FINAL EXAM Study Guide

Question 1

occupation vs. activity vs. task

Answer 1

Occupation = activity that gives meaning and identity; ie: mother

Activity = thing done as part of an occupation; ie: cooking (as a mother)

Task = basic unit of an action/activity; ie: mixing batter (part of cooking)

Question 2

contrived activities

Answer 2

Made-up activities that my include some of the same skills required for an occupation. Simulates actual activity, helps get client ready. Ex: using doll to practice before tying own shoes.

Question 3

preparatory activities

Answer 3

activities which help the client ready for the purposeful activity; ROM, exercise, strengthening/stretching, etc.

Question 4

purposeful activity

Answer 4

activity meaningful to client and used during intervention that is goal-directed and typically involves an end product (ie: making a sandwich as part of making lunch).

Question 5

occupational performance

Answer 5

ability to carry out ADLs and one’s occupations that result from interaction among client, context, and activity.

Question 6

function

Answer 6

action for which a person is fit; the ability to perform.

Question 7

Laddering (what and when?)

Answer 7

Laddering= Advancing career based on experience rather than returning to classroom.

1971-AOTA adopted resolution for COTAs to advance (to OTR) this way (Career Mobility Program).
1973-First group endorsed to take exam in 1974.
1982-Laddering stopped.

Question 8

Important events of OTA history:

Answer 8

• *1958: First 3-month educ prog. (for OTAs in mental health)
  1958: Mildred Schwagmeyer joins AOTA; most knowledgeable on OTA
  1967: AOTA holds first COTA meeting at conference
• *1977: First COTA certification exam
  1991: COTAs participate on AOTA exec board

Question 9

Women behind the field of OTA

Answer 9

• Ruth A. Robinson - president of AOTA 1955-89; on Committee on OTA from inception; developed training curriculum for OTAs
• Marion W. Crampton - Chair of Mass. OTA education program
• Mildred Schwagmeyer - Asst. Director of Educ at AOTA; then dir. of technical ed.; Most knowledgable on subject of OTAs
• Ruth Brunyate Wiemer - Pres of AOTA, guided thru reorg period (OTRs feared unknown and new OTAs)

Question 10

Benjamin Rush

Answer 10

US Quaker, first physician to institute moral treatment practices after Tuke and Pinel’s work.

Question 11

Herbert Hall

Answer 11

Considered a founder of OT as profession. “WORK CURE”

Harvard Med School physician who adapted arts and crafts movement for medical purposes/treatment. Worked with invalid patients providing supervised crafts to improve health/financial independence. Occupation as therapy for people with nervous/mental disorders called “WORK CURE.” Early president of Natl. Society for Promotion of OT (1920-23).

Question 12

Thomas Kidner

Answer 12

TB treatment and vocational rehab.

Friend of George Barton; fellow architect/teacher. Established presence of OT in vocational rehab and TB treatment. Developed system of vocational rehab for disabled Canadian vets of WWI. Constructed institutions for disabled. Designed hospitals in CA and US for treatment of TB.

Question 13

Gary Kielhofner

Answer 13

Developed Model of Human Occupation (MOHO) as grad student at USC. Published 19 textbooks and 150 journal articles; developed model that would allow OTs at all levels to better address important client issues. Provided profession with evidence to support occupation-based practice and tools to evaluate clients. Remained visionary and scholar; promoted field of OT.

Question 14

List the Founders of the Profession of OT:

Answer 14

• Herbert Hall
• George Edward Barton
• Dr. William Rush Dunton Jr.
• Eleanor Clarke Slagle
• Susan Tracy
• Susan Cox Johnson
• Thomas Kidner

Question 15

Eleanor Clarke Slagle

Answer 15

MOTHER OF OT. “HABIT TRAINING”

Student of social work; studied curative occupations; 1912, asked by Adolf Meyer to direct OT dept at Henry Phipps Psychiatric Clinic in MD. There, developed “HABIT TRAINING.” Later in Chicago, started workshop for chronically unemployed and first professional school for OTs, Henry B. Favill School of Occupations. Her home was first hq of NSPOT. Served each office there, and AOTA now has an award named after her.

Question 16

John Ruskin and William Morris

Answer 16

Led Arts and Crafts Movement; opposed machine production; using hands leads to health; high standard of craftsmanship

Question 17

George Edward Barton

Answer 17

Architect under Morris. Boston Society of Arts and Crafts. Disabled himself. Consolation House.

