Test Bank for Occupational Therapy for Children, 6th Edition : Case-Smith

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Product Details:

  • ISBN-10 ‏ : ‎ 032305658X
  • ISBN-13 ‏ : ‎ 978-0323056588
  • Author:  Jane Case-Smith

The sixth edition of Occupational Therapy for Children maintains its focus on children from infancy to adolescence and gives comprehensive coverage of both conditions and treatment techniques in all settings. Inside you’ll discover new author contributions, new research and theories, new techniques, and current trends to keep you in step with the changes in pediatric OT practice. This edition provides an even stronger focus on evidence-based practice with the addition of key research notes and explanations of the evidentiary basis for specific interventions.

  • Unique Evolve Resources website reinforces textbook content with video clips and learning activities for more comprehensive learning.
  • Case studies help you apply concepts to actual situations you may encounter in practice.
  • Evidence-based practice focus reflects the most recent trends and practices in occupational therapy.
  • Unique! Chapter on working with adolescents helps you manage the special needs of this important age group.
  • Unique! Research Notes boxes help you interpret evidence and strengthen your clinical decision-making skills.
  • Video clips on a companion Evolve Resources website reinforce important concepts and rehabilitation techniques.

 

Table of Content:

  1. SECTION I Foundational Knowledge for Occupational Therapy for Children
  2. CHAPTER 1 An Overview of Occupational Therapy for Children
  3. OBJECTIVES
  4. KEY TERMS
  5. BEST PRACTICES IN OCCUPATIONAL THERAPY FOR CHILDREN
  6. Child- and Family-Centered Practice
  7. TABLE 1-1 Principles of Client-Centered Intervention
  8. FIGURE 1-1 The family’s unique interests determine their priorities for spending time and resources. Occupational therapy services focus on the child’s ability to participate in valued family activities.
  9. Comprehensive Evaluation
  10. TABLE 1-2 Description of Comprehensive Evaluation of Children
  11. Assessing Participation and Analyzing Performance
  12. Ecologic Assessment
  13. FIGURE 1-2 By evaluating the child at home, the therapist gathers information about how the family uses the child’s technology and how the child accesses home environments and participates in activities of daily living.
  14. FIGURE 1-3 Through observation of a writing activity at school, the occupational therapist gains an understanding of the accommodations and supports needed as well as the child’s performance level.
  15. Evaluating Context
  16. Effective Interventions
  17. Providing Interventions to Enhance Performance
  18. Optimize Child’s Engagement
  19. Provide a Just Right Challenge
  20. FIGURE 1-4 A climbing wall activity challenged this child’s motor planning, bilateral coordination, strength, and postural stability.
  21. FIGURE 1-5 Applying a sensory integration approach, the therapist gradually introduced the child with gravitational insecurity to unstable surfaces and higher levels of vestibular input.
  22. CASE STUDY 1-1 Grading an Activity: Challenging and Eliciting Full Participation
  23. Establish a Therapeutic Relationship
  24. FIGURE 1-6 A hallway conversation helps to establish the therapist’s relationship with the child.
  25. Provide Adequate and Appropriate Intensity and Reinforcement
  26. FIGURE 1-7 In constraint-induced movement therapy, the child’s less involved arm was casted, and she received intensive therapy to build skills in the involved arm and hand.
  27. Adapting Activities and Modifying the Environment
  28. Interventions Using Assistive Technology
  29. FIGURE 1-8 The occupational therapist designed a mouth stick and game board setup so that the child could play the game with his father.
  30. FIGURE 1-9 A switch activates a computer program that simulates a storybook.
  31. Environmental Modification
  32. Consulting, Educating, and Advocating
  33. Consultation Services
  34. Education and Advocacy
  35. Occupational Therapy Services That Support Inclusion
  36. Early Intervention Services in the Child’s Natural Environment
  37. FIGURE 1-10 The occupational therapist coaches the child’s mother to facilitate the child’s perceptual motor skills.
  38. Inclusive Services in Schools
  39. Flexible Service Delivery Models
  40. FIGURE 1-11 Writing adaptations and peer support in the classroom promote the child’s writing performance.
  41. BOX 1-1 Desired Inclusion Outcomes
  42. Cross-Cultural Competence
  43. Cultural Diversity in the United States
  44. FIGURE 1-12 A father bonds with his just-born son.
  45. Influence of Cultural Practices on a Child’s Development of Occupations
  46. TABLE 1-3 Cultural Values and Styles That Influence Children’s Development of Occupations
  47. Scientific Reasoning and Evidence-Based Practice
  48. BOX 1-2 Steps in Evidence-Based Practice
  49. STEP 1
  50. STEP 2
  51. STEP 3
  52. STEP 4
  53. STEP 5
  54. Sensory Integration
  55. Sensory Modalities
  56. Play-Based, Relationship-Focused Interventions
  57. BOX 1-3 Components of the Denver Model Intervention for Children with Autism
  58. Family-Centered Care
  59. SUMMARY
  60. REFERENCES
  61. CHAPTER 2 Foundations for Occupational Therapy Practice with Children
  62. OBJECTIVES
  63. KEY TERMS
  64. OCCUPATIONAL THERAPY PRACTICE WITH CHILDREN
  65. Concepts Influencing Occupational Therapy Practice with Children
  66. Development
  67. Participation in Occupations
  68. FIGURE 2-1 The infant uses sensory motor play with mouth and hands to explore an object.
  69. BOX 2-1 Best Practice Principles of Occupational Therapy to Promote Participation in Everyday Life
  70. Environment
  71. Risk and Resilience
  72. FIGURE 2-2 The infant is motivated to seek and explore a new toy.
  73. Family-Centered Service
  74. World Health Organization International Classification of Functioning, Disability, and Health
  75. FOUNDATIONAL THEORIES
  76. Developmental Theories
  77. Piaget and Cognitive Development
  78. Vygotsky and the Zone of Proximal Development
  79. Maslow and the Hierarchy of Basic Needs
  80. Learning and Systems Theories
  81. CASE STUDY 2-1 Example of Vygotsky: Scaffolding and the Zone of Proximal Development
  82. Behavioral Theories
  83. BOX 2-2 Example of Shaping Techniques
  84. TABLE 2-1 Comparison of Discrete Trial Training and Incidental Teaching in Early Childhood Programs
  85. FIGURE 2-3 In this example, the child selected the activity (finger painting) and the medium (shaving cream). The occupational therapist reinforces the child’s efforts to reach overhead with praise and touch.
  86. Social Cognitive Theories
  87. The Influence of Motivation and Self-Efficacy on Learning
  88. Dynamic Systems Theory
  89. MODELS OF PRACTICE USED BY OCCUPATIONAL THERAPISTS
  90. TABLE 2-2 Principles of Dynamic Systems Theory Applied to Motor Development
  91. FIGURE 2-4 A, Person-environment-occupation model. B, Person-environment-occupation analysis.
  92. Specific Models of Practice
  93. A Systems Approach
  94. FIGURE 2-5 In this functional activity, a slant board is used to promote improved posture and grasp of the pencil. A weight on the pencil provides added proprioceptive input.
  95. Cognitive Approaches
  96. Adaptation and Compensation Interventions
  97. Psychosocial Approaches
  98. Coping Model
  99. Internal and External Coping Resources
  100. Effective Coping
  101. FIGURE 2-6 Teaching yoga to a child with Asperger’s gives him a method to improve his coordination, agility, and bilateral integration. It also gives him a method for exercising that can reduce stress.
  102. Social Skills Training
  103. TABLE 2-3 Occupational Therapy Interventions Designed to Improve Social Skills
  104. Motor Learning and Skill Acquisition
  105. FIGURE 2-7 This activity of threading a string through hooks to create a design involves eye-hand coordination, dexterity, and control of arm in space (strength). It requires multiple steps to achieve a completed product.
  106. FIGURE 2-8 In this task emphasizing bilateral coordination and hand strength, the therapist suggests an outcome but the child decides what she wants to create.
  107. TABLE 2-4 Application of Motor Learning Concepts
  108. Neurodevelopmental Theory
  109. Sensory Integration
  110. TABLE 2-5 Sensory Processing Disorder Categories
  111. FIGURE 2-9 The child’s selection of jumping on an inner tube helps to meet his need for vestibular and proprioceptive input.
  112. FIGURE 2-10 This child exhibits an adaptive response by pulling on the rope.
  113. TABLE 2-6 Core Elements of Sensory Integration Intervention
  114. Developmental Approaches
  115. CLINICAL APPLICATION EXAMPLES
  116. CASE STUDY 2-2 Stacey
  117. TABLE 2-7 Assessments, Interventions, and Expected Outcomes for Stacey
  118. CASE STUDY 2-3 Brian
  119. TABLE 2-8 Assessments, Interventions, and Expected Outcomes for Brian
  120. CASE STUDY 2-4 Chris
  121. TABLE 2-9 Assessments, Interventions, and Expected Outcomes for Chris
  122. REFERENCES
  123. CHAPTER 3 Development of Childhood Occupations
  124. OBJECTIVES
  125. KEY TERMS
  126. DEVELOPMENTAL THEORIES AND CONCEPTS
  127. Neuromaturation
  128. Development as an Interplay of Intrinsic and Environmental Factors
  129. The Influence of Social Interaction
  130. Dynamical Systems Theory
  131. Perceptual Action Reciprocity
  132. Functional Performance: Flexible Synergies
  133. FIGURE 3-1 Hand-to-mouth movement is observed throughout the first year, first for sensory exploration of the mouth and hand and then as a feeding behavior.
  134. FIGURE 3-2 By 7 to 8 months, an infant finger-feeds, prehending small food pieces and bringing hand to mouth.
  135. How Do Children Develop New Performance Skills?
  136. The Role of Motivation and Self-Efficacy
  137. FIGURE 3-3 Infants play in supported standing for extended periods, gaining postural stability and balance when holding onto a stable surface.
