ped exam 3 defintions

forward chaining

the child learns a multistep task starting with the first step while the therapist or caregiver completes the remaining steps; good for those who struggle with generalizing and sequencing activities

backward chaining

teaches a task by having the child complete the final step first, with the therapist completing earlier steps; this ensures the child always ends with task completion and success; good for those with low frustration tolerance or poor self esteem

self determination

the ability to act as the primary causal agent in one’s life through choice-making, goal setting, problem solving, and self advocacy; it develops through supported opportunities not independence alone

ADLs (activities of daily living) for children

bathing, showering, toileting (and related hygiene) , dressing, swallowing/eating & feeding, functional mobility, personal device care, personal hygiene & grooming, and sexual activity

client factors and performance skills

child disability or health status, body structures and functions, developmental ability

perforrmance environments and contexts

personal, temporal, and cultural contexts, social & physical environments, demands of activity

behaviorism examples

backward chaining & forward chaining

anticipatory problem solving

plan ahead & practice problem solving, modeling or social stories; planning or adapting tasks or environments in advance to prevent challenges and support participation

conditions in children who have trouble with tolieting

spinal cord injury, spina bifida, full or partial paralysis

common pediatric sleep problems

insomnia, sleep-wake cycle disruption, sleep apnea, hypersomina, parasomnias, pain or movement disorders during sleep

insomnia

resistance to bedtime o trouble falling/staying asleep

sleep-wake cycle disruption

irregular amount of time sleeping

sleep apnea

breathing disorders

hypersomnia

daytime sleepiness

parasomnias

nightmares or ununsual sleep experiences

common pediatric conditions that have sleep problems

ADHD, ASD, allergies. asthma, CP, diabetes, epilepsy, obesity, sickle cell disease, brain injury, anxiety, hx or trauma

daytime symptoms of sleep problems

irritability, headaches in the morning, sleepiness & tiredness

instrumental activities of daily living (IADLs)

care of others, care of pets, child rearingg, communication management, driving & community mobility, financial management, health management & maintenance, home establishmentt & management, meal prep & clean up, religious & spiritual activites, expression, safety & emergency maintenance and shopping

learned helplessness

occurs when a child stops attempting tasks due to repeated experiences of failure over-assistance, leading to reduced initiation and motivation; becomes more dependent on their parents or caregivers

coaching approach

emphasizes partnering with caregivers or teachers to support tthe child’s participation through guided reflection, modeling and problem solving rather than direct hands- on therapy

direct service

indivdiual or group intervention in a classroom or therapy space

consultative service

collaboration with teachers involves strategy development ad environmental supports

collaborative service

OT works alongside teachers during instruction; is actually present in the teaching process; integratd into classroom activities

monitoring

periodic check ins, no regular direct interventions

least restrictive environment (LRE)

students educated with typically developed peers to the maximum extent appropriate; removal from general education only when necessary, OT services should be delivered within natural school routines whenever possible; promotes inclusion, participation and access to the general education curriculum

free and appropriate public education (FAPE)

education must be free (no cost to families), appropriate (meets individual educational needs); OT serices must directly support educational benefit and are delivered based IEP

Individualized Education Program (IEP

a legally required written plan developed for students who qualify for special educatio services

components of an IEP

present levels of academic and function performance, annual education goals, special education services, related services, accomodations & modifications, methods for measuring student progress

related services

OT, PT, SPL, counseling services, transporation and assistive technology services; provided when they are necessary for the student to access and participate in their educational program

section 504 of the rehabilitation act

civil rights law preventingg discrimination, applies to student who do not qualify under IDEA, provides accommdations, not special education, OT role is typically consultative and limited

Individuals with Disabilites Education Act (IDEA)

federal law ensurin students with disabilites receive special education and related services, focuses on educational access and participation, OT qualifies as related service, not special education, requires services to be delivered in the LRE; applies primarily to the IDEA part B and Part C

aspiration

occurs when food, liquid, saliva, or gastric contents enter the airway below the level of the vocal folds, potientally reaching the lungs

clinical signs of aspirations

coughing or choking during or after feeding, wet or gurgly vocal quality, changes in breathing, increased respiratory infections

OT relevance of aspiration

impacts safety of oral feeding, requires colloboration with SLP and medcial team, influences feeding positioning, pacing, and texture recomendations

cleft lip and palate

a cogential craniofacial anomaly in which the lip, palate, or both do not fully form

clinical impact and OT relevance

difficulty creating suction, nasal regurgitation, increased risk for aspiration, feeding inefficiency and fatigue; support feeding with specialized bottles, educate caregviers on positioning and pacing, promote safe feeding and weight gain

dysphagia

a disorder of swallowing function that may occur in one or more phases of the swallow

modified food and liquid consistencies

alterations to texture or thickness of food/liquid to improve swallow safety; part of compoensatory feeding strategies, ensures participation while reducing aspiration risk

examples of modified food and liquid consistencies

pureed foods, minced/soft foods and thickened liquids

nasogastric (NG) tube

a tube inserted through the nose the stomach for temporary enteral feeding; often short term and OT suppports sensory tolerance and feeding routines