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NBCOT - Pediatrics

Terms in this set (203)

- Most common condition for premies
- Leads to heart failure and inadequate oxygenation

a. patent ductus arteriosus
b. Atrial septal deficits
c. Ventricular septal deficits
a
- Opening of the septum between the R and L atrial chambers
- "Wet lungs" = respiratory infection
- R ventricle becomes overworked = heart failure
- Poor exercise tolerance and small stature

a. patent ductus arteriosus
b. Atrial septal deficits
c. Ventricular septal deficits
b
- 1 or more openings in ventricular septum
- 50% of cases self-correct by age 5
- Results in Eisenmenger's complex
- Feeding difficulties, shortness of breath, respiratory infections, fatigue, delayed growth

a. patent ductus arteriosus
b. Atrial septal deficits
c. Ventricular septal deficits
c
- Pulmonary valve or artery stenosis, ventricular septal deficit, right ventricle hypertrophy and override of ventricular septum.
- Central cyanosis, coagulation defects, clubbing of fingers and toes, failure to thrive.

a. tetralogy of Fallot
b. Transposition of great arteries
a
- Lack of communication between the systemic and pulmonary circulations = transpositioning of ventricles
- Cyanosis, CHF, respiratory destress

a. tetralogy of Fallot
b. Transposition of great arteries
b
T or F: Children with cardiac conditions often have compromised endurance and activities should be appropriately paced.
true
_____________ can lead to CHF and is more common in children. Rates of 200-300 bpm!

a. bradydysrhythmia
b. tachydysrhythmia
b
- Acute condition
- Common in premies
- Deficiency of surfactant
- Surfactant not produced until 34-36th week gestation
- Compromised O2 absorption and CO2 elimination

a. Respiratory distress syndrome
b. Bronchopulmonary dysplasia
c. Asthma
d. Cystic Fibrosis
a.

It's an acute condition!
- Chronic condition
- Prolonged use of mechanical ventilation
- Thickened airway, excess mucus, restricted alveolar growth

a. Respiratory distress syndrome
b. Bronchopulmonary dysplasia
c. Asthma
d. Cystic Fibrosis
b
- Bronchial smooth muscle hyperactivity = constricted airway
- Appears before age 5
- Triggered by environmental factors

a. Respiratory distress syndrome
b. Bronchopulmonary dysplasia
c. Asthma
d. Cystic Fibrosis
c
- Degenerative condition characterized by muscle-producing glands malfunction and produce thick secretions blocking the pancreatic duct, bronchial tree and digestive tract
- Salty-skin, abdominal distention, greasy stools
- Chronic pulmonary disease is a SERIOUS complication

a. Respiratory distress syndrome
b. Bronchopulmonary dysplasia
c. Asthma
d. Cystic Fibrosis
d
Which of the following would not be a practical OT intervention for someone with CF?

a. Educate about disease progression
b. Energy conservation techniques
c. Heavy work to promote gland secretion
d. Breathing techniques
C
Which of the following would not be a practical OT intervention for someone with asthma?

a. Educate client on reduction of exposure to irritants
b. CBT
c. Pacing and stress management
d. Structured, peer-group activities
e. Breathing exercises, stretches
b
Erythrocytosis or transient leukemia is characterized by too many RBCs and elevated WBCs. Which condition is often associated with this disorder?
Down syndrome
- Absence or reduction of blood clotting proteins
- Common in males
- Long bleeding time, nosebleeds and bruising

a. erythrocytosis
b. hemophilia
c. anemia
d. sickle cell anemia
b
- Iron deficiency in blood
- Treated by change in diet

a. erythrocytosis
b. hemophilia
c. anemia
d. sickle cell anemia
c
- Abnormal shaped RBC
- Common in african americans
- Decreased energy for daily tasks
- Require intervention for pain management!!

a. erythrocytosis
b. hemophilia
c. anemia
d. sickle cell anemia
d
- "Brittle bones"
- Minor trauma = fx
- Multiple fx lead to misshapen limbs
- Decreased bone deposition d/t inability to form Type 1 collagen
- Heavy emphasis on maternal handling techniques

a. Osteogenesis Imperfecta
b. Marfan's syndrome
c. Achondroplasia
a
Of the three forms of OI, which is the most severe and often fatal?

Which is the least severe and beings in late childhood?
Fetal most severe. High fatality.

Juvenile least severe. Bones often harden.

