Pediatric NBCOT Practice Questions

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what are likely areas to evaluate cystic fibrosis?Endurance and ADLswhat are likely areas to evaluate developmental coordination disorders?Sensory processing, gross and fine motor skills, and ADLswhat are likely areas to evaluate developmental disabilities?Tone, overall developmental level of gross and fine motor skillswhat are likely areas to evaluate juvenile rheumatoid arthritis?Range of motion, stamina, and the need for assistive devices for ADLswhat are likely areas to evaluate muscular dystrophy?Strength, tone, ADLs, and the need for assistive deviceswhat are likely areas to evaluate musculoskeletal (e.g., limb deficiencies)?Range of motion, ADLs, play skills, and the need for assistive deviceswhat are likely areas to evaluate neural tube defects (e.g., spina bifida or myelomeningocele)?Tone, strength, developmental level, and the need for assistive deviceswhat are likely areas to evaluate neuromuscular disorders (e.g., cerebral palsy, including ataxia, spastic, and athetoid types)?Tone, strength, developmental level, feeding, and the need for adaptive equipmentwhat are likely areas to evaluate peripheral nerve injuries (e.g., brachial plexus injuries)?"Active range, strength, and the need for splintingwhat are likely areas to evaluate in prematurity?Feeding, positioning, and environmental stimulation, or sensory inputwhat are likely areas to evaluate in traumatic brain injury?Tone, ROM, and ADLs including feedingWhat is the Battelle Developmental Inventory?Birth-8 years; Personal social skills, adaptive behavior (e.g., self-help), psychomotor, communication, and cognitionWhat is Bayley Scales of Infant Development?1-42 months; Cognitive and motor developmentWhat is Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI)?Visual-motor integration deficitsWhat is the Bruininks-Oseretsky Tests of Motor Skills, second edition?4.5-14.5 years; Gross motor, upper limb, and fine motor proficiencyWhat is the DeGangi-Berk Test of Sensory Integration?3-5 years; Sensory processing difficultiesWhat is the Developmental Test of Visual Perception (DTVP-2)?4-10 years; Visual perceptual and visual motor integrationWhat is Miller Assessment for Preschoolers (MAP)?2 years 9 months-5 years 8 months; Sensory motor foundations, motor coordination, verbal coordination, verbal and nonverbal skills, and performance on complex tasksWhat is Motor-Free Visual Perception Test (MVPT-3)?4-70 years; Visual perceptual abilities that do not require motor involvementWhat is Peabody Developmental Motor Scales, second edition (PDMS-2)?Birth-5 years; Gross and fine motor skillsWhat is Sensory Integration and Praxis Test?4-9 years; Sensory integration processesWhat is the Test of Visual Motor Skills-revised?3-13 years; Eye-hand coordination skills needed to copy geometric designsWhat is the Test of Visual Perceptual Skills non motor (TVPS-3)?4-18 years; Visual perceptual skillswhat are examples of standardized assessments?Battelle Developmental Inventory; Bayley Scales of Infant Development; Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI); Bruininks-Oseretsky Tests of Motor Skills, second edition; DeGangi-Berk Test of Sensory Integration; Developmental Test of Visual Perception (DTVP-2); Miller Assessment for Preschoolers (MAP); Motor-Free Visual Perception Test (MVPT-3); Peabody Developmental Motor Scales, second edition (PDMS-2); Sensory Integration and Praxis Test; Test of Visual Motor Skills- Revised; Test of Visual Perceptual Skills non motor (TVPS-3)What is the Hawaii Early Learning Profile?Infants, toddlers, and young children; Developmental needs, intervention goals, and tracks progressWhat is the School Function Assessment?Kindergarten through grade 6; Student's level of participation, supports needed, and activity performance on specific school tasksWhat is the Evaluation Tool of Children's Handwriting (ETCH)?Grades 1 to 6; Manuscript and cursive handwriting skillsWhat is the Gross Motor Function Measure revised (GMFM)?Children whose motor skills are at or below a 5-year-old level; Gross motor function in children with cerebral palsy and Down syndromeWhat are examples of criterion-referenced assessments?HELP, SFA, ETCH, GMFMWhat is the Childhood Autism Rating Scale (CARS 2)?Age 2 years and older; distinguishes children with autism from children with other cognitive delays, and helps determine severity of autistic symptoms.What is the Erhardt Developmental Prehension Assessment (Revised)?Looks at components of arm and hand development in children with cerebral palsy or other neurological impairments.What is Knox Preschool Play Scale (Revised)?Birth to 6 years; assesses play behaviors.What is Wee FIM?Six months to 6 years; looks at self-care, mobility, and cognitive skills to determine the amount of caregiver assistance required.What is the Sensory Profile 2?Birth to 14 years 11 months and caregiver questionnaire. There is also an adolescent/adult sensory profile for ages 11 and olderWhat is Ages and Stages Questionnaire?Birth to 5 years, including communication, gross motor, fine motor, problem-solving, and personal social.What is the Canadian Occupational Performance Measure (COPM)?Helps identify family priorities for children with special needs.What is the Pediatric Evaluation of Disability Inventory (PEDI)?Six months to 7.5 years. Measures capabilities and performance in self-care, mobility, and social function.How do you test rooting reflex?Stroke the side of mouth and observe the head turning toward the stimulusHow do you test sucking reflex?Place a finger on the roof of the infants mouth and observe sucking abilityHow do you test palmar reflex?Press a finger into the palm and observe the fingers flexing in a tight gripHow do you test asymmetrical tonic neck?In supine, turn the head to one side and note extension of the arm and the leg on the face side and flexion of the limbs on the skull sideHow do you test symmetrical tonic neck?Prone over lap, flex the neck, and observe the arms flex and the legs extend; extend