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OTD 731 > Pediatric final > Flashcards

Pediatric final Flashcards

(95 cards)

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1
Q

Important oral structures in eating, feeding, and swallowing

A

oral cavity
pharynx
larynx
trachea
esophagus

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2
Q

Cranial nerves for eating, feeding, swallowing

A

CN V trigeminal: Sensory Innervation to the face​

CN VII facial: Controls facial movement and expression​

CN XII hypoglossal: Controls muscles that move the tongue​

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3
Q

Stages of swallowing

A

-anticipation (see,smell,think about food and start salivating)
-oral preparatory (tongue collects food/liquid forms bolus)
-oral propulsion (propels bollus into pharynx)
-pharyngeal (throat stage: epiglottis flips down, vocal cords close trachea, pharynx muscles squeeze down)
-esophageal (esophagus squeezes food gradually down to stomach)

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4
Q

Bolus

A

ball of food/liquid/saliva

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5
Q

Describe the positioning considerations for feeding: safety and function

A

alignment 90-90-90
stability at the trunk
midline orientation
head and neck aligned with slight chin tuck

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6
Q

Oral sensory dysfunction

A

Not neuromuscular or structural

oral over-registration or defensiveness
oral hypo-registration or under registration

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7
Q

Which sensory system comes first when a child is eating

A

the visual system

most children eat with their eyes and nose first

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8
Q

What role do the gustatory and olfactory systems play in feeding

A

gustatory perceives flavor
olfactory perceives odors

smell is an internal smoke alarm, can trigger memory
-inhibits or facilitates taste

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9
Q

Role of the tactile system in feeding

A

playing with food

largest sensory system and very powerful

it protects (hot/cold) and discriminates (hard/soft)

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10
Q

Proprioceptive system in feeding

A

allows one to lift spoon to mouth without spilling
tells body how much and what kind of food is in the mouth

decreased awareness could lead to overstuffing, gagging, spitting, fear of how to chew and swallow

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11
Q

Interoception in feeding

A

sensations alert that internal balance is off

e.g.: feeling thirsty, feeling hungry, feeling full

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12
Q

What is a common jaw control technique when feeding

A

jaw, lips, tongue

provides jaw control and oral support
can be done from front or from side (arm around back of head)

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13
Q

What are some sensory based feeding approaches

A

SOS
Food chaining (taste, texture, temperature)
getting messy (playing with food)
oral motor strategies

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14
Q

What is the SOS sensory based feeding approach

A

Sequential Oral Sensory

tolerates
interacts with
smells
touch
taste
eating

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15
Q

What are some oral motor strategies for sensory based feeding approaches

A

licking
biting

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16
Q

What are some possible environmental adaptations for mealtime

A

regularly scheduled meals
shorter meal lengths
sensory stimulation and distractions
order of food presentation

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17
Q

Responsive feeding therapy (RFT) principles

A

autonomy
relationship
internal motivation
individualized
competence

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18
Q

interventions to improve self feeding

A

Develop interest​

Gradually decrease amount of physical assistance​

Create balance between effort and swallowing safety​

Adaptive equipment​

Backward chaining​

Consistency in placement of food​

Prepare child for self-feeding ​

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19
Q

Pediatric feeding disorder

A

IMPAIRED ORAL INTAKE THAT IS NOT AGE APPROPRIATE AND IS
ASSOCIATED WITH MEDICAL, NUTRITIONAL, FEEDING SKILL,
AND/OR PSYCHOSOCIAL DYSFUNCTION.

