Pediatrics

Question 1

List the OT Process

Answer 1

Referral
Screening
Evaluation
Goal Setting
Intervention
-Planning
-Implementation
Revaluation
Discharge

Question 2

Describe the Top-Down Approach

Answer 2

Focuses on observing the client during functional tasks/occupations

Question 3

Describe the Bottom-Up Approach

Answer 3

Focusing on observing the client’s deficits that hinder performance in functional tasks (sensory, cognition, manipulation skills/motor)

Question 4

Norm-referenced vs. Criterion-referenced

Answer 4

Norm-referenced: compares performance to their peers

Criterion-referenced: compares performance on specific tasks

Question 5

Describe a standard deviation score, for which a client qualifies OT services

Answer 5

2 standard deviations OR lower

Ex: Mean = 100, Standard deviation = 15
70 or below, client qualifies for OT

Question 6

Describe the Moro Reflex & what it helps control

Answer 6

Birth — 6 months
-startled reflex
Arms out wide, with palms forward and open

Head control

Question 7

Describe the Rooting Reflex & what it helps control

Answer 7

Birth — 3 months
turning the head in response to touch
(important for breastfeeding)

head control

Question 8

Describe the Palmar Grasp Reflex & what it helps control

Answer 8

Birth — 6 months
Touching the palm results in grasping

release objects

Question 9

Describe the Asymmetric Tonic Neck Reflex (ATNR) & what it helps control

Answer 9

Birth — 6 months
Turning the head to the side results in extension of the arm & leg of the head facing direction & flexion of the opposite side

rolling / R&L coordination

Question 10

Describe the Tonic Labyrinthine Reflex (TLR) & what it helps control

Answer 10

Birth — 6 months
-Lying prone on the floor
Neck flexion = extremity/trunk flexion
Neck extension = extremity/trunk extension
(develops postural strength and muscles for head and neck control)

posture/transitions/tone

Question 11

Describe the Symmetric Tonic Neck Reflex (STNR) & what it helps control

Answer 11

Birth — 6 months

• Neck flexion = BUE flexion & BLE extension
• Neck extension = BUE extension & BLE flexion

Core / Coordination

Question 12

Describe the Landau Reflex & what it helps control

Answer 12

3-4 months — 24 months
-suspended in prone

Neck flexion = legs flexed
Neck extension = legs extended

“Superman”

Sitting / Standing Upright

Question 13

Describe Protective & Equilibrium Reactions

Answer 13

6 months/sitting up — FOREVER

We still have these
help you avoid falling/hurting yourself badly

Question 14

Milestones

Describe the mobility at 4 months

Answer 14

Able to lift head

Question 15

Milestones

Describe the mobility at 6 months

Answer 15

Raises trunk, reaches, rolls, raking grasp, hand-mouth, sits with propping

Question 16

Milestones

Describe the mobility at 12 months

Answer 16

Lying to sitting, sits w/o propping, crawling, stands with holding

Question 17

Milestones

Describe the mobiilty at 18 months

Answer 17

squats to pickup, walks well, uses cup/spoon

Question 18

Milestones

Describe the mobility at 2 years old

Answer 18

Climb up/down furniture, stairs (holding), jumps, runs, kicks

Question 19

Milestones

Describe the mobility at 3 years old

Answer 19

Catches large ball, pedal tricycle, dresses, Min A

Question 20

Milestones

Describe the mobility at 4 years old

Answer 20

Stand temp on 1 foot, begins to skip/hop, stairs alternating feet

Question 21

Milestones

Describe the mobility at 5 years old

Answer 21

Independent with toileting and dressing

Question 22

SI

List the senses

Answer 22

Visual
Auditory
Tactile
Olfactory
Gustatory
Vestibular
Proprioception
Interoception
(internal sensations: thirst, hunger, pain)

Question 23

SI

Describe Sensory Modulation

Answer 23

Our ability to respond appropriately to sensory information

Tactile - auditory - gravitational insecurity

Question 24

SI

Explain the differnce btw. Hypo-reactivity & Hyper-reactivity

Answer 24

Hypo-reactivity: under respond - delayed responses to stimuli (miss critical info)

Hyper-reativity: Over respond - over reacts to senspry input, results in discomfort, avoidance, distractibility, and anxiety

Question 25

# SI Describe Discrimination & Perception problems

Answer 25

Difficulty differentiating one sensory stimulus from another | visual - tactile - proprioception

Question 26

# SI Describe Vestibular - Bilateral function

Answer 26

Vestibular: balance & spatial orientation Bilateral: involving both sides of the body