Architect in London who studied under William Morris (arts and crafts movement). Went to Boston and founded Boston Society of Arts and Crafts. After personal experience with disabling conditions, he wanted to improve plight of convalescents. Opened Consolation House in 1914, using occupation (arts/crafts) for treatment.

Question 18

Adolf Meyer

Answer 18

POV became philosophical base of OT.

Swiss physician, came to US in 1892; became prof of psychiatry at Johns Hopkins Univ. Point of view became the philosophical base of OT. (Holistic, psycho-biological approach, meaningful activity promoting health)

Question 19

Susan Cox Johnson

Answer 19

Designer and arts/crafts teacher from Berkeley. Became director of occupations at Montefiore Home in NY; there showed occupations as uplifting, improving mental/physical health. Later taught at Columbia.

Question 20

Susan Tracy

Answer 20

First book on OT.

Nursing instructor involved with arts/crafts mvmt and use of occupations. Hired in 1905 at Adams Nervine Asylum in Mass., where she developed occupations program. Wrote first book on OT: “Studies in Invalid Occupations.”

Question 21

William Rush Dunton Jr.

Answer 21

Father of OT.

Psychiatrist. In 1891, became physician at Sheppard Asylum in MD; incorporated arts/crafts treatment in early 1910s. Known for his writings on OT and was president of NSPOT for 21 years.

Question 22

Philippe Pinel and William Tuke

Answer 22

Credited for Moral Treatment movement;
All ppl entitled to compassion; using purposeful activity.
Pinel=french physician
Tuke=english Quaker/merchant

Question 23

metaphysics

Answer 23

Concerned with nature of humankind and addresses how humans engage, organize their lives, and find meaning and interact with others. OT practitioners are committed to holistic and humanistic practice.

Question 24

epistemology

Answer 24

Related to the nature, origin, and limits of human knowledge and investigates such questions as “How do we know things?” and “How do we know that we know?” Provides base for understanding motivation, change and learning.

Question 25

axiology

Answer 25

Concerned with the study of values. This area explores questions of desirability and questions of ethics, such as "What are the standards and rules of right conduct?" For OTs, this includes client-centered care, quality of life, and ethics.

Question 26

reductionistic approach

Answer 26

US healthcare system generally operates this way; humankind reduced to separately functioning body parts. Professionals specialize and treat specific areas independently.

Question 27

holistic approach

Answer 27

Perspective traced to Adolf Meyer's philosophy of OT. Emphasizes organic and functional relationship between parts and the whole being. Interaction of biological, psychological, sociocultural, and spiritual elements. If one element is disrupted, it reflects throughout the whole.

Question 28

Humanism

Answer 28

The belief that the client should be treated as a person, not an object. Basis of OT. Goes further into concepts of altruism, equality, freedom, justice, dignity, truth and prudence (core values of OT).

Question 29

Core values and attitudes of OT:

Answer 29

Altruism, equality, freedom, justice, dignity, truth, and prudence.

Question 30

Emerging areas of practice

Answer 30

* Aging in place * Driver assessments/training programs * Community health and wellness * Needs of children and youth * Ergonomics consulting * Tech and assistive-device developing and consulting * Health and wellness * Vision

Question 31

CarFit Volunteer Positions

Answer 31

Technician: Assess drivers’ fit and educate on options. OTAs apply online and attend half-day training to be one. Instructor: Teach techs and event coordinators at training events. Ensure consistency of program.To be one, attend min of 3 events, have management and teaching skills, and knowledge of Carfit policies/procedures. Event Coordinator: Was previously technician; brings events to community. Host, secure and manage events, train techs, communicate with AAA, AARP, AOTA about events. Must attend a training to be one.

Question 32

NBCOT

Answer 32

National Board for Certification in Occupational Therapy. 15 member board of directors composed of 8 OT practitioners and 7 public members. Functions independently in all aspects of initial certification. Provides exam to become certified after completion of accredited OT/OTA education program.

Question 33

Accreditation Council for Occupational Therapy Education

Answer 33

ACOTE; part of AOTA that regulates entry-level education for OT and OTA programs in US; Reviewed/revised every 5 years; Educ. programs must show compliance to be accredited.

Question 34

Supervision as per CBOT (CA Board of OT)

Answer 34

“Supervision of an OTA” means that the OT shall at all times be responsible for all OT services provided to the client. The OT formulates/documents each client’s record, with his or her signature, the goals and plan for that client, and shall make sure that the OTA assigned to that client functions under appropriate supervision. OT conducts at least weekly review/inspection of OT services by the OTA. • The supervising OT must follow progress of each client, provide direct care to the client, and to assure that the OTA does not function autonomously. • An OT shall not supervise more OTAs, at any one time, than can be appropriately supervised in the opinion of the board. Three OTAs shall be the maximum supervised by an OT at any one time, but the board may permit a greater number. In no case shall OTAs exceed twice the number of OTs employed by a facility at any one time.

