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Exam 2 Review
Chapters 8, 10, 21, ot.com course #3641/3936
Terms in this set (124)
Activities of Daily Living for Pediatrics
- Bathing & showering
- Bowel & bladder management
- Toileting hygiene
- Dressing & undressing
- Eating & feeding
- Functional mobility
- Personal device care
- Sexual activity
keeping & manipulating food in the mouth & swallowing
process of setting up, arranging, & bringing food to mouth
Define oral motor control:
ability to use lips, cheeks, jaw, tongue, & palate
Oral motor development includes:
eating, sound play, & oral exploration
The OT practitioner evaluates a child's ability to perform occupations by examining the ______________ and ______________.
Performance skills (motor, process, social interaction); client factors.
How does an infant's oral area differ from an adult's?
Small oral cavity
fat pads in cheeks
limited mobility of tongue (back & forth movement; suckling)
oral cavity filled with tongue
In regards to oral motor development, at what age should an infant be able to use a mature suck pattern?
List the 5 reflexes important to oral motor development, eating, and feeding.
- Rooting reflex
- Suck-swallow reflex
- Gag reflex
- Phasic bite-release reflex
- Grasp reflex
Define the follow reflex and onset/integration for: Rooting reflex
When cheeks or lips slightly stroked, infant turns towards the stimulus; allows infant to search for food.
O/I: 0-3 months
Define the follow reflex and onset/integration for: Suck-swallow reflex:
When lips are touched, mouth opens, & sucking movement begins.
O/I: 0-2 to 5 months
Define the following reflex: Gag reflex:
Protects infant from swallowing anything that may block airway; highly sensitive at birth & elicited by stimulation to the back 3/4 of the tongue; gradually moves to back 1/4 of tongue.
Define the follow reflex: Phasic bite-release reflex:
When gums are stimulated, infant responds with a rhythmic up & down movement of the jaw; forms the basis for munching & chewing.
Define the follow reflex and onset/integration for: Grasp reflex:
When finger is pressed into the infant's palm, infant grasps the finger; as infant sucks, the grasp tightens; connection btwn sucking & grasping.
O/I: birth - 4 to 6 months (when cortex develops)
Development of Feeding Skills: Birth
Bottle or breast-feeding;
incomplete lip closure;
unable to release nipple
Development of Feeding Skills: 1-2 months
opens mouth & waits for food;
may lose coordination w/increased head movement;
improved lip closure;
active lip movement
Development of Feeding Skills: 3-5 months
voluntary control of mouth during feeding;
loses liquid from lip corners;
Development of Feeding Skills: 5 months
able to receive solid foods from spoon;
uses suckling pattern during spoon feeding;
gags at new textures;
tongue reversal after spoon is removed;
ejects food involuntary
Development of Feeding Skills: 4-5 months
exhibits phasic bite reflex with cracker
Development of Feeding Skills: 6 months
no liquid loss with bottle/breast;
suckles liquids from cup with loss;
coughs & chokes with cup drinking;
moves lips to remove food from spoon;
opens mouth when spoon approaches;
uses up/down jaw movement w/food;
plays with food;
good head control
Development of Feeding Skills: 7-9 months
suckles liquid in cup;
loses liquid when cup removed;
independently hold bottle;
feeds self a cracker using fingers;
holds jaw closed on soft solids to break off piece;
up/down movement with chewing (munching);
moves tongue laterally & jaw diagonally;
assists w/cup & spoon feeding.
Development of Feeding Skills: 10-12 months
lip closure on spoon;
uses upper/lower lip to remove food from spoon;
controlled sustained biting on soft cookies;
up/down and diagonal rotary chewing;
enjoys finger feeds independently;
likes to use spoon but needs assistance (inverts spoon);
At what age can an infant use a spoon with assistance bc of inversion?
At what age does an infant transition to cup drinking?