the neck and observe the arms extend and the legs flexHow do you test moro reflex?Support in a semi-reclined position and momentarily release support to observe for abduction, extension and external rotation of the arms, followed by flexion and adductionHow do you observe protective responses?In sitting, gently push the child off balance to the front, each side, and back, and observe for arm extension and placement to prevent fallingWhen do protective responses emerge?Front: 6-7 months; Side: 7-10 months; Back: 9-12 monthsHow do you observe head righting?In sitting or held suspended, tilt the child gently from side to side and from front to back and observe the child moving the head in the opposite direction to maintain head alignment with their bodyWhen does head righting emerge?3-4 monthsHow do you observe neck on body righting?In supine, rotate the child's head to one side; note if body rotation and the child rolling to prone occurs as a unit or segmentallyWhen does neck on body righting emerge?segmental rolling emerges at 4-5 monthsHow do you observe body on body righting?In supine, rotate the child's hips to one side; observe the child rotate the upper body and roll over to align the bodyHow do you observe body on body righting?Segmental rolling emerges at 4-5 monthsHow do you observe equilibrium reactions?Test in prone, supine, four point, and standing. Tilt the supporting surface to one side and then the other. When tilted to the left, observe for lateral flexion of the right side of the trunk with rotation, when tilted to the right, observe for lateral flexion of the left side of the trunk with rotation; all with head rightingWhen does equilibrium reactions emerge?Prone: 5-6 months; Supine: 7-8 months; Sitting: 7-10 months; Quadruped: 9-12 months; Standing: 12-20 monthshow is hypotonia noted?a decreased amount of resistance when a muscle is moved through available ROM; A soft feeling to the muscle, hypermobile joints, a slouched posture, and facial drooping may also be is hypertonia noted?when there is increased resistance or tension when a muscle is moved through available ROM; Decreased joint mobility, fisted hands, scissoring of the extremities, arching, and retraction or tightness of facial muscles may also be noted.Describe prone & supine skills for 2-4 months.In prone, the shoulder girdle begins to protract, and weight bearing occurs through the lower body. The child is able to lift the head and maintain posture. In supine, the child is able to maintain the head in neutral and can achieve some neck flexion in pull to sit. The child visually tracks and can get his or her hands to the mouth;Describe sitting & four point skills for 2-4 months.Unable to sit unsupported; rounded back in supported sitDescribe standing & walking skills for 2-4 months.Stepping reflexes when held in standingDescribe prone & supine skills for 4-6 months.In prone with hand propping and extended elbows. The child is able to roll from prone to supine. In supine, with midline play and the arms over the chest, the child is able to play with his or her feet. The child can roll to side lying;Describe sitting & four-point skills for 4-6 months.Can sit with hand support to the front or sides. Can momentarily free a hand. Can weight bear in quadruped position. Pivots in prone or may scoot backward;Describe standing & walking skills for 4-6 months.Partial weight bearing in supported standingDescribe prone & supine skills for 6-9 months.The child can assume a quadruped position and begin to rock and may crawl. The child rolls from prone to supine and from supine to prone with rotation;Describe sitting & four-point skills for 6-9 months.Moves in and out of sitting, sits well, and begins to creep;Describe standing & walking skills for 6-9 months.Stands supported and can bear full weight through the legsDescribe sitting & four-point skills for 9-18 months.Crawls wellDescribe standing & walking skills for 9-18 months.Cruises along furniture or walks with hands held. Walks independently at 12-18 monthsa 6 month old baby is referred for developmental screening. An OT is assessing prone development. The client is able to clear head and take weight on her elbows. What should be the next step in client's prone development?propping on arms with elbows with extendedan OT is evaluating an 8 year old child with developmental dyspraxia. What is the most likely area of challenge that the OT excepts to find with this child?motor planningThrough an evaluation of self care skills, and occupational therapist determines a child is able to feed self with a fork, can manipulate three or four buttons in front, independent in toileting, and puts on shoes but needs assistance with tying . Which normal developmental age are these actions consistent with?4 yearsan ot is evaluating hand skills in a child. While the child is holding a 1-inch cube, the child demonstrated an ulnar grasp pattern. Which of the following grasps should emerge next?radiala 10 year old client is struggling with handwriting because of a deficit in visual perceptual skills. In which other area is the ot most likely to find deficiences?spatial relationsa 3 year old child is referred to an outpatient clinic for an evaluation of possible motor development delays. Which approach would be most appropriate to evaluate this client's upper extremitiy strength?observe the child during structured play activitiesan ot is doing a consultation for a 2 year old child with osteogenesis imperfecta. Which instructions would be most essential for the ot to give to the caregivers?wearing and use of protective arm and leg guards and orthosesa student has poor posture while writing, an awkward pencil grip, and poor letter formation. The ot consulting with the teacher. Which of the following activities is most important to review?how to position the student to improve posture while writinga kid with spastic hemiplegia lacks 20 degrees of passive elbow extension on the right because of tone. Which of the following activities performed by the child would be best reuce tone?build a