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Mental Health Eval > Week 4 Lecture > Flashcards

Week 4 Lecture Flashcards

1
Q

Name 2 assumptions of the Allen Cognitive Disabilities Model.

A
  1. OT and other disciplines cannot really change a client’s cognitive level (it’s pretty much static.)
  2. However, we can change the environment and adapt activities to meet pts. cognitive level (just right challenge). In order for client to be successful change their environment.
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2
Q

What is the Allen Cognitive Disabilities Model based on?

A
  • Based on Piaget (theory of cognitive development) and Soviet psychology research.
  • Based on task analysis and use of everyday tasks and crafts
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3
Q
  • People functioning at this level are conscious and reflexes working but their level of awareness is markedly impaired.
  • Characterized by automatic motor responses and changes in the autonomic nervous system.
  • Conscious response to the external environment is minimal.
  • Actions are spontaneous
  • Most sensory cues are ignored.
  • Introspection does not occur.
A

Allen Cognitive Disabilities Model - Level 1 - Automatic Actions

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4
Q

What is Level 1 of the Allen Cognitive Disabilities Model titled?

A

Automatic Actions

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5
Q
  • Characterized by movement that is associated with comfort.
  • There is some awareness of large objects in the environment.
  • The individual may assist the caregiver with simple tasks.
A

Allen Cognitive Disabilities Model - Level 2 - Postural Actions

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6
Q

What is Level 2 of the Allen Cognitive Disabilities Model titled?

A

Postural Actions

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7
Q
  • Begins with the use of the hands to manipulate objects.
  • Motor actions are slow.
  • May be disoriented.
  • Focused on tactile cues and manual actions.
  • Attention is restricted to what can be touched and manipulated.
  • May be able to perform a limited number of tasks with long-term repetitive training.
  • Fail to connect their manual actions to a purposeful goal.
A

Allen Cognitive Disabilities Model - Level 3 - Manual Actions

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8
Q

What is Level 3 of the Allen Cognitive Disabilities Model titled?

A

Manual Actions

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9
Q
  • Characterized by the ability to carry simple tasks through to completion.
  • Relies heavily on visual cues.
  • Imitate a demonstrated direction one step at a time.
  • May be able to perform established routines but cannot cope with unexpected events.
  • There is very little initiative to find objects that cannot be seen.
  • Needs visual samples.
  • Memories of life histories may be disorganized.
  • New goals for the future are unrealistic.
A

Allen Cognitive Disabilities Model - Level 4 - Goal-Directed Actions

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10
Q

What is Level 4 of the Allen Cognitive Disabilities Model titled?

A

Goal-Directed Actions

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11
Q
  • Perceives all 5 senses
  • A series of directions can be imitated, written directions can be followed to a limited extent.
  • Characterized by overt trial and error problem solving.
  • Inductive reasoning, exploratory behavior may uncover new effects that are evaluated, desirable effects are continued, undesirable effects are inhibited.
  • Fail to anticipate errors, they fail to think before they act.
  • New learning occurs.
  • This may be the usual level of functioning for 20% of the population.
A

Allen Cognitive Disabilities Model - Level 5 - Exploratory Actions

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12
Q

What is Level 5 of the Allen Cognitive Disabilities Model titled?

A

Exploratory Actions

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13
Q
  • characterized by the absence of disability.

- the person can think of hypothetical situations and do mental trial and error problem solving.

A

Allen Cognitive Disabilities Model - Level 6 - Planned Actions

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14
Q

What is Level 6 of the Allen Cognitive Disabilities Model titled?

A

Planned Actions

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15
Q

further define the levels bc they found that the 6 levels did not offer sufficient discrimination. allow the therapist to more precisely locate the patient’s function level.

A

Allen Cognitive Disabilities Model - Modes of Performance

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16
Q

Name the 6 levels of Allen Cognitive Disabilities Model.

A
  1. Automatic Actions
  2. Postural Actions
  3. Manual Actions
  4. Goal-Directed Actions
  5. Exploratory Actions
  6. Planned Actions
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17
Q

an aggregate; bits of info of the whole level

A

.0

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18
Q

distinctive characteristics of time and place; easily overwhelmed.

A

.2

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19
Q

consolidate the level; repeated use of the information. the classic description of the level.

A

.4

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20
Q

open to the next level; thought orientation shifts up.