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20
Q

What are the four domains of PFD

A

medical
nutrition
feeding skill
psychological

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21
Q

PFD diagnostic criteria for the Medical domain

A

A disturbance in oral intake of nutrients,
inappropriate for age, lasting ≥2 weeks,
associated with ≥1 of :

Medical dysfunction
a. Cardiorespiratory compromise during oral feeding
b. Aspiration or recurrent aspiration pneumonitis

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22
Q

PFD diagnostic criteria for the nutritional domain

A

A disturbance in oral intake of nutrients,
inappropriate for age, lasting ≥2 weeks,
associated with ≥1 of :

Nutritional dysfunction
a. Malnutrition
b. Specific nutrient deficiency or significantly
restricted intake of ≥1 nutrient resulting from
decreased dietary diversity
c. Reliance on enteral feeds or oral supplements to
sustain nutrition and/or hydration

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23
Q

PFD diagnostic criteria in the feeding skill domain

A

A disturbance in oral intake of nutrients,
inappropriate for age, lasting ≥2 weeks,
associated with ≥1 of :

Feeding Skill dysfunction
a. Need for texture modification of liquid or food
b. Use of modified feeding position or equipment
c. Use of modified feeding strategies

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24
Q

PFD diagnostic criteria for the psychological domain

A

A disturbance in oral intake of nutrients,
inappropriate for age, lasting ≥2 weeks,
associated with ≥1 of :

Psychosocial dysfunction
a. Active or passive avoidance behaviors by child
when feeding/fed
b. Inappropriate caregiver management of child’s
feeding and/or nutrition needs
c. Disruption of social functioning within a feeding
context
d. Disruption of caregiver-child relationship
associated with feeding