four-piece puzzle in a right-side sitting positionan ot notes an ulnar grasp pattern while a child is holding a 1-inch cube. Which grasp should the ot anticipate to emerge next/palmer graspduring arean assessment in an early intervention setting, a teacher identifies FM delays in a student. Which of the following actions are most appropriate initially?determine educationally relevant long-and short-goalsan ot wants to evaluate equilibrium reactions in a 7 month old child. What is most appropriate way to observe those reactions in the client?place child in sitting position and slowly tilt child to lefta baby in NICU was born at 33 weeks gestation. Which activity is most important to teach parents?position baby in ways to support flexionan ot in developmental education setting for severely physically and cognitively impaired students is training a young adult to use a spoon to feed herself. Most appropriate technique to help student learn this skill?hand-over-hand technique combined with backward chainingA child was in a motor vehicle accident and sustained multiple fractures and a close head injury. The child is in the pediatric intensive care unit and the parents are at the bedside. Which of the following actions are most appropriate initially?Speak to the parents about the role of occupational therapyA 6 year old child was referred to occupational therapy for an evaluation. During the evaluation, the therapist finds that the client's tone, range, and strength are age appropriate. The client demonstrates difficulty buttoning, especially when not looking at the buttons, as she frequently repositioned the pencil in her hand drink by motor task. The parents reported that the child is very slow in getting dressed, especially if buttoning is involved; She also gets easily frustrated with fine motor tasks and has difficulty keeping food on the spoon when bringing it to her mouth. What is the most appropriate intervention for this child?sensory integrative approach for tactile discrimination and perception problemsA child with spastic hemiplegia lacks 20 degrees of passive elbow extension on the right because of tone. Which of the following activities performed by the child would best reduce the tone?build a four-piece shape puzzle in a right-side sitting positionA school occupational therapist is asked to evaluate a preschooler's fine motor performance. The therapist takes a child out of the treatment area to give a standardized test, but the child has difficulty staying on task and requires frequent redirection. Which action would be most appropriate to ensure that the completeness and accuracy of the assessment?Complete the assessment process by doing a skilled observation in the classroomAn occupational therapist is treating a 9 month old infant with a history of failure to thrive. The evaluation showed poor overall strength and endurance, which are being addressed through developmental positioning, or motor exercise, and home program activities with the family. After six weeks, minimum progress is noted. Which of the following actions is most appropriate?consult with a dietitian or a nutritionist to monitor caloric intakeA child with autism has difficulty with processing proprioceptive input. This problem interferes with the child's ability to control fine motor skills, play safely on the ground, and remain in line without hitting or bumping into other children. Which of the following activities best describes a compensatory technique the child could perform?Use a weighted pencil in classAn appropriate method for teaching a child to tie shoes in backward chaining . Which of the following activities best describes backward chaining?complete all shoe-tying steps except the last step, and let the child complete that step. When the child is successful, the child then completes the last two steps, and so on, until time occurs independentlyAn occupational therapist notes an ulnar grasp pattern while the child is holding a one inch cube. Which grasp should the therapist anticipate emerging next?Palmer graspAn 11 year old child but they diagnose seizure disorder is currently being managed with medications. Which of the following safety precautions have been most important to consider in this client intervention plan?Awareness of emergency procedures for seizures, environmental monitoring, and dietary restrictionsA 3-year-old child is referred to an outpatient clinic for an evaluation of possible motor development delays. Which approach would be most appropriate to evaluate this client upper extremity strength?Observe the child during structured play activitiesA 3 year old child is referred for an evaluation due to lack of expected development. Which of the following tasks will best evaluate upper extremity strength?Observe the child during structured play activitiesAn occupational therapist is asked to conduct an evaluation on a child. The clinic uses a standardized test with which the occupational therapist is not familiar. Which of the following actions is most appropriate?Evaluate the child using non standardized methodsA therapist is working with a 2-year-old child with a history of athetoid cerebral palsy. The parent's goal is for the child to be able to self-eat. Which technique would be best to develop hand to mouth skills?Providing shoulder depression and protraction and humoral supportAn 18-month-old baby with myelomeningocele can maintain grasp on an object but does not reach for objects. That baby does not transfer objects from hand to hand and always sits in a slouched position with one hand prop. which position is most appropriate for the occupational therapist to work on for developing midline plate and midline crossing?Side-lyingA child uses wrist extension every time an object is released. Which of the following activities is most likely to encourage wrist extension during release of an object?Ask the child to place objects into a container located just lateral of midline and at arm's lengthDuring evaluation of self-care skills, an occupational therapist observes a child feed