A

.6

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21
Q

composite adds info from the next level but cannot understand how the pieces fit together; inflexible.

A

.8

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22
Q

Describe the Allen Cognitive Level Screening.

A
  • 20 mins to administer.
  • leather lacing task
  • therapist demonstrates 3 different leather lacing stitches
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23
Q

Name the 4 different leather lacing stitches of the Allen Cognitive Level Screening.

A
  • running stitch
  • whipstitch
  • whipstitch with 2 twist errors
  • single cordovan stitch
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24
Q

Describe the Allen Diagnostic Module (ADM).

A
  • uses standardized craft activities to further evaluate clients at Allen Cognitive Levels 3.6 through 4.6.
  • guidance on how to administer each craft and scoring guidelines.
  • rating sheets and observations are recorded.
  • can take 15 mins to several hours to administer depending on the complexity of the craft project.
25
Q

Describe the Routine Task Inventory Expanded (RTI-E).

A

performance rating scale based on observation of task performance, self-report and/or caregiver’s report.

26
Q

Name the 4 areas evaluated in the Routine Task Inventory Explanded (RTI-E).

A
  • physical scale (ADLs)
  • community scale (IADLs)
  • communication scale
  • work readiness scale
27
Q

Allen Cognitive Disabilities Model - Caregiver Guide

A

tells caregivers how much assistance they should be giving based on the cognitive level of the pt.

28
Q

Name the 3 different steps within the Allen Cognitive Disabilities Model evaluation.

A
  1. leather lacing
  2. diagnostic module - crafts
  3. routine task inventory expanded
    (all 3 of these are used to get one result)
29
Q
  • designed to examine executive functions in the context of performing a task.
  • not just trying to measure level of disability but also trying to pinpoint what level of assistance/support a person needs to function effectively in the home and community.
A

Executive Function Performance Test (EFPT)

30
Q

Name the 3 purposes of the Executive Function Performance Test (EFPT).

A
  1. to determine which executive functions are impaired.
  2. to determine an individual’s capacity for independent functioning.
  3. to determine the amount of assistance necessary for task completion.
31
Q

executive functions

A

a group of cognitive processes which mediate goal-directed activity; involved in task execution.

32
Q

Name a unique feature of the Executive Function Performance Test (EFPT).

A

Unlike other tests of IADL, the EFPT does not examine what individuals cannot do. Rather, it identifies what they can do and how much assistance is needed for them to carry out a task.

33
Q

Scoring of the Executive Function Performance Test (EFPT) considers which 6 levels.

A
  1. no cues required
  2. indirect verbal guidance
  3. gestural guidance
  4. direct verbal assistance
  5. physical assistance
  6. do for the participant
34
Q

Name the 4 tasks of the Executive Function Performance Test (EFPT).

A
  • simple cooking
  • telephone use
  • medication management
  • bill payment
35
Q

Describe the cueing guidelines of the Executive Function Performance Test (EFPT).

A
  • unless the participant is in danger, do not intervene until the participant shows he/she is not processing to move to the next step.
  • if the person has difficulty with any aspect of any of the tasks, you must wait to give them time to process before giving the participant a cue, don’t wait to allow them to make an error, the cue avoids the error.
  • give 2 cues of each kind before progressing to the next cueing level.
36
Q

30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment. commonly used in medicine and allied health to screen for dementia. also used to estimate the severity and progression of cognitive impairment and to follow the course of cognitive changes in an individual over time.

A

Mini-Mental Status Exam/Folstein Test (MMSE)

37
Q

one-page 30-point test administered in approximately 10 mins. brief screening tool good for detecting mild cognitive impairment and mild dementia. addresses several cognitive domains.

A

Montreal Cognitive Assessment (MoCA)

38
Q

Is training and certification required for administering the MoCA?

A

yes - essential to insure quality and reliability of test results for clinicians and researchers who will use them to interpret disease progression or treatment response.

39
Q
  • designed as a trait measure of sensory processing patterns and effects on functional performance.
  • an individual answers questions regarding how he or she generally responds to sensations.
  • evaluate the possible contributions of sensory processing to the client’s daily performance patterns and identify and develop client awareness and strategies to optimize the desired sensory environment.
A

Adolescent/Adult Sensory Profile

40
Q

-may be described an insensitive or disconnected. do not pick up on subtle environmental cues, and require clear and urgent directives. most events of daily life are not intense enough to stimulate deep processing for these people, and their passive-reactive self-regulatory stance makes them somewhat oblivious to ongoing activity that is not explicitly engaging them.

