Health, Education, and Service Delivery Issues Flashcards
(37 cards)
which pediatric PT settings use the medically based model?
NICU, PICU, scute care service, rehabilitation unit, outpatient clinic
which pediatric PT settings use the educational model?
home care (early intervention) and educational setting (preschools/schools)
who is served in the NICU?
- high risk infants with a variety of diagnoses
- family members
what is the role of the PT in the NICU?
- examination and evaluation
- intervention
- re-examination and discharge planning
what does examination look like in the NICU?
history, observation, tolerance to handling, behavioral state and alertness, active movement and strength, muscle tone and reflexes, feeding
- *a lot of this is the babies ability to regulate their own state. muscle tone is usually low in the NICU. state and alertness relates to the maturity of the CNS
what are goals of PT in the NICU?
- do no harm
- education on handling and positioning for development
- promote sucking
- *need to position baby as they would be learning in utero –> missing out because born early
what does intervention look like in the NICU?
- positioning (*promote flexion, sidling)
- P/AROM
- motor and sensory (*slowly inc. sensory inputs, can go into sensory overload (laws for this))
- feeding
- organization
- pt/family ed (*won’t send baby home without good family)
what does the NICU transition look like?
- typically baby needs to be 5ish lbs to leave
- go to step down nursery, transitional facility, or home
what does acute care look like for PT?
- pts vary
- PT roles vary
- goals for therapy are medical stabilization followed by mobility
what does the (step down) rehabilitation setting look like for PT?
- pts who are intensive need, not safe to return to home/school, not reached full potential
- role of PT varies
- goals of therapy are maximize independence in least restrictive environment, promote safe mobility, and pt/family education
what does the pediatric outpatient setting look like for PT?
- pts vary, typically post hospitalization, can be supplemental if the child didn’t qualify for school based services
- role of PT is home exercise program and adaptive equipment- goals of therapy are less intense and are aimed at specific activity limitations for a specified period of time
what is the Education of All Handicapped Children Act of 1975
all children with handicapping conditions ages 6-21, regardless of severity, have available to them free appropriate public education which (special education services) to meet their unique needs
what is the Education of the Handicapped Amendment of 1986?
- expands AHCA of 1975 to infants, toddlers, and preschool children/families
- provides coordination of services between public and private agencies
- multidisciplinary, strong family involvement, delivered in natural settings
what is the Individual with Disabilities Education Act Amendment of 1991 (IDEA)?
- reauthorizes AHCA of 1975 and 1986 Amendment laws for ALL children of all ages, least restrictive environment, transition, family training, nutrition, and other related services
- *basically says free and public education in the least restrictive environment
what does part C of IDEA implement?
- coordinates payment from federal, state, local, and private sources
- expand capacity and expand/improve Early Intervention services
- expand opportunities for EI services to children who are at risk of having substantial developmental delay if they did not receive service
- *part C allows early intervention
how do children become eligible under IDEA part C?
- child shows developmental delay as defined by state in cognitive, physical, communication, or adaptive development (fine and gross motor)
– *need 1 33% delay or 2 25% delays in any of these domains (cognitive, physical, etc) –> using normative reference to determine these delays
OR - child has a diagnosed condition that has a high probability to result in a developmental delay
OR - child is at risk for developmental delay by the states discretion and who are in need of EI services
what are the key elements for EI under part C of IDEA?
- team collaboration (*family at center of team)
- non-discriminatory evaluation and assessment
- family centered for both children (0-3) and their families in their NATURAL ENVIRONMENT
what are some characteristics of team collaboration?
- members demonstrate honesty, trust, responsiveness, and mutual respect for each other
- open communication
- equal participation
- decisions made together
what does an Individual Family Service Plan consist of?
- review of medical records
- family interview (id resources, priorities, concerns, supports)
- observation
- assessment of five areas of development: physical, cognitive, communication, social/emotional, adaptive
what are the key elements of family centered care?
- parents as solution and experts
- parents in active roles (*whole purpose of EI)
- expanding the definition of family
- individual needs of family
- legal mandates include families
- cultural sensitivity and competency
- challenges and stresses to family
what is documentation under IDEA part C?
- IFSP 0-3 y/o
- diverse needs of child and family driven plan
- families are ACTIVE participants
- outcomes are functional and can be implemented into the Childs daily routine
what is IDEA part B?
outlines the right to free and appropriate education and related services for eligible children 3-21 y/o
what is “zero reject” under IDEA part B?
no matter the severity/type of condition, education is free and appropriate
what is the definition of least restrictive environment (LRE) under part b?
- scoops probed education with non-disabled children to as maximal extent as possible
- special classes/separate schooling/remove from class only when disability is such that education in regular class with aides and services can not be satisfactorily achieved
- if district thinks they don’t have a good enough program, they are responsible to find a place that does and the home district pays a tuition to the district with that program