Infantile is the moderate OI. Many fx's occur in early childhood.
T or F: Due to the nature of OI, weight bearing is contraindicated.
false; WB is encouraged
- Excessive growth at ephiphyseal plate
- Slender fingers, skull asymmetries, tall stature
- Lax, hypermobile joints
- Delayed walking milestones

a. Osteogenesis Imperfecta
b. Marfan's syndrome
c. Achondroplasia
b
- Stunting of epiphyseal plate growth and cartilage formation
- Lumbar lordosis, coxa vara and cubitus varas.

a. Osteogenesis Imperfecta
b. Marfan's syndrome
c. Achondroplasia
c
- Reduced anterior horn cells in the SC
- Incomplete fcontracutres of many or all of the joints
- UE and LE involvement
- Underdevelopment of muscles and can even cause paralysis if SC is involved

a. Achondroplasia
b. Arthrogryposis multiplex
c. developmental dysplasia of hip
b
Which of the following treatments would be contraindicated for someone with arthrogryposis?

a. Splinting, serial casting
b. Sensory integrative therapy
c. ROM and strength programs
d. AE to facilitate daily tasks
b
- Forefoot adduction and supination, heel varus, equines of the ankle, medial deviation of the foot
- Bony malformations and underdeveloped LE musculature
- Can be treated by taping, casting, splinting or surgery
Clubfoot
- Partial or full absence of radius + ulnar shaft bowing
- Underdeveloped nerves and musculature
- Progressive casting, static or dynamic splinting or surgery may be warranted for cosmetic reasons
Club hand

Hand is often functional but patients have concerns with cosmesis
- Occurs bilaterally
- Genetic and environmental causes
- Hip laxity
- Treated by bracing, casting or splinting within first few weeks

a. Achondroplasia
b. Arthrogryposis multiplex
c. developmental dysplasia of hip
c
Developmental hip dysplasia is often detected by the ______ test: Clicking is present when the child's leg is abducted and pressure is placed on the medial thigh.
Barlow
Developmental hip dysplasia will often develop a Trendenlenburg sign where the hip drops on the _________ side of the dislocated hip.
opposite
Name the condition

1.) Person has excess fingers or toes
2.) Webbing between fingers or toes
3.) Overly large digits. Difficulty with FMC tasks.
4.) Overly small digits
1. polydactyly
2. syndactyly
3. bradydactyly
4. microdactyly
Amelia is the absence of a limb or distal segments of a limb.

A fully or partial formed distal extremity and absence of one or more proximal segments.

a. phocomelia
b. paraxial deficiencies
c. transverse hemimelia
a
Amelia is the absence of a limb or distal segments of a limb.

Proximal segments of the lim are correctly developed, either medial or lateral limb is missing.

a. phocomelia
b. paraxial deficiencies
c. transverse hemimelia
b
Amelia is the absence of a limb or distal segments of a limb.

Amputation of a limb segment across the central area. Commonly bilateral or hemilateral.

a. phocomelia
b. paraxial deficiencies
c. transverse hemimelia
c
Strain: a ________ injury d/t excessive use of body part or force. Trauma to muscle/tendon insertion.

Sprain: a _________ injury caused by trauma to a joint.
muscle
ligament
A JRA diagnosis must be made on the basis of of persistent arthritis lasting for ____ or more weeks.
6
Pauciarticular JRA: involvement of fewer than ____ joints.

Polyarticular JRA: involvement of more than ____ joints.
5
5
Systemic JRA is a polyarticular JRA with _______ involvement.
organ
Which of the following would not be beneficial for treating a JRA patient?

a. splinting
b. AROM and PROM programs
c. NMES modality
d. Joint protection
e. energy conservation and AE use
c
- ________: The bone is broken straight through, and no bone fragments are connected to one another.
__________: The bone is broken into many splintered pieces.

________: The broken bone leads to an external wound at the site of the fracture, and bone
often protrudes through the skin.
complete
comminuted
compound
This time of bone fracture occurs when a bone is partially broken and bent. Only occurs in children and those with rickets!
Greenstick
T or F: Lordosis is an anteroposterior curvature; directed anteriorly.
false; posteriorly
The following are tx's for lordosis:

1. Stretching tight hip _______
2. Strengthening abdominals
3. Postural training
4. Back bracing
flexors
T or F: Kyphosis is referred to as Scheurmann's disease in adolescents.
true
A Milwaukee brace is for:

a. lordosis
b. scoliosis
c. kyphosis
c
Scoliosis needs to be treated if the lateral curvature is more than ____ degrees.
10
Scoliosis:

- Curves of less than ___° are considered mild.
- Curves of more than ___° may result in permanent deformity.
- Curves of 65°-80° may result in reduced ___________ function.
20
40
cardiopulmonary
After surgical correction of scoliosis, which muscle group is most important to strengthen?
abdominals
Which of the following is true regarding CP?

