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Peds Last Chance
Final exam material for OTA Pediatric Practice
| Question | Answer |
|---|---|
| Characteristics of conduct disorder | repetitive/persistent behavior that offends others, violates rights, rules of society * aggression, destruction of property, theft, truancy, runaway, no guilt * decreased self esteem, anxious depressed, suicidal |
| Conduct disorder is more common in boys by what ratio? | 2:1 |
| When does conduct disorder peak? | age 10 |
| Characteristics of oppositional defiant disorder | negative hostile and defiant behaviors towards authority figures * blames others * resentful and angry * often from childhood depression - unable to cope with anger |
| What gender is most affected by ODD? | same in both boys and girls |
| When does ODD peak? | Rises until 13-16 years |
| Problems of autism | lack of responsiveness to people, deficit in language/communication skills, bizarre responses to environment, peculiar speech patterns, onset before age 3 |
| Characteristics of autism | language/social skill disorder, motor problems, sensory problems, cognitive problems, intrapersonal problems, interpersonal problems, ADLs, work/leisure |
| motor problems of autism | stereotyped body movements, poor gross and fine motor coordination, delayed response to reflex/self-stim |
| sensory problems of autism | delayed or no response to human voice, aversion to touch, appears not to see humans but responds to objects, may not respond to pain, may overrespond to visual or auditory stimuli, may seek certain vestibular stim, visual perception tends to be good |
| cognitive problems of autism | intelligence ranges from normal to severe retardation, learning disorders, poor attending or orienting behavior and poor eye contact, may have short attention span and poor concentration skills |
| intrapersonal problems of autism | strong resistance to change in environment, insists on following routines in precise detail, repeats certain behaviors again and again, likes being alone |
| interpersonal problems of autism | lack of awareness of existence or feelings of others, usually fails to cuddle when held, stiffens body when picked up, avoids eye gaze or stares through you, may have strong attachment to objects not humans, does not imitate social behavior like waving |
| self care problems of autism | usually has to be directed to perform self-care activities |
| productivity problems of autism | difficulty learning to consistently perform job tasks as required, has no or impaired social play skills and prefers to play alone, does not show imagination in play activities |
| leisure problems of autism | difficulty developing interests beyond those involved in ritual perseverate behaviors |
| autism treatments | SI, NDT, behavior modification, play therapy |
| autism treatment areas | strength, endurance, tone; motor planning, decreased self injury; FMS; body awareness; attention; social skills; play skills; self-help; sensory processing |
| What is a learning disability? | an inefficiency in the working of the brain nivolving taking in, sorting out, and connecting information; inability to acquire, retain, or generalize skills |
| Criteria for LD | average to above average IQ, good vision/hearing, good learning opportunities |
| Common problems of LD | hyper or hypoactive; concentration/attn; irritable; forgetful, clumsy; sense of direction, position, time; speech/hearing; impulsive; immature; getting along with other kids; immediate satisfaction; visual percept; FMS; reading, writing, math |
| Characteristics of Down's Syndrome | decreased muscle tone, strength, endurance, protective responses, motivation (stubborn); joint laxity |
| CP hemiplegia classification | 1/2 of body involved (35-40%) - upper and lower |
| CP diplegia classification | legs involvement greater than arms (10-20%) - all 4 affected |
| CP quadriplegia classification | all 4 limbs involved (15-20%) |
| CP paraplegia classification | legs involved only |
| CP monoplegia classification | only 1 limb involved (rare) |
| CP triplegia classification | 3 limbs involved (rare) |
| 4 classifications of CP (based on brain region) | spasticity, athetosis, ataxia, mixed |
| Characteristics of spasticity CP | disharmony of muscle movements, muscles contract when stretch, contraction = tenseness and difficult, inaccurate voluntary movement |
| Percentage of CP patients with spasticity classification | 50% |
| Characteristics of athetosis CP | involuntary writhing movements/fluctuation in tone; uncontrollable contraction of successive groups of muscles |
| Percentage of CP patients with athetosis classification | 25% |
| Characteristics of ataxia CP | awkwardness of fine/gross motor movements (drunken sailor); movements required for balance, posture, orientation in space affected; jerky movements, fluctuation in tone |
| Percentage of CP patients with ataxia classification | 1-10% |
| Characteristics of mixed CP | several types combined |
| 9 types of muscular dystrophy | duchenne, myotonic, limb-girdle, Becker, facioscapulohumeral, congenital, oculopharyngeal, distal, Emery-Dreifuss |
| Characteristics of MD | hereditary, progressive weakness in voluntary muscles, affects skeletal muscles, abnormal genes, not painful, muscle wasting |
| Characteristics of Duchenne MD | appears age 2-6, males; first affects upper arms, upper legs, hips/pelvis; progression slow deterioration with periods of rapid degeneration (w/c by 9); life expectancy early 20s |
| Which is the most common MD? | Duchenne - 1 per 3,500 male births |
| Which is the most severe MD? | Duchenne |
