Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
OT IN PEDIA
OT FOR CHILDREN WITH ASD & ADHD
| Term | Definition 1 | Definition |
|---|---|---|
| AUTISM SPECTRUM DISORDER | - A developmental disability characterized by differences in social communication development and a pattern of restricted interests and repetitive behavior. | |
| What were the changes made from DSM IV-TR to DSM V? | Symptoms must be present in early developmental period | |
| DSM IV-TR (4) | - Pervasive developmental disorder not otherwise specified (PDDNOS) | |
| 3 core areas for diagnosis DSM IV-TR (4) | ■ Social impairment ■ Communication impairment ■ Restricted, repetitive behaviors | ○ Distinction between the subtypes was unreliable and inconsistent across diagnosis ○ Symptoms must be present before age 3 |
| DSM V | - subtypes are merged into a single diagnosis (Autism Spectrum Disorder) | |
| DSM V (5) | - Social communication and social interaction - Changes to the diagnostic criteria = social communication single category | |
| SOCIAL COMMUNICATION & SOCIAL INTERACTION PROBLEMS | - SOCIO-EMOTIONAL RECIPROCITY - NONVERBAL COMMUNICATIVE BEHAVIORS - DEVELOPING, MAINTAING, AND UNDERSTANDING RELATIONSHIPS | |
| SOCIO-EMOTIONAL RECIPROCITY | ● Understanding social cues ● Joint attention (focusing on one thing) ● Does not initiate conversations ● Failure of back-and-forth communication ● Response to name calling or when spoken to | |
| NONVERBAL COMMUNICATIVE BEHAVIORS | ● No meaningful eye contact ● Deficit in use and understanding ● Facial expressions ● Functional gestures ● Volume (pitch and intonation of speech) | |
| DEVELOPING, MAINTAING, AND UNDERSTANDING RELATIONSHIPS | ● Cannot understand the disinterest ● Some children stay in parallel play level | |
| STEREOTYPED OR REPETITIVE BEHAVIORS (B1) | ● Non-functional play (not meaningful) ● Lining up of objects ● Echolalia ● Hand clapping/ flicking of fingers ● Tiptoeing | |
| INSISTENCE OR SAMENESS & INFLEXIBLE ADHERENCE TO ROUTINES/RITUALIZED PATTERNS OF VERBAL/NONVERBAL BEHAVIOR (B2) | ● Frustration tolerance ● Difficulty in transitions between activities ● Difficulty understanding attempts of humor | |
| HIGHLY RESITRCTED, FIXATED INTEREST THAT ARE ABNORMAL IN INTENSITY OR FOCUS (B3) | ● Fixations ● Narrow range of interests | |
| HYPER-/HYPO-REACTIVITY TO SENSORY INPUT/UNSUAL INTEREST IN SENSORY ASPECT OF ENVIRONMENT (B4) | ● Sensory integration symptoms (proprioception, vestibular, tactile, visual, auditory, etc.) | |
| ATTENTION DEFICIT HYPERACTIVITY DISORDER | ● Most common neurobehavioral disorder of unknown cause that often occurs in childhood but persists through adolescence and adulthood. | |
| POSSIBLE ADHD PRESENTATIONS | - Inattentive - Hyperactive-Impulsive - Combined | |
| Inattentive | ○ Seen in schoolwork/ household ○ Difficulty following instructions ○ Any activity with EF , Higher mental functions ○ Easily distracted, does not listen, daydreaming | |
| Hyperactive-Impulsive | ○ Runs around / often on the go acting as if driven by motor ○ Difficulty in sitting still ○ Verbal hyperactivities (interrupting others, turn-taking in conversations, excessive talking) | |
| Combined | ○ Shows both Inattentive and hyperactive symptoms | |
| POSSIBLE DEVELOPMENTAL IMPACTS OF ADHD Level: Preschool | DEVELOPMENTAL IMPACT: ● Behavioral Disturbance ● Unintentional injuries ● Feelings of parental Incompetence | |