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25
What is the goal of sensory integration
to help children achieve functions through sensory experiences
26
What are the end products of a functioning sensory system
ability to concentrate ability to organize self-esteem self-control self-confidence academic learning ability capacity for abstract thought and reasoning specialization of each side of the body and the brain
27
According to Ayres Sensory Integration what is the foundation for participation (bottom of pyramid)
Sensory integration: rapid and accurate registration, modulation, and discrimination/perception of sensory information
28
What are the neurological structures for senstation
spinal cord: basic pathways to transmit sensory information brainstem: integration of sensory information cerebellum: grading of the force and speed of movement cerebral cortex: connects previous sensory experiences with current ones to allow engagement in tasks
29
Foundational sensory systems used in sensory integration therapy
Tactile (discriminative & protective touch) Vestibular (static & dynamic) Proprioception (conscious & unconscious)
30
SIPT
Sensory Integration and Praxis Test Norm-referenced series of tests designed to measure the sensory integration processes that underlie learning and behavior among children 4 years through 8 years, 11 months
31
What are the guiding principles of the Ayres SI Intervention Methods
- follow typical development -just right challenge - use sensory rich environments -child directed but not child dictated
32
Sensory processing
the way the nervous system receives messages from the senses
33
Sensory Processing Disorder (SPD)
sensory information goes into the brain but does not get organized into appropriate responses symptoms may results in motor, behavior, social, emotional, or attention problems
34
three categories of sensory processing disorder (SPD)
Sensory Modulation Disorder (SMD) -SOR: sensory over-responsivity -SUR: sensory under-responsivity -SC: sensory craving Sensory- Based Motor Disorder (SBMD) -Dyspraxia -Postural Disorder Sensory Discrimination Disorder (SDD) -visual, auditory, tactile, taste/smell, position/movement, interoception
35
What are the neurological thresholds in Winnie Dunn's Sensory Processing Framework
Quick response- low threshold (sensitization/high sensitivity) Slow response- high threshold (habituation/low sensitivity)
36
What is habituation in the Winnie Dunn model
extreme end of high threshold recognizing that familiar stimuli do not require special attention
37
What is sensitization in the Winnie Dunn model
extreme end of low threshold enhances an awareness of potentially important stimuli
38
What is modulation
ability to regulate and grade responses that are appropriate to sensory situation experienced in daily life balance between habituation and sensitization
39
What are self regulatory behaviors and the two ends of the spectrum
The way people behave to manage their own needs passive: let things happen and then respond active: one works to control the amount of and type of sensory input
40
intervention for individuals with low registration
More/ much more: require aditional sensory information less/ much less: prefer predictable activities or repetition
41
intervention for sensory seeking individuals
More/ much more: provide a variety of sensory experiences less/ much less: activities that provide graded sensory experiences
42
Intervention for individuals with sensory sensitivity
more/ much more: relatively consistent and predictable environment less/ much less: activities that provide additional variety to everyday events
43
intervention for sensation avoiding individuals
more/ much more: relatively consistent and predictable environment less/ much less: activities that provide additional variety to everyday events
44
What are the skills needed in the educational readiness skills
Fine motor skills visual motor skills social skills self-help skills attention/self regulation
45
Fine motor skills involve:
reaching grasping manipulating objects
46
What are the norms for fine motor skills
0-3 months: bringing hands to mouth, swinging arms at toys, hands start to open more​ 3-6 months: reaches for toys with both arms, grasps small object, briefly holds rattle, holds hands in midline​ 6-9 months: brings toys to mouth, shakes rattle, uses raking grasp, transfers objects between hands​ -12 months: releases object voluntarily, develops refined pincer grasp, bangs two toys together, points to objects, turns pages in book​ 12-18 months: claps hands together, waves bye bye, uses both hands to play, scribbles​ 18-24 months: build 3-4 block tower, stacks rings on ring stacker​ 2-3 years: uses digital pronate grasp>tripod grasp, stringing beads​ 3-5 years: scissor skills, button and unbutton, place small objects into container​
47
timeline of grasping development
raking grasp: 4-6 months radial digital grasp: 7-9 months isolation of index finger: 8-10 months fine pincer grasp: 10-12 months tripod pencil grasp: 4-5 years
48
When does hand preference usually emerge
2 years but children often switch hand use up to 5 year
49
T/F : Crawling is essential in developing muscles and arches on the ulnar side.
True
50
T/F: Reaching and grasping objects is important for developing the muscles on the radial side of the hand. ​
true
51
Basic developmental progression of hand use
radial>ulnar gross grasp>precision grasp mass action > refined control of fingers straight plane>rotation
52
When do children need to focus on "worker" hand and "helper" hand to foster consistent motor memory for paper/pencil skills and scissor use?
3-5 years
53
in-hand manipulation
Translation (moving object from fingers to palm or palm to fingers) Shift (e.g shifting a pen to hold it closer to the tip) Rotation (rotating an object along one or more axes - e.g. turning a screw top bottle)
54
What skills are important building blocks to develop pre-writing readiness?
hand and finger strength crossing midline pencil grasp hand-eye coordination bilateral coordination upper body strength object manipulation visual perception hand dominance hand division (using thumb, index and middle finger together to manipulate objects)
55
What is the first writing stroke in pre writing skills
vertical line
56
What are the types of attention
focused attention selective attention shifting attention sustained attention divided attention
57
visual acuity
acuteness or clearness of vision, which is dependent on the sharpness of the retinal focus within the eye. (Normal visual acuity is commonly referred to as 20/20 vision, tested on a Snellen chart.)​ ​
