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Management of the pediatric patient > Week 3 > Flashcards

Week 3 Flashcards

1
Q

What is considered the distal environment of a child?

A

Neighborhood/community

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2
Q

What is considered the proximal environment of a child?

A

Family, home, caregivers, culture

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3
Q

In a young child the ___ environment is the most important to them and they get older the ____ environment becomes much more influential

A

In a young child the proximal environment is the most important to them and they get older the distal environment becomes much more influential

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4
Q

What are some of the family factors that influence intervention?

A
  • Family structure
  • Family function
  • Family resources
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5
Q

What are the aspects of the family structure that we pay attention to?

A
  • Caregiving family
  • Household composition
  • Interactions between members of the family and with the child
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6
Q

What does the term family function refer to?

A

The family’s ability to conduct and accomplish everyday activities across situation/ carry out day to day routines

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7
Q

What are the aspects of the family function that we pay attention to?

A
  • Family routines
  • Parenting behavior & childrearing beliefs
  • Parent-child interactions
  • Culture
  • Parenting stress/coping
  • Caregiver health
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8
Q

What are the aspects of the family resources that we pay attention to?

A
  • Socioeconomic status: pt’s with low status tend to have the need for more services
  • Informal & formal support
  • Home environment
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9
Q

What is family centered care?

A

Family-centered care is made up of a set of values, attitudes, and approaches to services for children with special needs & their families. Family-centered service recognizes that each family is unique; that the family is the constant in the child’s life; and that they are the experts on the child’s abilities and needs. The family works with service providers to make informed
decisions about the services & supports the child and family receive. In family-centered service, the strengths & needs of all family members are considered

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10
Q

What are the key elements of family centered care?

A

• Recognize the family as a constant in a child’s life
• Facilitate family-to-family networking
• Promote parent-professional collaboration
• Incorporate developmental needs of children into health care in the context of the family routine
• Implement programs & policies that provide emotional and financial support to meet the
needs of the family
• Honor diversity (racial, cultural, socioeconomic, ethnic)
• Design health care services that are accessible, flexible, and responsive to the family’s needs

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11
Q

What are the goals of family centered care?

A
  • Enhance growth/development of the child
  • Support the child
  • Support the family
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12
Q

What part of the IDEA are we as PTs more concerned about when treating children?

A

Parts B and C

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13
Q

What does IDEA part B offer?

A
  • Free and appropriate public education (FAPE) for children age 3-21 years (special ED)
  • Least restrictive environment (LRE): to the maximum extent appropriate, children with disabilities should be educated with children who are not disabled as much as possible
  • Related services: PT and other services should be provided for children that with disabilities
  • Assistive technology that will maintain or improve functional capabilities
  • Individualized education program (IEP)
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14
Q

Besides PT, what are some other related services offered in the IDEA part B?

A
  • Transportation
  • Speech
  • Audiology
  • Psychology
  • OT
  • Recreational, medical, and counseling services
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15
Q

How do we determine a child’s eligibility for IDEA part B services?

A

We do an evaluation

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16
Q

What are the components of an evaluation according to the IDEA?

A

• Multidisciplinary
• Done in natural enviornments
• Conducted to “assist in determining whether a
child is a child with a disability”

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17
Q

What are the disabilities defined for the IDEA as eligible for services?

A 
• Autism
• Deaf-blind
• Deaf
• Developmental delay
• Emotional disturbance
• Hearing impaired
• Mental retardation
• Multiple disabilities
• Orthopedic impairment
• Other health impairment
• Specific learning impairment
• Speech & language
impairment
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18
Q

Once a child has been recognized to be eligible for IDEA services, where are these services documented?

A

Individualized educational

program (IEP)

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19
Q

What are the characteristics of the Individualized educational
program (IEP)?

A
  • Developed by the team

* Reviewed & rewritten yearly at minimum

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20
Q

What does the Individualized educational program (IEP) include?

A
  • Present level of performance
  • Annual goals
  • Description of how progress will be measured
  • Statement of special ed & related services to be provided
  • Transition plan (age 16 and up)
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21
Q

Once the IEP is developed, what is the PT’s contribution to it?

A
  • Must relate to educational needs & be “required to assist a child with a disability to benefit from special education”. services must be educationally relevant
  • Measurable annual academic/functional goals
  • Short-term objectives
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22
Q

What are the model of service delivery for pediatric patients?

