NBCOT Study Pack: Domain 1 Flashcards

exploratory play

Play occupation that uses sensory input to learn new experiences (e.g., infant touching mother’s face)

Also referred to as sensorimotor play

relational play

Play occupation that uses toys consistent with their intended purpose (e.g., pretending to self-feed with a spoon)

Also referred to as functional play

pretend play

Play occupation that involves making objects/toys perform intended actions (e.g., pretending to use a phone to talk)

Also referred to as symbolic or imaginary play

social play

Play occupation that includes:
• interaction with and emotionally relating to others
• behavior and skills to develop and progress through childhood

gross motor play

Play occupation that involves full body, kinesthetic motor movements (e.g., climbing on a play structure)

constructive play

Play occupation that involves using objects/toys to produce or build something (e.g., put together a puzzle)

play occupations

Meaningful, intrinsically motivating, and purposeful performance activities of childhood, types include:
• exploratory play
• relational play
• pretend play
• constructive play
• social play
• gross motor play

grasp pattern

Fine motor function of the hand, either precision or power, used to manipulate items
Patterns include:
• cylindrical grasp
• power grasp
• tripod grasp

power grasp

Grasp used when stability and strength are required, involves:
• ulnar digits FLEXED and ulnar side of hand controlling the object
• radial digits less flexed while manipulating the object

hook grasp

Type of prehension grasp used to carry an item with a handle (e.g., lunchbox, briefcase) without using thumb and palm

cylindrical grasp

Grasp used for holding a tube-shaped item (e.g., drinking glass, baseball bat)

lateral pinch

Prehensile pattern used to grasp a small item with the thumb opposed to the radial side of the index finger (e.g., placing a key in a lock)

pincer grasp

Prehensile grasp used to manipulate small objects with the thumb opposed to the index and middle finger pad (e.g., picking up a pencil)

tripod grasp

Precision grasp used to manipulate small objects with thumb opposed to the index and middle finger tips, providing more stability than pincer grasp (e.g., writing tool)

tip pinch

Pinch used to pick up and hold small objects with thumb opposed to the end of the index finger forming an oval shape (e.g., picking up a pin)

spherical grasp

Grasp used to pick up and hold round items (e.g., apple, baseball)

primitive developmental reflexes

Automatic movements performed by an infant without conscious effort in response to a stimulus, typically integrated by early childhood and are a precursor to functional movement

what does a persistent primitive reflex typically indicate?

a central nervous system dysfunction

righting reaction

Postural reflex present from approximately 3 months to 6 months of age that functions to orient the body in response to visual and vestibular input

Examples include:
• neck on body
• body on body
• body on head

protective extension

Postural response present at approximately 6 months of age and continues throughout life, characterized by reflexive straightening of the upper extremities in response to a loss of balance

equilibrium reaction

Postural reflex present at approximately 6 months of age and continues throughout the life span

Reflexive response to help maintain or recover balance, includes shifting the body to reorient to midline

emotional regulation development: neurophysiologic modulation phase

Phase of emotional regulation development, occurring between birth and 2-3 months of age

Characterized by ability to:
• regulate arousal (e.g., self-soothe, respond to parental soothing)
• activate organized patterns of behavior (e.g., routine sleep-wake cycles)

emotional regulation development: sensorimotor modulation phase

Phase of emotional regulation development, occurring between 3-9 months of age

Characterized by:
• enjoyment of sensorimotor play
• sensory exploration
• possible sensory modulation challenges

emotional regulation development: control phase

Phase of emotional regulation development, occurring between 12-18 months of age

Characterized by:
• emerging awareness of social demands
• varying levels of inhibition and compliance
• self-initiated monitoring related to an understanding of consequences

emotional regulation development: self-control phase

Phase of emotional regulation development, occurring between 24-48 months of age

Characterized by:
• emerging sense of identity
• demonstrated knowledge of social rules
• minimal flexibility and adaptation to change

emotional regulation development: self-regulation phase

Phase of emotional regulation development, occurring between 36 months of age and older