a. Nonprogressive
b. Prematurity account for majority of cases
c. Primitive reflexes and automatic reactions are retained
d. Lack of muscle coactivation and abnormal compensatory patterns contribute to poor posture
e. all the above
e
- ________: fluctuation of tone from low to normal with little spasticity

- ____________: constant fluctuations from low to high tone, without cocontractions; typically appears as jerky movements
Athetosis

Choreoathetosis
A reflexive back and forth movement of the eyes when the head moves.

a. nystagmus
b. strabismus
c. dysarthria
Nystagmus
Eye alignment deviation.

a. nystagmus
b. strabismus
c. dysarthria
b
Which of the following would NOT be beneficial for a child with CP?

a. AROM, PROM stretches and exercises
b. AE, AT to increase education, play, leisure and social participation
c. Seating and positioning
d. Heat modalities
d
Generalized seizures involve the entire cerebral cortex. A ______ seizure begins in a single location then spreads to one area of the cortex.
partial
- Most frequent type
- Can tell when seizure will begin
- Loss of consciousness and rhythmic clonic contractions
- Lasts ~5 min
- Incontinence is common

a. Tonic clonic seizures
b. Absence seizures
c. Akinetic seizures
a
- Brief lapse of loss of awareness
- Absence of motor activity (eye blinking)
- ~30 seconds
- Mistaken for daydreaming

a. Tonic clonic seizures
b. Absence seizures
c. Akinetic seizures
b
Contractions of single muscles or muscle groups

a. Tonic clonic seizures
b. Myclonic seizures
c. Akinetic seizures
b
Loss of muscle tone for more than 30 minutes.

a. Akinetic seizures
b. Absence seizures
c. Status seizures
a
- Exented seizures
- Requires prompt medical attention

a. Akinetic seizures
b. Absence seizures
c. Status seizures
c
- Temporal lobe
- Lip smacking, chewing, buttoning clothing
- Similar to absence seizure

a. complex partial seizure
b. simple partial seizure
a
- Motor cortex
- Clinic activity of face or extremities
- Visual or auditory hallucinations

a. complex partial seizure
b. simple partial seizure
b
- Proximal muscles of pelvis and shoulder girdle
- Slow progression
- Onsets within first 30 years of life

a. limb girdle MD
b. facioscapulohumeral MD
c. Duchenne's MD
d. Congenital MD
a
- Occurs in adolescence
- Sloped shoulders and limited ability to raise arms above head
- Decreased mobility in facial muscles; "mask like" appearance

a. limb girdle MD
b. facioscapulohumeral MD
c. Duchenne's MD
d. Congenital MD
b
- Most common MD
- Only in boys
- Deficiency in dystrophin production = muscle degeneration
- Progresses quickly
- Usually w/c bound by 9

a. limb girdle MD
b. facioscapulohumeral MD
c. Duchenne's MD
d. Congenital MD
c
When asked to get up from sitting on the floor, the child will move the hands on the legs as though crawling up to the thighs and then assume a standing position. Seen in kids with Duchenn'es MD!
Gower's sign
What is the typical reason why people with Duchenne's MD die?
respiratory problems or cardiovascular complications
OT interventions should focus on which of the following for MD?

a. prevent deformity
b. increase strength and ROM
c. provide psychosocial support
d. AE
e. all of the above
e
- Brain involvement is apparent, along with neuromuscular functioning
- Hypotonia, weakness, contractures
- Clubfoot, torticollis, and congenital heart defects

a. limb girdle MD
b. facioscapulohumeral MD
c. Duchenne's MD
d. Congenital MD
d
- Protrusion in the occipital region of brain
- Cognitive impairments, hydrocephalus, motor impairments and seizures

a. encephalocele
b. anencephaly
c. spina bifida
a
- Lack of development above brain stem level
- Do not survive infancy

a. encephalocele
b. anencephaly
c. spina bifida
b
- Most common neural tube defect
- Defect of vertebral arches and spinal column
- May have cognitive or learning issues

a. encephalocele
b. anencephaly
c. spina bifida
c
- mild form of spina bifida
- 1-2 vertebral involvement
- no spinal cord involvement
- NO symptoms may be present

a. spina bifida occulta
b. meningocele
c. myclomeningocele
a
- Extensive spinal opening with exposed pouch of CSF and meninges

a. spina bifida occulta
b. meningocele
c. myclomeningocele
b
- Most severe
- Excessive spinal cord opening, exposed CSF and meninges
- Nerve roots are exposed
- LE paralysis common

