ot325 final exam

palmar grasp

raking grasp

cylindrical grasp

spherical grasp 

lateral grasp

hook grasp

radial digital grasp 

three jaw chuck

inferior pincer

superior pincer 

what hand manipulation should a 12-15 m be able to do?

finger to palm translation

what hand manipulation should a 2 y/o be able to do?

palm to finger translation and 90 degree simple rotation

what hand manipulation should a 3 y/o be able to do?

shift

what hand manipulation should a 4 y/o be able to do?

180-360 degree complex rotation

snipping (scissor skills)

small cuts in paper

cutting lines (scissor skills)

cutting along straight or curved lines

cutting shapes (scissor skills)

cutting out complex shapes

what does haptic perception allow children to do?

identify objects through touch 

stereognosis tests evaluate….

the ability to recognize objects without seeing them

somatosensory function supports….

precise finger movements and stable grasping

what are primative reflexes

survival reponses present at birth

examples of primative reflexes

moro, atnr, rooting, grasp

reflex present at birth and is triggered by sudden movement… sudden ext.

moro reflex

when should moro reflex be integrated by 

4 months 

what are righting reactions

help align head and trunk

examples of righting reactions

labrynthine, optical righting, BOH, HOB, landau

which reaction is this?

stimulus: change in head postion 

response: head moves to stay upright 

labrynthine head righting 

which reaction is this?

stimulus: visual input from environment

response: head orients to keep eyes level

optical righting 

what reaction is this?

stimulus: movement of body in space

response: head aligns with body

BOH

what reaction is this?

stimulus: rotation of head

response: body follows to align

HOB

what reaction is this?

stimulus: horizontal suspension in prone

reaction: ext of head, trunk, legs

landau

reflex that emerges around 6 months and allows dynamic balance and weight shifting

equilibrium response

when do protective reactions appear 

6-9 months 

phasic primative reactions do what

produce observable movement in response to touch, pressure, movement of body, sight or sound…. for survival and protection 

example of phasic reflexes

moro, rooting, suck, palmar, planter

tonic primitive reflexes do what 

change position of whole body to respond to changes in head position…. FOR STABILITY 

examples of phasic reflexes

ATNR, STNR< TLR, landau

what reactions are automatic

protective and equilibrium

this reflex distributes tone on opposite patterns on either side of midline FLAG POSITION

atnr

what happens if atnr reflex persists 

difficulty with:

• hand eye coordination

• ability to cross vertical midline

• visual tracking

when should atnr reflex be integrated by

6 months

when does stnr emerge by and integrated by

emerges: 4-6 months

integrated: 9-12 months

reflex where…

• neck ext—> UE ext and LE flex

• neck flex—> UE flex and LE ext

STNR

which reflex is a precursor to crawling

STNR

what happens if STNR persists

child may have difficulty with….

• standing still

• poor hand eye coordination

• posture and balance problems

this reflex is a primitive reflex in infants that causes the body to extend when the head is tilted back and flex when the head moves forward

TLR

when should TLR be integrated by

4/6 months

what happens if tlr persists or is non integrated

child struggles withhhh

• turning on side/rolling 

• holding supine flexion 

• sitting up 

what movement pattern is this

• developmental process of shifting weight from upper to lower parts of body

• ex. squatting

bilateral weight shift

what movement pattern is this

• all weight is shifted to one side of midline

unilateral weight shift

what movement is this

• ex. when crawling opposite arm and opposite leg

• infant shifts their body's weight to the opposite side of their body from a limb that is moving or being lifted.

contralateral weight

What Is Play?

-A fundamental right and essential for growth, learning, and development (AOTA, 2008)

Play as a Means and End

Play is used in OT in 3 primary ways:

• tool 

• reward

• occupation

Parten's Stages

Unoccupied Play, Solitary Play, Spectator/Onlooker Behavior, Parallel Play, Associative Play, Cooperative Play

Parten's Stages: Unoccupied Play (Birth-3 Months):

• The infant is moving arms, legs, hands, feet, etc.

• They are learning about and discovering how their body moves. Swiping/pre-reaching

Parten's Stages: Solitary Play (3 months-2 Years):

The child plays alone; no interest in playing with others quite yet.

Parten's Stages: Spectator/Onlooker Behavior (2 Years):

Child watches and observes other children playing but not playing with them

Parten's Stages: Parallel Play (2-3 Years):

The child plays alongside or near to others but does not play with them.

Parten's Stages: Associative Play (3-4 Years):

• The child begins to interact with others during play, but little cooperation is required.

• Children share and interact intermittently on shared goals.

Parten's Stages: Cooperative Play (4+ years):

The child plays with others and has interest in both the activity and other children involved in playing.

Takatas Taxonomy of Play

-Sensorimotor (0-2 years)

-Symbolic and simple constructive (2-4 years)

-Dramatic, complex constructive, and games w/more simple rules (4-7 years)

-Games with rules/competitive sports (7-12 years)

-Recreational (Adolescents-12 emerging adulthood)

For a child with sensory challenges, OT may recommend ...

outdoor play for vestibular input and motor planning.