independently with a fork, but in three to four buttons in front, toilet independently, and put on shoes with tying assistance. What is the minimum developmental age of the child?4 yearsAn 18 month old child with spastic cerebral palsy cannot sit independently and is having problems with reaching. The parents' goal is for the child to walk. Which of the following explanation should be provided to the family?Occupational therapy goals can be attained through improved trunk controlA preschool age child has sensory processing difficulties, which include negative reaction to light touch, for proprioceptive awareness, and difficulty grading movements. During free play time, the child frequently pushes other children or screens when approached. The teacher described the students play as roughhousing with very little imaginative play. Which of the following suggestions is most important regarding free time play?Provide the child with proprioceptive input, such as jumping, just before free play time to improve personal space awareness.A child with sensory integrative disorder is receiving occupational therapy period treatment has included proprioceptive and vestibular input to work on modulating sensory input. The occupational therapist has planned an obstacle course today, but upon entering the room the child sees a swing it begins talking about how it would make a great pirate ship. Which of the following approaches would be best for this treatment session?Follow the child's lead and set up the treatment so that the child is required to activate the swingA therapist is working with a 5 year old child who has leukemia and is undergoing chemotherapy . The client was developing normally before the diagnosis. And occupational therapist evaluation reveals that the child is weak and dependent in activities of daily living. The mother feels useful when she can help her daughter when bathing, dressing, and grooming. What is the most appropriate approach to take?Focus the occupational therapy treatment on strengthening and allow the mother to continue her caregiving role.A six month old baby is referred for a developmental screening. A therapist is assessing prone development. The client can clear her head and take weight on her elbows. What should be the next step in this client's prone development?Propping on arms with elbows extendedA 5 year old student with a diagnosis of right spastic hemiplegia is coming to therapy for decreased left hand control period the therapist places the child insight sitting position to her left side, so she must bear weight on her left upper extremity. Where does the most likely purpose of using this position with this child?This position will improve stability in the scapular humoral areaWhat is adaptive response?A successful response to an environmental challengeWhat is body scheme?The brain's map of body parts and how they interrelateDefine perception.The organization of sensory data into meaningful unitsWhat does praxis mean?The ability to conceptualize, organize, and execute non-habitual motor tasksWhat does ideation mean?The ability to conceptualize a new action to be performed in a given situationWhat does sensory defensiveness mean?Characterized by over responsivity in one or more sensory systemsWhat does sensory integration mean?Organization of sensation for useDefine sensory modulation.Ability to generate a response that is appropriately proportionate to the incoming sensory stimuliWhat does sensory registration mean?Process by which the central nervous system attends to stimuliWhat does sensory processing refer to?Referring to the handling of sensory information by neural systemsWhat does vestibular mean?Pertaining to receptors and organs that detect head position, movement, and gravityWhat does somatosensory mean?Pertaining to the tactile and proprioceptive systems.Describe gravitational insecurity.The child reacts negatively to movement, especially when the head is moving backwardDescribe hyperresponsivity.The child reacts defensively to ordinary sensory input and frequently demonstrates activation of the sympathetic nervous systemDescribe hyporesponsivity.The child tends to ignore sensory stimuli that would produce a response in most individualsDescribe sensory seeking.The child searches out specific sensory input at a higher frequency and/or intensityDescribe tactile defensiveness.The child tends to react negatively to clothing, dislikes having shoes off, and has a tendency to weight bear on the fingertips rather than the palmsDescribe over responsiveness.Disorder used interchangeably with hyperresponsivityDescribe under responsiveness.Disorder used interchangeably with hyporesponsivityWhat is an example of pincer (i.e., two-point or pad to pad) grasp?Picking up a piece of cerealWhat is an example of lateral pinch?Using a key in a lockWhat is an example of a power grasp?Scooping ice creamWhat is an example of three jaw chuck (i.e., Three-point tripod)?grasp on a pencilWhat is an example of spherical grasp?Holding a ballWhat is an example of a cylindrical grasp?Holding a glassWhat is an example of a hook grasp?Carrying a pailWhat is an example of a disk grasp?Unscrewing the lid of a jarWhat does bilateral hand use involve? What are examples?the coordination of both Hands; throwing a large ball, or one for stability and the other for movement, such as holding a piece of paper to cut with scissors.What does tool use include? What are examples?the purposeful use of an object to manipulate another object; for example, silverware, writing instruments, and scissors.Describe finger to palm translation.Grasping an object with the pads of the fingers and thumb and moving it into the palm of the handWhat is an example of finger to palm translation?picking up coins to hold in a handDescribe Palm to finger translation.Isolated control of the thumb and finger flexion moving toward finger extensionWhat is an example of palm to finger translation?Taking coins from the palm of the hand and putting them in a vending machineDescribe Shift.Linear movement of an object on a