A

low registration (high threshold, passive)

41
Q

sensory input bothers them, they try to limit the input they must deal with. unfamiliar input is distressing and difficult to understand or organize so they regularize their experience through rituals, rules and habits. these provide a high rate of familiar input while limiting exposure to new input. the threatening nature of change can make sensory avoiders rigid, uncooperative and withdrawn.

A

sensory avoiding (low threshold, active)

42
Q

need and enjoy high levels of sensory stimulation and they generate extra input for themselves. they are active, engaging and excitable. they place a high premium on novelty which can be disruptive in cases where they do not persist in beneficial activities, abandoning them for something new once the novelty of the initial activity has worn off.

A

sensory seeking (high threshold, active)

43
Q

detect more input and notice more sensory events than others, and comment on them regularly rather than trying to ward them off. they are distractible and can be complainers. they are helped by participating in structured experiences so they are not overwhelmed by unstructured and disruptive input.

A

sensory sensitivity (low threshold, passive)

44
Q
  • evaluate the possible contributions of sensory processing to the client’s daily performance patterns.
  • obtain info about everyday sensory experiences and the impact on behavior in different settings.
  • used for identifying and developing client awareness and strategies to optimize the desired sensory environment.
  • 60 items with 15 items for each quadrant.
  • generates and individualized profile of sensory processing across 4 quadrants: low registration, sensation seeking, sensory sensitivity, and sensation avoiding.
A

adolescent/adult sensory profile

45
Q

name the 6 sensory processing categories in the adolescent/adult sensory profile.

A
  • taste/smell processing
  • movement processing
  • visual processing
  • touch processing
  • activity level
  • auditory processing
46
Q
  • passive response to a low threshold
  • easily respond to sensory stimuli
  • notice things other people don’t notice
  • highly aware of their surroundings
  • distractible
A

sensory sensitivity

47
Q
  • active counteracting a low threshold
  • intentional withdrawal or blocking of sensation
  • use of rituals and routines
  • overwhelmed by sensory rich environments
  • good at creating structured and supportive environments.
A

sensation avoiding

48
Q
  • passive response with a high threshold
  • miss available sensory input
  • spacey, clumsy
  • under-responsive or slow to respond
  • can focus in distracting environments
  • flexible, comfortable in wide range of environments
A

low registration

49
Q
  • behavioral response to counteract a high threshold
  • enjoys sensory rich environments
  • creates sensation
  • easily bored
  • trouble tolerating low stimulus environments
A

sensation seeking

50
Q

Describe the typical sensory profile of someone with schizophrenia.

A
  • low scores on sensation seeking.

- high scores on sensation avoiding and low registration.

51
Q

Describe the typical sensory profile of someone with bipolar disorder.

A
  • avg scores on low registration.

- high scores on sensation avoiding and low scores on sensation seeking.

52
Q

Describe the typical sensory profile of someone with autism/aspergers.

A
  • more likely to exhibit behaviors in sensation seeking, low registration and sensory sensitivity.
  • especially sensitive to auditory and oral motor input.
53
Q

provide an environment that nurtures the body and invites the person to engage in activities that help them to feel good and to focus on strengths and interests and personal self-care.

A

sensory rooms

54
Q

Name 7 tasks of the case manager.

A
  • comprehensive awareness of the client’s needs.
  • link clients to the services they need.
  • monitor the services being provided.
  • assist the client with daily problems and tasks.
  • crisis intervention
  • advocacy work for the client
  • counseling the client
55
Q

Name Abrom’s 5 D’s.

A
  • destructiveness - to self or others.
  • disorganization - problems with reality testing or life management.
  • deviancy - breaking rules, acting out.
  • dysphoria - withdrawal of interest.
  • dependency - interferes with independent functioning.
56
Q

problem-focused treatment

A

identify pts. problems and design therapy to fix those problems.

57
Q

strength-based treatment

A

identify pts. strengths and build on their strengths

58
Q

Name 2 ways to prioritize pts. problems

A
  • Abrom’s 5 D’s

- Maslow’s Hierarchy of Needs

Mental Health Eval (16 decks)

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