a. spina bifida occulta
b. meningocele
c. myclomeningocele
c
Portion of the cerebellum and medulla oblongata slip down through the foramen magnum to the cervical spinal cord
Arnold-Chiari syndrome
T or F: Myclomeningocele patients do not require bowel and bladder programs since LE paralysis does not often occur.
false; may be indicated
List the nerve roots of the BP.
C5-T1
- Upper BP injury (C5-C6)
- Caused by extreme shoulder flexion
- Breech deliveries
- Weakness of hands and poor sensations
-"Waiter's tip"
- Typically occurs within 3-24 months

a. Erb-Duchene palsy
b. Klumpke's palsy
a
- Lower BP injury (C8-T1)
- Paralysis of hand and wrist muscles = claw hand deformity
- Can result in full paralysis of entire UE

a. Erb-Duchene palsy
b. Klumpke's palsy
b
T or F: It would be inappropriate to perform MMT on a BP injury.
false; appropriate
BP Injury Tx:

Fabrication of a sling that fits proximally around the humerus to ensure proper alignment and prevent ________ due to gravity
subluxation
- Peripheral nerve injury where some degree of paralysis is present
- NO peripheral degeneration

a. neruapraxia
b. axonotemsis
c. neruotmesis
a
- Peripheral nerve injury where endometrium is intact
- Axon degenerates distal to legion

a. neruapraxia
b. axonotemsis
c. neruotmesis
b
- Peripheral nerve injury
- Most serious type
- Axon and endometrium is severed

a. neruapraxia
b. axonotemsis
c. neruotmesis
c
- ______ injuries are caused by rapid movement of the head in which the brain strikes the skull.
- _______ injuries are caused when an object enters the brain.
closed
open
Client shows no response

a. RLA 1
b. RLA 2
c. RLA 3
A
Client shows a generalized response.

a. RLA 1
b. RLA 2
c. RLA 3
B
- Client shows periods of being awake
- Can follow simple commands

a. RLA 3
b. RLA 4
c. RLA 5
a
- Client is confused and agitated.

a. RLA 4
b. RLA 5
c. RLA 6
a
- Client is confused
- Short attention span
- May need step-by-step instructions
- Responds inapropriately

a. RLA 4
b. RLA 5
c. RLA 6
b
Client may demonstrate memory and cognitive processing problems and may still be somewhat confused.

a. RLA 4
b. RLA 5
c. RLA 6
c
- Attention may still be a concern
- Clients action are more appropriate to situation
- Breakdown of skills during stress
- Can complete self-care routines

a. RLA 5
b. RLA 7
c. RLA 8
b
- Purposeful and appropriate actions
- More flexibility in thinking
- Better problem solving

a. RLA 6
b. RLA 7
c. RLA 8
c
TBI treatment:
- Sensory stimulation to increase awareness
- ROM
- Positioning to prevent skin breakdown
- Splinting

a. Acute care
b. Rehabilitaiton
c. Community reentry
a
TBI:
- Assessments: COPM, PEGS
- Assess VMI, VP, SP, and psychosocial factors
- Regain ADLs, IADLs, executive functioning
- Training on AD for school reentry and organization

a. Acute care
b. Rehabilitaiton
c. Community reentry
b
TBI:
- Home and community visits to assess activity demands and problem solve
- Home and school modifications
- Reducing written work, peer models, typed out notes, picture schedules, reducing classroom stimuli

a. Acute care
b. Rehabilitaiton
c. Community reentry
c
An intellectual disability is the most common developmental disability. If a child scores more than ___ standard deviations below normative range, it is considered an ID.
2
IQ between 55 and 70; ability to learn academic skills at the 3- 7 grade level; able to work with minimal support.

a. mild ID
b. moderate ID
c. severe ID
d. profound ID
a
IQ between 40 and 55; able to learn academic skills to at least the second-grade level and able to perform unskilled as well as some skilled work tasks.

a. mild ID
b. moderate ID
c. severe ID
d. profound ID
b
IQ between 25 and 40; able to communicate and perform some basic ADLS and health habits; often requires support to complete routines.

a. mild ID
b. moderate ID
c. severe ID
d. profound ID
c
IQ below 25; requires caregiver assistance for basic tasks; also generally has neuromuscular, orthopedic, or behavioral deficits.

a. mild ID
b. moderate ID
c. severe ID
d. profound ID
d
Onset of ASD is typically before age ____.

a. 1
b. 3
c. 6
3
Children with ASD may have difficulty with empathy or taking others' perspectives and hypothesize about what they might do next.

a. theory of mind
b. weak central coherence
a
Children with ASD often have an acute sense for detail, almost to the point of missing the bigger pictures.