| POSSIBLE DEVELOPMENTAL IMPACTS OF ADHD Level: School Age | DEVELOPMENTAL IMPACT: ● Behavioral disturbance, including aggressive tendencies ● Academic impairment ● Difficulties in social interaction often tolerated by peers | |
| POSSIBLE DEVELOPMENTAL IMPACTS OF ADHD Level: Adolescence | DEVELOPMENTAL IMPACT: ● Not fulfilling academic potential ● Reduced tolerance by peers ● Low self-esteem ● Smoking/alcohol/drug experimentation ● Antisocial behavior | |
| POSSIBLE DEVELOPMENTAL IMPACTS OF ADHD Level: College Age | DEVELOPMENTAL IMPACT: ● Academic failure ● Not coping with routine tasks ● Occupational difficulties ● Low self-esteem ● Alcohol and substance misuse ● Injuries/unintentional incidents | |
| POSSIBLE DEVELOPMENTAL IMPACTS OF ADHD Level: Adulthood | DEVELOPMENTAL IMPACT: ● Mood instability ● Low self-esteem ● Relationship problems ● Increased road and occupational incidents ● Difficulty planning and completing tasks ● Alcohol and substance misuse ● Inconsistent parenting style | |
| SENSORY PROCESSING | ● Seen in both children with ASD and ADHD ● Behaviors seen in ASD and ADHD may be attributed to Sensory Processing Disorder | |
| 3 types of sensory processing problems | - Sensory Modulation - Sensory Discrimination - Sensory-Based Motor Problems | |
| Sensory Modulation | ■ Generating appropriate responses in the gradation of the sensory integration we receive ■ Underresponsive/ Overrespponsive | |
| Sensory Discrimination | ■ Distinguishing different sensory stimuli ■ Can be discriminated based on the quality, touch, taste, sight, sound, proprioception | |
| Sensory-Based Motor Problems | ■ Praxis problems, vestibular problems | |
| QUADRANTS OF THE SENSORY PROFILE | - REGISTRATION - SEEKING - SENSITIVITY - AVOIDING | |
| REGISTRATION | - Need additional input to respond to stimuli but take a passive approach. - "I don't seem to notice when my face or hands are dirty” | |
| SEEKING | - Need additional input to respond to stimuli and actively seek stimuli. - "I like to attend events with a lot of music." | |
| SENSITIVITY | - Respond readily to low threshold stimuli but does not actively avoid stimuli. - "I startle easily at unexpected or loud noises." | |
| AVOIDING | - Respond readily to lower Threshold stimuli But actively avoid Stimuli. - "I only eat familiar foods." | |
| SENSORY PROCESSING | ● (Common manifestations) see transes* | |
| OT EVALUATION PROCESS | ● Reassess after 6 months 1. Referral to Pediatric Occupational Therapy 2. Gather Preliminary Data 3. Develop Child’s Occupational Profile 4. Select and Administer Assessment Measures 5. Revise Evaluation Plan, if necessary | 6. Develop Analysis of Child’s Occupational Performance 7. Develop Recommendations and Functional Outcomes 8. Document Evaluation Results 9. Plan and Implement Intervention 10. Reevaluate when necessary |
| ANALYSIS OF OCCUPATIONAL PERFORMANCE | ● Standardized tests ● Interview ● School Visits ● Checklists ● Areas of Occupation ● Rest and Sleep ● Performance Skills / Client Factors ● Communication Skills, VPS, Social Skills, Sensory Processing/Sensory Integration | |
| ANALYSIS OF OCCUPATIONAL PERFORMANCE Prioritize: | play, self-care, education | |
| OT FOR ADHD | ● Modifying the classroom environment ● Social Skills Training ● Self Management T echniques ● Interventions to enhance sensory modulation ● What activities can we provide? | |
| Modifying the classroom environment | ○ Reduce sources of distractibility ( visual distractions, auditory distractions) ○ Seating arrangement of the child | |
