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NBCOT > Eval and intervention for perf in areas of occ (ch 15) > Flashcards

Eval and intervention for perf in areas of occ (ch 15) Flashcards

1
Q

Scales of functional performance: (total assist, max assist, etc… define each)

A
  • Total assistance: need for 100% assistance by one or more people to perform all physical activities and/or cognitive assistance to elicit a functional response to an external stimulation.
  • Max assist: need for 75% assistance by one person to perform gross motor actions in response to direction.
  • Mod assist: need for 50% assistance by one person to sustain/complete simple, repetitive activities safely.
  • Min assist: need for 25% assistance by one person to perform functional activities safely.
  • Standby assist: need for supervision when error and need for safety precautions are not always anticipated by patient
  • Independent.
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2
Q

Intervention should follow a __________ progression- considering the person’s areas of occupation first, rather than a __________ approach which focuses initially and/or solely on performance skills and client factors.

A

top down; bottom up

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3
Q

Assessment of Motor and Process Skills (AMPS) (focus, method, scoring, population)

A
  • focus: assessment of effectiveness, efficiency, or safety of a person’s ADL performance, including PADL, IADL, and some leisure.
  • method: interview to determine 3-5 relevant tasks that are sufficiently challenging; OT observe the quality of performance in 2-3 selected tasks; *training required to administer.
  • scoring: rater scores quality of motor skills and process abilities; entered into computer program; interpretation allows OT to determine person’s difficulty, abilities, quality of change after tx.
  • population: anyone with developmental age older than 2 years with any diagnosis that limits ADL function.
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4
Q

Barthel Index (focus, method, scoring, population)

A
  • focus: measurement of person’s independence in BADL and functional mobility before and after tx, and the level of personal care needed by the person.
  • method: direct observation of task performance, interview, review of medical records.
  • scoring: based on performance and assistance needed; determines need for personal assistance with BADL- NOT ability to live indep at home.
  • population: adults and elders with phys dis and/or chronic illnesses. (Used typically in medical model settings)
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5
Q

Cognitive Performance Test (CPT) (focus, method, scoring, population)

A
  • focus: assessment of six functional ADL tasks that require cognitive processing skills (based on ACL): dressing, shopping, making toast, making phone call, washing, traveling.
  • method: person does each task.
  • scoring: based on ACL. scores range from 6-36 (higher is better). determines person’s capabilities and ability to live indep.
  • population: adults and elders with psych and/or cognitive dysfunction.
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6
Q

FIM System and WeeFIM System (focus, method, scoring, population)

A
  • focus: assessment of severity of a disability as determined by what the person actually does and the amount of assistance needed to complete each task. 6 areas: self care, sphincter management, mobility, locomotion, communication, social cognition.
  • method: observation of activity performance.
  • scoring: each item given 1-7; higher score better. (when WeeFIM used for less than 3 y/o scoring is 1-3).
  • population: adults with disabilities who are not functionally indep for the FIM; WeeFIM= 6 months-7 years.
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7
Q

Katz Index of ADL (focus, method, scoring, population)

A
  • focus: assessment of level of indep and type of assistance required in 6 ADLs: bathing, dressing, toileting, transferring, continence, feeding.
  • method: observation/interview
  • scoring: each item rated indep, some assistance req, or dependent. Then individual ratings converted into global letter score. Used to eval intervention outcomes and prognosis in a broad, general manner.
  • population: adults and elders with chronic illnesses
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8
Q

Kitchen Task Assessment (KTA) (focus, method, scoring, population)

A
  • focus: measurement of the judgment, planning, and organizational skills used to perform a simple cooking task.
  • method: observation of making cooked pudding from a mix.
  • scoring: 0-3 (indep to totally incapable) rated for initiation, organization, perf all steps, sequencing, judgement/safety, and completion of task. higher scores= increased impairment.
  • population: adults and elders with cognitive dysfunction.
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9
Q

Klein-Bell Activities of Daily Living Scale (K-B Scale) (focus, method, scoring, population)

A
  • focus: assessment of independent functioning in ADL in 6 areas: dressing, elimination, mobility, bathing/hygiene, eating, emergency phone communication.
  • method: observation.
  • scoring: 170 items rated as achieved or failed.
  • population: 6 months to elderly with any diagnosis
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10
Q

Kohlman Evaluation of Living Skills (KELS) (focus, method, scoring, population)

A
  • focus: determination of person’s knowledge and/or performance of 17 basic living skills needed to live indep in 5 areas: self-care, safety/health, money management, transportation/telephone, work/leisure.
  • method: task completion; standard questions.
  • scoring: score of indep or needs assistance is given according to criteria. Total score of 5.5 or less indicates presence of skills for indep living. Score of 6+ = doesn’t have skills for indep living.
  • population: adolescents/adults with diversity of diagnoses
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11
Q