Question 35

Levels of Supervision

Answer 35

* Direct/Continuous = in immediate area at all times; for student, limited permit holder or aides * Close = daily, direct contact at work site * Routine = face-to-face at least every 2 weeks at work site; interim supervision thru telecommunication * General = initial direct contact at least once/month; interim supervision as needed by tele-communication

Question 36

Non-Entry Level Roles of OTA

Answer 36

* Educator to consumers * Educator to peers * Fieldwork educator * Supervisor * Administrator * Consultant * Dept. Manager * Academic fieldwork coordinator * OTA program director

Question 37

Board certification

Answer 37

AOTA offers this to OTs in gerontology, mental health, pediatrics and physical rehab.

Question 38

Specialty Certification

Answer 38

AOTA provides certification to OTs and OTAs for: • community mobility • environmental modification • feeding, eating and swallowing • low vision. (Practitioners document # of hours in 3 years; submits application and portfolio)

Question 39

Entry-level vs Intermediate-level vs Advanced-Level Practitioner

Answer 39

Entry-level= developing skills, socialization into profession, acceptance of expected responsibilities/role Intermed-level= increased independence, mastery of basic functions, more abilities based on experiences, educating other personnel, initiation of specialization/collaboration Advanced-level= refinement of specialized skills, understanding complex issues affecting role functions, contributing to knowledge base and profession growth, considered expert

Question 40

Frequency supervising OT must review/inspect services provided by OTA:

Answer 40

At least weekly, according to CBOT.

Question 41

Number of OTAs that may be supervised by one OT

Answer 41

According to CBOT, maximum of 3, but board could approve more. Never twice as many OTAs as OTs.

Question 42

CFOT

Answer 42

California Foundation for Occupational Therapy; enhances public view of OT, supports students/practitioners/researchers advance knowledge and skills.

Question 43

OTAC

Answer 43

Occupational Therapy Association of California; collective voice for OTs/OTAs in CA, advocates for members

Question 44

WFOT

Answer 44

World Federation of Occupational Therapists; world-wide voice of OT that sets standards of practice internationally; promotes research/educ.; demonstrating OTs relevance to society.

Question 45

AOTF

Answer 45

American Occupational Therapy Foundation. 501 (c)(3) that supports OT research through grants/scholarships and publications.

Question 46

CBOT code for supervising aides

Answer 46

Section 2570.2 (a): OT or OTA must provide direct in-sight supervision of aides, and to document client’s record of tasks performed by aide.

Question 47

2 Sections of the Framework

Answer 47

1. Domain: Outlines profession’s purview and areas in which members have established body of knowledge and expertise. 2. Process: Dynamic occupation and client-centered process used in the delivery of OT services.

Question 48

Aspects under Domain:

Answer 48

1) Occupations 2) Client Factors 3) Performance Skills 4) Performance Patterns 5) Contexts and Environments

Question 49

Principles included in OT Code of Ethics

Answer 49

6 total: 1) Beneficence 2) Nonmaleficence 3) Autonomy 4) Justice 5) Veracity 6) Fidelity

Question 50

Beneficence (define):

Answer 50

Well-being of client. Using proper judgment and competency. Concern for the well-being and safety of the recipients of services. Taking action by helping others; promoting good by preventing and removing harm.

Question 51

Nonmalificence (define):

Answer 51

Do no harm. Uncompromised care. To abstain from causing harm to others. To not impose risks of harm even if potential risk is without malicious or harmful intent. Goals pursued justify the risks that must be imposed to achieve those goals (ie: treatment that has pain will over time benefit the client).

Question 52

Autonomy (define):

Answer 52

Client’s choice. Transparency. Respect the right of client to self-determination, privacy, and consent. Allowing client to decide goals for intervention; involve authorized agent when needed. Protect confidential information.

Question 53

Justice (define):

Answer 53

Fair and lawful. Access and advocacy. OTP shall promote fairness and objectivity in provision of services. Respect and consistently follow applicable laws. Generate unbiased decisions.

Question 54

Veracity (define):

Answer 54

Honesty and accuracy. Provide comprehensive, accurate and objective information when representing the profession. Use truthfulness, candor and honesty in transmission of info and foster understanding. Requires thoughtful analysis of how full disclosure of info may affect outcomes.

