Peds exam 3

What is most important for the therapist to consider when providing families with home programs?

Family routines and habits

The occupational therapist is making a home visit to a family in a rural community. The grandmother, mother, and mother’s sister are present during the session, with the grandmother bottle-feeding the 8-month-old infant when the therapist arrives. The occupational therapist is there to work with the family to develop the child’s motor skills. What initial action should the therapist take?

Engage the caregivers in conversation about the child and progress the child has made since the last therapy visit. 

Engage the caregivers in conversation about the child and progress the child has made since the last therapy visit. 

Children generalize skills more easily across contexts.

The parents of a child participating in early intervention programming would like the therapist to go to the daycare center and provide strategies to help him get along better with his peers. What is the correct response to this request?

Complying with the request would be appropriate as the daycare is a natural environment for the child. 

The use of telehealth within early intervention services results in which outcome(s)?

All of the above: Improved access to services and providers, family participation and empowerment, high levels of family satisfaction

What is the first step in providing child- and family-centered care?

Identifying the concerns of the child and family

To optimize a young child’s performance during an evaluation in the early intervention setting, which of the following strategies should be incorporated?

Family involvement 

An OTR is reevaluating a child who is participating in an early intervention program using a norm-referenced assessment. The assessment results indicate a drop in scores on the assessment over the course of the intervention period. What best explains this change in performance?

The child has developed slower than typical age peers.

Which statement reflects the current research on providing services in natural environments?

Children generalize skills more easily and sooner in natural settings. 

What key information is included in the IFSP (Individualized Family Service Plan)?

Goals, type of services, providers, service location, frequency, duration, and transition plan

What is Ayres’s definition of sensory integration?

Organization of sensation for use

Which statement reflects Ayres’s theory of central nervous system (CNS) organization?

Increased efficiency at the levels of the brainstem and thalamus enhances higher order functioning.

Charlie is a 10-year-old boy who will eat only mashed foods, does not like noises (e.g., he gets upset when the phone rings), and has difficulty sitting during meals. Charlie’s parents report that he does not like new clothes and cannot wear jeans. What type of sensory integrative problem does Charlie have?

Sensory modulation problems

Ramon is a 12-year-old boy who will not play on the swings or slides at school. He has difficulty climbing up the second-floor staircase at school and cannot sit in the bleachers. What type of problem does this depict?

Gravitational insecurity

Lisa is an 8-year-old girl who bumps into things frequently, bears down hard on her pencil at school, and stands very close to her friends. Lisa gets in trouble in school because she is always “talking herself through” her handwriting homework. Lisa likes to play rough at home and is frequently called a bully by her younger brother. What type of dysfunction does this scenario depict?

Proprioceptive problems

Complete the following sentence. All challenging behavior

Serves a purpose

Which of the following has been established by research to be motivators for challenging behavior?

Both Avoid and Obtain something

Positive behavior during transitions can be supported through

use of physical objects that represent the next activity. 

Antecedent strategies to reducing challenging behavior include which of the following:

Visual schedules

Which of the following is NOT an environmental modification strategy that supports positive behaviors for all students?

Providing a variety of loud stimulating activities

What is/are the purpose(s) of assistive technology?

All of the above:to provide tools that improve function and allow for greater participation in activities that are meaningful and life-sustaining, primarily to compensate, as opposed to remediate, defined by legislation

Which practice model/framework is not used to make decisions about assistive technology?

Neurodevelopmental Theoretical (NDT) approach

What does IDEA require of IEP teams in terms of AT

The need for assistive technology should be considered at each IEP.

What is included as AT?

All of the above: pictured schedule, pencil grip, electronic aid to daily living

Which of the following statements best represent the components addressed in a transition plan regarding assistive technology?

client’s needs, steps for AT use, roles, and training needs of team members

What is not a cause of cerebral palsy in children?

Socioeconomic status

Which approach has the most evidence to support its use in occupational therapy for children with cerebral palsy?

Motor control 

Which postural reflex realigns the head with the body?

Righting

Which of the following is considered a secondary impairment in children diagnosed with cerebral palsy?

Joint contracture

According to the medical record, Jenny had damage to her primary motor cortex during birth trauma. She has been receiving OT, PT, and SLP since birth. The therapist observed the following during the initial evaluation:

• Abnormal movements and atypical reflexes present (i.e., ATNR)

• Hypertonicity in her arms with spasticity greater in her right bicep, wrist flexors, and thumb adductor

• Hypertonicity in her legs with spasticity greater in hip adductors, hamstrings, and gastroc/soleus

• Delayed or absent righting and equilibrium responses

Why type of cerebral palsy does Jenny have?

Spastic