Milwaukee Evaluation of Daily Living Skills (MEDLS) (focus, method, scoring, population)

A
  • focus: assessment of actual or simulated performance of basic living skills needed to function in the person’s expected enviro. (basic communication, personal care, medication management, personal device care, time awareness, eating, dressing, home/community safety, phone skills, transportation, clothing maintenance, use of money)
  • method: task completion
  • scoring: according to criteria in booklet.
  • population: adults with ADL deficits.
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12
Q

Routine Task Inventory (RTI) (focus, method, scoring, population)

A
  • focus: measurement of level of impairment in ADL according to ACL. (grooming, dressing, bathing, walking, feeding, toileting; housekeeping, food prep, spending money, taking meds, laundry, shopping, phone use, and traveling.)
  • method: 3 possible methods… observation, self-report, caregiver report.
  • scoring: rated based on ACL 1-6. Interpretation can be used to design intervention based on Allen model.
  • population: adults/elders with cognitive impairment
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13
Q

Scoreable Self-Care Evaluation (focus, method, scoring, population)

A
  • focus: measurement of functional performance and identification of difficulties in 18 basic living tasks in 4 main areas: personal care, housekeeping, work/leisure, financial management.
  • method: motivational questionnaire, task performance and observation.
  • scoring: based on inability to do task. Tx can be planned based on deficits.
  • population: adolescents, adults, and elders with psychiatric illnesses in acute hospital settings or living in community.
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14
Q

Test of Grocery Shopping Skills (TOGSS) (focus, method, scoring, population)

A
  • focus: determination of person’s ability to shop for groceries in grocery store using a grocery list.
  • method: eval completed in the person’s community grocery store; person given a list of 10 items in specific size and asked to locate and select at lowest price; OT observation.
  • scoring: based on accuracy, time, redundancy, strategies person uses to shop.
  • population: patients with cognitive impairments which interfere with community living skills.
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15
Q

Self-care abilities of SCI level C1-C3

A

Totally dependent in all-self care but can instruct others in preferences for care. Can chew and swallow.

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16
Q

Self-care abilities of SCI level C4

A

Totally dependent in all-self care but can instruct others in preferences for care. Can drink from a glass with a long straw.

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17
Q

Self-care abilities of SCI level C5

A

Feeding requires total assist for setup; then indep with AE. AE includes: mobile arm support or suspension sling; dorsal wrist splint with u-cuff; dycem; scoop dish/plate guard; angled utensils.
Dressing req min to mod A with UB dressing. Dependent in LB.
Bathing req mod to min A.
Grooming req setup A; with splint and u-cuff can be indep with toothbrush and combing hair; indep using electric shaver fit to hand.

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18
Q

Self-care abilities of SCI level C6

A

Feeding: indep using AE: u-cuff or tenodesis splint; rocker knife; scoop dish/plate guard; cup with large handle.
Dressing: indep in LB dressing in bed; req max A with socks/shoes. indep with UB dressing using button hook, zipper pull, and velcro.
Bathing: min A using hand-help shower, tub bench, and sliding board transfer.
Grooming: indep using tenodesis grasp/splint.

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19
Q

Self-care abilities of SCI level C7

A

Feeding: indep
Dressing: indep, may need button hook
Bathing: indep using hand-held shower, tub bench, and depression transfers.
Grooming: indep with tenodesis grasp or splint.

20
Q

Self-care abilities of SCI level C8-T1

A

Indep in all self-care; uses tub bench and hand-held shower. Performs depression transfer. Can transfer from wc to floor and back to chair with SBA.

21
Q

Self-care abilities of SCI level T6-L4

A

Indep in all self-care.

22
Q

what is PLISSIT and what does it stand for?

A

a model for guiding interventions regarding sexuality.
P=permission (create atmosphere which gives client permission to raise concerns about sexuality).
LI= limited information (provided by OT to ensure the person has accurate knowledge of sexual abilities/potential).
SS= specific suggestions (provided by OT to facilitate the person’s pursuit of satisfying sexual expression, alone or with partner).
IT= intensive therapy (indicated when person requires intervention for long-standing relationship problems and/or enduring sexual problems).