finger's surface to allow for repositioningWhat is an example of shift?Separating two pieces of paperDescribe Simple rotation.Fingers act as a unit with the thumb in an opposed position while turning an object 90° or lessWhat is an example of a simple rotation?Unscrewing a small capDescribe Complex rotation.Rotation of an object 180° to 360° as the fingers move independently and alternate with the thumbWhat is an example of complex rotation?Turning a pencil to use the eraserWhat is included in domains?Letter formation, copying, both near and far point, writing dictated words, and writing from original thought.What is included in legibility?Size, formation, alignment, and spacing.What is speed?Measured in relation to peer and classroom expectations.What are some ergonomic factors?Posture, pencil grip, stability, and mobility of the upper extremities.What is visual acuity?ability to track, localize, and focus on objects.What is visual tracking/oculomotor control?Look for the ability to separate eye movement from head movement, the ability to smoothly follow across midline, and the ability of the eyes to work together.What is functional vision?Can the child complete puzzles, find objects on a page or with a variety of other objects, copy from near or far points, sort objects, and move around obstaclesWhat is Sensitivity to visual stimuli?Visual reactivity to stimuli such as bright lights.What is Form perception?Constancy, closure, and figure ground recognition.What is spatial perception?Position in space, depth perception, and topographic orientation.What is Visual motor integration?How the eyes and hands work together; generally assessed through tracing or copying designs.what type of food does a 0-3 month old take?liquids onlywhat type of food a 4-6 month old take?liquids/pureedwhat type of food does a 9 month take?soft foods & mashed table foodswhat type of food does a 12-18 month take?coarsely chopped foodswhat sucking/drinking does a 0-3 month have?suckling patternwhat sucking/drinking does a 4-6 month have?suckling pattern is more maturewhat sucking/drinking does a 9 month have?can begin cup drinkingwhat sucking/drinking does a 12-18 month have?primarily from a cupwhat are self-feeding skills for 5-7 months?Takes pureed food from a spoonwhat are self-feeding skills for 6-9 months?"Attempts to hold a bottle, holds a cracker or cookie and attempts to eat it, and may grab a spoon but sucks on either end"what are self-feeding skills for 9-13 months?"Finger feeds self a portion of the meal and is more proficient with cup drinking"what are self-feeding skills for 12-14 months?"Dips a spoon into food but not yet skilled enough to be independent"what are self-feeding skills for 15-18 months?"Scoops food with a spoon and brings the spoon to the mouth"what are self-feeding skills for 24-30 months?"Interested in using a fork, proficient in using a spoon with mixed consistency foods, and can drink from a straw"a 31 week gestational age baby is referred to OT to address his nippling skills. The infant currently has a nasogastric tube, receives oxygen via a nasal cannula, and is noted to have an increased respiratory rate at rest. Which approach to tx would be most appropriate?begin working on addressing non-nutritive sucking techniquesA 6 year old child with no clear diagnosis is referred for evaluation and treatment at an outpatient clinic. The parents report that the child has difficulty holding and manipulating objects. The OT evaluation indicates normal tone and strength but fine motor skills that are at the level of a four-year-old. What is the most appropriate intervention for this client?refer the child to a school-based programA 12-month-old child has good head and neck control when relaxed, by frequently pushes into extension because of increased extensor tone. The parents report that tone makes it difficult to dress the child. Which of the following suggestions is most appropriate?Place the child on a lap and supported sittingAn occupational therapist is writing a goal for a child with mild cerebral palsy. The student has decreased fine motor skills as a result of increased tone but is independent with most activities of daily living. Which of the following goals is most appropriate for the iep?the student will use scissors to cut a 6-inch lineA student is observed to have consistent slouching when standing or sitting, rest the head on the desk after a few minutes of being seated, has difficulty kicking a ball, and has difficulty with jumping jacks in gym. Which of the following sensor processing skills most likely need to be addressed?Vestibular proprioception problemsAn occupational therapist is asked to give an in-service program on handwriting to teachers of kindergarten through second grade and believes that activities based on the biomechanical model of practice would be the easiest to carry out in the classroom. Which of the following strategies should be included?Check desk height a student's ability to touch feet to the floor, provide a variety of pencil grips for the teachers to try with the students, and tape strips on the desk to show proper position of the paper while writingA child uses wrist extension every time an object is released. Which of the following activities is most likely to encourage wrist extension during release of an object?Ask the child to place objects into a container located just lateral of midline and at arm's length.A therapist is working with an 8-year-old child who demonstrates wrist flexion every time she releases an object. which action would be best to encourage increased wrist extension with object release?Place the container just lateral at midline and at almost arm's length from the childAn infant has delayed developmental skills as a result of severe hypotonia. The child is currently able to maintain a static prone on elbows position and can push into prone on extended hands position for a few seconds. Which of the following activities will best facilitate continued development?Weight shifting into a prone on elbows positionA young adult with