Question 55

Fidelity (define):

Answer 55

Respect and discretion. Selflessness. Treat clients, colleagues and other professionals with respect, fairness, discretion and integrity. Keep commitments. Maintain respectful collegial and organizational relationships.

Question 56

Define Lifespan (Developmental) Stages

Answer 56

1. Infancy: birth to 1 year 2. Childhood: Early (1-6 years); Later (6-12 years) 3. Adolescence: 12-20 years 4. Young and Middle Adulthood: 20-65 years 5. Later Adulthood: Over 65 years

Question 57

Pediatrics – Define and Common Issues

Answer 57

Pediatrics = Birth to end of high school. (Sometimes work with pregnant mothers.) Common issues: • Sensory processing disorders • Low muscle tone, decreased muscle strength • Fear of movement • Decreased attention span, hyperactivity • Difficulty with motor planning, balance, gross motor delays, fine motor delays • Immature play skills, overreacting • Improper pencil grip/poor handwriting • Impaired bilateral or hand-eye coordination • Difficulty with self care, ADLs

Question 58

Landmarks of Infancy:

Answer 58

* Rapid growth in motor, social, cognitive skills * Gross/fine motor develop via reach, grasp, roll, sit, crawl and walk * Primitive reflexes * Social-expressing emotions * ADLs – recognition of food sources, bathtime, al-lowing dressing * Cognitive – awareness of objects, faces, voices

Question 59

Landmarks of Childhood:

Answer 59

* Growth and refining skills * Play is main occupation * Play goes from solitary to parallel, moves toward end goal, rules start, cooperative play * Imaginative play from 3-5 years * Move into occupation of education – rules, routines, reading, writing, socializing, cog. Skills

Question 60

Landmarks of Adolescence:

Answer 60

* Striving toward independence, peer group pressure * Games with rules, group standards instead of adult standards, leisure and social activities * Focus moves outside of family * Confusion in relationship with adults * Sexual identity developing * Growth changes, postural changes, awkward motor movement

Question 61

Landmarks of Young/Middle Adult-hood:

Answer 61

* Time of achievement * Employment decisions * Group affiliations * Guiding next generation; child rearing * Completing education * Relationships * Home management

Question 62

Landmarks of Late Adulthood:

Answer 62

* Reflection/evaluation of one’s life * Physical changes – sensory/health issues * Adjustment to/acceptance of impending death * What I’m leaving behind * Decreased workload – increased time on hands * Loss of peers

Question 63

Intervention for Infancy:

Answer 63

* Muscle tone * Coordination * Symmetrical movements * Posture * Play (motor skill development), sensory regulation, splinting, positioning, cardiac rehab., feeding, behavior reg., parent training * Family centered

Question 64

Intervention for Childhood:

Answer 64

* Play development (Motor, cognitive, social, psychological, language skills) * Least restrictive environment – closest to a regular classroom, yet encouraging success

Question 65

Intervention for Adolescence:

Answer 65

* Firm yet fair limits * Emotional expression * Learn to trust * Give control where possible * Group interaction * Self care * Work preparation activities * Leisure exploration

Question 66

Intervention for Young/Mid Adults:

Answer 66

* Help re-engage in meaningful occupation * Help be successful in roles and consider context * Ergonomics * Rehab from illness/injury

Question 67

Intervention for Later Adults:

Answer 67

* Safety * Home evaluation * Driving * Rehab for illness/injury * Depression * Learned helplessness – person relinquished control to others due to level of help offered; no longer making decisions

Question 68

CBOT Minimum Standards for Infection Control

Answer 68

Regulation 4175: OTs must comply with all applicable Standard Precautions. Avoiding spreading infectious agents. Includes: Hand hygiene, use of PPE, respiratory hygiene (cough etiquette), client care equipment handling/cleaning.

Question 69

CBOT 4175 Regulation on handwashing:

Answer 69

* When hands are visibly soiled, hands shall be washed with soap and water for a 20-second scrub and 10- second rinse or an antimicrobial hand wash. * If hands are not visibly soiled, an acceptable alter-native is with an alcohol-based hand rub.

Question 70

HIPAA

Answer 70

Health Insurance Portability and Accountability Act. Set rules for access to protected health information (PHI). Manages and safeguards information, encourages patient rights. PHI access based on “need to know” and “minimum necessary” principles.