  138. Temperament and Emotional Development
  139. Risk and Resiliency
  140. AN OCCUPATIONAL THERAPY PERSPECTIVE
  141. Development of Occupations
  142. Contexts for Development
  143. Cultural Contexts
  144. Social Contexts
  145. Physical Contexts
  146. CHILDREN’S OCCUPATIONS, PERFORMANCE SKILLS, AND CONTEXTS
  147. Infants: Birth to 2 Years
  148. Play Occupations
  149. BOX 3-1 Development of Play Occupations: Infants—Birth to 6 Months
  150. PLAY OCCUPATIONS
  151. Exploratory Play
  152. Social play
  153. PERFORMANCE SKILLS
  154. Regulatory/Sensory Organization
  155. Fine Motor/Manipulation
  156. Gross Motor/Mobility
  157. Cognitive
  158. Social
  159. BOX 3-2 Development of Play Occupations: Infants—6 to 12 Months
  160. PLAY OCCUPATIONS
  161. Exploratory Play
  162. Functional Play
  163. Social Play
  164. PERFORMANCE SKILLS
  165. Regulatory/Sensory Organization
  166. Fine Motor/Manipulation
  167. Gross Motor/Mobility
  168. Cognitive
  169. Social
  170. BOX 3-3 Development of Play Occupations: Infants—12 to 18 Months
  171. PLAY OCCUPATIONS
  172. Relational and Functional Play
  173. Gross Motor Play
  174. Social Play
  175. PERFORMANCE SKILLS
  176. Regulatory/Sensory Organization
  177. Fine Motor/Manipulation
  178. Gross Motor/Mobility
  179. Cognitive
  180. Social
  181. BOX 3-4 Development of Play Occupations: Toddlers—18 to 24 Months
  182. PLAY OCCUPATIONS
  183. Functional Play
  184. Gross Motor Play
  185. Pretend or Symbolic Play
  186. Social Play
  187. PERFORMANCE SKILLS
  188. Regulatory/ Sensory Organization
  189. Fine Motor/Manipulation
  190. Gross Motor/Mobility
  191. Cognitive
  192. Social
  193. Performance Skills
  194. Sensory and Motor Skills
  195. FIGURE 3-4 Inprone position, the infant shifts his weight from side to side when playing with toys; later he learns to pivot while prone to expand where he can reach and what he can visualize.
  196. FIGURE 3-5 A, In dynamic sitting, the infant has sufficient postural stability to reach in all directions. B, By 10 months, the infant easily moves into and out of sitting positions.
  197. FIGURE 3-6 Crawling on all fours allows the infant to explore new spaces. This form of mobility increases shoulder and pelvic stability for upright stance and promote the rotational patterns needed for ambulation.
  198. FIGURE 3-7 Supported stance is a favorite play position for infants 8 to 11 months of age.
  199. FIGURE 3-8 A, Grasping patterns evolve from palmar grasps without active thumb use to radial digital grasps as in B. C, At 4 months, the infant holds the object tight against the palm, with all fingers flexing as a unit. D, At 8 months, the infant holds objects in the radial digits.
  200. Cognitive Skills
  201. Social Skills
  202. FIGURE 3-9 The 2-year-old boy engages in social play, imitating an adult, sequencing action, taking turns, and demonstrating understanding of object permanence on self.
  203. Contexts of Infancy
  204. Cultural Contexts
  205. Physical Contexts
  206. Early Childhood: Ages 2 to 5 Years
  207. Play Occupations
  208. BOX 3-5 Development of Play Occupations: Preschoolers—24 to 36 Months
  209. PLAY OCCUPATIONS
  210. Symbolic Play
  211. Constructive Play
  212. Gross Motor Play
  213. Social Play
  214. PERFORMANCE SKILLS
  215. Regulatory/Sensory Organization
  216. Fine Motor/Manipulation
  217. Gross Motor/Mobility
  218. Cognitive
  219. Social
  220. BOX 3-6 Development of Play Occupations: Preschoolers—3 to 4 Years
  221. PLAY OCCUPATIONS
  222. Complex Imaginary Play
  223. Constructive Play
  224. Rough-and-Tumble Play
  225. Social Play
  226. PERFORMANCE SKILLS
  227. Fine Motor/Manipulation
  228. Gross Motor/Mobility
  229. Cognitive
  230. Social
  231. Performance Skills
  232. Sensory and Motor Skills
  233. BOX 3-7 Development of Play Occupations: Preschoolers—4 to 5 Years
  234. PLAY OCCUPATIONS
  235. Games with Rules
  236. Constructive Play
  237. Social Play; Dramatic Play
  238. PERFORMANCE SKILLS
  239. Fine Motor/Manipulative
  240. Gross Motor/Mobility
  241. Cognitive
  242. Social
  243. BOX 3-8 Development of Play Occupation: Kindergartners—5 to 6 Years
  244. PLAY OCCUPATIONS
  245. Games with Rules
  246. Dramatic Play
  247. Sports
  248. Social Play
  249. PERFORMANCE SKILLS
  250. Fine Motor/Manipulation
  251. Gross Motor/Mobility
  252. Cognitive
  253. Social
  254. FIGURE 3-10 Four-year-old children complete puzzles and enjoy construction activities in small groups.
  255. Cognitive Skills
  256. Social Skills
  257. Contexts
  258. Cultural and Social Contexts
  259. Physical Contexts
  260. FIGURE 3-11 Special places and favorite play partners have high significance to young children.
  261. Middle Childhood: Ages 6 to 10 Years
  262. Play Occupations
  263. FIGURE 3-12 Children seek opportunities to challenge their balance. By 9 and 10 years, postural stability and strength are sufficiently developed to maintain standing balance on a porch railing.
  264. BOX 3-9 Development of Play Occupations: Middle Childhood—6 to 10 Years
  265. PLAY OCCUPATIONS
  266. Games with Rules
  267. Crafts and Hobbies
  268. Organized Sports
  269. Social Play
  270. PERFORMANCE SKILLS
  271. Fine Motor/Manipulation
  272. Gross Motor/Mobility
  273. Cognitive
  274. Social
  275. Performance Skills
  276. Sensory and Motor Skills
  277. FIGURE 3-13 Favorite play activities for all children include swimming, ball play, and outdoor sports.
  278. Cognitive Skills
  279. Social Skills
  280. Contexts
  281. Cultural Contexts
  282. Physical Contexts
  283. SUMMARY
  284. REFERENCES
  285. CHAPTER 4 In Transition to Adulthood: The Occupations and Performance Skills of Adolescents
  286. OBJECTIVES
  287. KEY TERMS
  288. ADOLESCENCE
  289. ADOLESCENT DEVELOPMENT
  290. CASE STUDY 4-1 My Sister Is a Teenager
  291. FIGURE 4-1 Sisters Corinne and Caroline
  292. BOX 4-1 Facts about American Teenagers
  293. PHYSICAL DEVELOPMENT AND MATURATION
  294. Physical Activities and Growth: Teenagers with Disabilities
  295. PUBERTY
  296. Psychosocial Development of Puberty and Physical Maturation
  297. TABLE 4-1 Normal Development of Body Image
  298. COGNITIVE DEVELOPMENT
  299. PSYCHOSOCIAL DEVELOPMENT
  300. The Search for Identity: Identity Formation
  301. TABLE 4-2 Summary of the Typical Characteristics of Psychosocial Development
  302. BOX 4-2 Being Disabled Is Not an Identity
  303. Sexual Orientation: Gender Identity
  304. Self-Concept and Self-Esteem
  305. TABLE 4-3 Behavioral Indicators of Self-Esteem
  306. Adolescence and Mental Health
  307. BOX 4-3 Critical Health Behaviors of American Adolescents
  308. ALCOHOL & DRUG USE
  309. TOBACCO USE
  310. INJURY & VIOLENCE (INCLUDING SUICIDE)
  311. NUTRITION
  312. PHYSICAL ACTIVITY
  313. SEXUAL BEHAVIORS
  314. AREAS OF OCCUPATION: PERFORMANCE SKILLS AND PATTERNS
  315. Work: Paid Employment and Volunteer Activities
  316. Work Opportunities for Adolescents with Disabilities
  317. Instrumental Activities of Daily Living
  318. Achieving Competencies in IADLs with a Disability
  319. Leisure and Play
  320. Social Participation
  321. FIGURE 4-2 Examples of goal-directed activities. A, Baseball. B, Snowboarding. C, Basketball.
  322. Peer Relationships
  323. Navigating Social Participation with a Disability
  324. CASE STUDY 4-2 Bullying: Nick’s Story
  325. The Evolution of Adolescent-Parent Relationships
  326. THE ENVIRONMENTS OF ADOLESCENCE
  327. OCCUPATIONAL THERAPY TO FACILITATE ADOLESCENT DEVELOPMENT
  328. BOX 4-4 Environmental and Contextual Factors of Healthy Adolescent Development
  329. SUPPORT
  330. EMPOWERMENT
  331. BOUNDARIES AND EXPECTATIONS OF ADOLESCENTS
  332. CASE STUDY 4-3 A Parent’s Reflections on Her Daughter’s High School and College Experiences
  333. FIGURE 4-3 Brie and friends.
  334. BOX 4-5 Eligibility for OT Services
  335. CASE STUDY 4-4 Understanding that Development Is the Foundation of Effective Occupational Therapy Practice
  336. SUMMARY
  337. REFERENCES
  338. CHAPTER 5 Working with Families
  339. OBJECTIVES
  340. KEY TERMS
  341. REASONS TO STUDY ABOUT FAMILIES
  342. BOX 5-1 Therapists’ Professional Responsibility in Light of Family Diversity
  343. THE FAMILY: A GROUP OF OCCUPATIONAL BEINGS
  344. BOX 5-2 Outcomes of Family Occupations
  345. BOX 5-3 Family Resources
  346. SYSTEM PERSPECTIVE OF FAMILY OCCUPATIONS
  347. BOX 5-4 Key Concepts of a Family System Model
  348. FIGURE 5-1 Matthew and his brother wait for the school bus.
  349. FAMILY SUBSYSTEMS
  350. Parents
  351. FIGURE 5-2 Matthew’s family celebrates Dad’s birthday.
  352. Siblings
  353. FIGURE 5-3 A, Father enjoys holding his child while attending an early intervention program in the evening with his family. B, Playtime with Dad before bed.
  354. FIGURE 5-4 Matthew and his brothers enjoy backyard play. A sandbox is a fail-proof medium that provides equal opportunity for multiple levels of play.
  355. FIGURE 5-5 Although Matthew is the oldest of four boys, his younger brothers already take the initiative to help him participate. A round of miniature golf requires his brothers’ assistance, which does not detract from the fun.
  356. Extended Family
  357. FIGURE 5-6 Matthew’s grandparents enjoy their time with him and offer important support to his parents.
  358. FAMILY LIFE CYCLE
  359. Early Childhood
  360. School Age
  361. FIGURE 5-7 Matthew has an aide at school who supports his participation in both academic and nonacademic activities.