a. theory of mind
b. weak central coherence
b
- Progressive neurologic disorder found only in girls
- Head growth slows
- Loss of hand skills and poorly coordinated trunk and gait coordination
- Loss of social skills
- Handwringing and waking hyperventilation is a common characteristic
- Nonambulatory and non verbal
Rett syndrome
Which of the following is not true concerning ADHD?

a. More common in boys
b. Brain activity is diminished in the frontal lobe
c. CBT is encouraged
d. enhance sensory modulation and support organizational routines
b. parietal lobes
Challenging automatic thoughts, reducing cognitive distortions, challenging underlying beliefs and assumptions, mental imagery, controlling recurrent thoughts, controlling behavior. This describes what type of therapy?
CBT
What's the difference between a genetic and chromosomal disorder?
genetic - involves one gene
chromosomal - more than one gene
This diagnosis may have issues with atlantoaxial instability (AAI). Not allowed to hyper flex the neck.

a. Down syndrome
b. Trisomy 12
c. Turner's syndrome
a
- Anomalies affecting the eyes, ears, nose, lips, palate and digits
- Microcephaly and neural tube differences
- Low survival rate

a. Down syndrome
b. Trisomy 12
c. Turner's syndrome
b
- Webbing of neck, congenital edema of extremities and cardiac problems
- Short, obese and lack of secondary sexual characteristics
- Do NOT have intellectual disabilities
- Visual perception problems

a. Down syndrome
b. Trisomy 12
c. Turner's syndrome
c
- Catlike cry in infancy
- Microcephaly, down-slanting eyes, cardiac abnormalities and failure to thrive
- Have in ID

a. Cri du chat syndrome
b. Klinefelter's syndrome
c. Fragile X
a
- Boys who have an extra X chromosome
- Learning disability and emotional/behavioral problems
- Tall, slim, small genitalia, infertile

a. Cri du chat syndrome
b. Klinefelter's syndrome
c. Fragile X
b
Children have an ID, craniofacial deformities, elongated face, large ears, flat feet and hyper mobile joints

a. Neurofibromatosis
b. Klinefelter's syndrome
c. Fragile X
c
- Multiple tumors on the central and peripheral nerves
- Cafe-au-late birthmarks
- mild ID or learning disabilities
- skeletal anomalies; SHORT STATURE

a. Neurofibromatosis
b. Klinefelter's syndrome
c. Fragile X
a
Children with this disorder present with moderate intellectual disabilities, food-seeking behaviors, hypotonia, poor thermal regulation, underdeveloped sex organs, and a long face with slanted eyes.

a. Neurofibromatosis
b. Prader-Willi syndrome
c. Williams syndrome
b
- Cerebral and cardiovascular abnormalities
- ID, affinity for music, social skills and writing
- difficulty with visual, spatial and motor skills

a. Neurofibromatosis
b. Prader-Willi syndrome
c. Williams syndrome
c
- Progressive neuromuscular disease as a result of difficulty metabolizing purines
- Only boys have this syndrome
- ID, neuromotor degeneration and spasticity
- Prevent self-injurious behavior

a. Galactosemia
b. Lesch-Nyhan syndrome
c. PKU
c
T or F: DCD commonly affects speech and language production.
true
Which of the following is NOT an intervention for DCD?

a. Implement modifications for written language such as keyboarding
b. promote safe practice of motor skills
c. provide group intervention to incorporate mirror play for motor planning
d. Perform assessment with the CO-OP
C.

Provide individual intervention first so that the child can master the skill before group play
- Client-centered, problem solving approach
- Devise solutions for everyday life situations involving motor performance
- Child selects goals and works on ways to generalize skills
- Goal is obtain skill acquisition, generalization, transfer and positive gains in self-efficacy for independent strategy development

Which assessment is being described?
Cognitive Orientation to daily Occupational Performance (CO-OP)
T or F: Infections transmitted from mother to child are known as "STORCH" infections: syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes simplex virus-2
true
T or F: Antiretroviral drugs are used to treat AIDS in children.
true
________ is an inflammation of the brain.

______ is an infection of the tissue that covers the brain and the SC.
encephalitis

meningitis
T or F: Meningitis is often caused by a viral infection.
false; bacterial
A rapid movement of the eye between fixation points
saccade
A binocular cue for perceiving depth; the extent to which the eyes converge inward when looking at an object
convergence
Hearing conditions commonly have ______ dysfunction: decreased balance, low tone, poor visual development, delayed reflex maturation.
vestibular
Warren's model for assessment - Vision.