Characterized by emerging:
• flexibility to adapt to unexpected change
• self-awareness
• capacity to evaluate own behavior

stage of motor learning: exploratory stage

Stage of motor learning development, occurring between 1-3 months of age where the infant learns about the self and the environment using primitive movement patterns to:
• swipe at objects
• initiate reach
• complete low level skills

stage of motor learning: perceptual learning stage

Stage of motor learning development, occurring between 3-6 months of age where the infant uses perceptual skills developed through exploration

Characterized by:
• more accurate and direct reach
• consistency of movement patterns
• engagement in trial-and-error learning

stage of motor learning: skill achievement

Stage of motor learning development, occurring between 6–9 months of age

Characterized by:
• high adaptability
• both perceptual learning and increased self-organization
• using action patterns that are orderly and efficient

neurodegenerative condition

Progressive neurological disease of the central nervous system, may be structural or neurochemical, and advances according to characteristic stages

Examples include:
• Parkinson's disease (PD)
• Multiple sclerosis (MS)
• Amyotrophic lateral sclerosis (ALS

parkinson’s disease

Neurodegenerative condition associated with deterioration in the substantia nigra, characterized by:
• rigidity
• bradykinesia
• resting tremor
• festinating gait

multiple sclerosis

Neurodegenerative condition associated with white matter lesions in the CNS and demyelination process, characterized by fluctuant changes in:
• energy level
• sensation
• weakness
• cognition
• vision
• mobility

guillain-barre syndrome

Acute demyelinating condition, characterized by:
• symmetrical and progressive paralysis
• ascending weakness starting at the feet
• possible involvement of cranial nerves and muscles of respiration

Typical course includes:
• acute phase (2- 4 weeks): progressive increase in symptoms
• plateau phase (few days to few weeks): no change occurs
• progressive recovery phase (up to 2 years): gradual improvement

amyotrophic lateral sclerosis (ALS)

Neurodegenerative condition associated with progressive death of upper and lower motor neurons, characterized by:
• muscle weakness in one or more extremity
• difficulties with speech, swallowing, and / or breathing

huntington’s disease

Genetically-inherited degenerative neurological disease typically beginning between 30-50 years of age, characterized by choreiform movements, decline in thinking and reasoning skills, and alterations in mood

huntington’s disease intervention focus

focus on supporting engagement in occupation (e.g., environmental modification, assistive devices, augmentative communication devices, dysphagia management, cognitive strategies, seating and mobility, and caregiver training)

duchenne’s muscular dystrophy

Inherited genetic disorder resulting in muscular weakness and atrophy of the proximal musculature of the pelvis and shoulder girdle, symptoms more common in males and detected around 3 years of age

duchenne’s muscular dystrophy symptoms

Results in gradual loss of independent ambulation and progressive deterioration of musculature of the trunk, neck, and distal extremities

Cognition typically remains unaffected

systemic lupus erythematosus

Autoimmune inflammatory disease affecting, joints, skin, blood cells and vital organs, characterized by a distinct butterfly-shaped facial rash that crosses both cheeks

systemic lupus erythematosus symptoms

Symptoms may be acute, chronic or episodic and may include one or more of the following: joint pain and swelling, skin lesions, fatigue, Raynaud’s phenomenon, dyspnea, alterations in cognition

alzheimer’s disease

Most common form of dementia characterized by a decline in memory, thinking and performance skills with 3 stages:
• mild
• moderate
• severe

alzheimer’s disease: mild stage

Stage of Alzheimer’s disease progression associated with:
• difficulty remembering new information
• getting lost
• challenges with money management
• increased time to complete ADL and routines
• mood and personality changes

alzheimer’s disease: moderate stage

Stage of Alzheimer’s disease progression associated with:
• increased memory loss and confusion
• impulsive behavior
• difficulty in completing daily activities
• poor problem solving and judgement
• may experience, hallucinations, delusions, and paranoia

alzheimer’s disease: severe stage

Stage of Alzheimer’s disease progression associated with:
• inability to communicate
• dependent in ADL
• dysphagia and increased risk of aspiration
• incontinence

macular degeneration

Progressive age-related visual condition, characterized by:
• atrophy of the macula (posterior part of the retina)
• decrease in central visual acuity
• blurry, distorted, or low vision

macular degeneration interventions

Intervention(s) may include: magnification devices, lighting recommendations, color and contrast enhancements, visual skills training

myasthenia gravis

Autoimmune motor unit disorder, characterized by:
• ptosis and double vision
• possible difficulty with chewing, swallowing, and speech
• weakness and fatigue that increases throughout the day

myasthenia gravis interventions

Intervention(s) may include: energy conservation and work simplification education, sleep hygiene strategies, recommendation of adapted and assistive devices, activity modification

chronic obstructive pulmonary disease (COPD)