  362. Adolescence
  363. FAMILY RESOURCES AND THE CHILD WITH SPECIAL NEEDS
  364. Financial Resources
  365. Human Resources
  366. Time Resources
  367. Emotional Energy Resources
  368. SOURCES OF DIVERSITY IN FAMILIES
  369. Ethnic Background
  370. Family Structure
  371. Socioeconomic Status
  372. Parenting Style and Practices
  373. RESEARCH NOTE 5-1
  374. ABSTRACT
  375. OBJECTIVE/METHOD
  376. RESULTS
  377. CONCLUSIONS
  378. IMPLICATIONS FOR PRACTICE
  379. AN ECOLOGIC PERSPECTIVE
  380. SUPPORTING PARTICIPATION IN FAMILY LIFE
  381. Development of Independence in Self-Care and Health Maintenance Routines
  382. FIGURE 5-8 Matthew’s bath time routine allows him to practice a range of skills, including play and social interaction.
  383. FIGURE 5-9 A therapist gives the mother recommendations for increasing the child’s skills in self-feeding. Supportive positioning equipment and adapted feeding utensils make the task easier for the child and the mother.
  384. Participation in Recreation and Leisure Activities
  385. FIGURE 5-10 A, Recreational opportunities in the community provide an important family occupation. B, Matthew bowls with a friend.
  386. FIGURE 5-11 A, Most skiing facilities have equipment for children unable to stand independently. B, Wee Can Ski provides equipment for children with a variety of disabilities.
  387. FIGURE 5-12 Keith has a tennis lesson while Dad watches proudly.
  388. FIGURE 5-13 A, Dad pulls his tired children through a theme park. B, Years later, Todd returns the favor.
  389. FIGURE 5-14 Activity centers with soft mats, bolsters, balls, and tunnels for tumbling offer safe and accessible environments for children with physical disabilities.
  390. Socialization and Participation in Social Activities
  391. Fostering Readiness for Community Living
  392. FAMILY ADAPTATION, RESILIENCE, AND ACCOMMODATION
  393. PARTNERING WITH FAMILIES
  394. Establishing a Partnership
  395. TABLE 5-1 Cultural Considerations in Intervention Services
  396. Providing Helpful Information
  397. Providing Flexible, Accessible, and Responsive Services
  398. Respecting Family Roles in Decision Making
  399. COMMUNICATION STRATEGIES
  400. HOME PROGRAMS: BLENDING THERAPY INTO ROUTINES
  401. TABLE 5-2 Communication Methods between Parents and Professionals
  402. WORKING WITH FAMILIES FACING MULTIPLE CHALLENGES
  403. RESEARCH NOTE 5-2
  404. ABSTRACT
  405. OBJECTIVE
  406. METHOD
  407. RESULTS
  408. CONCLUSION
  409. IMPLICATIONS FOR PRACTICE
  410. Families in Chronic Poverty
  411. Parents with Special Needs
  412. CASE STUDY 5-1 Family with Multiple Challenges
  413. SUMMARY
  414. REFERENCES
  415. Appendix 5-A A Parent’s Perspective
  416. INITIAL RESPONSE
  417. ACCESSING SERVICES AND RESOURCES
  418. WHOSE DISTRESS, WHOSE STRUGGLE?
  419. WHERE DO WE GO FROM HERE?
  420. SCHOOL
  421. GIFTS AND DREAMS
  422. CHAPTER 6 Common Conditions That Influence Children’s Participation
  423. OBJECTIVES
  424. KEY TERMS
  425. CARDIOPULMONARY DYSFUNCTIONS
  426. Congenital Heart Disease
  427. FIGURE 6-1 Atrial septal defect.
  428. FIGURE 6-2 Ventricular septal defect.
  429. FIGURE 6-3 Tetralogy of Fallot.
  430. Dysrhythmias
  431. Neonatal Respiratory Problems
  432. Asthma
  433. Cystic Fibrosis
  434. MUSCULOSKELETAL DISORDERS
  435. Congenital Anomalies and Disorders
  436. TABLE 6-1 Age at Onset Effects of Osteogenesis Imperfecta
  437. FIGURE 6-4 Bilateral congenital talipes equinovarus. A, Before correction. B, Undergoing correction in plaster casts.
  438. Limb Deficiencies
  439. FIGURE 6-5 Child with multiple congenital limb deficiencies, including bilateral transverse upper arm deficiency and bilateral proximal femoral focal deficiency.
  440. Juvenile Rheumatoid Arthritis
  441. FIGURE 6-6 Components of a typical synovial joint.
  442. Curvature of the Spine
  443. FIGURE 6-7 Defects of the spinal column. A, Normal spine. B, Kyphosis. C, Lordosis. D, Normal spine in balance. E, Mild scoliosis in balance. F, Severe scoliosis not in balance. G, Rib hump and flank asymmetry seen in flexion caused by rotary component.
  444. NEUROMUSCULAR DISORDERS
  445. Cerebral Palsy
  446. Classification of Cerebral Palsy
  447. FIGURE 6-8 Limb involvement classification and severity in cerebral palsy: Left, Hemiplegia; middle, diplegia; right, tetraplegia or quadriplegia.
  448. TABLE 6-2 Cerebral Palsy Classifications
  449. Seizure Disorders and Epilepsy
  450. Muscular Dystrophies
  451. BOX 6-1 Emergency Treatment of Seizures
  452. FIGURE 6-9 Initial muscle groups involved in muscular dystrophies. A, Pseudohypertrophic. B, Facioscapulohumeral. C, Limb-girdle.
  453. FIGURE 6-10 Child with Gower’s sign.
  454. Neural Tube Defects and Spina Bifida
  455. FIGURE 6-11 Three forms of spina bifida.
  456. CASE STUDY 6-1 Angela
  457. Hydrocephalus
  458. FIGURE 6-12 Ventriculoperitoneal shunt. Catheter is threaded subcutaneously from small incisions at the sites of ventricular and peritoneal insertions.
  459. Peripheral Nerve Injuries
  460. Birth Injuries
  461. Traumatic Injury of Peripheral Nerves
  462. TRAUMATIC BRAIN INJURIES
  463. DEVELOPMENTAL DISABILITIES
  464. Intellectual Disabilities
  465. FIGURE 6-13 Criteria for determining the four degrees of severity in intellectual disabilities.
  466. Autism Spectrum Disorders or Pervasive Developmental Disorders
  467. Autism
  468. Asperger’s Syndrome
  469. Rett Syndrome
  470. Attention Deficit–Hyperactivity Disorder
  471. Learning Disabilities
  472. Developmental Coordination Disorder
  473. Genetic and Chromosomal Abnormalities
  474. Chromosomal Disorders
  475. Genetic Disorders
  476. Inborn Errors of Metabolism
  477. DIABETES
  478. TOXIC AGENTS
  479. Prenatal Toxins
  480. Fetal Alcohol Syndrome Disorders
  481. TABLE 6-3 Effects of Common Teratogens on the Developing Fetus and Child
  482. FIGURE 6-14 Typical facial features of a child with fetal alcohol syndrome (FAS).
  483. Cocaine and Opiates
  484. Heavy Metals
  485. INFECTIOUS CONDITIONS
  486. Maternal Infections
  487. TABLE 6-4 Intrauterine Infections (STORCH)
  488. Acquired Immunodeficiency Syndrome
  489. Encephalitis and Meningitis
  490. BURNS
  491. FIGURE 6-15 Estimation of distribution of burns in children. A, Children from birth to 5 years of age. B, Older children.
  492. FIGURE 6-16 Classification of burn depth.
  493. GENERAL DEVELOPMENTAL CONCERNS
  494. Pediatric Obesity
  495. Suicide and Depression
  496. FIGURE 6-17 Body weight indexes. A, Boys. B, Girls.
  497. SUMMARY
  498. REFERENCES
  499. Suggested Readings
  500. SECTION II Occupational Therapy Evaluation in Pediatrics
  501. CHAPTER 7 Purposes, Processes, and Methods of Evaluation
  502. OBJECTIVES
  503. KEY TERMS
  504. EVALUATION PURPOSES
  505. Comprehensive Evaluation for Intervention Planning
  506. FIGURE 7-1 Family environment: parents playing with their two children at the park.
  507. FIGURE 7-2 Fine motor materials from the Peabody Developmental Motor Scales-2 (PDMS-2) assessment tool.
  508. Application
  509. Screening
  510. CASE STUDY 7-1 Kobe
  511. FIGURE 7-3 Kobe learning to print his letters at school.
  512. TABLE 7-1 Methods and Measures for Kobe’s Evaluation
  513. FIGURE 7-4 Materials for the Developmental Test of Visual Perception (2nd ed.) (DTVP-2).
  514. FIGURE 7-5 Materials for the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2).
  515. FIGURE 7-6 Therapist interviewing an adolescent about her preference for assistive technology.
  516. Eligibility and Diagnostic Purposes
  517. Reevaluation Purposes
  518. Clinical Research
  519. FIGURE 7-7 A, Skilled observation of a child in supine flexion. B, Skilled observation of a child’s posture in a wheelchair.