1. Primary visual skills: oculomotor control, visual fields, acuity
2. Visual ________
3. Scanning
4. _______ recognition
5. Visual ________
6. Visual cognition
attention
pattern
memory
A school age boy has problems completing work tasks on time and avoids reading or writing tasks. He most likely has dysfunctions with:

a. visual-reception
b. visual-cognition
c. refraction
a
- Eye fatigue.
- Distraction or inattention to visual material

a. visual-reception
b. visual-cognition
c. refraction
a
The inability of the eye to adjust to different lighting conditions, visual-field problems, accommodations and other oculomotor functions.

a. visual-cognition dysfunction
b. refractive errors
b
_________ : when accommodation for near objects is poor

_________: when one eye turns in, out, up, or down as a result of muscle imbalance; can
result in blurred or double vision

_________: a tendency for one eye to move slightly in, out, up, or down without overt misalignment
Presbyopia
Strabismus
Phoria
While administering an assessment to a school age student, you notice he is having deficits with visual attention, visual memory, figure-ground and depth perception. These are all areas of:

a. visual-reception
b. visual-cognition
b
When assessing visual-__________, look for:

1. How well the eyes work together
2. Determine where visual control is most effective
3. Identify eye movements that are quick and accurate
4. Observe for excessive head movements while reading or skipping lines when reading
reception
When assessing visual-__________, use the following assessments:

- BOT - Motor
- Proficiency
Jordan Left-Right Reversal
- Motor-Free VP Test
- Beery VMI
- Test of Pictures, Forms, Letters, Numbers
cognition
Which of the following is a visual accommodation for a school-age patient?

a. organized, clutter-free environment
b. Teaching strategies for scanning
c. Use chunking, maintenance rehearsal and mnemonic devices
d. Use computers to help develop skills
e. Use color coding
f. all the above
f
Scribbles on paper.

a. 10-12 mo
b. 3 yr
c. 4-5 yr
a
Imitates horizontal, vertical and circular marks.

a. 2 yr
b. 3 yr
c. 4-5 yrs
a
Copies vertical lines, horizontals, and circles.

a. 2 yr
b. 3 yr
c. 4-5 yrs
b
Copies a cross, right oblique line, square, left diagonal line, left oblique cross. Some letters and numbers. Possibly write name.

a. 3 yrs
b. 4-5 yrs
c. 5-6 yrs
b
Of the following shapes, which forms first then last?

Square, circle, triangle
Circle, square, triangle.

Triangles requires incorporation of diagonal lines which is harder. 5-6 is when triangles are formed BECAUSE at age 4-5 diagonal lines are mastered.
List the development of Benbow's classification of basic skilled hand use:

1. Upper extremity support
2. ______ and ______ development
3. Visual control
4. ________integration
5. __________ analysis
6. Kinesthesia
wrist; hand
bilateral
spatial
The whole hand or extended fingers and a pronated forearm are used to hold writing utensil; the writing movement comes from the shoulder.

a. primitive grip
b. transitional grip
c. mature grip
a
Writing utensil is held with flexed fingers with pronated forearm and radial side down and then progresses to a supinated forearm position.

a. primitive grip
b. transitional grip
c. mature grip
b
The writing utensil is stabilized by distal phalanges of the thumb, middle, and index finger; the ring finger may also be used; wrist is slightly extended, and the supinated forearm rests on the table.

a. primitive grip
b. transitional grip
c. mature grip
c
The pencil rests against distal phalanx of the radial side of the middle finger, and the pads of the fingers control the movement; the thumb is opposed to the index finger.

a. dynamic tripod
b. lateral tripod
a
The pencil rests against the radial side of the middle finger, and the pads of the fingers control the movement; the thumb is not opposed to the index finger and rests on the distal interphalangeal joint.

a. dynamic tripod
b. lateral tripod
b
The pencil rests against the distal phalanx of the radial side of the ring finger, and the pads of the fingers control the movement; the thumb is opposed to the index finger.

a. dynamic quadrupod
b. lateral quadrupod
a
The pencil rests against the radial side of the ring finger, and the pads of the fingers control the movement; the thumb is not opposed to the index finger and rests on the distal interphalangeal joint.

a. dynamic quadrupod
b. lateral quadrupod
b
Word legibility formula: total number of _________ words divided by total number of words written
readable
T or F: Handwriting interventions have various approaches including: neruodevelopmental, acquisitional, sensorimotor, biomechanical and psychosocial.
true
- Handwriting approach best used for kids with: poor postural control, automatic reactions, limited limb control, tone issues and poor proximal stability.
- Activities should help modulate tone, promote proximal joint stability, improve hand function.

a. Neurodevelopmental approach
b. Acquisitional approach
c. Sensorimotor approach
...
- Handwriting approach that states:
1. Handwriting should be taught directly
2. Implemented in brief, daily session
3. Individualized to the child
4. Handwriting should be overlearned

a. Biomechanical approach
b. Acquisitional approach
c. Sensorimotor approach
b
There are 3 phases to the acquisitional approach to handwriting. Which is being described?