a TBI has dysphasia and has now advanced to oral feeding. The first food entering taken orally should includeapplesauce and fruit nectar thickened with bananaAn 11-year-old client presents to occupational therapy with spastic diplegic cerebral palsy. Which of the following categories of information from the international classification of functioning disability and health vest provides the occupational therapist with the context in which the client occupational rules occur?Personal and environmental factorsA child was developmentally delayed has decreased had control, poor proximal stability, and increased tone throughout the body. During treatment in a prone on elbows position, the baby cries after a short duration of time period which of the following recommendation is best to give the parents?Work on the prone on elbows position at home for short periods, several times a day, to increase infant tolerance.when does a child cooperate in dressing and pulls off shoes and socks?1 yeara child removes unfastened front opening garments and helps pull down pants at-2 yearswhat are the dressing skills for a 2.5 year old?"Removes elastic waist pants, puts on front opening coat/shirt, and unbuttons large buttons"Describe dressing skills of a 3 year old."Puts on pullover shirt, puts on shoes without fasteners, puts on socks, pulls pants down independently, zips and unzips if already engaged, and buttons large buttons"what are dressing skills like for a 3.5 year old?"Snaps or hooks in front, unzips separating zipper, buttons series of 3-4 buttons, can dress with supervision for correct orientation of front and back of garments"describe dressing skills for a 4 year old."Removes pullover garment, zips, buckles, puts on shoes, laces but cannot yet tie, and consistent with front and back of garments"when does a child tie/untie knots & dress unsupervised?5 yearsdescribe dresssing skills for a 6 year old."Closes back zipper, ties bows, buttons back buttons, and snaps back snaps"what is dyspraxia?"Apraxia that results in difficulty with motor planning necessary to perform tasks."what is equilibrium?"The ability to maintain balance and posture."what is an IEP?"A plan developed by an educational institution typically in elementary and secondary programs that ensures teaching and learning modifications for children with disabilities."what is IDEA?"A law that ensures free and appropriate public education for students with disabilities."What is sensory processing?"A complex organization of neurological processes regarding the sensation of a person and their environment."what does early internvention provide?"services for children from birth to 3 years of age."what is the goal for early intervention?""prevent or minimize the physical, cognitive, emotional, and resource limitations of young children disadvantaged by biologic or environmental risk factors"""t/f: children have been identified as having an established developmental delay or are determined to be at either a biological and/or an environmental risk of developing a delay in function"truewhat is the primary role of OT in school-based services?"support the child's academic challenges inclusive of their surrounding environment"t/f: Preterm infants are generally hypotonic at birthtrueWhat is the resting position for a premature infant?"resting positioning is generally very flat, with extension and abduction of the arms and legs and asymmetrical positioning of the head to one side."what are the benefits of supine position?1. Encourages: Hands to reach and engage Midline activities Eye contact; 2. Develops: Stomach muscles (i.e., body flexion) Movement control of the legs and flexibility; 3. Enables the hands to reach and touch the leg; 4. Recommended position to reduce sudden infant death syndrome (SIDS)what are the disadvantages of supine position?1. Can encourage extensor tone; 2. May not challenge the child enough (i.e., provides too much support); 3. Can Encourage external rotation deformities of the arms and legs (i.e., may need outside positioning to decrease these deformities) with children who have weakness and low toneWhat are the benefits of prone position?1. Develops: Head control, Muscles in the shoulders and the arms, Muscles in the back, Hip muscles; 2. Initiates posterior weight shift; 3. Facilitates development of flexor tone in premature infants; 4.Improves oxygenation and ventilation in premature infants; 5. Reduces reflux, especially if the head of surface is elevated 30 degrees; 6. Can help reduce hip flexion contracturesWhat are the disadvantages of prone position?1. Associated with increased risk of SIDS in infants; 2. If not properly positioned, can cause flattened, frog leg positioning; 3. Infants with weak and/or low tone may not have enough strength to clear airway; 4. Makes visual exploration more difficult; 5. Less face-to-face contact with caregiversWhat are the benefits of prone on elbows position?1. Develops: Head control, Muscles in the shoulders and the arms, Muscles in the back, Cocontraction, Ability to weight shift posteriorly to the hips, Ability to weight shift side to side when reachingWhat are the disadvantages of prone on elbows position?1. Infants with weak and/or low tone may not be able to obtain or sustain this position; 2. Can result in decreased visual exploration if difficulty sustaining cervical extension & controlling rotational movements are present; 3. Can result in a frog leg positioningWhat are the benefits of prone on extended elbows position?1. Develops: Head control, Muscles in the shoulders and the arms, Muscles in the back, Cocontraction, Ability to weight shift when reaching; 2. Elongates the hip and stomach musclesWhat are the disadvantages of prone on extended elbows position?1. Infants with weak and/or low tone may not have enough strength to obtain or sustain this position; 2. Can result in frog leg positioningWhat are the benefits of side-lying position?1. Develops the rib cage; 2. Encourages rolling when reaching for toys; 3. Encourages midline orientation of the head and the extremities; 