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Treatment Approaches and Frames of Reference
Terms in this set (25)
Remedial/Restorative/Transfer of Training Approach
Focuses on restoration of components to increase skill. Deficit specific. Targets cause of symptoms. Emphasizes performance components. Assumes improvements in performance components will result in increased skill. Assumes the cerebral cortex is malleable and can reorganize. Utilizes tabletop and computer activities such as memory drills, block designs, parquetry, etc. as treatment modalities. (Therapy Ed, 279)
Involves repetitive practice of functional tasks. Emphasizes modification. Activity choice driven by tasks the person needs, or wants, to perform. Emphasizes intact skill training. Treats symptoms, not the cause. Utilizes techniques of environmental adaptation and compensatory strategies. Treatment is task specific. Utilizes functional tasks (BADL), IADL, work, and leisure tasks) that the individual desires, or is required, to perform at discharge as the basis of treatment. (Therapy Ed, 279)
Information Processing Approach
Provides info on how the individual approaches the task. Investigates how performance changes with cueing. Standardized cues are given to determine their effect on performance. Cues or feedback are utilized to draw attention to relevant features of the task. Investigative questions are used to provide insight to the underlying deficits. (Therapy Ed, 279)
Dynamic Interactional Approach
Emphasizes transfer of information from one situation to the next. Utilizes varying treatment environments. Practice of a targeted strategy with varied tasks and situations (multicontextual). Emphasizes metacognitive skills (selfawareness of strengths and deficits) as basis of learning and generalization of learning. Transfer of learning must be taught from one situation to the next and does not occur automatically. Transfer of learning occurs through a graded series of tasks that decrease in similarity (e.g., training scanning strategies for a person with a visual neglect to find items in a refrigerator to a less similar task such as scanning to cross the street). The person's processing abilities and self-monitoring techniques are used to facilitate learning for different tasks or environments. The therapist utilizes awareness questioning ("How do you know this is right?") to help the individual detect errors, estimate task difficulty, and predict outcomes. (Therapy Ed, 279)
The Quadraphonic Approach
Based on remediation. Based on information processing theory and teaching/learning theory. Micro-perspective includes evaluation of management of performance component subskills such as attention, memory, motor planning, postural control, and problem solving. Macro-perspective evaluation includes the use of narratives, interview, real-life occupations (shopping, cooking, etc.). Makes use of several theories: Information processing, teaching/learning evaluation, neurodevelopmental evaluation, biomechanical evaluation. (Therapy Ed, 279)
Based on learning theory. Specifically used for individuals with acquired neurological impairments. Focuses on retraining real world skills rather than cognitive-perceptual processes. Utilizes an overall adaptive approach but incorporates some remediation components. Treatment is focused on training specific functional skills in true contexts. (Therapy Ed, 280)
Cognitive Disabilities Model
Originally developed for use with individuals who have psychosocial dysfunction, currently also being utilized with persons with neurologic dysfunctional and dementia. Each level describes the extent of a person's disability and difficulty in performing occupations. After the person's level has been established, routine tasks are presented that the person can perform or that have been adapted so that he/she can perform them. Focus is placed on adaptive approaches and strengthening residual abilities. (Therapy Ed, 280)
Model of Human Occupation (MOHO)
Personal occupational choices and engagement in occupation shape the individual. The environment impacts on the individual through the opportunities, demands, resources, and constraints it provides. Eval focuses on exploring the individual's occupational history, goals, volition, habits, and occupational performance. Intervention focuses on occupational engagement and includes activities that are purposeful, relevant, and meaningful to people and their social context. (Therapy Ed, 281)
Life -Style Performance Model
Proposes a method for looking at the match between the environment and the individual's needs. Evaluation focuses on obtaining an activity history and performance profile related to self-care and maintenance, intrinsic gratification, service to others, and reciprocal relationships. Intervention addresses these questions: what does the person need to be able to do? What is the person able to do? unable to do? What are the characteristics/patterns of activity that will enhance the QOL? (Therapy Ed, 282)
Ecology of Human Performance Model
Emphasizes the role of the pt.'s context (culture, physical, social env.) & how environment impacts a persons performance. Eval uses checklists for the person, the environment, task analysis, and a priorities checklist. Interventions include these strategies: establish and restore, alter, adapt/modify, prevent, and create. (Therapy Ed, 282)
Concerned with with the processes that the individual goes through to adapt to his/her environment. consists of 3 elements: the person, the occupational environment, and the interaction between the 2. Eval: Potential for adaptation, best means for it to occur
TX: addresses pt. & environ. increasing skills for adapt. to occur. (Therapy Ed, 283)
Eval focuses on gathering data indicative of function/dysfunction. Intervention focused on the acquisition of the specific skills an individual needs in order to function in his/her environment. (therapy E, 283)
Cognitive Behavioral Frame of Reference
Interventions include psychoeducational group approach, Self-Regulation Model, Social and Life Skills Training Model, and Coping Model
involves defense mechanisms
Person, Environment, Occupation Performance
Focuses on the interdependent relationship between occupations and performance. These occupations in turn influence one's life roles.
Behavioral frame of reference
interventions include behavior modification and social skills training. identifies problem behaviors that need to be extinguished. Includes case-effect associations, shaping, reinforcement, and behavior modification. Recommended for those whose cognitive abilities are impaired by psychosis, who have normal attention span and memory abilities, or those living in a highly structured and consistent environment.
Biomechanical frame of reference
Client factors and performance skills include ROM, strength, endurance, ergonomics, and the effects/avoidance of pain as related to occupational performance.
Concerned with establishing or restoring client-chosen, age-appropriate occupations within continued life roles and helping them to adapt to the changes brought on by health conditions within and across the lifespan.
best for individuals with memory and/or attention deficits, for those who must learn to do situational problem-solving, or when skills learned need to be generalized to other situations. Includes role playing, rehearsal, imagery, and memory enhancement techniques
attempts to clarify thoughts, feelings, and experiences that influence behavior
applied to individuals with brain damage
analogous to occupational approach; focuses on the child's performance as it interacts with environmental activities, contexts, and conditions (Case-Smith, 684)
Motor Re-Learning Program (MRP)
provides verbal and visual feedback to give a person the input needed to make postural and limb adjustments. intervention is focused on learning general (not specific) strategies for solving motor problems.
Contemporary Task-Oriented Approach
practice with varied strategies to find optimal solutions for motor problems. Functional tasks help organize motor behavior. interventions are focused on practicing functional tasks or close simulations
interventions are focused on remediating motor control in persons with CNS dysfunction. Ultimate goal is the acquisition of functional skills that can be generalized to multiple situations and environments
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