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OTA Peds disorders

Pervasive developmental disorders peds

QuestionAnswer
Define Autism qualitative impairment in social interaction as manifested by: impairment in multiple nonverbal behaviors: eye gaze, body postures, & gestures to regulate social interaction. failure to develop peer relationship, lack of spontaneous, enjoyment, interst.
Define Autism cont. Impairments in Communication: Delay in, total lack of, development of spoken language. adequate speech, initiate or sustain conversation with others. stereotyped and repetitive use of language, lack of varied, make believe play or socal imitative play.
Define Autism Cont. Restricted repetitive/stereotyped patterns of behavior, interest, and activities: Inflexible adherence to specific nonfuncational routines, persistent preoccupation with parts of object, repetitive motor mannerisms, hand flapping to whole body.
Autism Incidence 1- Onset is prior to the age of 3 2- Prevalence is estimated as 5 to 6 per cent of the popumation, with many more boys affected than girls
Possible causes of Autism A- Previous though: Coldness of mother child interaction, guilt laid on parents. B- Current thinking: is neurologic dev. Primary areas of brain affected(amygdala, cerebellum, R somatosensory cortex, orbitofrontal cortex and cingulated gyri.
What are the Predisposing Factors of Autsim Autism is seen in families of all racial, ethnic, intellectual, and socieconomis classes. No one knows what causes it, thought it does seem to have a genetic component as it runs in families.
Analyzing Behaviors of Autism Many Individual with autism have problems with sensory processing, which can include problems with sensory defensiveness. difficulties communicating. cannot tell you will words what is bothering them. you need to analyze the behavior to determine words.
when charting about each observed behavior what should be in the chart? Just prior to the targeted behavior: -who is present? What was happening? what was the client doing? Once the behavior starts: -Did the people change? Did the surrounding activity change? Did the client activity change?
Cont. of charting about behavior What intervention (if any) was used Did one person have better effectiveness than another? Did changing the environment have an impact? At what point did the client seem to begin to change behavior?
Analyzing the information, Does the client seem to use the behavior to: Arouse himself, calm himself, bring ppl closer, drive ppl away, avoid a particular task, avoid a particular space, Signal frustration
Calming and Facilitaing Techniques Calming Wilbarger Protocol, Hugging machine or deep pressure, Rocking (Socially appropriate)Neutral warmth -Facilitaing Preparation for next transition, cocooning(isolation of placement in classroom and reduction of visual and auditory stimuli)calm vo
Asperger's Disorder Similar to Autism, Impairment in Social Communication skills, tend to have normal intelligence,ADLs, and adaptive behavior normal curiosity about environment. -Tend to misunderstand other's affect, show lack of empathy, tend to intellectualize feelings.
Childhood Disintegrative Disorder (Heller's Syndrome) Normal Dev. for at least first two years of life, then suuden significant loss of previously acquired skills in at least two areas: expressive/receptive language, social skills/adaptive behavior, bowel/bladder control, play, or motor skills
Rett's Disorder Prenatal/perinatal dev. through the first five months or so. following deceleration of head growth resulting in microcephaly. hand skills are lost stereotyped hand wringing/washing movements. gait/trunk uncoordinated, nonambulatory in late childhood,GIRLS
Treatment A- Interdisciplinary Approach B- Medication -Antipychotics to deal with temper tantrums or other behaviors(self abuse), Anti depressants help with mood, meds to focus attention, antiseizure med if necessary
Occupational Therapy Review of interventions for Autism used in/of relevance to OT Six Categories -SI or Sesnory based tx -Relationship-based intervention -Development skills based programs/behavior -Socail Cognitive skill training -Parent directive/ parent mediated appo
Sensory Integration Approaches? Widely used, but need more research as to efficacy study of daily massage (deep Pressure) done by parents improved attention/reduced behaviors Approches using auditory integration training have inconclusive evidence for their effectiveness
Relationship based Approaches? Adults imitation of the child's actions, implements high levels of positive reiforcement, applying prompting and cues, peer interaction, enviornment suppoting social interactions. Waiting for child's responses arranging environment to prevent challenges.
what are structure play activites? using Lego's tapped into the children's preference for small constructive toys, focus was cooperative play and fun, peers and aides facilitates play. has positive effects with 175% increase is duration of social intercation with peers in free play.
What is Floor time? Encourages parents to imitate and engage in whatever the child is doing. Parents become more responsive to child, and child becomes more socially competent. 10-15 year follow up study showed good results maintained socail/interactive competence when young
Development skill based programs Instruction based and include TEACCH This method uses visual strategies in both teaching and communication. establish visual stategies that cue the child as to what ax comes next, guide child in sequencing/ completing ax.
Social Cognitive Skill Training? done as a older child or adult. taught about emotions and trained in social skills, but had difficulty generalizing the skills social Stories are sometimes used by OT or others before an event so child by giveing them directives for expected behaviors
Parent Directed and parent mediated approaches Parents taught to motivate and respond to theit children in targeted behaviors were compared with parents taught to teach and reward their children. the formaer were more successful and felt less stressed.
Intensive behavioral intervention Involves discrete trial training similar to that developed by Lovaas, and done over an intensive period of time. Original research data showed strong gains in IQ and academics, most recent not so glowing, yet still shows mod gains,even when less intensit
So how do we apply these to OT? Assist with social interaction by responding positively, establishing eye contact, reinforcing the child' communication attempts, wait for response, and modify environment to elcit communication. Treat child as an individual with unique need.
Created by: TIFFANYN812