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Peds Last Chance

Final exam material for OTA Pediatric Practice

QuestionAnswer
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