23
Q

Activity Index (focus, method, scoring, population)

A
  • focus: determination of the person’s perception of the meaning of leisure and the extent the person participates in leisure activities
  • method: questionnaire
  • scoring: person checks his level of interest and participation on each activity along 4-point scale (1- don’t do; 4- do at least 3x/week). Used to design interventions using meaningful activities.
  • population: age 65+, but can be used with others.
24
Q

Interest Checklist (focus, method, scoring, population)

A
  • focus: assessment of person’s level of interest in 80 leisure activities and hi perspective on how leisure interests/involvement has evolved over time.
  • method: checklist; interview regarding life history of leisure interests/pursuits
  • scoring: level of interest is rated strong, casual, or no interest. Scores do not indicate if person actually pursues the activity. Interview not rated; questions provide info about activity engagement. Data guides tx planning.
  • population: adolescents to elders
25
Q

Leisure Diagnostic Battery (LDB) (focus, method, scoring, population)

A
  • focus: measurement of leisure experience, and motivational and situational issues that influence leisure.
  • method: questionnaire
  • scoring: 1-3 rating indicating agreement with statements; info used to identify knowledge of leisure opportunities, enviro resources/barriers, and leisure characteristics that are motivating/interesting to the person.
  • population: adults. Adapted scales for children 9-14 with or without cognitive deficits.
26
Q

Leisure Satisfaction Questionnaire (focus, method, scoring, population)

A
  • focus: measurement of person’s perception that leisure pursuits are meeting personal needs in 6 categories: psychological, educational, social, relaxation, physiological, aesthetic.
  • method: questionnaire
  • scoring: 5-point scale, 1= almost never true; 5= almost always true. Info used to discuss needs satisfied by leisure and identify ways leisure can be modified to better meet individual needs.
  • population: adults and elders.
27
Q

Meaningfulness of Activity Scale (focus, method, scoring, population)

A
  • focus: measurement of the person’s level of enjoyment, motivational source, perception of competence, and participation in leisure.
  • method: questionnaire
  • scoring: Likert-scale used for 3 subscales: level of activity enjoyment, reason for doing activity, perception of activity competence. 3 subscale scores totaled to obtain an overall meaningfulness of activity score. Info used to plan tx.
  • population: adults and elders.
28
Q

Minnesota Leisure Time Physical Activity Questionnaire (focus, method, scoring, population)

A
  • focus: measurement of the energy expended by a person during engagement in leisure activities.
  • method: interview with list of 63 physical activities to determine which the person has done in past year.
  • scoring: for each activity performed, person gives level of participation each month. OT determines if activity is light, medium or heavy according to eval standards; total activity metabolic index and estimate of avg daily caloric expenditures are obtained. Info used to assess pre-morbid physical activity levels and examine their relationship with general health, disease, cardiovascular fitness, weight control. Tx plans made to increase physical activity.
  • population: adults.
29
Q

Play History (focus, method, scoring, population)

A
  • focus: assessment of child/adolescent’s developmental level and adequacy of his play enviro
  • method: semi-structured interview with parents/caregivers.
  • scoring: values assigned to the historical interview info according to standards; knowledge of play hx and play enviro can increase understanding of current play behaviors.
  • population: children and adolescents.
30
Q

Preschool Play Scale (focus, method, scoring, population)

A
  • focus: observation of a child’s play behavior within 4 play dimensions: space management, material management, imitation, participation.
  • method: observation for 15-30 minutes. Comparison of observations with expected play behaviors for specific age groups.
  • scoring: a “play age” score is derived by comparing observed behaviors to expected age-specific behaviors. OT should have knowledge of play theory and child development and experience in play behavior scoring.
  • population: children!
31
Q

EPIC Functional Evaluation System (focus, method, scoring, population)

A
  • focus: determination of the individual’s capacity for lifting, carrying, climbing, industrial pulling/pushing, balance while walking, motor coordination, standing, whole body ROM, and finger/hand dexterity.
  • method: simulated work in six modules.
  • scoring: formal training needed for evaluator.
  • population: adults.
32
Q

Jacob’s Prevocational Assessment (JPVA) (focus, method, scoring, population)

A
  • focus: assessment of work-related skills in 14 major areas (ex. cognitive-perceptual skills, motor skills, etc).
  • method: task completion
  • scoring: OT checks off areas that were observed to present difficulty to the person during task performance.
  • population: adolescents and preadolescents with learning disabilities.
33
Q

McCarron-Dial System (MDS) (focus, method, scoring, population)

A
  • focus: assessment of prevocational, vocational, and education abilities of people with disabilities and/or sociocultural disadvantages in 5 areas: cognitive, verbal, spatial; sensory; motor; emotional; coping, integrative, and adaptive behaviors.
  • method: pre-screening interview; work samples in each area; systematic observation.
  • scoring: according to quality and quantity of performance. (training required for all evaluators)
  • population: age 16+ with neurophysiological and/or neuropsychological impairment.
34
Q

Reading-Free Vocational Interest Inventory (focus, method, scoring, population)