Early Childhood Eating/Feeding: 2 years
able to eat most meats & raw vegetables;
independent in spoon feeding & drinking from a cup
Early Childhood Eating/Feeding: 2-3 years
mature rotary chewing present;
able to drink from straw
Early Childhood Eating/Feeding: 3 years
able to pour liquids from a container into a glass;
able to serve own food;
experiments stabbing with a fork.
selecting clothes and accessories appropriate for the weather
putting clothes on sequentially
fastening and adjusting clothes and shoes
Independence in dressing depends on:
family's cultural expectations;
type of clothing worn;
opportunities for practice;
At what age is a child independent in dressing and undressing?
Dressing & Undressing: By 1 year
able to remove loose-fitting clothes (hats, mittens, socks);
motor skills necessary for independence in dressing & undressing present (disassociation btwn arms & legs)
Dressing & Undressing: 2 years
able to raise arms to pull shirt over head & maintain balance
Dressing & Undressing: 3 years
more aware of details;
can find arm & leg holes easily
Dressing & Undressing: 3 1/2 years
finds front of clothing;
snaps or hooks clothing in front;
unzips front zipper;
puts on mittens;
buttons series of 3 to 4 buttons;
unbuckles belt or shoe;
puts on boots;
Dressing & Undressing: 4 years
recognizes correct sides & able to manipulate most fasteners;
removes pullover garment independently;
buckles belt or shoes,
zips coats & inserts zipper;
puts on elastic waist shorts/pants;
puts on sock w/appropriate heel placement;
puts on shoes-assistance w/tying;
constantly knows front & back
Dressing & Undressing: 5 years
can recognize correct & incorrect sides & use buckles, zippers, and laces;
puts on pullover shirt correctly each time;
ties & unties knots;
Dressing & Undressing: 6 years
ties bow knot (shoes);
ties hood string;
buttons back buttons;
snaps back snaps;
selects clothing appropriate for weather & specific activities
Personal Hygiene & Grooming info:
develop after development of eating & dressing skills; cultural expectation & social routines of the family determine independence
Typical personal hygiene & grooming include:
face washing, hand washing, hair care, comb hair, nail grooming, oral hygiene, personal care device care, bathing & showering & toilet hygiene.
Personal hygiene and grooming: 1 year
cooperates during hand washing & drying
Personal hygiene and grooming: 1.5 years
allows teeth to be brushed
Personal Hygiene & Grooming: 2 years
attempts to brush teeth (imitates adult)
Personal Hygiene & Grooming: 3 years
washes own hands;
brushes teeth with assistance
Personal Hygiene & Grooming: 4 years
washes & dries hands independently;
brushes teeth with supervision
Personal Hygiene & Grooming: 5-6 years
independently brushes teeth
Bathing & Showering involves:
soaping, rinsing, & drying the body
Bathing & Showering: 2 years
able to assist with washing
Bathing & Showering: 4 years
able to wash & dry with supervision
Bathing & Showering: 8 years
independent w/o supervision
Toilet Hygiene involves:
clothing management, maintaining position, transferring to and from toilet, and cleaning the body
Toilet Hygiene: 2-3 years
voluntary physiologic control of urination;
toilet training begins (only if child can remain dry for 1 or more hours at a time);
daytime bowel and bladder control
Toilet Hygiene: 5 years
independence in daytime toileting
Toilet Hygiene: 6 years
nighttime bladder control
Personal Device Care: OT practitioners provide:
info and training on the care of devices and help children establish roles and routines for maintenance of the equipment
Define Functional Mobility:
movement in the home & the community
Sexual Activity: OT practitioners may:
allow children to speak about issues,
help children understand what this means for them,
provide a resource for parents.
Complex activities of daily living needed to function independently in home school or the community.
