Health literacy and pediatric conditions

Personal health literacy

the degree to which individuals have the ability to find, understand, and use information, and services to inform health-related decisions and actions for themselves and others

Organizational health literacy

the degree to which organizations equitably enable individuals to find, understand, and use info and services to inform health related decisions and actions for themselves and others

Acute care OT role

-conduct eval and interventions due to short hospital stays

-support occupational performance within the limits created by the medical event

-review findings from the diagnostic tests

-be aware of precautions associated with the child's status, lab values, and vital signs

-be aware of medications and common side effects

-report changes in status or behavior to the doctor or nurse

-consider the child's behavioral and mental health and the family's stress level during this time

-intervention often conducted in the child's hospital room, and coordinated around medical procedures

-practitioners work as part of a large medical team in a fast-paced environment

NICU OT role

-eval infant needs including feeding and positioning

-support caregivers in creating caregiver-infant bond

-support caregivers by identifying and helping them recognize the infants behavioral communication

-promote infant's development and regulation

-modify environments to reduce stimulation when necessary

-consider the parents mental health and significant stressors that are associated with having an infant in the NICU

-specialized environment requiring advanced training and mentoring

Inpatient rehab OT role

-focus on resuming the roles and occupations deemed important to the child and family's life

-address cognitive, neuromuscular and musculoskeletal complications that affect occupational performance

-target restoration of lost skills and function using biomechanical, sensorimotor, perceptual-cognitive, and rehab approaches

-fabricate or fit orthoses to maintain positions, increase ROM, or promote function

-recommend compensatory strategies

-teach client's adapted routines, assistive devices, and environmental modifications, and energy conservation, joint protection, and work simplification

-teach/train others to take over specific strategies or methods

-develop a transition or discharge plan, may include home visit

-consider child's behavioral and mental health

-depending on child's age, the team should be focusing on assisting the child's return to school or other previous activities

Inpatient psychiatric unit OT role

-assist children to "develop and maintain positive mental health, prevent mental ill health, and recover from mental health challenges in order to live full and productive lives"

-promote self efficacy, self determination, responsibility, feelings of connectedness, and socialization

-engage in group intervention to foster skills such as coping, frustration tolerance, problem solving, and goal setting

-many units have strict protocols in place regarding client access to certain materials for safety

-clients may not be allowed off the unit or outside to play

Palliative care OT role

-facilitate quality of life

-engage clients and their caregiver in important occupations that support the families adaption and assist them in finding peace and preparing for death

-modify important occupations to allow their completion for someone in pain, reduced energy, emotional distress, or physical limitations from illness

-provided in home or a facility

-necessary support caregivers will need for their roles and mental health

Outpatient OT role

-eval and treat a variety of possible areas of occupation

-function as a consultant and coordinate care with other settings (ex. school)

-provide recommendations for, or assist in obtaining needed adaptive equipment, orthotics, or home modifications

-may have to manage multiple insurance plans and requirements for documentation

Home health OT role

-eval and intervene in a variety of occupational performance areas

-provide parent education

-advocate for needed community services & seek them out

-provide recommendations for environmental adaptations

-collab with the family regarding physical changes to the home

-consult with others in the client's care

-case management

-assist the family in obtaining respite care

-supervise volunteers or run special events

-consider the child's behavioral and mental health needs

-practitioner is a guest and is subject to certain social rules

-appointments should support family routines and not interfere with daily schedule

-workers occasionally encounter ethical dilemmas typically involving safety

Early intervention OT role

-services may be provided directly or as a consultative transdisciplinary model

-primary service provider team approach: each child & family have fill team support and availability to them

Schools OT role

-support education and learning for all children and youth including participation in academic, non-academic, and extramural activities

-provide direct support and consultation with teachers and school staff

-adapt classroom environments to support attention and behavior

-teach cognitive strategies

-promote social emotional competence and learning

-support children's social and emotional skill development to promote self regulation

Prevalence in frequency of condititons

proportion of a population who have a specific disorder during a given time, such as a year, regardless of when they were diagnoses