  520. BOX 7-1 Checklist for Skilled Observations of Neuromotor Status
  521. CASE STUDY 7-2 Jason
  522. FIGURE 7-8 Materials for the Sensory Integration and Praxis Tests.
  523. EVALUATION PROCESS
  524. Referral
  525. Development of the Child’s Occupational Profile
  526. FIGURE 7-9 Occupational therapy assistant evaluating children’s performance during a handwriting activity school.
  527. FIGURE 7-10 Flowchart for the evaluation process using the Occupational Therapy Practice Framework.
  528. Administration of Evaluation
  529. TABLE 7-2 Selection of Appropriate Evaluation Methods
  530. BOX 7-2 Checklist for Selection of Methods and Measures
  531. Analysis of the Child’s Occupational Performance
  532. Development of Recommendations Based on Evaluation Results
  533. CASE STUDY 7-3 Occupational Therapy Evaluation Report for Kobe
  534. BACKGROUND INFORMATION
  535. REFERRAL INFORMATION
  536. OCCUPATIONAL PROFILE
  537. ASSESSMENTS USED
  538. ASSESSMENT SITUATION
  539. ASSESSMENT RESULTS
  540. School Function Assessment
  541. Observations of Neuromotor Status
  542. Visual Perception
  543. SUMMARY AND ANALYSIS OF OCCUPATIONAL PERFORMANCE
  544. RECOMMENDATIONS
  545. BOX 7-3 Behavior Strategies for Testing Young Children
  546. Documentation of Evaluation Results and Recommendations
  547. EVALUATION METHODS
  548. Standardized Assessments
  549. FIGURE 7-11 Materials for the evaluation of children’s handwriting.
  550. FIGURE 7-12 A, Observation of child in his natural environment. B, Observation of peer interaction during play.
  551. Ecologic Assessments
  552. Skilled Observation
  553. FIGURE 7-13 Observation of child performing a functional task at school.
  554. Interviews
  555. BOX 7-4 Basic Strategies for Interviewing Parents, Older Children, and Adolescents
  556. Inventories and Scales
  557. FIGURE 7-14 Examples of items from the Caregiver/Parent–Child Interaction Feeding Scale.
  558. Arena Assessments
  559. SUMMARY
  560. REFERENCES
  561. Appendix 7-A Common Measures Used in Pediatric Occupational Therapy
  562. Adolescent/Adult Sensory Profile
  563. Ages & Stages Questionnaires
  564. Alberta Infant Motor Scale (AIMS)
  565. Bayley Scales of Infant and Toddler Development (3rd Edition)
  566. Bayley Scales of Infant and Toddler Development—Third Edition Motor Scale
  567. Beery-Buktenica Developmental Test of Visual–Motor Integration, 5th Edition (BEERY VMI)
  568. Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)
  569. Canadian Occupational Performance Measure (4th edition)
  570. Child Occupational Self-Assessment (COSA)
  571. Childhood Autism Rating Scale (CARS)
  572. Children’s Assessment of Participation and Enjoyment (CAPE)
  573. Denver Developmental Screening Test (Revised) (Denver-II)
  574. Developmental Test of Visual Perception (Second Edition) (DTVP-2)
  575. Developmental Test of Visual Perception—Adolescent and Adult
  576. Early Coping Inventory
  577. Evaluation Tool of Children’s Handwriting (ETCH)
  578. FirstSTEP: Screening Test for Evaluating Preschoolers
  579. Functional Independence Measure for Children (WeeFIM)
  580. Gross Motor Function Measure (Revised) (GMFM)
  581. Hawaii Early Learning Profile (HELP)
  582. Home Observation for Measurement of the Environment (HOME)
  583. Infant/Toddler Sensory Profile
  584. Knox Preschool Play Scale (Revised)
  585. Miller Function & Participation Scales
  586. Motor-Free Visual Perception Test (MVPT-3)
  587. NCAST Caregiver/Parent–Child Interaction Scales
  588. Occupational Therapy Psychosocial Assessment of Learning (OT PAL)
  589. Peabody Developmental Motor Scales (2nd edition) (PDMS-2)
  590. Pediatric Evaluation of Disability Inventory (PEDI)
  591. Pediatric Volitional Questionnaire (PVQ) (2.1)
  592. Preferences for Activities of Children (PAC)
  593. Quality of Upper Extremity Skills Test (QUEST)
  594. School Function Assessment (SFA)
  595. School Assessment of Motor and Process Skills (School AMPS)
  596. Sensory Integration and Praxis Tests (SIPT)
  597. Sensory Processing Measure (SPM)
  598. Sensory Profile
  599. The Short Child Occupational Profile (SCOPE) (2.2)
  600. Test of Playfulness (ToP)
  601. Test of Environmental Supportiveness (TOES)
  602. Test of Visual-Motor Skills (Revised) (TVMS-R)
  603. Test of Visual-Motor Skills—Upper Level (TVMS-UL)
  604. Test of Visual–Perceptual Skills (Non-Motor) (TVPS-3)
  605. Toddler and Infant Motor Evaluation (TIME)
  606. Transdisciplinary Play-Based Assessment (TPBA)
  607. CHAPTER 8 Use of Standardized Tests in Pediatric Practice
  608. OBJECTIVES
  609. KEY TERMS
  610. INFLUENCES ON STANDARDIZED TESTING IN PEDIATRIC OCCUPATIONAL THERAPY
  611. PURPOSES OF STANDARDIZED TESTS
  612. Assistance with Medical or Educational Diagnoses
  613. Documentation of Developmental and Functional Status
  614. Planning of Intervention Programs
  615. TABLE 8-1 Summary of Selected Pediatric Standardized Tests
  616. TABLE 8-2 Developmental Domains Assessed in Four Screening Tools
  617. Measurement Instruments for Research Studies
  618. CHARACTERISTICS
  619. TYPES OF STANDARDIZED TESTS
  620. BOX 8-1 Calculating the Chronologic Age and Corrected Age
  621. CALCULATING THE CHRONOLOGIC AGE
  622. CALCULATING THE CORRECTED AGE
  623. FIGURE 8-1 A therapist prepares to test a child on the broad jump item from the Bruininks-Oseretsky Test of Motor Proficiency 2.
  624. FIGURE 8-2 Administration and scoring protocol for Bruininks-Oseretsky Test of Motor Proficiency 2, subtest 5, item 8.
  625. FIGURE 8-3 A portion of the caregiver questionnaire for the Sensory Profile.
  626. BOX 8-2 Administration and Assessment Procedures and Processes for Hawaii Early Learning Profile: Item 4.81—Snips with Scissors (23 to 25 Months)
  627. BOX 8-3 Administration and Assessment Procedures and Processes for Hawaii Early Learning Profile Item 4.81—Snips with Scissors: Activity Guide Suggestions
  628. TECHNICAL ASPECTS
  629. FIGURE 8-4 One category of activity performance and corresponding rating scale for the School Function Assessment (SFA).
  630. TABLE 8-3 Comparison of Norm-Referenced and Criterion-Referenced Tests
  631. Descriptive Statistics
  632. FIGURE 8-5 The normal curve and associated standard scores.
  633. Standard Scores
  634. Correlation Coefficients
  635. Reliability
  636. Test–Retest Reliability
  637. Inter-rater Reliability
  638. Standard Error of Measurement
  639. Validity
  640. Construct-Related Validity
  641. Content-Related Validity
  642. Criterion-Related Validity
  643. TABLE 8-4 Correlations between the Sensory Profile and the School Function Assessment
  644. Rasch Model of Measurement
  645. BECOMING A COMPETENT TEST USER
  646. Choosing the Appropriate Test
  647. Learning the Test
  648. Checking Inter-rater Reliability
  649. FIGURE 8-6 A child performs a fine motor item from the PDMS-2.
  650. FIGURE 8-7 Two therapists check their inter-rater reliability by scoring the same testing session.
  651. TABLE 8-5 Raters’ Scores for Point-by-Point Agreement
  652. Selecting and Preparing the Optimal Testing Environment
  653. FIGURE 8-8 A child completes a portion of the visual-motor subtest of the Bruininks-Oseretsky Test of Motor Proficiency 2.
  654. Administering Test Items
  655. Interpreting the Test
  656. BOX 8-4 Steps to Becoming a Competent Test User
  657. Evaluating the Clinical Usefulness of the Test
  658. ETHICAL CONSIDERATIONS IN TESTING
  659. Examiner Competency
  660. Client Privacy
  661. Communication of Test Results
  662. Cultural Bias
  663. ADVANTAGES AND DISADVANTAGES OF STANDARDIZED TESTING
  664. Advantages
  665. Disadvantages
  666. CASE STUDY 8-1 Caitlin
  667. TEST RESULTS
  668. OBSERVATIONS AND RECOMMENDATIONS
  669. SUMMARY
  670. RESEARCH NOTE 8-1
  671. ABSTRACT
  672. IMPLICATIONS FOR PRACTICE
  673. REFERENCES
  674. SECTION III Occupational Therapy Intervention: Performance Areas
  675. CHAPTER 9 Application of Motor Control/Motor Learning to Practice
  676. OBJECTIVES
  677. KEY TERMS
  678. FIGURE 9-1 Children playing involves a variety of motor skills.
  679. CASE STUDY 9-1 Teagan
  680. CASE STUDY 9-2 Georgia
  681. CASE STUDY 9-3 Devin
  682. BOX 9-1 Description of Developmental Coordination Disorder
  683. MOTOR CONTROL: OVERVIEW AND DEFINITION
  684. FIGURE 9-2 A and B, Children working on academics.
  685. CASE STUDY 9-4 Rachel
  686. BOX 9-2 Rood’s Sensory Techniques
  687. DYNAMICAL SYSTEMS THEORY
  688. FIGURE 9-3 Dynamical systems theory.
  689. CASE STUDY 9-5 Teagan (cont’d)
  690. Whole Learning
  691. FIGURE 9-4 W-sitting.
  692. Variability
  693. FIGURE 9-5 A and B, Playing with blocks in varied positions promotes motor control.
  694. Problem-solving
  695. Meaning
  696. DEVELOPMENT OF MOTOR CONTROL
  697. FACTORS AFFECTING MOTOR PERFORMANCE
  698. Social-Emotional Factors
  699. FIGURE 9-6 Children can become frustrated when learning new motor skills or tasks.
  700. Physical Factors
  701. FIGURE 9-7 Sitting in an adapted seat with tabletop helps postural control.
  702. CASE STUDY 9-6 Kiera
  703. RELATING DYNAMICAL SYSTEMS THEORY TO BALANCE
  704. Balance: An Overview
  705. Sensory Organization and Control of Balance/Posture
  706. Vestibular System
  707. FIGURE 9-8 What is involved in posture/balance control?
  708. CASE STUDY 9-7 Margi
  709. Proprioceptive/Somatosensory Systems
  710. Visual System
  711. Intersensory Function
  712. FIGURE 9-9 Sway and sensory conditions. 1 = visual, proprioceptive, and vestibular inputs all present and accurate; 2 = visual input is not available; 3 = conflicting visual information is present; 4 = ankle proprioception information is degraded; 5 = visual is not available and proprioceptive information is degraded; 6 = conflicting visual information is present, proprioceptive information is degraded.
  713. Motor Coordination Aspects of Posture/Balance Control
  714. Postural Reflexes
  715. TABLE 9-1 Age of Postural Reactions Acquisition
  716. Postural Synergies
  717. Integrative Responses
  718. Balance Control Issues in Children with Developmental Coordination Disorder
  719. Vision and Proprioception
  720. Improving Balance: Intervention
  721. Primary Components
  722. Body Movement
  723. Use of Vision
  724. External Base of Support
  725. Secondary Components
  726. Position of the Body
  727. Internal Base of Support
  728. Elevation
  729. Examining Balance: Process Characteristics
  730. VISION, VISUAL PERCEPTION, AND MOTOR CONTROL
  731. BOX 9-3 Assessment of Balance
  732. NON-STANDING BALANCE
  733. STATIONARY AND MOVING UPRIGHT BALANCE
  734. A Theoretical Perspective
  735. Eye Movement Control
  736. Tracking/Pursuit Movements
  737. FIGURE 9-10 Williams’ checklist of process characteristics of balance performance.134
  738. Fixation/Search Movements
  739. Body Awareness and Motor Control
  740. FIGURE 9-11 Schematic: components of body awareness.
  741. Body Schema
  742. Body Image
  743. Body Awareness
  744. Internal Aspects
  745. FIGURE 9-12 Laterality refers to developing an understanding of both sides of the body and having a preferred side for tasks. Craft activities can be used to help children develop a sense of laterality.