Rest & Sleep: Newborns
sleep as much as 16 hours a day;
1-2 hour increments
Rest & Sleep: Preschoolers & Elementary-aged children:
Sleep an average of 10-12 hours a day;
may move to a bigger bed;
necessary to establish a routine
Rest & Sleep: Adolescents
experience a change in patterns and want to stay up later and sleep more;
need to catch up on the weekends
Formal Education is
mandated by public law
Informal Education is
Preschool Education Readiness
independence in toileting w/minimal assistance to handle fasteners;
cooperative play behavior;
understand rules & schedules;
beginning of behavioral and emotions maturity
(control temper & mood swings)
Kindergarten Readiness Skills
Recognizes letters and numbers;
ability to sit quietly;
adequate fine motor skills (coloring, manipulating small objects);
adequate gross motor skills (running, hopping, & jumping)
Elementary School Readiness Skills
Independence and skill in occupations;
independence in bathroom;
independent in cafeteria (self-feeding, carry lunch tray, assist in cleaning tables);
remain seated for extended periods;
remain "on task" and attend to work while seated (in-seat behavior);
expectations of reading, writing, spelling, and math skills depend and increase with each grade level;
adequate perceptual & motor skills to participate in games & organized sports
Middle Childhood & Adolescent Readiness Skills
Build on competence;
appropriate social skills & manners;
increased skill in creative thinking, problem solving & development of ideas;
expressive writing skills emerge;
begin to seek independence;
question authority figures but must learn to work with them effectively in educational setting
Formal vocational activity:
part time job with salary
Informal vocational activity:
mowing neighbor's lawn, selling cookies or lemonade
____________ is the ________________ of childhood!
not associated with time consuming duties and responsibilities
During leisure activities, children do what?
refine skills, relax, reflect, and engage in creativity
OTPF III definition of play:
spontaneous or organized activity that provides enjoyment, entertainment, amusement, or diversion.
Piaget's Stages of Play: 0-2 years
Sensorimotor: practices games, exploratory behaviors, reflexive behaviors, repetition.
Piaget's Stages of Play: 2-6 years
Symbolic: uses imaginary objects, pretend play
Piaget's Stages of Play: 6-10 years
Games w/Rules: participates in team sports, activities w/flexible rules, goals.
Occupational Therapy Theorists: Reilly
1. Exploratory behaviors
Occupational Therapy Theorists: Takata
Play History interview format
Occupational Therapy Theorists: Knox
Revised Preschool Play Scale (PPS)
Divides play into 4 dimensions:
Occupational Therapy Theorists: Bundy
Test of Playfulness (ToP), objective measure of a child's playfulness.
Child's attitude and approach to play
Play Skill Acquisition: Infancy
Explore environment through senses,
play focuses on opportunities for exploration,
Encourage body awareness,
Play should be fun
Play Skill Acquisition: Early Childhood
Development of friendships which provides opportunities to learn negotiation, problem-solving, and communication skills,
manipulative play, imitation, games, and social play with child of same sex,
Play Skill Acquisition: Middle Childhood
refinement of skills: speed, dexterity, strength, and endurance;
more competent in play,
games with rules & competition,
assists with finding their identities
Play Skill Acquisition: Adolescence
parent need to facilitate socially appropriate play and leisure activities,
activities with peers,
school or community clubs,
play can promote independence
Occupational Therapy process:
family-centered, cultural diversity, therapeutic use of self, activity analysis
Models of Practice:
help to organize thinking,
focus on the factors that influence functioning
Examples of MOPs:
Model of Human Occupation (MOHO),
Person-Environment-Occupation (PEO) Model,
Occupational Adaptation Model,
Canadian Model of Occupational Performance
The only Model of Practice that considers Spirituality:
Canadian Model of Occupational Performance
Evaluation Period consists of:
Levels of Performance:
Frames of Reference (FORs)
help us decide how to intervene for direct OT intervention; helps the OT practitioner identify problems and develop solutions.
