social script

Narrative used to promote social participation or a skill to children, written from the perspective of the child, and practiced for use in a variety of contexts

Typical narratives relate to:
• giving or receiving compliments
• asking for or giving help
• self-introductions

social story

Narrative used to promote social participation or a skill to children, written to prepare children how to act and respond in a variety of contexts

Consists of four types of sentences:
• descriptive
• directive
• perspective
• control/affirmative

stress thermometer

Visual feedback scale used for assisting children identify and quantify emotions, moods, or perceptions of their behaviors

explicit instruction

Most direct level of graded cueing that includes instruction in the next step required for a given activity (e.g., "Now that you’ve finished bathing, it’s time to dry your feet")

verbal instruction

A method in which a therapist gives brief directions to encourage a movement, guide a behavior, or teach a skill

graded cue

Varying levels of guidance to support activity performance and participation with modification and adjustments to allow for progression towards independence, cues can be:
• visual
• verbal
• tactile