| Characteristics of myotonic MD | chromosome 19; most common adult type; age 20-40; males and females; first affects hands, feet, face and neck; slow deterioration; life expectancy 50-60 |
| Characteristics of limb-girdle MD | appears late childhood to middle age; males and female; first affects shoulders and hips/pelvis; slow deterioration; shortened life expectancy |
| Characteristics of Becker MD | onset 2-16 like Duchenne but slower progression |
| Characteristics of fascioscapulohumeral MD | onset early adolescent, boys and girls, face, UEs and scapula |
| Characteristics of congenital MD | chromosome 9, birth onset, slow progressions |
| Characteristics oculopharyngeal MD | chromosome 14, middle to adult onset; eye and throat |
| Characteristics of distal muscular dystrophy | onset 40-60; hands, forearms, legs |
| Characteristics Emery-Dreifuss MD | child to teen onset; shoulder, arms, shins; slow progression, cardio problems later |
| OT interventions for MD | exercise, keep physically and mentally active, maintain ROM, assistive/adaptive equipment, dexterity, downgrade activities - do not want them exerting too much |
| In-hand manipulation prerequisites | supination, wrist extension, opposition of thumb and fingers, isolation of thumb and fingers, control of arches, separation of hand |
| What are the 5 types of grasps? | hook, power, lateral pinch, 3-jaw and tip |
| Describe hook grasp | Object held horizontally in hand to carry objects; is a "power grasp" (suitcase) |
| Describe power grasp | object held horizontally in hand, strength on ulnar side and skill on radial side (e.g., brush hair) |
| Describe lateral pinch grasp | power on small objects, pad of thumb against radial side of index (e.g., turn key) |
| Describe 3-jaw grasp | opposition of thumb to index and third finger; picking up small to med objects is a power pinch |
| Describe tip grasp | opposition of thumb to index tip, forms circle with web space, picking up small objects is a skill pinch (Cheerios) |
| Two types of in-hand manipulation | translation and rotation |
| What is translation (in terms of in-hand manipulation) | moving objects vertically within hand in a linear movement (fingers to palm and vice versa) |
| What is rotation (in terms of in-hand manipulation) | Rotating objects horizontally within hand |
| What are the two types of rotation (in-hand manipulation)? | simple (turn object 90 degrees like unscrew bottle); complex (turn object 180-360 degrees like turning pencil to erase) |
| Scissors skills of 2 year old | snipping (at edges) |
| scissors skills of 2.5 year old | cuts across paper |
| scissors skills of 3-3.5 yr old | cut on line (hold paper supinated with thumb on top and hold on opposite side) |
| scissors skills of 3.5-4 yr old | cut circle |
| scissors skills of 4.5-5 yr old | cuts square |
| scissors skills of 6-7 yr old | refines skill (should be able to cut irregular shapes) |
| handwriting interventions | NDT, acquisitional approach, sensory integration, biomechanical |
| Tx ax for in-hand manipulation - translation fingers to palm | crumpling paper, getting a coin out of a change purse |
| Tx ax for in-hand manipulation - translation palm to fingers | moving a penny from palm to fingers, moving a food item to put in mouth |
| Tx ax for in-hand manipulation - rotation (simple or complex depends on object orientation) | remove or put on a small jar lid, put on or remove bolts from nuts, rotate marker to pu top on, rotating puzzle piece for placement in board, rotating toothbrush o eating utensil during use |
| Three efficient grips for writing | tripod, quadropod, adapted tripod |
| Describe tripod grip | thumb and index finger pads hold pencil/pen; side of pencil/pen rests against distal part of middle finger; writing process involves wrist movement |
| Describe adapted tripod grip | pencil/pen is between middle and index finger (used for CP; Karen does not teach this one) |
| Describe quadropod grip | pencil/pen is secured by index and middle finger and thumb; rests against distal part of ring finger |
| What are the four basic strokes for capital letters? | big lines, little lines, big curves and little curves |
| What are the two starting points for capital letters? | top left and top center |
| Always teach numbers in their ___ ___. | numerical order |
| Which numbers start in the upper left corner? | 1-7 and 10 |
| Which numbers start in the middle? | 8 |
| Which numbers start in the upper left hand corner? | 9 |
| What assistive technology is used for writing mechanics? | regular pencil or pen; pencil/pen with adaptive grip; special paper; slant board; use of prewritten words; portable word processor; voice recognition software |
| What assistive tech is used for computer access? | key guard; arm support; track ball/trackpad/joystick with on-screen keyboard; alternative keyboard; head master; switch with scanning; voice recognition |
| What assistive tech is used for writing - composing? | word cards, pocket dictionary, writing templates, electronic spell checker, computer spell checker, talking word processor, word prediction, multimedia software, speech recognition |
| What are six inefficient grips for handwriting? | thumb wrap, thumb tuck, supinate, transpalmar, interdigital brace, key or lateral pinch |
| What are supervision guidelines for school-based OT? | face to face every 2 weeks or 10 tx days; general supervision after competent; biweekly eval of child by OTR; share or own caseload; can go to IEP but cannot represent. OTR does interpretation! |
Created by:
ota2012
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