| Social Skills Training | ○ Child w/ ADHD tendency to be disruptive due to hyperactivity which affects their ability to make friends or sustain conversations ○ Correction of disruptive behaviors and promote positive behavior | |
| Self Management T echniques | ○ Self-regulation techniques | |
| Interventions to enhance sensory modulation | ○ Sensory Diet | |
| OT FOR ASD | ● Interventions for Occupations ● Interventions for Motor Skills ● Sensory Integration / Processing Interventions ● Behavior Modification T echniques ● What activities can we provide? | |
| Interventions for Occupations | ○ Challenging occupations: Sleep and ADLs ■ Which can be rooted to sensory processing | |
| Sensory Integration / Processing Interventions | ○ Common management | |
| Behavior Modification T echniques | ○ Specific context where the behavior manifests ○ Prompts, reinforcements ○ If the behavior does not improve, do SI | |
| PLAY EVALUATION | ● Social Communication ● Environment / Object / T oys ● Cognitive development | |
| PLAY INTERVENTION | ● Facilitate Playful engagement ● Expand Variety in Play ● Enhance Complexity and Creativity in Play ● Develop Participation in Peer Play ● Generalize Play Skills across Social or Physical Envi. | |
| ADL | ● Rule out if sensory, motor, or other underlying factors | |
| ADL EVALUATION | ● Communication ● Social interaction ● Motor skills ● Sensory processing ● Functional cognition ● Restricted and repetitive behaviors ● Regulation skills | |
| ADL INTERVENTION | ● Sensory Based Interventions ● Joint Attention ● Social Learning ● Environmental Modifications ● Behavioral | |
| EDUCATION FACTORS | ● Grade Level ● School Type (Traditional, Progressive, Montessori) ● Type of Classroom (Self-Contained vs. Inclusive) ● School Demands | |
| EDUCATION EVALUATION | ● Routine Activities ● Instruction / Curriculum / Environment ● LRE measures ● Push-in or Pull-out Services ● IEP: T eam Approach ● School Visits | |
| EDUCATION INTERVENTION | ● Maximizing Special Interest Areas (SIAs) ● Performance Skills and Client Factors ● Environmental, Curriculum, and Instruction Modifications ● Sensory Processing ● Executive Functions ● Emotional Regulation ● Social Perspective T aking | |
| FEEDING CHALLENGES | ● Any diff that hinders nutritional intake ● Nutritional Challenges ● Restricted Diets and Food Selectivity ● Oral Motor Challenges ● Health Concerns ● Maladaptive Behaviors | |
| FEEDING AND MEALTIME PARTICIPATION EVALUATION | ● Feeding Culture, Values, and Goals ● Feeding Hx ● Current Status ● Family Dynamics ● Mealtime Environment, Schedule, and Routines ● Self-help Skills and Oral Motor Skills ● Sensory Processing | ● Behaviors and Rigidity ● Regulation ● Posture, T one, and Motor Skills ● Health ● Nutrition |
| FEEDING AND MEALTIME PARTICIPATION INTERVENTION; Behavioral Approach | ○ Operant Conditioning ○ Systematic Desensitization | |
| FEEDING AND MEALTIME PARTICIPATION INTERVENTION; Interventions | ○ Sequential Oral Sensory (SOS) ○ Autism MEAL Plan parent training for food selectivity ○ BUFFET (Building Up Food Flexibility and Exposure Treatment) ○ EAT UP parent training to increase dietary variety | |
| SKILL DEVELOPMENT AND MEALTIME PARTICIPATION; Before (Prep) | ○ Routine ○ Set- up ○ Proper seating ○ Type of chair | |
| SKILL DEVELOPMENT AND MEALTIME PARTICIPATION; During | ○ Modeling ○ Gradual food exposure and aspirations ○ Avoid long periods of mealtime ○ Avoid screentime/ gadgets | |