  746. FIGURE 9-13 Playing hopscotch requires balance.
  747. External Aspects
  748. INFLUENCE OF NON-MOTOR FACTORS
  749. MOTOR LEARNING
  750. Transfer of Learning
  751. Sequencing and Adapting Tasks
  752. BOX 9-4 Williams’ Motor Learning Principles
  753. TRANSFER OF LEARNING
  754. FEEDBACK
  755. Modeling or Demonstration
  756. Verbal Instructions
  757. Knowledge of Results (KR) and Knowledge of Performance (KP)
  758. DISTRIBUTION AND VARIABILITY OF SKILL PRACTICE
  759. WHOLE VERSUS PART PRACTICE
  760. MENTAL PRACTICE
  761. TABLE 9-2 Grading and Adapting Activity
  762. Practice Levels and Types
  763. FIGURE 9-14 Distributed practice. A, Child begins to learn to swing with feet close to the ground and with frequent rests. B, As the child develops, she is able to swing with her feet off the ground, with few rests.
  764. FIGURE 9-15 Variable practice. The child ties her shoes right before she goes outside to play. She is able to tie different sneakers and often she sits on the floor to complete the task.
  765. RESEARCH NOTE 9-1
  766. Error-Based Learning
  767. Feedback
  768. Knowledge of Performance
  769. Knowledge of Results
  770. Verbal Feedback
  771. APPLICATION OF MOTOR CONTROL/LEARNING THEORY IN OCCUPATIONAL THERAPY PRACTICE
  772. CASE STUDY 9-8 Paul
  773. OCCUPATIONAL PROFILE
  774. OCCUPATIONAL PERFORMANCE
  775. SYSTEMS CONTRIBUTING TO PERFORMANCE
  776. Environment
  777. School
  778. Neuromuscular
  779. Sensory
  780. INTERVENTION PLANNING
  781. SUMMARY
  782. REFERENCES
  783. CHAPTER 10 Evaluation and Interventions to Develop Hand Skills
  784. OBJECTIVES
  785. KEY TERMS
  786. COMPONENTS OF HAND SKILLS
  787. CONTRIBUTIONS OF CONTEXT FACTORS TO HAND SKILLS
  788. CONTRIBUTIONS OF BODY FUNCTIONS TO HAND SKILLS
  789. Visual Skills
  790. Somatosensory Functions
  791. Sensory Integration
  792. Visual Perception and Cognition
  793. Skeletal Integrity
  794. Muscle Function
  795. GENERAL DEVELOPMENTAL CONSIDERATIONS
  796. DEVELOPMENT OF HAND SKILLS
  797. Reach and Carry
  798. FIGURE 10-1 This typically developing child demonstrates reach with trunk rotation, full elbow extension, slight forearm rotation, and wrist stability, yet some degree of excess finger extension before grasp.
  799. Grasp Patterns
  800. Classification
  801. FIGURE 10-2 A, Hook grasp used to carry a child’s art case. B, Power grasp with the right hand, used in cutting bread.
  802. FIGURE 10-3 Lateral pinch with the right hand, used to open a lock on a door.
  803. FIGURE 10-4 A, Pincer grasp, used to place “food” for the “climbing polar bears.” B, This child uses variations of a three-jaw chuck grasp with her right hand, depending on task demands.
  804. FIGURE 10-5 Tip pinch with the right hand, used to complete a bead craft project. Normal radial grasps, such as the tip pinch, are accompanied by slight forearm supination.
  805. FIGURE 10-6 Spherical grasp, used in preparation to throw a ball.
  806. FIGURE 10-7 This child uses a cylindrical grasp with his left hand and a disk grasp with his right hand to open a jar. Note the grading of finger abduction with the left hand to provide adequate stability to the jar.
  807. Sequential Development of Grasp Patterns
  808. BOX 10-1 Approaches to Describing the Progression of Grasp Development
  809. FIGURE 10-8 Ulnar-palmar grasp. The index finger and thumb are not used in this pattern.
  810. FIGURE 10-9 This baby uses a radial-digital grasp with both hands to hold a toy for shaking and mouthing.
  811. In-Hand Manipulation Skills
  812. Classification
  813. FIGURE 10-10 A,The child shows the ability to keep the palm in a cupped position to hold several stones for a game. The forearm is in almost full supination. B, Palm-to-finger translation with stabilization is initiated for one of the stones while the other stones are retained in the palm. The translation movement produced by the fingers is accompanied by forearm rotation into midposition. C, Palm-to-finger translation with stabilization is completed for one stone. The other stones are retained in the hand by flexion of the ulnar fingers. The forearm moves toward pronation to assist with placement of the stone on the game board.
  814. Developmental Considerations
  815. Voluntary Release
  816. Bilateral Hand Use
  817. FIGURE 10-11 A, Full finger extension and some wrist movement occur with voluntary release. Note the visual regard of the object being released. B, The child’s shoulder, elbow, and wrist are stable, and less finger extension occurs with release. The child visually monitors release of the object into a small container. C, Stability of the shoulder, elbow, forearm, wrist, and fingers combines with perceptual development to promote accurate placement of objects. This 5-year-old is able to use forearm supination to midposition with controlled finger extension. In this challenging task, only slight overextension of the fingers occurs.
  818. Ball-Throwing Skills
  819. Tool Use
  820. Hand Preference
  821. RELATIONSHIP OF HAND SKILLS TO CHILDREN’S OCCUPATIONS
  822. Play
  823. Activities of Daily Living
  824. FIGURE 10-12 A, Different grasp patterns are used in preparation for putting toothpaste on a toothbrush. The child uses just-right force to stabilize the toothbrush with a modified power grasp (with supination to midposition) while using a cylindrical grasp on the toothpaste container. B, The child has used forearm supination and the in-hand manipulation skill of simple rotation to position the toothpaste container for application of the toothpaste to the toothbrush.
  825. FIGURE 10-13 A, The child grasps the spoon from the table surface with a radial-digital grasp. The forearm is slightly supinated. B, He uses the in-hand manipulation skill of complex rotation to move the handle of the spoon from the palmar surface of his hand toward the web space between the index finger and thumb. Isolation and differentiation of the index finger and thumb are needed to produce this rotation. Forearm movement toward midposition assists. C, The child completes spoon positioning in his hand by moving the spoon so that the end of the handle is stabilized in the web space. Additional flexion of the metacarpophalangeal (MCP) joints of the fingers while extension of the interphalangeal (IP) joints is sustained assists with optimal positioning for eating.
  826. School Functions
  827. GENERAL MOTOR PROBLEMS THAT AFFECT HAND SKILLS
  828. FIGURE 10-14 A, This child, who has involuntary movement, demonstrates the attempt to find stability by locking her left elbow with the arm in extension and by elevating her right shoulder during hand use. She also has difficulty isolating upper extremity movements and using the two hands together at midline. B, During voluntary release this child shows overextension and increased abduction of the fingers, with hyperextension at the MCP joints of the ulnar fingers. He also shows adduction of the thumb rather than slight abduction.
  829. FIGURE 10-15 Poor trunk stability affects the upper extremity range of motion that this child can use. Note the right forearm pronation and wrist flexion. The child is unable to use a three-jaw chuck, or pincer, grasp effectively on the materials. However, she demonstrates awareness of the need to use both hands in this manipulative activity and good visual monitoring of the materials.
  830. OTHER FACTORS THAT AFFECT HAND SKILLS IN CHILDREN WITH DISABILITIES
  831. Somatosensory Problems
  832. Learned Nonuse Phenomenon in Children with Hemiplegia
  833. Hand Skill Problems in Children and Adolescents with Various Developmental Difficulties
  834. Differences in Developmental Trends between Children with and without Disabilities
  835. RESEARCH NOTE 10-1
  836. ABSTRACT
  837. IMPLICATIONS FOR PRACTICE
  838. EVALUATION OF HAND SKILLS IN CHILDREN
  839. Screening for Hand Skill Problems
  840. Evaluation Content
  841. TABLE 10-1 Screening Activities for Hand Skills
  842. BOX 10-2 Problem: Inability to Engage Effectively in Constructive Play (Performance Problems, Body Function Factors, and Causes)
  843. GUIDELINES FOR INTERVENTION
  844. Setting Goals
  845. Considering Roles of the Occupational Therapy Assistant and Others in Intervention
  846. Sequencing of Intervention Sessions
  847. Preparation for Hand Skill Development
  848. Positioning the Child
  849. FIGURE 10-16 This child is seated at a table that is an appropriate height for tabletop activities. She can effectively place her arms on the surface without elevating her shoulders. Arm support on the surface, elbow flexion, and handing her the candles in a vertical position rather than having her grasp them from a table surface encourages the child’s use of forearm supination and fingertip control during grasp and placement of the candles on the clay birthday cake.
  850. Improving Postural Tone and Control
  851. Improving Muscle Strength
  852. Development of Hand Skills
  853. Promoting Isolated Arm and Hand Movements
  854. RESEARCH NOTE 10-2
  855. ABSTRACT
  856. IMPLICATIONS FOR PRACTICE
  857. Enhancement of Reach and Carry Skills
  858. Problems
  859. Goals
  860. Intervention Strategies
  861. BOX 10-3 Typical Sequence of Reaching Patterns Used to Enhance Shoulder Flexion, Neutral Rotation, and Elbow Extension*
  862. FIGURE 10-17 Facilitation is provided to prompt use of slight humeral external rotation and forearm supination. The object is held vertically to assist this reaching pattern. A lotto card game is used to engage the child and allow for repetition of the pattern.
  863. Enhancement of Grasp Skills
  864. Problems
  865. FIGURE 10-18 When this child combines reach with grasp, he demonstrates significant difficulties with effective hand positioning. Note the slight wrist flexion, the thumb adduction with IP joint extension, and the finger MCP joint hyperextension with IP flexion that he uses in an attempt to achieve stability with this grasp. The arm positioning in abduction and internal rotation (not shown) contribute to use of this grasp pattern.