Child is beginning to understand the demands of handwriting and develops a cognitive strategy for necessary motor movement.

a. cognitive phase
b. associative phase
c. autonomous phase
a
There are 3 phases to the acquisitional approach to handwriting. Which is being described?

Child continues to practice and begins self-monitoring; proprioceptive feedback and visual cues are essential.

a. cognitive phase
b. associative phase
c. autonomous phase
b
There are 3 phases to the acquisitional approach to handwriting. Which is being described?

Child can perform handwriting with minimal conscious attention.

a. cognitive phase
b. associative phase
c. autonomous phase
c
- Handwriting approach that states: Multisensory input is provided to enhance the integration of the sensory systems.
- Various sensory experiences, media and novel materials are incorporated
- Write on multiple writing tools, writing surfaces and positions for writing should be offered.

a. Biomechanical approach
b. Acquisitional approach
c. Sensorimotor approach
c
Handwriting approach that states: Intervention is focus on ergonomic factors that influence writing production.
- Seated with feet on floor
- Table should be 2 inches above flexed elbow
- Paper should be slanted parallel to forearm
- Provide AE like grips

a. Biomechanical approach
b. Acquisitional approach
c. Sensorimotor approach
a
- Handwriting approach that focuses on self-control, coping skills and social behaviors.
- Communicate the importance of good handwriting
- Enhance self-confidence

a. Biomechanical approach
b. Acquisitional approach
c. Psychosocial approach
c
In Ayres SI, proximal senses are emphasized and dominate a childs life. List the 3 proximal senses and the 2 distal senses as stated by Ayres.
Proximal: vestibular, proprioceptive, tactile

Distal: hearing, vision
An individualized plan that provides a specific child with the optimal
sensory experiences that the child needs to be functional in his or her environment.
sensory diet
An __________ response is the result of optimal organization and leads to efficient goal-directed action.
adaptive
T or F: As tasks become more complicated and children continue to demonstrate adaptive response, their SI becomes more effective and efficient.
true
Adaptive responses are thought to lead to changes at the neuronal synaptic level; these changes alter the brain through a process called ______ _________.
neural plasticity
Ayres hypothesized that SI takes place in the lower levels of the CNS, specifically at the brain stem and the thalamus.

________ input is processed mostly in the brain stem.

__________ input is processed mostly in the thalamus.
vestibular
somatosensory
Sensory ________ is regulation by the CNS of its own activity.
modulation
What are the 3 parts of praxis?
ideation
planning
execution
Children with dyspraxia have difficulty with:

a. motor planning
b. tactile perception and discrimination
c. all the above
c
T or F: Children with SI dysfunction consistency demonstrate adaptive responses.
false; will not consistently demonstrate adaptive responses
- Requires 19-20 min to administer
- Measures tactile, vestibular, proprioception, VM coordination, bilateral integration and praxis
- Requires specialized training

a. SensoryIntegration and Praxis Test
b. BOT
c. SFA
d. Sensory Profile
a
Which of the following is NOT a principle of Ayres SI treatment?

a. Sensory input should be meaningful
b. Intervention should occur on an individual basis
c. Therapist-directed environment
d. Therapist should create the just-right chalet
e. Linear movements are tolerated first
c.

Child-directed!
According to Ayres, what should the frequency and duration of treatment be for children with SI dysfunction?
45-60 min, 1-2 per week x 2 years
Typically, children between the ages of ____-____ are able to copy a triangle, print their own name, and copy most letters from a model.

A. 3-4
B. 4-4.5
C. 5-6
C
When evaluating a behavioral patient, the OTR should:

a. Have the teacher complete a preassessment checklist
b. Observe the child in a natural environment
c. Include assessments such as: Social Skills Rating System and SFA
d. Review medical information
e. all the above
e.
- Interactions between the child and OT are considered opportunities for learning
- Safety is priority
- Develop decision-making skills and increased socialization
- Provide the least amount of control necessary so that the child can make decisions

What type of intervention is being described?
Rational Intervention (RI)

Used with behavioral children
T or F: Using the rational intervention (RI), the child should not be given many opportunities to make choices unless demonstrating proper behaviors.
false; give the child opportunities to make choices
Behaviors are those that are slightly problematic and require additional observations; the child may benefit from environmental adjustments, cues, or facilitation.

a. green zone
b. yellow zone
c. red zone
b
Behaviors are those that require immediate intervention (verbal or physical) because the child or others are being put at risk as a result of a negative behavior.