A
  • focus: identification of vocational areas of interest (ex. animal care, automotive, housekeeping, clerical work.)
  • method: evaluator presents group of 3 pictures representing unskilled, semi-skilled, and skilled job tasks, and request that the person select the picture that represents the job task most preferred. 55 sets of pictures. Literacy not required.
  • scoring: selections converted into a numerical score that represents his level of interest in 11 interest areas.
  • population: adolescents and adults with learning or developmental disabilities
35
Q

Smith Physical Capacity Evaluation (focus, method, scoring, population)

A
  • focus: person’s performance on 154 work items.
  • method: real or simulated work task performance based on interests.
  • population: adults.
36
Q

Testing, Orientation, and Work Evaluation in Rehabilitation (TOWER) (focus, method, scoring, population)

A
  • focus: assessment of person’s ability to complete specific work samples (14 job training areas with 110 work samples. Mainly clerical, assembly, and manufacturing jobs.)
  • method: task completion.
  • scoring: performance compared to norms which were obtained for people with disabilities.
  • population: adults with physical and/or psychiatric disorders.
37
Q

Valpar Component Work Sample (VCWS) (focus, method, scoring, population)

A
  • focus: assessment of groups of skills that are required for specific employment tasks (ex. clerical) and basic functional capabilities (ex. EU function, dexterity, visual coordination).
  • method: 23 work sample tasks
  • scoring: quality of and time for task perf scored and converted to Methods-Time Measurement (an industrial standards with norm data). 17 worker behavior characteristics are rated on 5-point scale.
  • population: adults with or without disabilities. Adapted VCWS for visually impaired.
38
Q

Vocational Interest Inventory- Revised (VII-R) (focus, method, scoring, population)

A
  • focus: measurement of student interest in 8 employment areas for adolescents who are unclear about their vocational interests.
  • method: questionnaire.
  • scoring: occupation interests compared to established norms and list of interest-compatible college majors. Use for edu and vocational guidance.
  • Population: high school students.
39
Q

Vocational Interest, Temperament, and Aptitude System (VITAS) (focus, method, scoring, population)

A
  • focus: assessment of vocational interests, temperament, and aptitudes to assist with career guidance.
  • method: 22 work samples and vocational interest interview.
  • scoring: time and quality of perf scored based on observations and compared to norms.
  • population: age 14+
40
Q

Worker Role Interview (WRI) (focus, method, scoring, population)

A
  • focus: determination of psychosocial and environmental factors related to person’s past work experience, job setting, and ability to return to work.
  • method: structured interview.
  • scoring: responses scored 1-4 rating scale with 1= problems related to a return to work; 4= supports for a return to work.
  • population: adults involved in a work-hardening program.
41
Q

characteristics of work-hardening programs

A
  • interdisciplinary approach
  • real or simulated work activities are used
  • transition between acute care and return to work is provided
  • issues of productivity, safety, physical tolerance, and worker behaviors are addressed.
  • CARF accreditation is required
42
Q

characteristics of work conditioning programs

A
  • one discipline is provider of services.
  • real or simulated work activities are used
  • transition between acute care and return to work is provided
  • flexibility, strength, movement, and endurance are addressed.
43
Q

characteristics of ergonomic programs

A
  • prevention is main focus… to fit the workplace to the human body
  • types of programs: ergonomic survey; specific job site analysis; manager and employee training; educational seminars; exercise and stretching programs.
44
Q

characteristics of rehabilitation (sheltered) workshops, supported employment programs, and transitional employment programs (TEP)

A
  • multidisciplinary or interdisciplinary approach used.
  • real work activities used (participants are paid at piece-work rate in rehab workshops; paid at wage for TEP and supported employment programs)
  • participants considered employees with supports provided PRN. (job coaches; reasonable accommodations).
  • transition between program participation and competitive employment provided according to participant’s functional level.
  • rehab workshops and supported employment can be final/permanent employment goal.
  • accreditation is not requirement.
45
Q

discharge criteria from work programs

A
  • exhibits limited potential for improvement
  • declined services
  • non-compliant with program
  • met program goals
  • returned to work.
46
Q

intervention for rest and sleep

A
  • develop a daily pattern of relaxation activities and pre-sleep routines (meals consumed at least 2 hours before sleep)
  • establish health/restorative sleep-wake patterns (consistent bedtime)
  • remediate symptoms which hinder rest/sleep
  • modify the sleep enviro (soothing music, darkening shades, white nose, cool/dark/quiet enviro!!)
  • implement sleep restriction training (wake at same time daily, avoid naps, limit bedroom to sleep and sex, go to sleep when sleepy, get up if you can’t sleep).
  • employ CBT strategies to address thought processes which cause anxiety and hinder sleep (make a list of concerns to address when waking and leave them outside the room).

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