Pediatric Examination Flashcards

1
Q

What are the different approaches to evaluation and assessment?

A
  1. Bottom-Up: Traditional deficit-driven model - what we learned in MSA
  2. Top-Down: Outcome-driven model - I need to reach into my cubbord to get dishes to cook for myself and need to do that to live alone work on reach, may realize its not the issue (stool, put cubbord down some ex)
  3. Routine Based: Ex: watching during bath time – note deficits in strength, ROM, etc
  4. Judgment Based: Home health to a tea
  5. Ecologic/Naturalistic: One person is hands on with the child, and others are making observations, etc while that’s occurring; Not all are hands on
  6. Arena Assessment
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2
Q

distinguishes between individuals with and without a particular characteristic; percentile rank, standard, or age equivalent scores

A

Discriminative

- i.e., PDMS-2

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3
Q

classifies people into categories based on what is expected will be their future status

A

Predictive

- provides estimate of prognosis or future status; i.e., TIMP

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4
Q

measure the magnitude of change over time or after treatment; Outcome is specific to individual child

A

evaluative

-i.e., GMFM

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5
Q

What are the screening tests?

A
  1. Dever II
  2. Ages and stages
  3. Checklists
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6
Q

What is the gold standard screener?

A

ages and stages

  • 4-60 months
  • screens overall development in communication, gross motor, fine motor, problem solving, and personal-social
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7
Q

What are the comprehensive developmental scales?

A
  1. Bayley Scales of Infant Development II
  2. Battle Developmental inventory
    - performed by an interdisciplinary team, each assesses according to their area of expertise
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8
Q
  • Target Population: 1-42 months
  • Purpose: Identify developmental delay and monitor a child’s developmental progress
  • Characteristics: 3 areas tested - mental (language, perceptual), motor (gross, fine), behavior; Individually administered test using standardized materials, instructions, and criteria with items arranged according to degree of difficulty with pass/fail scoring system; Norm-referenced; 25-60 minutes to administer
A

Bayley Scales of infant development II

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9
Q
  • Target Population: Birth to 8 years
  • Characteristics: Areas tested: personal-social, adaptive, motor, communication, cognition; Administered through structured format, interviews with caregivers, and/or naturalistic observations; Norm-referenced; <1 hr for children <3 and >5 and 1.5-2 hours for children 3-5 to administer; Often used in EI programs
A

Battle developmental inventory

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10
Q

What are the tests of motor function?

A
  1. AIMS
  2. GMFM
  3. PDMS-2
  4. BOT-2
  5. TIMP
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11
Q
  • Target Population: Birth to independent walking (0-18 mo.)
  • Purpose: Identification of infants who are delayed in motor development; Evaluation of motor development over time
  • Characteristics: 58 items in prone, supine, sit and stand measuring posture, WB, and antigravity movement; Not appropriate to measure change over time in infants with atypical patterns of movement; Norm-referenced; Observe spontaneous movement (little handling); 20-30 minutes to administer; Well Baby Clinics
A

Alberta Infant Motor Scales (AIMS)

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12
Q
  • Target Population: Validated for children with CP; Also valid for children with Down Syndrome
    Children whose motor skills are < 5yrs.; Validated for children 5 mo. – 16 years; 2-5 years best
  • Measures: Change in gross motor function over time in the following categories: lying and rolling; sitting; crawling and kneeling; standing; walking, running, jumping; All items could be achieved by normally developing 5y/o
  • Characteristics: 88 or 66, 4 ordinal scale instrument; Administration time: 45-60 min., shorter for 66 item
A

Gross Motor Function Measure (GMFM)

  • Scored on 4 point scale: 0-cannot do, 1-initiates (<10% of the task), 2-partially completes (10-<100% task), 3-task completion
  • criterion referenced
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13
Q
  • Target Population: Birth to 6 years
  • Purpose: Determine the level of motor skill acquisition
  • Characteristics: 6 subtests (4 gross motor 2 fine motor): reflexes, stationary, locomotion, object manipulation, grasping, visual-motor integration; 45-60 minutes to administer; Norm-referenced; 20-30 minutes to administer GM portion only
A

Peabody Developmental Motor Scales-2 (PDMS-2)