Pulmonary condition associated with limited airflow from the lungs, characterized by:
• difficulty breathing
• shortness of breath during activities
• dyspnea and fatigue that influence occupational performance
• persistent cough
• includes emphysema and chronic bronchitis

dyspnea

Shortness of breath due to impaired breathing in response to activity or at rest, may require:
• medical attention
• modification to activity demands
• instruction in breathing techniques
• dyspnea control postures

orthopnea

Shortness of breath due to impaired breathing when lying in a supine position

orthopnea recommendations

Recommendations may include for client to sleep in an upright position

myocardial infarction

Emergency medical condition characterized by blocked flow of blood to the heart muscle, resulting in damage to the heart

angina

Chest pain or pressure in response to exertion or at rest radiating to:
• arms
• neck
• jaw
• back

modifiable risk factors for cerebrovascular accident

Risk factors the client can control:
• smoking
• hypertension
• diabetes mellitus
• obesity
• sedentary lifestyle
• stress
• high cholesterol

non-modifiable risk factors for cerebrovascular accident

Risk factors the client cannot control:
• family history
• age (late adulthood)
• gender
• post-menopausal
• history of heart disease

neurologic deficits associated with RIGHT hemisphere dysfunction

Deficits typically associated with damage to this hemisphere of the brain include:
• left hemiparesis or hemiplegia
• sensory impairment on left side of body
• unilateral body and spatial neglect
• visual field cut on left side
• decreased insight into deficits

** Deficits depend on the specific area of the right hemisphere that is damaged.

neurologic deficits associated with LEFT hemisphere dysfunction

Deficits typically associated with damage to this hemisphere in the brain include:
• right hemiparesis or hemiplegia
• sensory impairment on right side of the body
• language impairment (expressive and/or receptive aphasia)
• bilateral motor apraxia
• frustration

** Deficits depend on the specific area of the left hemisphere that is damaged

cerebral palsy

Neurological condition caused by a brain injury or brain malformation that occurs while the brain is developing before, during, or immediately following birth, characterized by impaired:
• body movements and gross motor skills
• muscle control and tone
• muscle coordination and fine motor skills
• reflexes, posture, and balance
• oral motor functioning

down syndrome

Genetic disorder associated with chromosome 21;

characterized by mild to moderate intellectual disability, physical developmental delay, low muscle tone, and characteristic facial features

autism spectrum disorder

Neurodevelopmental disorder characterized by a range of symptoms, such as:
• social dysfunction
• stereotypical behavior patterns
• perseverative thoughts or interests
• sensory processing deficits
• executive dysfunction

developmental dyspraxia

Neurodevelopmental disorder (also called developmental coordination disorder)

Characterized by:
• clumsiness and poor coordination
• motor planning deficits
• learning difficulties
• perceptual deficits (visual and motor)

attention deficit hyperactivity disorder (ADHD)

Neurobehavioral disorder characterized by one or more of the following behaviors:
• inattention
• restlessness
• impulsivity
• emotional dysregulation
• sensory processing
• social immaturity

fetal alcohol spectrum disorder

Congenital birth defect secondary to gestational exposure to alcohol resulting in mild to severe impairment in one or more of the following areas of development:
• physical
• cognitive
• social
• behavior

torticollis

Dystonic disorder that is either congenital or acquired; defined by an abnormal, asymmetrical head or neck position