4. Keeps hands together and makes it easier to touch or hold a toy; 5. Allows for shoulder movement in a gravity-eliminated plane; 6. Facilitates hand to mouth; 7. Helps to decrease extensor patterning when positioned appropriately (i.e., requires less effort to move); 8. Right side-lying can improve gastric emptying; 9. Left side-lying can assist with decreasing refluxWhat are the disadvantages of side-lying position?"1. May be difficult to maintain position of a child with increased extensor patterning; 2. Left side-lying can decrease gastric emptying; 3. Right side-lying can increase reflux symptomswhat are the benefits of side-sitting?1. Encourages: Cocontraction, Weight shift, Unilateral reaching, Rotational components of movementWhat are the disadvantages of side-sitting?1. May be difficult to sustain this position with children who have low tone, athetosis, or spasticity 2. Need to ensure Proper shoulder alignment on the weight bearing side to prevent injuryWhat are the benefits of sitting?1. Facilitates balance; 2. Good alerting posture; 3. Good visual exploration; 4. Encourages social interactionWhat are the disadvantages of sitting?1. Can cause increased fixation patterns if the child is not strong enough to stay up against gravity; 2. Children with low tone and weakness will likely have difficulty raising their hands against gravity. May weight bear on their hands for support; 3. Children with low tone and weakness may show a forward flexed position that can impact respiratory effort (e.g., may see Pushing into extension); 4. Children with increased tone may be unable to sustain this position and frequently push into extensionWhat are the benefits of four-point position?1. Develops: Muscle control and strength in the shoulders, arms, hips, legs, and back, Cocontraction, Balance with weight shifting, Trunk stabilityWhat are the disadvantages of four-point position?1. Can be difficult to keep in proper positioning; 2. If too difficult, the child will assume a locked, static Position that decreases function and contributes to deformitiesWhat are the benefits of standing?1. Frees UE for prehension and manipulation; 2. Facilitates higher level neurological integrationsWhat are the disadvantages of standing?1. Requires the child to have a good stability to be successful; 2. May be hard to move the arms against gravity and the child may seek fixationEarly intervention services provides services to what age range?birth to 3 yearsKids in early intervention services have been identified as having-an established developmental delay/ determined to be either biological and/or an environmental risk of developing a delay in functionwhat is the emphasis of early intervention?how child functions within the family unit and uses a family-centered approacht/f: Occupational therapists providing school-based services do not have to have an understanding of the school context and the federal laws and regulations that guide them and they need to apply their understanding of the occupational therapy domain within these boundaries.falsewhat does IDEA (2004) require in schools?""free appropriate education in the least restrictive environment for students with disabilities attending public schools." It also "stipulates that individually designed special education and related services mustbe provided to students 3 to 21 years of age, if the student needs such services to benefit from her or his education""Occupational therapists in school-based settings must provide what kind of services?"educationally relevant, by contributing to the development, or improvement of the child's academic and functional school performance"Intervention strategies when consulting in a school-based setting typically include what?Reframe the teacher's perspective (e.g., educate the teacher on the student's particular diagnosis and sensory processing disorder); Improve student skills; Adapt tasks; Adapt the environment; Adapt routinesOccupational therapists need to integrate mental health strategies into the school environment, including the school curriculum, routines, and classroom settings; some examples include- the following:Informally observe all children for behaviors that might suggest mental health concerns or limitations in social-emotional development; bring concerns to the educational team; Provide tips for promoting successful functioning throughout the school day, including transitioning to classes, organizing work spaces, handling stress, and developing strategies for time management; Consult with teachers to modify learning demands and academic routines to support a student's development of specific social-emotional skills; Develop and run programs to foster social participation for students struggling with peer interaction; Identify ways to modify or enhance school routines to reduce stress and the likelihood of behavioral outburstsHospital-based services support what kind of approach?family-centered caret/f: Appropriate proximal stability and postural control help to provide a basis from which functional gross motor and fine motor skills develop, which includes the ability to isolate oral movements required during eating.truewhat happens if proximal stability and postural control are inadequate?the child will develop compensatory strategies and inefficient movement patterns.what kind of effective ways are there to address proximal stability and postural control?Working on unstable surfaces, providing activities to promote movement through developmental positions, and reaching outside of the child's base of support and/or above the child's center of gravitya child with decreased strength in what areas can experience a significant loss in functional skills?trunk, UEs, and/or facial musculatureStrengthening activities for young children must be incorporated into occupational tasks, such as-lifting a weighted ball up onto a slide for it to roll down and knock over bowling pins, pushing a toy grocery cart with weights inside, completing activities with wrist weights on, and finding items that have been buried in