  • Strengths:
    1. Distinguishes between gross and fine motor skills
    2. Test broken down into different areas to identify strengths and needs
    3. Scoring system takes into consideration emerging skills
  • Weaknesses:
    1. Test does not include quality of movement
    2. Some test materials are not easily acquired
    3. Motor activities program book may encourage teaching test items
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14
Q
  • Target Population: 4-21 y/o
  • Purpose: Determine the level of motor skill acquisition
  • Characteristics : 4 motor composites with 8 subtests: fine motor precision, fine motor integration, manual dexterity, upper-limb coordination, bilateral coordination, balance, running speed and agility, strength; 40-60 minutes to administer; Norm referenced (sex specific and combined)
A

Bruininks Oseretsky Test of Motor Proficiency (BOT-2)

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15
Q
  • Target Population: Infants 32 weeks gestation to 3.5 months
  • Purpose: Asses postural control and alignment needed for age-appropriate functional activities necessary for movement in early infancy
  • Characteristics: 25-40 minutes
    Observed (27 items) and Elicited (25 items); Observed (present or absent) Elicited (5 or 6 pt. scale); Criterion Referenced and Predictive
A

Test of Infant Motor Performance (TIMP)

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16
Q

What are the assessments of functional capabilities?

A
  1. PEDI
  2. FIM/WeeFIM
  3. SFA
  4. COPM
  5. GMFCS
17
Q
  • Target Population: 6 mo to 7.5 years developmental level for norm- referenced; can be used at any age as criterion referenced
  • Assesses: Self-Help, Mobility, and Communication: Measures
    functional capabilities and performance, monitor progress, and evaluate program outcomes; Shift of Focus from: “Can the child do it?” to “Can the child do it in their natural environment?”
A

PEDI

  • 197 fxn’l skill items
  • done via parent report, structured interview, professional observation
  • toilet transfers, car transfers, indoor locomotion distance/ speed, stairs, etc.
18
Q
  • Target Population: Non-disabled children 6mo- 8 yr; Children with developmental disabilities 6mo – 12 yr; Individuals with mental ages <7 yrs
  • Measures: Determines severity of a child’s disability, measurement of caregiver assist, outcomes of rehab; Functional strengths and limitations across: health, development, educational and community settings
  • Characteristics: 18 item, 7 ordinal scale instrument; Administration time=45-60 minutes (10-20 min if parent interview); Research shows most useful for age 2-5 yrs; Criterion referenced
A

Wee-Fim

  • self-care, sphincter control, mobility, locomotion, communication, social cognition
  • certification is required to conduct this test
19
Q
  • Target population: Children with disabilities K-6
  • Criterion referenced
  • Areas Tested: Participation, Task supports, Activity performance, Physical tasks, Cognitive/behavioral Tasks
  • Purpose: Assess function and guide program planning for students with disabilities within the educational environment
A

School function assessment (SFA)

  • Playground/ recess, travel, setup/ cleanup, hygiene, eating/ drinking, clothing management, written work, up/down stairs, computer/ equipment use, written work
  • Strengths: Requires input from a variety of people; Judgment is based on typical not optimal performance
  • Weaknesses: Time consuming; Does not determine cause of limitations
20
Q
  • Assesses: Self-care, Productivity, Leisure
  • Semi-structured interview to identify child/family priorities (tasks); Importance of each priority rated 1-10 (1=not important, 10=very important); 5 highest ratings identified for intervention; Child/family rates each problem separately on current performance and satisfaction with current performance 1-10 (1=not able to do it, not satisfied at all 10=able to do well, completely satisfied)
A

Canadian Occupational Therapy Performance Measure (COPM)

21
Q

Developmental sequence of geometric forms; To be copied with paper and pencil; Assesses ability to coordinate visual and motor skills; Ages 3-7

A

Visual Motor Integration (VMI)

22
Q

Assesses:

  • Visual Discrimination- Point to a form that matches the one above (out of 5)
  • Visual Memory: Memorize a form and find it on the next page
  • Visual Spatial-Relationships: Find the form that is different
A

Motor-free visual perceptual skills test

23
Q

Each goal is scaled to measure 5 levels of attainment; Goal outcome; 2 outcomes which are less favorable; 2 outcomes which are more favorable; -2, -1, 0, +1, +2

A

Goal Attainment Scaling

24
Q

A method of test administration that dictates specific procedures for item presentation. Any deviation from the standardized method will skew norm-referenced results

A

Standardized

- test was validated with specific measures so you must follow those exactly