Interventions may include:
• ROM exercises
• positioning
• environmental adaptations

major depressive disorder

Mood disorder that may be characterized by:
• persistent low mood
• anhedonia
• changes in sleeping and appetite
• decreased energy
• feelings of hopelessness

bipolar disorders

Mood condition that manifests as manic, depressive, or mixed episodes:
• type I is primarily manic
• type II is primarily depressive

cyclothymic disorder

Less severe form of bipolar disorder

Duration of symptoms does not meet the criteria of major maniac or depressive disorder

schizophrenia

Psychotic thought disorder with altered sense of reality, symptoms may include:
• hallucinations and delusions
• disturbance in thinking and behavior
• emotional blunting, social isolation, and cognitive changes

anxiety disorders

Emotional condition characterized by an abnormal reaction, overwhelming fear, and uncontrollable thoughts resulting in a physiological response impacting daily function

personality disorders

Psychological condition that may be characterized by:
• disturbance of personality traits
• behaviors inconsistent with societal norms and expectations
• problems with interpersonal relationships

addiction

Condition impacting personal, social, and occupational functioning with physical or uncontrollable dependence on a:
• substance (e.g., drug, alcohol)
• behavior (e.g., gambling)

substance use disorder

Condition in which an individual is reliant on the use of substances for non-medical purposes; may lead to physical and psychological addiction

substance use disorder intervention

Intervention may include:
• cognitive behavioral therapy
• 12-step programs
• recovery programs
• pharmacotherapy

eating disorders

Serious emotional and physical disorders including extreme preoccupation with food, body image, and weight

eating disorders intervention

Intervention approaches may include:
• cognitive behavioral therapy
• group therapy
• family therapy

anorexia nervosa

Eating disorder characterized by:
• fear of gaining weight
• inability to maintain adequate nutritional intake due to distorted perception of body weight and body image

bulimia nervosa

Eating disorder characterized by:
• fear of gaining weight
• binge eating followed by purging (e.g., vomiting, or use of laxatives/diuretics) secondary to excessive concern about body weight

binge eating disorder

Eating disorder characterized by:
• excessive intake and weight gain
• maladaptive coping mechanism to deal with stress, anxiety, or depression

hallucination

Perceived sensory experiences (visual, auditory, tactile, gustatory, and somatic) without an actual stimulus, may be associated with psychosis, schizophrenia, or brain injury

delusion

False and unfounded belief contrary to the reality of the situation or environment

May be a symptom in schizophrenia

perseveration

Thinking or talking about the same thing repeatedly without ability to independently redirect

May occur following brain injury or cognitive dysfunction

obsession

Persistent, unwanted, and intrusive thoughts that create feelings of urgency and anxiety

Psychological state commonly seen in obsessive compulsive disorder

compulsion

Repetitive behaviors performed in response to obsessive thoughts used to minimize anxiety

Psychological state commonly seen in obsessive compulsive disorder

depersonalization

DSM-5 classification of dissociative disorders characterized by:
• retreating into a dreamy world with unrealistic feelings
• impaired self-awareness
• disconnecting from the physical being

splitting

Strain between therapist-client relationship and/or interprofessional team members where the staff response to manipulative behaviors of a client include:
• blurring professional boundaries
• creating team division

affective instability

Emotional state commonly seen in borderline personality disorder, characterized by rapid mood swings usually between negative emotions such as:
• anger
• anxiety
• depression

self-mutilation

Maladaptive coping mechanism to express feelings, includes intentional act of self-injurious behaviors of:
• burning
• cutting
• pricking
• scratching

restlessness

A neurobehavioral impairment that results in a decreased ability to remain still or relax

irritability

A neurobehavioral impairment that results in feelings of agitation or annoyance

emotional lability

A neurobehavioral impairment characterized by a rapid change in mood that is often disproportionate to the circumstance or the expected emotion

frustration

An emotional response that results in resistance to participate in an activity and provokes the desire to stop engagement in an activity

confabulation

A memory impairment that causes an individual to share false details of situations, memories of past events, or personal information without the intention to deceive

apathy

Lack of interest in purposeful activities or events in the environment

Associated with impairment in the prefrontal cortex

cognitive flexibility

A component of executive functioning that involves the ability to think about various ideas simultaneously and switch between different ideas

neurobehavior

Processing of sensory stimuli that results in a behavioral response

sensory processing

Ability of the central nervous system to interpret and regulate responses to sensory input

sensory integration

Ability to process, interpret, and integrate sensory information to produce a behavioral or motor response

sensory modulation problem

Inability of the central nervous system to regulate responses to sensory input from common daily stimuli, resulting in:
• hyper-responsiveness
• hypo-responsiveness
• sensory-seeking

hypo-responsiveness

A form of sensory modulation in which the central nervous system is slow to register or process sensory input