Question 71

WHO’s 5 Moments of Hand Hygiene

Answer 71

1) Before touching patient 2) Before clean/aseptic procedure 3) After body fluid exposure risk 4) After touching a patient 5) After touching patient surroundings

Question 72

Standard Precautions Practices (Types)

Answer 72

``` Infection preventing practices: • Hand hygiene • Personal Protective Equipment (PPE) • Safe Injection Practices • Respiratory Hygiene/Cough Etiquette ```

Question 73

Precaution Types (for inpatient care)

Answer 73

1) Airborne Precautions: TB, Chickenpox; Use Airborne Isolation Room (AIIR), door shut; Wear N95 2) Droplet Precautions: Flu, Bact Meningitis, Pertussis; Private room, door shut; Wear standard mask w/wout shield 3) Contact Precautions: MRSA, VRE, C diff.; Private room, door open; Wear gloves and gown

Question 74

% of Time Spent Sleeping

Answer 74

1/3 of life

Question 75

Sleep position for least back pressure

Answer 75

On your back (2nd least is side)

Question 76

Weight limit for backpacks

Answer 76

10% of body weight; or never more than 25 lbs.

Question 77

How far below waist to wear back-pack?

Answer 77

Never more than 4 inches below waist

Question 78

Ways to solve monitor glare

Answer 78

* Use glare screen * Place monitor perpendicular to light source * Aim lights at wall or desk to diffuse them * Reduce contrast betw screen and border around it

Question 79

Best monitor for color choices

Answer 79

8-bit LCD panel monitor

Question 80

20/20/20 Rule

Answer 80

For every 20 mins on a screen, look at something 20 feet away, for 20 seconds

Question 81

Distance from face to place monitor

Answer 81

Arm’s length

Question 82

How to set screen brightness

Answer 82

Should be same as a white sheet of paper held next to it in that lighting/time of day.

Question 83

Applications of Telehealth in OT

Answer 83

* Early Intervention for Children * School Based * Pediatric Private Practice * Pediatric Hospitals * VA Healthcare System * Burn Unit Consultations * Adult Private Practice (Rehab and Wellness) * Mental Health (education, independence, emotional health, employment, ADLs) * Productive Aging * Ergonomics * Coaching patients with TBI

Question 84

Considerations for incorporating tele-health:

Answer 84

* Client access to technologies * Services that are amenable to telehealth * Position of employer on using it * Knowledge of telehealth resources * Licensure in my state * Will I be reimbursed? * Are technologies HIPAA compliant? * Do I have/can I acquire competency to deliver services this way * Can OTAs be supervised

Question 85

CBOT 4172 Standards of Practice for Telehealth

Answer 85

• OT or OTA must have valid license • OT must inform patient and get their consent • OT shall determine if in-person eval is necessary based on details of the intervention • OT/OTA delivering telehealth must: a) Use same standard of care; b) Comply with all other provisions/regulations of OT Practice Act

Question 86

Certified Driver Rehabilitation Specialists

Answer 86

(CDRS). Gold standard in driver rehab service through ADED. With backgrounds in healthcare and/or driver education, driver rehabilitation specialists are professionals who have completed additional training and education in the field of driver rehabilitation. *DRS (Driver Rehab Specialists) are allied health professionals who have not obtained ADED certification.

Question 87

ADED

Answer 87

Association for Driver Rehabilitation Specialists – nonprofit org dedicated to promoting safe, independent mobility for aging and disabled. Provides educ and support for professionals in field of driver rehab. Certifies Certified Driver Rehabilitation Specialists (CDRS).

Question 88

Four common conditions in which driving concerns are addressed

Answer 88

1) Dementia 2) Parkinson’s Disease 3) COPD 4) Physical Disabilities

Question 89

Body Language

Answer 89

Read others’ body language, but also be aware of your own! Consider what you are projecting before you react to a negative response. Posture, stance, gestures, eye contact, personal space, facial expression and energy level send messages you may not intend.

Question 90

Vocal Cues

Answer 90

How you speak often gives a perception: ``` Monotone=boredom Slow speed/pitch=depression High voice/emphatic pitch=enthusiasm Ascending tone=astonishment Abrupt speech=defensiveness Terse/loud=anger High pitch/drawn out=disbelief ```

Question 91

Tips to Improve Listening:

Answer 91

1) Do not fake understanding. Ask to repeat if needed. 2) Do not tell speaker you “know how they feel”. Reflect you understand but not that “you are with them” 3) Vary your responses. 4) Focus on the feelings (when reflecting back, use accurate feeling word)

Question 92

Questions to ask yourself about the effectiveness of your people skills:

Answer 92

1) Are you truly listening and hearing what is being said? | 2) How can you slow down your rx and respond successfully to behavior you do not like or expect?