TheraputtyAbnormal tone leads to the development of abnormal movement patterns resulting in what?high energy and inefficient patterns that impact all areas of function.Normal movement patterns are based on what?flexible synergy patterns.flexible synergy patterns have consistent characteristics in what?their sequence of movements and the ratios of joint movement, but are flexible in nature in order to allow for completion of the specific task at hand.Children with abnormal muscle tone what kind of populations develop synergistic movement patterns that are fixed and repetitive?children with cerebral palsy, muscular dystrophy, stroke, or traumatic brain injuries,Activities such as what can provide an inhibitory impact on tone?static weight bearing on the extremity, pressure to the thenar eminence, prolonged stretch, and neutral warmtht/f: Slow sustained traction with deep massage can help reduce muscle tone to an area that allows for increased range and movement.truewhat is an excellent technique to provide neutral warmth and prolonged stretch to an area to help decrease tone?Serial castingt/f: serial casting must be combined with activities to facilitate functional movement patterns of the joints proximal and distal to the area being casted.truewhat does serial casting do?inhibits movement of the area into synergistic or compensatory patterns during functional movement of the extremity.What are Air splints?Come in a variety of sizes and can be used to position a tonal area and provide neutral warmth and pressure to help inhibit tone.To promote functional improvement, the Air splint must be combined with activities to what?encourage more functional involvement of the joints proximal and distal to the tonal area.What is Antispasticity?Best used to help alignment and prevent deformity prior to the development of spasticity.t/f: Antispasticity are not difficult to apply and can be easy to keep on depending on the amount of tone and the size of the hand.falsewhat is Neoprene?Provides neutral warmth and pressure. May require the use of stays to keep the client with higher levels of tone from pushing back into tonal positioning.What are Weight bearing splints?Splints used to position the hand and wrist in a more extended position allows for improved positioning during weight-bearing activities.Hypotonia is often an issue in what kind of populations?premature infants, children with muscular dystrophy, children with Down syndrome, some children with autism, and some forms of cerebral palsy.t/f: The child's nutritional status and state of arousal can have a significant impact on children appearing hypotonic.truet/f: Children with chronic, poor nutritional intake can be hypotonic partially because they lack the protein needed to allow for muscle development.truet/f: A child can also show more increased tone when they are alert and interacting, but this same child will appear more hypotonic when tired or sleeping.truewhat is constraint-induced therapy?involves casting or splinting for the noninvolved or less involved extremity to facilitate use of the more involved extremity.what does constraint-induced therapy do?makes it more difficult for the child to use the casted extremity in activities, and encourages the child to recruit the use of their involved or weaker extremity in order to be able to complete the desired activity.Components of successful constraint-induced therapy include what?Often used with children with diagnoses such as brachial plexus injuries and hemiplegia; Must sustain the use of a cast or splint on the noninvolved side for extended periods during the day; Activities need to be provided to engage the involved extremity in repetitive motions for extended periods; More successful in cases of neglect where the involved extremity has reached a point of function that will allow the client to use the extremity in activities without excessive frustration.What does the term SI refer to?how the body takes in and processes sensory information for function; also used to refer to a treatment approach for treating those who have difficulty in sensory processing.What happens when sensory information is taken in and appropriate integration of that information occurs?the person makes appropriate, adaptive responses to the environmental stimuli.What is the goal of SI?to help clients obtain an appropriate sensory basis with just the right amount of challenge to their system.what are different treatment strategies for modulation disorders/tactile defensiveness?Combine tactile, proprioceptive, and vestibular input; Respect the child's personal space (i.e., do not impose); Use deep pressure and firm touch input; Reduce sensory overload in the environment, use natural light, and work in small spaces to reduce the threat of uncontrolled tactile input; Use a Benik vest or air splint to provide deep pressure; Use activities in various textures (e.g., beans, rice, and a ball pit); Provide tools for use in various textures (e.g., sand, beans, and rice); Cover equipment with textured materials; Allow the child control over tactile input; Use wide paint brushes and textured mitts for "painting" skinwhat are the expected outcomes for modulation disorders/tactile defensiveness?Maintain an optimal state of arousal in the presence of tactile input; Decrease overreaction to tactile input; Improve social-emotional skills; Improve organizational skills; Improve fine motor skillsWhat are the expected outcomes for hypo-responsiveness to touch/tactile discrimination disorders? Improve body scheme; Gradually improve localization, two-point discrimination, and stereognosis; Improve hand skills and the ability to manipulate objects; Improve motor planning; Improve peer interactionWhat are different treatment strategies for hypo-responsiveness to touch/tactile discrimination disorders? Encourage movement in pressure (i.e., body socks and in a pool); Use items such as shaving cream, finger paints, or lotions (e.g., have the child dip their finger and write on the body to identify letters); Place stickers of various sizes on