Question 27

# SI Describe sensory based motor disorders and list some common challenges

Answer 27

Dyspraxia: difficulty with motor planning Challenges: -clumsy/awakward movements -Diffiulty w/ sequencing and timing actions -Difficulty accurately imitating actions of others

Question 28

# SI Describe sensory seeking behaviors and some actions that would indicate this

Answer 28

Seeking intense sensory stimulation -Proprioceptive seeking: stomping, jumping, intentionally bumping into objects -Tactile seeking: touching things/people excessively -Vestibular seeking: intense swinging/spinning on suspended equipment (w/o becoming dizzy)

Question 29

# SI For a child demonstrating hyposensitivty, describe what type of technique you would implement.

Answer 29

Arousal Techniques: -Tactile & vestibular (WAKE UP)

Question 30

# SI For a child with hypersensitivity, describe what type of technique you would implement.

Answer 30

Organizing & calming techniques: -Proprioception -modifying the environment (dimming lights, decreasing distractions

Question 31

# Autism List 3 performance patterns/skills conerns that children with Autism can demonstrate

Answer 31

Rigidity: restricted and repetitive behaviors Sensory: hypo/hyper -reactivity to sensory input Motor skills: poor gait/posture, balance/coordination issues, dyspraxia

Question 32

# Autism - intervention strategies For a child with difficulties with engagement with social play, describe an intervention you would implement.

Answer 32

Implement strategies to capture their attention or involve them -Use preferred objects -sing familiar songs and leave out the last word -create fun problems to be solved

Question 33

# Autism - intervention strategies A child is demonstrating difficult behavior, specifically during transitions. Describe some intervention strategies for this.

Answer 33

1. Give the child advance notice - visual schedules, written instructions, structure familiar routines 2. Build tolerance to unexpected changes - provide choices, prompting/chaining/fading out, token systems/sticker charts/ food rewards

Question 34

# Autsim - intervention strategies A child demonstrates distress about demands with their daily tasks. Describe possible intervneiton strategies for this situation.

Answer 34

1. Sensory strategies to reduce discomfort 2. Grading task to find just-right-challenge

Question 35

# Autism - intervention strategies A child is fixated on an object, has repetitive behaviors and perseverates on particular things. Describe your intervention strategy.

Answer 35

Prompt and help them generate new ideas - discuss affordances - use realistic props, movie characters to promote imagination - create a game with unsual materials

Question 36

# Autism - intervention strategies Describe an intervention strategy for a child with difficulty in motor planning and executing unfamiliar tasks.

Answer 36

Increase their attention to movement OR body awareness -obstable courses/challenging motor abilities -alternate preferred sensory activitites w/ more challenging motor tasks

Question 37

# Autism - intervention strategies Describe an intervention strategy for a child who does not engage socially with peers.

Answer 37

Strategies to incease play skills -peer mediated play groups -video modeling -choice -preferred sensory toys or perseverative interests

Question 38

Motor Control vs. Motor Learning

Answer 38

Motor Control: how one directs & regulates movements Motor Learning: learning & refining motor skills overtime

Question 39

# Interventions Motor Control Principles

Answer 39

* Whole Learning - (play/ game activities: dress-up, cooking) * Variability - (objects/ placement, environmental context, task requirements) * Problem Solving - error based learning (varying degrees of difficulty)

Question 40

# Positioning When would a sidelying position be beneficial?

Answer 40

useful for weakness, as this position is a gravity-eliminating position

Question 41

# Positioning Name 2 prepatory positions for crawling

Answer 41

1. Prone Extension / Prone on Elbows 2. Quadruped Position

Question 42

# Positioning Name 2 prepatoty positions for standing

Answer 42

1. Tall kneel (praying) 2. Half kneel (proposal)

Question 43

# Positioning List and describe unsupported sitting

Answer 43

* Long sitting: sitting on their bottom, legs extended * Ring / Tailor sitting: sitting on their bottom with legs infront, feet touching * W sitting: sitting on their bottom, knees bent, feet positioned outside of their hips (normal up to 12 months - can be problematic - stresses joints)

Question 44

# Mobility Describe appropriate wheelchair measurements

Answer 44

* 1 inch rule: seat to back of knee & hips to sides of chair * Seat height: ends at scapula - can change 2/2 postural instability (then high back)

Question 45

# Mobility Describe wheelchair position/adaptations for postural weakness

Answer 45

* recline * tilt-n-space * higher backrest * custom contoured * lateral trunk supports * lap tray * harness - dynamically stable