  866. Goals
  867. Intervention Strategies
  868. Children with Severe Disabilities
  869. Children with Moderate Disabilities
  870. FIGURE 10-19 A, The child shows the ability to use a controlled radial-digital grasp pattern with the wrist in a neutral position, thumb opposition, and appropriate finger flexion when he is not asked to combine reach with grasp. Note that the therapist’s presentation of the object helps ensure that the child will grasp the object with his fingertips. Her grasp also ensures that the object remains stable while the child initiates the grasp pattern. B, The child practices grasping from the therapist’s hand. His arm is stabilized on his leg during this grasp. The therapist’s hand provides some degree of stability to prevent the object from moving during initiation of grasp.
  871. Children with Mild Disabilities
  872. FIGURE 10-20 The child uses a substitution for a standard pincer grasp or tip pinch. Note that with slight adduction of the thumb, the pad of the thumb is more aligned with the middle finger than the index finger. The index finger is slightly too flexed to participate in the grasp.
  873. Enhancement of Voluntary Release Skills
  874. Problems
  875. Goals
  876. Intervention Strategies
  877. FIGURE 10-21 Positioning materials to elicit elbow extension during release encourages the child’s use of wrist extension.
  878. Enhancement of In-Hand Manipulation Skills
  879. Problems
  880. Goals
  881. Intervention Strategies
  882. Children with No In-Hand Manipulation Skills
  883. Children with Beginning In-Hand Manipulation Skills
  884. BOX 10-4 In-Hand Manipulation Activities
  885. PREPARATION ACTIVITIES
  886. SPECIFIC IN-HAND MANIPULATION ACTIVITIES
  887. Children with Basic In-Hand Manipulation Skills
  888. FIGURE 10-22 The peg has been placed in the child’s hand upside down to encourage rotation prior to placement in the game board.
  889. Facilitation of Bilateral Hand Use Skills
  890. Problems
  891. Goals
  892. FIGURE 10-23 A, The child is forming a picture with a set of puzzle blocks. He is encouraged to find the side of the block that fits the design being constructed. The therapist has placed the correct side of the block against the palm of his hand so that he must use complex rotation to find it. B, Prior to using the in-hand manipulation skill of complex rotation, the child must use palm-to-finger translation to move the block toward the distal finger surface. In that process the block begins to be turned. C, Having identified the correct side, the child shifts the object out to the pads of the fingers prior to placement with the other blocks.
  893. Intervention Strategies
  894. Children with Severe Disabilities
  895. FIGURE 10-24 A, This child shows the bilateral skill of stabilizing with a refined grasp with her left hand while placing a penny in the bank with her right hand. Note the appropriate use of force in holding both objects. B, Bilateral manipulation occurs with both hands in this construction activity. The child uses modifications of the power grasp with different forearm positions on the right and left while connecting two parts of the toy.
  896. Children with Moderate Disabilities
  897. Children with Mild Disabilities
  898. Children with Muscle Weakness
  899. Group Intervention for Children with Hand Skill Problems
  900. Generalization of Skills into Functional Activities
  901. RESEARCH ON INTERVENTION FOR HAND SKILL PROBLEMS
  902. Constraint-Induced Movement Therapy for Children with Hemiplegic Cerebral Palsy
  903. SPLINTING
  904. Precautions and Indications for Splint Use
  905. TABLE 10-2 Evidence Table and Research Summary: Constraint-Induced Movement Therapy (CIMT) & Hand-Arm Bimanual Intensive Training (HABIT)
  906. Types of Splints Used with Children
  907. FIGURE 10-25 A, Dorsal splint to support the wrist in extension for stability or to control a mild to moderate pull into flexion. The hand section can be molded to support the palmar arch. B, Short opponens thumb splint made of a thermoplastic material. A similar design can be made with Neoplush. C, A Neoplush thumb splint is worn with orthokinetic cuffs on the forearm and upper arm. Both orthokinetic cuffs are designed to promote extension and inhibit flexion. The active area of the cuff on the forearm is over the wrist and finger extensors. The active area on the cuff on the upper arm is over the triceps.
  908. SUMMARY
  909. REFERENCES
  910. CHAPTER 11 Sensory Integration
  911. OBJECTIVES
  912. KEY TERMS
  913. SENSORY INTEGRATION IN CHILD DEVELOPMENT
  914. NEUROBIOLOGICALLY BASED CONCEPTS
  915. Sensory Support for Development and Brain Function
  916. Adaptive Response
  917. FIGURE 11-1 Adaptive responses help the child acquire skills such as riding a bicycle. Although training wheels reduce the challenge for this boy, his nervous system must integrate vestibular, proprioceptive, and visual information adequately for him to successfully steer the bicycle while it is moving.
  918. Neural Plasticity
  919. Central Nervous System Organization
  920. SENSORY INTEGRATIVE DEVELOPMENT AND CHILDHOOD OCCUPATIONS
  921. Prenatal Period
  922. Neonatal Period
  923. FIGURE 11-2 Tactile sensations play a critical role in generating feelings of security and comfort in the infant and are influential in emotional development and social relationships throughout the lifespan.
  924. First 6 Months
  925. FIGURE 11-3 Strong inner drive to master gravity is evident in this infant’s efforts to lift his head and shoulders off the floor. This is an early form of the prone extension posture.
  926. Second 6 Months
  927. FIGURE 11-4 Because somatosensory processing and visual-motor coordination strongly influence self-feeding skills, sensory integration is an important contributor to the development of dining, a fundamental occupation.
  928. Second Year
  929. FIGURE 11-5 As motor planning develops during the second year of life, the infant experiments with a variety of body movements and learns how to transition easily from one position to another. These experiences are thought to reflect the development of body scheme.
  930. Third through Seventh Years
  931. FIGURE 11-6 Adaptive responses involved in this activity require precise tactile feedback and sophisticated praxis. During activities such as this one, the preschooler becomes adept at handling tools and objects that are encountered in daily occupations throughout life.
  932. FIGURE 11-7 By the time a child reaches school age, sensory integrative capacities are almost mature. The child now can devote full attention to the demands of academic tasks because basic sensorimotor functions, such as maintaining an upright posture and guiding hand movements while holding a tool, have become automatic.
  933. WHEN PROBLEMS IN SENSORY INTEGRATION OCCUR
  934. RESEARCH BASE FOR SENSORY INTEGRATIVE PROBLEMS
  935. TABLE 11-1 Purpose, Methods, Results, and Contributions of Studies of Sensory Integrative Patterns
  936. TABLE 11-2 Factors and Clusters Identified in Research
  937. SENSORY INTEGRATIVE PROBLEMS
  938. Sensory Modulation Problems
  939. FIGURE 11-8 Continuum of sensory responsivity and orientation.
  940. FIGURE 11-9 Dunn’s Model of Sensory Processing.
  941. Sensory Registration Problems
  942. FIGURE 11-10 Miller et al.’s (2001) Ecological Model of Sensory Modulation. Light shading, underresponsivity; medium shading, normal responsivity (a match between the external and internal dimensions); dark shading, overresponsivity; darkest shading, lability, severe overresponsivity alternating with severe underresponsivity.
  943. Sensation-Seeking Behavior
  944. Overresponsiveness
  945. Tactile Defensiveness
  946. Gravitational Insecurity
  947. Overresponsiveness in Other Sensory Modalities
  948. Sensory Discrimination and Perception Problems
  949. Tactile Discrimination and Perception Problems
  950. Proprioception Problems
  951. Visual Perception Problems
  952. Other Perceptual Problems
  953. Vestibular-Proprioceptive Problems
  954. Praxis Problems
  955. Secondary Problems Related to Sensory Integrative Difficulties
  956. ASSESSMENT OF SENSORY INTEGRATIVE FUNCTIONS
  957. Interviews and Questionnaires
  958. FIGURE 11-11 Because parents know their child better than anyone else, they are invaluable sources of information to the therapist, especially in beginning phases of the assessment process.
  959. Informal and Formal Observations of the Child
  960. Informal Observations
  961. Clinical Observations
  962. BOX 11-1 Examples of Commonly Used Clinical Observations
  963. Standardized Testing
  964. TABLE 11-3 Functions Measured by the Sensory Integration and Praxis Tests
  965. FIGURE 11-12 The Constructional Praxis Test is 1 of 17 tests of the Sensory Integration and Praxis Tests (SIPT). The SIPT must be administered individually with strict adherence to standardized procedures.
  966. Consideration of Available Services and Resources
  967. Interpretation of Assessment Findings
  968. RESEARCH NOTE 11-1
  969. OBJECTIVES
  970. METHOD
  971. RESULTS
  972. CONCLUSION
  973. IMPLICATIONS FOR PRACTICE
  974. INTERVENTIONS FOR CHILDREN WITH SENSORY INTEGRATIVE PROBLEMS
  975. BOX 11-2 Guiding Principles from Ayres Sensory Integration® (ASI®) Theory
  976. Individual Ayres Sensory Integration® (ASI) Intervention
  977. CASE STUDY 11-1 Karen
  978. HISTORY
  979. REASON FOR REFERRAL
  980. EVALUATION PROCEDURE
  981. EVALUATION RESULTS
  982. RECOMMENDATION
  983. OCCUPATIONAL THERAPY PROGRAM
  984. FIGURE 11-13 Individual ASI intervention requires the therapist to attend closely to the child on a moment-by-moment basis to ensure that therapeutic activities are individually tailored to changing needs and interests of the child.
  985. FIGURE 11-14 Rather than passively imposing vestibular input on the child, classic sensory integration treatment emphasizes active participation and self-direction of the child.
  986. FIGURE 11-15 The setting in which classical sensory integration treatment takes place provides a variety of sensory experiences. Immersion in a pool of balls presents challenges to sensory modulation.
  987. Training in Specific Skill Development
  988. Group Intervention
  989. BOX 11-3 Expected Outcomes of Ayres Sensory Integration® (ASI®) Intervention
  990. FIGURE 11-16 Group programs provide opportunities for children with sensory integrative disorders to develop coping skills that help them function in social context with peers.
  991. Consultation on Modification of Activities, Routines, and Environments
  992. CASE STUDY 11-2 Drew
  993. HISTORY
  994. REASON FOR REFERRAL
  995. EVALUATION PROCEDURE
  996. EVALUATION RESULTS
  997. RECOMMENDATION
  998. OCCUPATIONAL THERAPY PROGRAM
  999. FIGURE 11-17 Consultation in school involves joint problem solving between the occupational therapist and the teacher.