| SKILL DEVELOPMENT AND MEALTIME PARTICIPATION; Outside of family mealtimes | ○ Where are they going, and how long? ○ Packed food and activities while waiting | |
| REST AND SLEEP | ● Non-REM sleep and REM sleep | |
| Sleep Problems: | ○ Insomnia and Hypersomnia ○ Parasomnia ○ Decreased sleep efficiency ○ Periodic limb movement disorder ○ Sleep Anxiety and Heightened bedtime resistance ○ Restless Leg Syndrome ○ Sleep Apnea | |
| AGE: 0-3 mos | RECOMMENDED SLEEP DURATION (hours) 14-17 | |
| AGE: 4-11 mos | RECOMMENDED SLEEP DURATION (hours) 12-15 | |
| AGE: 1-2 yrs | RECOMMENDED SLEEP DURATION (hours) 11-14 | |
| AGE: 3-5 yrs | RECOMMENDED SLEEP DURATION (hours) 10-13 | |
| AGE: 6-13 yrs | RECOMMENDED SLEEP DURATION (hours) 9-11 | |
| AGE: 14-17 yrs | RECOMMENDED SLEEP DURATION (hours) 8-10 | |
| REST AND SLEEP EVAL | ● Modify Sleep Environment ● Establish bedtime routines and rituals (1 hour before) ● Pharmacological: Melatonin ● Behavioral ○ Social Story (Sleep Story) ○ Supervision and Fading | |
| REST AND SLEEP INTERVENTION | ● Modify Sleep Environment ● Establish bedtime routines and rituals (1 hour before) ● Pharmacological: Melatonin ● Behavioral ○ Social Story (Sleep Story) ○ Supervision and Fading | |
| FINE MOTOR SKILLS EVAL | ● Hand Dominance ● Grasp and Prehension Patterns ● Manipulation Skills ● Interactions with Objects | |
| FINE MOTOR SKILLS INTERVENTION | ● Sensorimotor (Perceptual Motor - SI) ● Skill Building ● Problem Solving (Cognitive) ● Behavioral | |
| PRAXIS | ● What to do for motor planning, cognitive process; Idea of an action or interaction with certain objects - Ideation - Motor Planning - Sequencing | |
| Ideation | – Idea of an action or interaction with a certain object | |
| Object affordance | – working possibilities and functions of an object based on what you can do with the object/characteristics | |
| Action affordance | – actions that can be performed by the person with a certain environment/object/space, depending on the context you are given | |
| SENSORY INTEGRATION EVAL | ● Patterns of self-regulation within each environment ● Attention to T ask Performance ● Changes in Social Behavior ● Impact of Environment on Participation | |
| SENSORY INTEGRATION INTERVENTION | ● Desensitization ● Exploration ● Modification or Monitoring of Sensory Environment ● Modification of Sensory Input | |
| FUNCTIONAL COMMUNICATION | - Learning Supports - Interpersonal Supports | |
| Learning Supports | – AAC, modifications in the Ax/environment, proper predictable sequence of actions | |
| Interpersonal Supports | modeling, responsive adults/peers that would facilitate communication | |
| SOCIAL SKILLS | ● Group-based Social Skills Training Programs ● Peer mediated Social Skills Interventions ● Activity-based Social Skills Interventions ● Computer-based Social Skills Interventions ● Social Stories | |
| BEHAVIOR MANAGEMENT | ● Simulation ● Least to Most Prompting ○ Least: no prompts/cues ○ Most: physical assistance (HOHA) ● Fading ● Chaining ● T echnology Supported Interventions | |
| ANTECEDENT BASED INTERVENTIONS | ● Prevent or Promote ● Escape / Avoid Sensory Features, Activity Demands ● Seek to Obtain Attention or Sensory Input ● Communicate ● Setting Events | |
| SLEEP HYGIENE | ● How do we improve sleep hygiene? ○ Consistent bedtime schedule ○ Relaxing bedtime routine ○ Look at the activities of the child throughout the day ○ Screentime ○ Diet before bed? What does the child eat before bed? |
Created by:
avemaria