Cooperative play goals ...

—work with peers, take turns, follow rules.

Intervention Strategies for play

Toy adaptation, environmental modifications, family involvement, universal access.

Toy size reccomendation

Toy size (≥1¼ inches diameter, ≥2¼ inches length) to prevent choking--so that they can't be swallowed or lodged in the windpipe

Feeding

process of setting-up, arranging, and bringing food from plate to mouth

Eating

ability to keep in and manipulate food/liquid in mouth and swallow

Oral motor control

use of lips, cheeks, jaw, tongue, and palate

Oral motor development and progression

• feeding, sound play, oral exploration (not always related to food)

• -Rooting/suck reflex at birth → spoon use by 18 months → fork use by 2-3 years, cutting spreading with knife 5 years or older

Cultural influences on eating

Pre-chewing, baby-led weaning, communal eating, use of spices.

OT assesses positioning

trunk and neck stability for safe feeding.

Infant (4-6 mo) milestones for eating?

• semi-reclined position for puree introduction

• Typically, ready for pureed foods at 4-6 months

Toddler (18 mo) milestones for eating?

begins self-feeding with spoon; OT may recommend adaptive utensils for success.

Strategies for picky eaters

Offer one new food at a time, involve child in food prep, maintain routine.

OT role in interdisciplinary teams (eating)

OT role in interdisciplinary teams: Collaborate with SLP for swallowing safety.

6 Month Milestones for eating?

-Sucks small amount of liquid presented from cup

-Up/down jaw movements ("munching") of puree foods

-Holding bottle or sippy cup with two hands

7-9 Months milestones for eating?

-Significant changes in postural control and UE activity

-With spoon, uses more lip movements (lip closure) to remove food

-Exposure to many textures of food, including those that require biting and chewing (mainly up/ down movements of jaw)

IDEA

-stands for the Individuals with Disabilities Education Act, a federal law that ensures children with disabilities have access to a free and appropriate public education.

• this law provides for special education and related services, establishes a legal framework for creating an Individualized Education Program (IEP), and supports early intervention services for infants and toddlers with disabilities.

IFSP

Part C of IDEA: Addresses early intervention services for infants and toddlers. (0-3)

IEP

Part B of IDEA: Composed of school personnel and the child's parents or guardian. IDEA requires that children with disabilities be educated in the least restrictive environment (3-21)

Section 504

-to ensure equal opportunity and access for people with disabilities, and in schools, it can provide accommodations and modifications

-accommodations!!!

Americans with Disabilities Act - ADA

-law enacted in 1990 that prohibits discrimination based on disability

-accessibility!!! 

The Every Student Succeeds Act - ESSA

-include state-determined assessments, accountability systems with clear metrics for success beyond standardized tests, and a requirement for states to provide transparent information to parents through annual report cards.

-achievement!!! 

Workforce Innovation and Opportunity Act - WIOA

-to improve the skills of the workforce and connect employers with skilled workers through programs like career services, job training, and support for those facing employment barriers.

-transition to work!!! 

Universal Design for Learning (UDL)

Flexible environments, barrier reduction, sensory supports.

Tiered Models (RTI/MTSS)

Tier 1 universal supports

Tier 2 targeted interventions

Tier 3 intensive individualized support.

OT's collaborate with teachers to identify needs, collect data, and implement evidence based strategies for student success

Child with sensory processing challenges, OT recommends ...?

OT recommends quiet corner, noise-canceling headphones.

Preschooler with fine motor delays, OT recommends ...?

adaptive scissors, slant board, visual schedules.

High school student with executive functioning challenges, OT recommends ...?

locker organization system, visual timers, structured work-based learning.

Feeding Disorders

involve persistent inadequate eating and may require specialized medical and therapeutic management.

Developmental Delays in feeding

are slower progression through feeding milestones like delayed spoon use or limited texture tolerance.

24-30 mo feeding milestones?

-Most all table food except tough food and food with skin due to increased sensorimotor skills

-Adult-like drinking pattern, no liquid loss- from open cup

-Uses spoon with efficiency (supination)- adjusts movements

-Uses fork to stab at food (2-3 years)

examples of ADLS

dressing, bathing, toileting

examples of IADLS

grocery shopping, meal prep, money management, etc.

which theorist….. adls support autonomy vs. shame and doubt, initiative vs guilt, and industry vs inferiority 

erikson 

which theorist…. kids learn adls through scaffolding and guidance

vygotsky

which theorist… visual cues and modeling help younger children…. older kids use logic for sequences (preoperational stage —> preoperational learning —> concrete operational)

piaget

which theorist…. family, school, culture shape adl development 

bronfenbrenner 

which theorist… adls meet basic needs and build confidence

maslow

attachment theory

adls strengthen caregiver-child bonding… adls are co occupations