58
Visual perception
The total process responsible for the reception and interpretation of visual stimuli, allows us to accurately interpret and compare/contrast visual information
59
components of visual perception
visual discrimination form constancy visual memory visual sequential memory visual closure visual spatial relationships visual figure ground
60
visual discrimination
The ability to determine differences or similarities in objects based on size, color, shape, etc.​
61
visual constancy
The ability to know that a form or shape is the same, even if it has been rotated, made smaller/larger, or looked at from up close or far away.​
62
visual memory
The ability to recall visual traits of a form or object.​
63
visual sequential memory
the ability to recall a sequence of objects or forms in the correct order
64
visual closure
the ability to recognize a form or object even when the whole picture of it isn't available
65
visual spatial relationships
understanding the relationships of objects within the environment
66
figure ground
the ability to locate something in a cluttered or busy background
67
assessments for vision
Beery Test of Visual Motor Integration (VMI) Motor Free Visual Perception Test of Visual Perceptual Skills (TVPS)
68
What are the 3 main components of the Beery VMI
visual motor integration visual perception motor coordination
69
What are the perceptual areas of the TVPS-4
visual discrimination visual memory spatial relationships form constancy sequential memory visual figure-ground visual closure
70
what are the frames of reference for handwriting without tears
Acquisitional FoR : emphasizes learning/teaching process Sensory and motor based approaches (biomechanical, sensory processing, motor learning)
71
M-FUN (The Miller Function & Participation Scales)
developmental tool using observation and demanded performance child's motor competency affects his/her ability to engage in home and school activities
72
What is the age range for the M-FUN
2.5 years - 7 years 11 months
73
what are the two domains of the M-FUN
performance assessment participation assessment
74
executive funtioning
allows us to multi task, remember instructions / details, and come up with and carry out plans
75
causes of executive functioning delay
ADHD Depression and anxiety Bipolar disorder Schizophrenia OCD Autism TBI Epilepsy (hemispherectomy)
76
executive functioning skills
planning organization self-control task initiation time management metacognition working memory attention flexibility perseverance
77
Development of executive functioning
combines sensory cognitive, communication, and motor skils which children develop and utilize around school age starts with baby's response to caregivers, learning through repetition and games
78
important concepts of foundational theory
-motivation -choice -active involvement -supportive environmental context -scaffolding to attain "just right" -self-discovery process -learning continues through the lifetime
79
cognitive interventions
cognitive behavioral video modeling coaching four quadrant model of facilitated learning CO-OP approach
80
video modeling
applies cognitive theory to teach children with ASD and intellectual disabilities by providing a visual role model using technology
81
coaching
Based on child and adult cognitive and educational learning theory ​ Involves a reciprocal process and collaborative relationship between the individual and coach (facilitator)​ Engages the child or youth to participate in a meaningful activity or occupation to the maximal extent possible by applying cognitive strategies
82
Guiding principles of coaching
Acknowledge prior knowledge​ Offer choice ​ Involve in goal setting and collaborative planning​ Promote active involvement and practice​ Utilize scaffolding by an adult or competent peer to support performance​ Observe performance and provide feedback​ Involve in self-discovery/reflection​ Encourage self-evaluation ​ Utilize resources and the environment to support participation​
83
Four quadrant model of facilitated learning (4QM)
based on Vygotsky's theory employs teaching and learning as an intervention strategy to achieve occupational performance More easily applied to perceptual motor activities like handwriting​
84
key aspects of Four quadrant model of facilitated learning (4QM)
Considers the interact of the person, occupation, and environment Student can do the task but lacks the ability to independently plan/perform/evaluate/adapt the task within a specific context Learner’s needs change dynamically and require a changing level of support
85
CO-OP Approach (Cognitive orientation to daily occupational performance)
based on cognitive and behavioral psychology, health, human movement science, and occupational therapy Emphasizes the interaction between individual and environmental factors to support participation in daily activities​ Uses a top-down approach in context of daily activities and occupations​
86
Key features of the Co-Op approach
goal plan do check
87
four enabling principles of the CO-OP approach
make it fun promote learning work toward independence promote generalization/ transfer
88
guided discover in the CO-OP approach
one thing at a time ask, don't tell coach, don't adjust make it obvious!
89
Hippotherapy
refers to how OT, PT, and SLP professionals use evidence-based practice and clinical reasoning in the purposeful manipulation of equine therapy tool to engage sensory, neuromotor and cognitive systems to promote functional outcomes
90
Why the horse?
horses emotional intelligence multidimensional movement horse's rhythmic movement movement can be manipulated motor and sensory input
91
Hippotherapy vs. therapeutic riding
hippotherapy: purposeful manipulation of equine movement therapeutic riding: correct riding position and utilization of reigns
92
positions for clients in hippotherapy
forward sitting backward sitting side sitting prone over barrel quadruped
93
types of holds for side walkers in hippotherapy
cuff hold: provides stability for foot/lower leg heel hold: prevents foot from turning inward and provides support thigh hold: provides more support and stability for client pelvis hold: most support
94
Activities used during hippotherapy sessions
fine motor gross motor visual motor
95
Benefits of hippotherapy
increased strength, muscle coordination, sensory processing increased motivation and participation in treatment

OTD 731 (3 decks)

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