Frames of Reference help us:
based on theory, research and clinical experience,
defines the population,
describes the continuum of function.
provides assessment tools,
describe treatment modalities & intervention techniques,
defines role of practitioner,
suggests outcomes measures,
Tools of OT Practitioners:
therapeutic use of self
process of changing steps during an activity to facilitate client engagement
the process of arranging in steps or stages; a sequence; shading
Therapeutic Use of Self
be aware of body language,
read verbal and nonverbal cues,
be caring and nonjudgmental,
exercise cultural awareness and sensitivity.
Short-term Objectives: RUMBA
*Disposition to play
*Individual style of play is an aspect of a child's personality.
*Encompasses intrinsic motivation, internal control, and freedom to suspend reality
*Spontaneity and flexibility
Play is the __________________, Playfulness is the ______________________.
primary activity; primary process
Play for Children with Disabilities
Normal sequence is often delayed,
require intervention to engage
Relevance of Play
vital to a child's development,
important outcome of OT intervention,
can be a tool or goal,
can facilitate development in other areas
Play as a Tool (Means)
used to increase strength, motor planning, problem solving, grasping, or handwriting.
arranges environment to promote play, playfulness, and pretend play.
Should be free of rules.
Play as a Goal (End)
Practitioners model play, cultivate the skills needed for play, & set up environment.
Goal is to increase skills needed for play.
Approach & the way a child plays is emphasized.
Goal is spontaneous play.
7 Principles for Inclusive Play Spaces
1. Equitable use
2. Flexibility in use
3. Simple & intuitive use
4. Perceptible information
5. Tolerance for error
6. Low physical effort
7. Size & space form approach & use
Arranging a Play Space to Promote Types of Play
1. Pretend Play
2. Constructive Play
3. Reflective or reading area
4. Sensorimotor area
5. Exploratory play
6. Computer play area
7. Musical play
In relation to the hierarchy of functions most important to human beings, which of the following is the highest?
Which of the following is most likely to support positive feeding development?
Caregivers enjoying healthy food options
If a positive feeding relationship is the overall goal, which of the following is the most supportive example?
An infant is grabbing for the spoon and the caregiver allows him to have it and gets another to continue feeding
Which of the following is the best example of allowing a young child to learn about feeding through observation, experience, and interaction?
Ensure the young child has opportunities to interact with food and people in ways other than eating or being fed
If a child has a cold and has difficulty breathing through his nose, which of the following behaviors might a caregiver expect to see?
The child may take smaller sips and/or eat less until he can breathe again
If a child is experiencing delayed motor development and is only beginning to sit independently around a year, which of the following foods might she be expected to eat?
If an infant is taking a bottle for the first time, which of the following would be the pattern of tongue movement?
Front to back tongue movement
If an infant is 3 months old and the family budget is tight, which of the following is the most appropriate source of nutrition?
Breast milk or formula
Which of the following statements is most true about a young child who loves chicken but who has trouble chewing and swallowing it sometimes so she pulls it in and out of her mouth?
This is a typical occurrence and is part of the exploratory process
Which of the following is the best practice for a family with a child who is just beginning to accept semi-solids?
The caregivers should include the child in the family meal
What are the benefits of play?
Play experiences provide learning opportunities,
play sparks creativity and curiosity,
play fosters self-esteem
Young children learn best through play that is _________________.
Relevant and meaningful to the child's life
What are the connections between brain development and play during the early years?
Play is essential for healthy development,
All healthy young mammals play,
The early games and play equip young children for the skills they will need later in life
Which one does NOT describe a type of play?
Electronic and playground play
What is the difference between object play and social play?
Object play refers to how children play with toys; social play refers to how children play with other people.
Which response best describes an example of Active Play?
Child makes music by banging wooden spoons on pots and pans
Which of the following is a stage of Object Play?
Random and exploratory play,
Cause and effect play,
Purposeful and functional play
What occurs during the 6th stage of Object Play, also called "Imaginative and Themed Play"?
Child pretends to be something - takes on different roles (dress up, etc)
Which responses are included in the stages of social play?
Play with adults
Successful play is all about the __________________.
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