  1000. Expected Outcomes of Occupational Therapy
  1001. Increase in the Frequency or Duration of Adaptive Responses
  1002. Development of Increasingly More Complex Adaptive Responses
  1003. Improvement in Gross and Fine Motor Skills
  1004. Improvement in Cognitive, Language, or Academic Performance
  1005. Increase in Self-Confidence and Self-Esteem
  1006. Enhanced Occupational Engagement and Social Participation
  1007. Enhanced Family Life
  1008. Measuring Outcomes
  1009. Research on Effectiveness of Intervention
  1010. RESEARCH NOTE 11-2
  1011. OBJECTIVES
  1012. METHOD
  1013. RESULTS
  1014. CONCLUSION
  1015. IMPLICATIONS FOR PRACTICE
  1016. REFERENCES
  1017. CHAPTER 12 Visual Perception
  1018. OBJECTIVES
  1019. KEY TERMS
  1020. DEFINITIONS
  1021. THE VISUAL SYSTEM
  1022. Anatomy of the Eye
  1023. FIGURE 12-1 Cross-section of the eye.
  1024. Visual-Receptive Functions
  1025. Visual-Cognitive Functions
  1026. Visual Attention
  1027. Visual Memory
  1028. Visual Discrimination
  1029. Object (Form) Perception
  1030. Spatial Perception
  1031. Visual Imagery
  1032. Motor and Process Skills
  1033. Developmental Framework for Intervention
  1034. FIGURE 12-2 Hierarchy of visual-perceptual skills development.
  1035. DEVELOPMENTAL SEQUENCE
  1036. Visual-Receptive Functions
  1037. Visual-Cognitive Functions
  1038. Object (Form) Vision
  1039. TABLE 12-1 Developmental Ages for Emergence of Visual-Perceptual Skills
  1040. Spatial Vision
  1041. Role of Vision in Social Development
  1042. VISUAL-PERCEPTUAL PROBLEMS
  1043. Visual-Receptive Functions
  1044. Refractive Errors
  1045. Visual-Cognitive Functions
  1046. Attention
  1047. FIGURE 12-3 Checklist of observable clues to classroom vision problems.
  1048. Memory
  1049. Visual Discrimination
  1050. Object (Form) Vision
  1051. Spatial Vision
  1052. Diagnoses with Problems in Visual Perception
  1053. Effects of Visual-Perceptual Problems on Performance Skills and Occupations
  1054. Problems in Reading
  1055. Problems in Spelling
  1056. Problems in Handwriting and Visual Motor Integration
  1057. Problems in Mathematics
  1058. EVALUATION METHODS
  1059. Evaluation of Visual-Receptive Functions
  1060. TABLE 12-2 Vision Screening Tests
  1061. Evaluation of Visual-Cognitive Functions
  1062. Visual-Spatial Tests
  1063. Visual-Perceptual Tests
  1064. Visual-Motor Integration Tests
  1065. INTERVENTION
  1066. Theoretical Approaches
  1067. BOX 12-1 Compensatory Instruction Guidelines
  1068. Intervention Strategies
  1069. Infants
  1070. Preschool and Kindergarten
  1071. FIGURE 12-4 Kyle making letters with clay.
  1072. Elementary School
  1073. Organizing the Environment
  1074. FIGURE 12-5 Todd in a study carrel.
  1075. Visual Attention
  1076. FIGURE 12-6 Alternate positions for visual-perceptual activities.
  1077. FIGURE 12-7 Todd uses a mask to uncover one line at a time.
  1078. Visual Memory
  1079. Visual Discrimination
  1080. CASE STUDY 12-1 Todd
  1081. Decoding Problems in Reading
  1082. Visualization
  1083. Learning Styles
  1084. FIGURE 12-8 Diagnostic learning styles.
  1085. BOX 12-2 Suggestions for Tactile and Kinesthetic Learners
  1086. TABLE 12-3 Matching Reading Methods to Perceptual Strengths
  1087. Visual-Motor Integration
  1088. BOX 12-3 Postulates for Change
  1089. Computers
  1090. SUMMARY
  1091. TABLE 12-4 Evidence of Visual-Perceptual and Visual-Motor Treatment
  1092. REFERENCES
  1093. Appendix 12-A Publications for Classroom Activities
  1094. COMPUTER PROGRAMS
  1095. CHAPTER 13 Psychosocial Issues Affecting Social Participation
  1096. OBJECTIVES
  1097. KEY TERMS
  1098. TEMPERAMENT: A “PERSON” FACTOR THAT INFLUENCES AND IS INFLUENCED BY THE ENVIRONMENT
  1099. CASE STUDY 13-1 Theresa
  1100. ATTACHMENT: A DYNAMIC INTERACTION OF BIOLOGY AND ENVIRONMENT
  1101. FIGURE 13-1 Temperament types: easy, difficult, and slow-to-warm up child.
  1102. TABLE 13-1 Patterns of Attachment in Infants and Parents
  1103. CHILD ABUSE AND NEGLECT: PROBLEMS WITH THE PARENT-CHILD RELATIONSHIP AND ENVIRONMENT
  1104. TABLE 13-2 Risk Factors for Child Abuse
  1105. ENVIRONMENTAL FACTORS AND SOCIAL PARTICIPATION
  1106. BOX 13-1 Environmental Stress and Its Effects on Children
  1107. TIME-LIMITED ENVIRONMENTAL STRESS FACTORS*
  1108. LONG-TERM ENVIRONMENTAL STRESS FACTORS*
  1109. Time-Limited Environmental Stress and Its Impact on Occupational Performance
  1110. CASE STUDY 13-2 Brooke
  1111. Chronic Environmental Stress and Its Impact on Occupational Performance
  1112. MENTAL HEALTH FACTORS AFFECTING SOCIAL PARTICIPATION
  1113. CASE STUDY 13-3 Marcus
  1114. SELECTED MENTAL DISORDERS COMMONLY AFFECTING CHILDREN AND ADOLESCENTS
  1115. Mood Disorders
  1116. Anxiety Disorders
  1117. Attention Deficit Disorder
  1118. Disruptive Behavior Disorders
  1119. Autism Spectrum Disorders
  1120. The Occupational Therapist’s Role Relative to Psychotropic Medication
  1121. PRACTICE ENVIRONMENTS
  1122. Early Childhood Intervention Programs
  1123. Public School Systems
  1124. TABLE 13-3 Settings for Psychosocial Treatment of Children and Adolescents
  1125. CASE STUDY 13-4 Vanessa
  1126. CASE STUDY 13-5 Dylan
  1127. Mental Health Services
  1128. BOX 13-2 Examples of Activity-Based Intervention for Students with Emotional Disturbances
  1129. CASE STUDY 13-6 Mario
  1130. Residential Treatment Centers
  1131. CASE STUDY 13-7 The Diners’ Club
  1132. Juvenile Corrections
  1133. Inpatient Psychiatric Hospitals
  1134. EVALUATION AND INTERVENTION
  1135. Evaluation
  1136. Intervention
  1137. FIGURE 13-2 Pre-Assessment Checklist for Teachers (Revised).
  1138. RESEARCH NOTE 13-1
  1139. ABSTRACT
  1140. IMPLICATIONS FOR PRACTICE:
  1141. CASE STUDY 13-8 Max
  1142. TABLE 13-4 Levels of Social Appropriateness and Rational Intervention
  1143. SUMMARY
  1144. CASE STUDY 13-9 Brenda
  1145. BOX 13-3 Response Options in Rational Intervention
  1146. FACILITATION
  1147. MONITORING
  1148. GENTLE CORRECTION
  1149. MODERATE CORRECTION
  1150. STRONG CORRECTION
  1151. REFERENCES
  1152. CHAPTER 14 Interventions and Strategies for Challenging Behaviors
  1153. OBJECTIVES
  1154. KEY TERMS
  1155. STRATEGIES FOR MANAGING DIFFICULT BEHAVIOR
  1156. Behavior Happens
  1157. Purposes
  1158. CASE STUDY 14-1 Sam and Eli
  1159. Being Prepared for Problem Behavior
  1160. Ruling Out Pain or Illness
  1161. Establishing Predictability and Consistency
  1162. Creating a Calm Atmosphere
  1163. TABLE 14-1 Selected Single-Subject-Design Studies of Behavior Management Interventions
  1164. BOX 14-1 Factors That Influence Behavior
  1165. INTERNAL FACTORS
  1166. EXTERNAL FACTORS
  1167. Attending to Appropriate Behaviors
  1168. Using “Do” Statements
  1169. Keeping Perspective
  1170. BEHAVIOR MANAGEMENT APPROACHES
  1171. Preventing Challenging Behavior
  1172. Minimizing Aversive Events
  1173. Sharing Control
  1174. Providing an Environment That Promotes Successful Engagement
  1175. CASE STUDY 14-2 Dominic
  1176. Increasing Communication Effectiveness
  1177. Clarifying Expectations
  1178. Supporting Self-Regulation
  1179. BOX 14-2 Environmental Modifications to Support Self-Regulation
  1180. Matching Demands to Abilities
  1181. SUPPORT POSITIVE BEHAVIOR
  1182. General Strategies
  1183. Meeting Sensory Needs
  1184. Building New Skills
  1185. Specific Strategies
  1186. Increasing Compliance Through Contingency Methods
  1187. CASE STUDY 14-3 Stephen
  1188. BOX 14-3 Skills That Promote Social Participation
  1189. Token Economies
  1190. Positive Reinforcement
  1191. CASE STUDY 14-4 Stephen
  1192. Alternate Preferred and Nonpreferred Activities
  1193. CASE STUDY 14-5 Anastasia
  1194. Addressing Transitions
  1195. General Support Strategies
  1196. CASE STUDY 14-6 Meg
  1197. INTERVENE WHEN CHALLENGING BEHAVIORS ALREADY EXIST
  1198. SUMMARY
  1199. CASE STUDY 14-7 Jessie
  1200. REFERENCES
  1201. CHAPTER 15 Feeding Intervention
  1202. OBJECTIVES
  1203. KEY TERMS
  1204. FEEDING: DEFINITION AND OVERVIEW
  1205. The Role of the Occupational Therapist
  1206. THE MEALTIME: AN OVERVIEW
  1207. Contextual Influences on Mealtime
  1208. Personal Influences on Mealtime
  1209. DEVELOPMENTAL SEQUENCE OF MEALTIME PARTICIPATION
  1210. Progression of Mealtime Participation
  1211. Development of Oral Structures
  1212. TABLE 15-1 Functions of Oral Structures in Feeding
  1213. FIGURE 15-1 Anatomic structures of the mouth and throat.
  1214. BOX 15-1 Cranial Nerves for Oral Sensory Motor Function
  1215. Phases of Swallowing
  1216. ORAL MOTOR DEVELOPMENT ASSOCIATED WITH EATING SKILLS
  1217. Coordination of Sucking, Swallowing, and Breathing
  1218. TABLE 15-2 Developmental Sequence of Eating Skills
  1219. Biting and Chewing
  1220. Self-Feeding
  1221. TABLE 15-3 Developmental Continuum in Self-Feeding
  1222. Drinking
  1223. EVALUATION
  1224. Feeding Problems: An Overview
  1225. FIGURE 15-2 Using a straw to drink requires lip pursing and active lip seal.
  1226. BOX 15-2 Feeding History and Caregiver Concerns
  1227. Neuromotor Evaluation