Incidence in frequency of conditions

the number of new cases diagnosed in a period

ADHD: Inattention chatacteristics

-easily distracted

-forgetful of daily activities

-poor organization

-appearing not to listen

ADHD: hyperactive-impulsive characteristics

-excessive talking

-fidgeting

-unable to take turns

Domains of occupation impacted with ADHD

-all domains could be impacted

-specifically, when occupations require executive functioning skills

Anxiety characteristics

-feeling nervous, restless, or tense

-having a sense of impending danger, panic, or doom

-having an increased HR

-breathing rapidly

-sweating

-trembling

-feeling weak/tired

-trouble concentrating or thinking about anything other than the present worry

-having trouble sleeping

-experiencing GI problems

-having difficulty controlling worry

-having the urge to avoid things that triggers

Domains of occupation impacted with anxiety

-ADL

-IADL

-Health management

-rest & sleep

-education

-work

Developmental coordination disorder (DCD)

neurodevelopmental disorder that impacts fine and gross motor coordination

Developmental coordination disorder characteristics

-motor difficulties

-balance

-coordination

-manual dexterity

-visual motor skills

Domains of occupation impacted with DCD

-any occupations that require motor coordination

-ADL (dressing & grooming)

-education (handwriting, typing, gym class)

-social participation

Depression characteristics

-feeling sad

-loss of interest or pleasure in activities once enjoyed

-changes in appetite (weight loss or gain)

-trouble sleeping or sleeping too much

-loss of energy or increased fatigue

-increase in purposeless physical activity (inability to sit still, pacing, handwringing)

-slowed movement or speech

-feelings of worthless or guilty

-difficulty thinking, concentrating, or making decisions

-thoughts of death or suicide

Domains of occupations impacted with depression

-ADL

-IADL

-health management

-rest & sleep

-education

-work

-play

-leisure

-social participation

Autism Spectrum disorder

a lifelong neurodevelopmental condition that predominantly impacts communication and behavior

ASD characteristics

-impaired social communication, interaction, and observable behaviors

-inconsistent eye contact

-unusual tone of voice

-difficulties initiating conversation

-echolalia (repetition of words or phrases heard previously)

-specific interests

-sensory sensitivity

Domains of occupation impacted by ASD

-play

-ADL (grooming, eating, bathing)

-IADL (cooking, health management)

-educational participation

Eating disorder characteristics

-anorexia nervosa

-bulimia nervosa

-avoidant restrictive food and intake disorder

-Pica (compulsive cravings and non-food items such as ice, paint, or clay)

-rumination disorder (repeatedly regurgitates undigested or partially digested food from stomach)

Domains of occupation impacted with eating disorders

-ADL

-health management

-rest & sleep

-education

Cerebral palsy

-motor problems that begin early in life, pre-natal (before birth) or peri-natal (immediately before or after birth)

-caused by an injury or insult to a still developing brain

Cerebral palsy characteristics

-spasticity (increased muscle stiffness/tightness)

-ataxia (uncoordinated movements, poor balance, FM difficulty)

-fluctuating muscle tone

-atypical posture

TBI

head injury or concussion that results from loss of consciousness for a minimum of 5 minutes or if there is an overnight stay of at least one night

TBI characteristics

-sleep disturbances

-somatic issues (headache/dizzy)

-emotional (moody, depressed)

-physical (balance, visual-ocular motor dysfunction)

-cognitive (memory, inattention, forgetfulness, executive function)

-associated with other conditions such as ADHD, seizures, behavior issues, mental disorders, learning, and hearing problems

Domains of occupation impacted with TBI

-ADL

-IADL

-health management

-play

-educational participation

-work

SCI characteristics

-either complete or incomplete

-impaired mobility

-secondary health conditions: neurogenic bladder and bowel dysfunction, pressure injuries, spasticity, pain, and autonomic dysfunction

Domains of occupation impacted by SCI

-all domains

-specifically ADL, IADL, work, & social participation

Down syndrome

congenital, genetic disorder that is referred to as an intellectual disability or trisomy (3 copies of a chromosome instead of the usual 2)

Down syndrome characteristics

-low muscle tone

-shorter stature

-facial differences

-congenital heart defects

-epilepsy

-expressive language difficulties

-hearing and vision difficulties

Domains of occupation impacted by down syndrome

-all major domains

-ADL

-educational participation

-social interaction

-work and vocational skills

Trauma or adverse childhood experiences

exposure of children to situations or events that surpass their ability to cope , trauma may occur once, as a series of events, or be continuous. abuse, violence, and addiction are common causes

Trauma or adverse childhood experiences characteristics

-extreme fear

-guilt

-helplessness

-shame

-disassociation from body and surroundings

-numb to physical and emotional feelings

-feels like floating outside of body

-no memories of event