neuro competency 1

Demonstrate how you would test for light touch and sharp/dull. Why

would you test for these?

distal to proximal, pin prick test, cotton swab, impaired sensation, safety

Demonstrate how you would test for stereognosis. Why would you test for this?

occlude vision, 6 objects, feel each, 3 or less=impaired; allows us to ID objects w/out looking, get things from pockets, bags, etc.

Demonstrate bed mobility from supine to edge of bed for a patient

with posterior hip precautions.

no flexion past 90, no adduction/crossing, no rotation

Demonstrate screening for CN3. What functional impairments may

accompany CN3 dysfunction?

H & X test, shine light for pupils, ptosis, strabismus, makes reading difficult, skips words, unable to find things

Demonstrate a way to screen visual acuity in a clinical setting. A client presents with low acuity; name three ADL adaptations for them.

Snellen’s chart or functional test, high contrast, bigger letters/numbers, use lighting

Perform a seated visual field screening (confrontational screening). If irregular results are discovered, what functional implications may that have?

bring hands out to sides until they see them. field cuts indicate difficulty seeing threats, bumping into things, finding items while shopping

Perform a seated screening for saccades. If irregular results are discovered, what functional implications may that have?

back and forth sticks. impairs hand eye coordination, reading, karaoke, fatigue in eyes, poor environmental awareness/body mapping

Perform a seated screening for smooth visual pursuits. If irregular results are discovered, what functional implications may that have?

follow the stick, overwhelmed in crowds, poor hand eye coordination, unnecessary head movement

 Perform a seated screening for convergence. If irregular results are discovered, what functional implications may that have?

bring stick in until they see double. difficulty checking speedometer, judging distance, copying notes from a board

Name three symptoms of unilateral neglect and describe an

occupational therapy intervention for left sided neglect

forgetting things on neglected side (combing, glasses, food), difficulty using both hands at once, bumping into things on that side, wasting on that side; CIMT, force use of that side

A patient demonstrates poor figure ground skills. Describe three

interventions an OT may implement.

high contrast simple fonts, reduce clutter, cover unneeded things

A person presents with visual object agnosia. Describe three strategies that could be used to complete basic ADLs.

tactile cues on objects, adjust the environment to be predictable, distinct colors on things, train to distinguish objects by other features (shapes)

Verbalize one functional impairment associated with poor spatial

relations skills and describe one occupation-based intervention.

dysmetria, trouble judging distances, difficulty orienting body in space; when dressing use tactile cues on clothes to ensure they are rightside in; use orientation tape when cleaning up

A person is tripping on curbs, spilling water when pouring, and fearful of falling. What are three areas of vision that you would assess and how

spatial relations, figure ground, MVPT, peripheral vision, confrontation screening

You are trying to identify if your client has challenges with initiation.

Describe what you would expect to see during functional tasks and

then demonstrate a functional screening for initiation.

getting stuck at the beginning of a task, appears to stall, needs prompts even when they know the task. play cards what do they do when it’s their turn, asking them to do a simple task (go wash your hands)

You are trying to identify if your client has challenges with problem-

solving. What would you expect to see during functional tasks, then

demonstrate a functional screening for problem-solving.

difficulty working through challenges, unexpected changes, finding solutions, changing course; make a meal while missing ingredients, pill sorting, budgeting

Identify two ways to test memory that does not involve expressive

language.

card matching game, give them a 2-3 step task and have them complete it.

You are trying to identify if your client has challenges with insight.

Explain what you would expect to see during functional tasks and

describe a functional screening for insight.

lack of knowledge about self, confusion to feedback, difficulty monitoring behavior; tape them doing a task then review with them, error identification, estimate the time it will take to complete a task

Provide an example of functional loss of divided attention. Describe two intervention ideas.

unable to focus on two tasks at once, making dinner while also watching your child; do one thing at a time, dual task training, break tasks into smaller steps, simplify

Describe a restorative/remediative and an adaptive/compensatory

approach to address decreased short-term memory.

errorless learning, memory games (restorative), using written instructions, keeping a planner, organizers (comp.)

You are trying to identify if your client has challenges with mental

flexibility. What would you expect to see during functional tasks?

Describe one remedial and one compensatory approach to address

poor mental flexibility.

difficulty switching tasks/transitioning, shifting responses; work on mindfulness techniques/create a mental checklist for when changes occur, skill train with different types of items; use visual cues for transitions, follow a script

Demonstrate two ways you could use a deck of cards to intervene for two separate areas of executive function

play a game with turn taking to work on inhibition, sort the cards in a specific way to work on planning, solitaire for problem solving (not 100% if Sarah considers Problem solving EF)

Verbalize 5 risk factors for falls.

weakness, poor balance, clutter, loose rugs/cords, ill fitting shoes/pants, old age

 Demonstrate a screening for static and dynamic sitting balance.

observe them sit w/out support, do they slump, lean, etc.? Give them a little push or have them reach for dynamic balance

Demonstrate a screening for static and dynamic standing balance.

4 stage balance test, nudge them or have them reach for dynamic

Describe 5 items in a Basal Ganglia screening

bradykinesia, akinesia, resting tremor, rigidity, chorea, ballismus

Describe 5 items in a cerebellar screening.

intention tremors, movement decomposition, dysmetria, dysdiadochokinesia, rebound phenom, motor impersistence, ataxia, dysarthria

Discuss 5 strategies to manage ataxia during ADLs

weighted utensils, dressing sticks, grab bars, energy conservation, splints to make arm/wrist more stable