A
  • Direct
  • Integrated
  • Consultative
  • Monitoring
  • Collaborative
23
Q

What is considered as a direct mode of service delivery?

A

Very one on one services/ pull out from group for individualized care. not desirable, due to wanting more integrative care

24
Q

What are the most commonly seen frequency/intensity of service delivery for a child?

A
  • Intensive (3+ times/week)
  • weekly or every other week
  • periodic (monthly or less)
  • consultative/as needed
25
What are the thing that we need to consider when deciding on the frequency/intensity of service delivery for a child?
* Potential to benefit from intervention * Is it a critical period of skill progression or regression * Consider the amount of the motor program that can be safely performed by others * Consider the amount of training that has been provided by the PT to others carrying out the program * The impact of motor problems in the environment and the educational program
26
What are the aspects of intervention for pediatrics under the IDEA?
* Coordination, communication, and documentation * Child- and family/teacher/staff-related instruction * Procedural interventions
27
If a child does not qualify for services under the IDEA part B, they may qualify for Section 504 of the Rehabilitation Act. What does this do?
Establishes eligibility for related services for "qualified handicapped persons," even if the child does not qualify for special education services
28
What are the IDEA part C services?
Early intervention services for eligible infants and toddlers, birth to 3 years of age, and their families and focuses on the development of the child. These services have to be performed in a child's natural environment
29
What does the evaluation under IDEA part C include?
* Comprehensive, multidisciplinary * Used to determine eligibility * May be conducted by a separate evaluation team
30
What is the determination criteria for the eligibility of IDEA part C services?
``` Developmental delay or disability (or diagnosed physical or mental condition with a high probability of resulting in developmental delay) in one or more of the following areas of development: • physical • cognitive • communication • social or emotional • adaptive ``` **varies by state**
31
Once a child has been deemed eligible for IDEA part C services, an Individualized family service plan (IFSP) is made. What are the characteristics of it?
* Developed by the team | * Reviewed every 6 months, rewritten yearly
32
What does the Individualized family service plan (IFSP) include?
* Present level of development * Family resources, priorities, & concerns * Measurable outcomes determined by the family * Statement of early intervention services * Natural environments * Transition plan to IDEA part B
33
What is the PT's contribution to the individualized family service plan (IFSP)?
* Must be family-directed * Recommendations must be consistent with information obtained in family interview, focus on strengths, use lay language, and be flexible
34
What are the characteristics of the interventions under the IDEA part C?
* Interventions must support family outcomes * Should be routines-based * May address play, socialization, caregiving and selfcare, environmental adaptations, assistive technology * Should balance adult-directed learning opportunity (family/caregiver education) and child-directed activity
35
The Individualized family service plan (IFSP) is developed based on ___
The Individualized family service plan (IFSP) is developed based on *family needs, priorities and resources*
36
Around what age, does transition from part C to part B in the IDEA services?
• At age 2 1/2, the Part B program holds an initial IEP meeting which includes Part C representatives • Child transitions to Part B program on his third birthday
37
Who regulates medical services?
Regulated by health care | law & insurance policies
38
Who regulates educational services?
Regulated by education | law (IDEA)
39
What is the purpose of therapy in medical services?
Therapy provided to assist the child to be as functionally independent as possible
40
What is the purpose of therapy in educational services?
Therapy is provided to assist a child to benefit from special education
41
What is the philosophy behind the implementation of medical services?
Medically necessary
42
What is the philosophy behind the implementation of educational services?
Educationally relevant
43
What is the eligibility criteria of medical services?
Any child may receive services
44
What is the eligibility criteria of educational services?
Children must have an educational disability & demonstrate a need
45
What is the age range for patients under the IDEA part B service?
3-21
46
What is the age range for patients under the IDEA part C service?
Birth-3
47
What is the eligibility criteria for patients under IDEA part B?
Categories of disability defined by federal law
48
What is the eligibility criteria for patients under IDEA part C?
Varies by state
49
What is the documentation used under IDEA part B?
IEP
50
What is the documentation used under IDEA part C?
IFSP
51
What is the parameter for determining outcomes and interventions under the IDEA part B?
Has to be educationally relevant
52
What is the parameter for determining outcomes and interventions under the IDEA part C?
Has to be family-centered
53
What is the role of PT under the IDEA part B?
It is a related service
54
What is the role of PT under the IDEA part C?
It is a primary service

Management of the pediatric patient (8 decks)

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