a. green zone
b. yellow zone
c. red zone
c
- Type of RI
- OT matching his or her response to the child's behavior

a. matching
b. facilitation
c. monitoring
a
- Type of RI
- Observing the child and improving the child's environmental supports

a. matching
b. facilitation
c. monitoring
b
- Type of RI
- Observing the child and letting the child know the OT is present, encouraging the child, using guiding questions to prompt the child to problem solve.

a. matching
b. facilitation
c. monitoring
c
- Type of RI
- Altering the environment
- Reminding the child of expectations, modeling appropriate behavior and redirecting the child to another location or activity

a. gentle correction
b. moderate correction
c. strong correction
a
- Type of RI
- Giving the child a break by redirecting the child

a. gentle correction
b. moderate correction
c. strong correction
b
- Type of RI
- Time outs given; time away from the activity until child is calm
- May need physical management if safety is an issue

a. gentle correction
b. moderate correction
c. strong correction
c
Tantrums are a natural part of development. They occur frequently with 2-year-olds and diminish significantly by age ____, when verbal communication is typically easier for the child.
4
T or F: When addressing a behavioral child, do not use phrase directives as questions. For example, don't say "Ryan do you want to put your shoes on?". Say, "Ryan, shoes go on."
true
Which of the following is NOT true regarding behavioral treatment principles?

a. Limit the amount of positive attention
b. Use rewards and incentives
c. Grade reinforcers so that tangible rewards (cookie) are paired with non tangible rewards (high five) and systematically reduce tangible rewards
a. limit negative attention
- Age ___ mo: able to WB through BLE; the infant also begins to transition from sitting to kneeling

- Age ___ mo: able to stand while holding on to a surface or a piece of furniture; the infant also beings to crawl

Age ___ mo: taking purposeful steps while holding on to an adult's hands for assistance

Age ___ mo: beginning to walk independently
7
9
10
12
Age ___: Expresses discomfort when diaper is wet or dirty; moves bowels regularly
.
Age ___: Can sit on toilet with supervision.

Age ___: Begins to show interest in toileting; can stay dry for 2 hr or more; can flush toilet independently; urinates regularly.
1
1.5
2
- Age ___: Tells someone when having to go to the bathroom; can be on a regular toileting schedule; may need assistance to get positioned on the toilet; wakes up dry at night; can wipe self after urinating; washes hands independently.

- Age ___: Goes to the bathroom independently; may need assistance wiping, particularly after bowel movements; may need assistance fastening or managing some clothing items.

Ages ___-___: Independent with toileting, washing hands, and clothing management.
2.5
3
4-5
Assists with dressing by cooperating during the activity; pulls off shoes and removes socks.

a. Age 1
b. Age 2
c. Age 2.5
a
Able to doff coat after fasteners have been undone; Removes shoes if not tied; Can help pull down pants; an locate armholes in shirt.

a. Age 1
b. Age 2
c. Age 2.5
b
- Able to pull down paints with an elastic waistband
- Helps with putting on socks, coat and shirt
- Unbutton large buttons

a. Age 1
b. Age 2
c. Age 2.5
c
- Don pullover shirt with little A
- Can donn socks and shoes
- Able to zip zipper once engaged
- Can button large buttons

a. Age 3
b. Age 3.5
c. Age 4
a
- Can distinguish between front and back of clothes
- Can manage snaps and hooks
- Can unzip zipper completely
- Can button buttons and begin to buckle
- Can put on mittens
- Dresses with supervision

a. Age 3
b. Age 3.5
c. Age 4
b
- Removes pullover garment (I)
- Can buckle buckles
- Can zip zipper completely
- May lace shoes!

a. Age 3
b. Age 3.5
c. Age 4
c
Able to weave belt though belt loops.

a. Age 4.5
b. Age 5
c. Age 6
a
Can tie and untie knots; can dress without supervision.

a. Age 4.5
b. Age 5
c. Age 6
b
Can tie bows, can manage fasteners in the back of garments.

a. Age 4.5
b. Age 5
c. Age 6
c
Scissor development:
Age ____: Cut across a 6 in piece of paper.
Age ___: Cut on a line 6 in long
Age _____: Cut out circle
Age _____: Cut out square and simple figures
2.5
3
3.5
4.5
At what month do babies start:
Sitting?
Crawling?
Cruising?
Sit: 6 months
Crawl: 9 months
Cruising: 10 months
At what months do babies:
- Develop better color vision and depth perception
- Develop capital flexion
- Can track objects side to side in supine
- Can push up on forearms and explore environment in prone

a. 0-2 months
b. 3-4 months
c. 5-6 months
b
At month ___, babies can start prop sitting and lay in prone with arms extended.
5
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