  1228. Examination of Oral Structures and Oral Motor Patterns
  1229. Eating and Feeding Performance
  1230. Videofluoroscopic Swallow Study (VFSS)
  1231. Medical Conditions Affecting Eating
  1232. Contextual Factors
  1233. BOX 15-3 Guiding Questions to Evaluate the Contexts for Feeding
  1234. PHYSICAL
  1235. SOCIAL
  1236. TEMPORAL
  1237. CULTURAL
  1238. INTERVENTION: GLOBAL CONSIDERATIONS
  1239. Safety and Health
  1240. INTERVENTION STRATEGIES
  1241. Environmental Adaptations
  1242. Positioning Adaptations
  1243. FIGURE 15-3 Face-to-face positioning for feeding.
  1244. FIGURE 15-4 Tumble Forms Feeder Chair offers support and an adjustable feeding angle.
  1245. FIGURE 15-5 Rifton chair provides a firm base of support to trunk and feet during self-feeding.
  1246. Interventions for Sensory Problems
  1247. Neuromuscular Interventions for Oral Motor Impairments
  1248. FIGURE 15-6 Using a resistive device to improve oral motor skills for advanced food textures.
  1249. Adaptive Equipment
  1250. RESEARCH NOTE 15-1
  1251. ABSTRACT
  1252. IMPLICATIONS FOR PRACTICE
  1253. Modifications to Food and Liquid Properties
  1254. BOX 15-4 Liquid Consistencies Categorized from Thinnest to Thickest
  1255. TABLE 15-4 Food Progression Based on Texture and Consistency
  1256. BOX 15-5 Levels of Food Texture for Dysphagia Management
  1257. Behavioral Interventions
  1258. Interventions to Improve Self-Feeding
  1259. FIGURE 15-7 The therapist supports and guides the child’s hand during self-feeding using the thumb on hand dorsum and finger in his palm.
  1260. INTERVENTION: SPECIFIC REFERRAL PROBLEMS AND MEDICAL DIAGNOSES
  1261. Dysphagia
  1262. RESEARCH NOTE 15-2
  1263. ABSTRACT
  1264. IMPLICATIONS FOR PRACTICE
  1265. Food Refusal or Selectivity
  1266. Delayed Transition to Textured Foods
  1267. Delayed Transition from Bottle to Cup
  1268. BOX 15-6 Foods Indicated and Contraindicated for Children with Immature Oral-Motor Skills
  1269. PROPERTIES OF INDICATED FOODS
  1270. PROPERTIES OF CONTRAINDICATED FOODS
  1271. FIGURE 15-8 Jaw control and oral support. A, From the side. B, From the front.
  1272. Cleft Lip and Palate
  1273. FIGURE 15-9 Infant using Habermann feeder.
  1274. Other Structural Anomalies
  1275. TABLE 15-5 Nipple Characteristics Related to Use with Children Who Have Oral Structural Defects
  1276. Transition from Nonoral Feeding to Oral Feeding
  1277. SUMMARY
  1278. CASE STUDY 15-1 Marco
  1279. EVALUATION FINDINGS
  1280. INTERVENTION
  1281. DISCHARGE STATUS
  1282. REFERENCES
  1283. CHAPTER 16 Activities of Daily Living
  1284. OBJECTIVES
  1285. KEY TERMS
  1286. IMPORTANCE OF DEVELOPING ADL OCCUPATIONS
  1287. FACTORS AFFECTING PERFORMANCE
  1288. Child Factors and Performance Skills
  1289. Performance Environments and Contexts
  1290. Personal and Temporal Contexts: Family Life Cycle and Developmental Stage
  1291. CASE STUDY 16-1 Karina
  1292. FIGURE 16-1 Partial participation. This child partially participates in hair combing and picks out her barrettes while therapists support her in her hospital bed.
  1293. Social Environment
  1294. Cultural Context
  1295. Physical Environment
  1296. Virtual Context
  1297. Activity Demands
  1298. EVALUATION OF ADLS
  1299. Evaluation Methods
  1300. TABLE 16-1 Instruments for Assessing ADL Performance in Children and Adolescents
  1301. TABLE 16-2 Rating of Self-Care Skill Independence during Task Analysis
  1302. Team Evaluations
  1303. Measurement of Outcomes
  1304. RESEARCH NOTE 16-1
  1305. ABSTRACT
  1306. IMPLICATIONS FOR PRACTICE
  1307. INTERVENTION STRATEGIES AND APPROACHES
  1308. Promoting or Creating Supports
  1309. TABLE 16-3 Approaches to Improving the Performance of Activities of Daily Living
  1310. Establishing, Restoring, and Maintaining Performance
  1311. FIGURE 16-2 This simple picture sequence gives Adam the needed cues to wash his hands independently.
  1312. Adapting the Task or Environment
  1313. Adapting or Modifying Task Methods
  1314. FIGURE 16-3 Hierarchy of cues, from most intrusive to least intrusive. A, A hand-over-hand approach is used for squirting soap onto the child’s hands. B, Two fingers are used to guide zipping of the child’s coat. C, The therapist shadows her hand over the top of the child’s hands to cue hand movements for hand washing. D, The therapist verbally cues the child on how to wash the hands.
  1315. Adapting the Task Object or Using Assistive Technology
  1316. RESEARCH NOTE 16-2
  1317. ABSTRACT
  1318. IMPLICATIONS FOR PRACTICE
  1319. Adapting the Physical Environment
  1320. TABLE 16-4 Typical Adaptation Principles Used with Children and Adolescents with Disabilities
  1321. Work Surface
  1322. FIGURE 16-4 Sample talking book. This frame from Talking Shoes was created with Microsoft PowerPoint.
  1323. Positioning
  1324. TABLE 16-5 Environmental Adaptations for the Home When Accessibility Is Limited
  1325. TABLE 16-6 Stabilization Materials and Application Procedures
  1326. FIGURE 16-5 Commercially available chair with positioning components and a desk with an adjustable height and an adjustable inclined work surface.
  1327. Prevention/Education
  1328. Problem Solving: Cognitive Approach
  1329. Anticipatory Problem Solving
  1330. FIGURE 16-6 Sitting postures. A, Incorrect sitting resulting from a massive extension pattern and an asymmetrical tonic reflex posture. B, Correct sitting posture. Weight is equally distributed on the sitting base, and the feet and elbows are supported.
  1331. Cognitive Orientation Approach
  1332. Coaching and Education
  1333. CASE STUDY 16-2 Nadia
  1334. RESEARCH NOTE 16-3
  1335. ABSTRACT
  1336. IMPLICATIONS FOR PRACTICE
  1337. SPECIFIC INTERVENTION TECHNIQUES FOR SELECTED ADL TASKS
  1338. Toilet Hygiene and Bowel and Bladder Management
  1339. Typical Developmental Sequence
  1340. Typical Factors That Interfere with Toileting Independence
  1341. TABLE 16-7 Typical Developmental Sequence for Toileting
  1342. Children with Limited Motor Skills and Bodily Functions
  1343. Children with Intellectual Limitations
  1344. Adaptation Strategies for Improving Toileting Independence
  1345. Social Environment and Temporal Context
  1346. Physical Environment
  1347. Toileting Adaptations
  1348. TABLE 16-8 Analysis and Interventions for Toileting
  1349. FIGURE 16-7 Electrically powered bidet makes it possible to clean the perineal area independently, without using hands or paper.
  1350. Adaptations for Unstable Posture
  1351. Menstrual Hygiene
  1352. Teaching Methods for Girls with Limitations in Cognition
  1353. Teaching Methods for Physical Limitations
  1354. Dressing
  1355. Typical Development
  1356. TABLE 16-9 Typical Developmental Sequence for Dressing
  1357. Typical Problems and Intervention Strategies
  1358. Limitations in Cognitive and Sensory Perceptual Skills
  1359. FIGURE 16-8 This example of a story is used before Mimi goes out for recess, to help her rehearse what she is going to do and help her understand why.
  1360. RESEARCH NOTE 16-4
  1361. ABSTRACT
  1362. IMPLICATIONS FOR PRACTICE
  1363. Physical or Motor Limitations
  1364. Adaptive Methods for Dressing Children with Motor Limitations
  1365. FIGURE 16-9 When dressing a child who is hypertonic, the caregiver should carefully flex the hip and knee before putting on socks and shoes.
  1366. Adaptive Methods for Self-Dressing
  1367. FIGURE 16-10 The side-lying position may reduce stiffness and make dressing easier.
  1368. Bathing or Showering
  1369. Typical Development
  1370. TABLE 16-10 Adaptation Strategies for Dressing with Different Types of Garments
  1371. Establishing or Restoring Performance
  1372. Adapting the Task or Environment
  1373. Prevention/Education for Bathing Safety
  1374. Personal Hygiene and Grooming
  1375. Skill Development
  1376. FIGURE 16-11 Adapted seating equipment for bathing. A, The hammock chair is adjustable and equipped with oversized suction feet. It fully supports the child who has no sitting balance and poor head control. B, Trunk support ring is lightweight and compact and fits all bathtubs. C, A shower bench aids seating and transfers. D, An inflatable bath collar can be used when the child is in either the supine or the prone position.
  1377. Intervention
  1378. FIGURE 16-12 A hand-over-hand approach works well for Lydia, who is sensitive to tooth brushing, as she is participating in the activity and directing which part of the teeth she wants to brush first.
  1379. Sexual Activity
  1380. CASE STUDY 16-3 Josie
  1381. Care of Personal Devices
  1382. Performance Patterns
  1383. Directing Others
  1384. TABLE 16-11 Typical Sexuality Concepts Discussed with Children and Adolescents with Disabilities
  1385. SUMMARY
  1386. TABLE 16-12 Health Care Maintenance for Typically Developing Children and Children with Spina Bifida
  1387. CASE STUDY 16-4 Feddah
  1388. FIGURE 16-13 Sample task analysis and data collection sheet for hearing aid maintenance.
  1389. REFERENCES
  1390. SUGGESTED READINGS
  1391. CHAPTER 17 Instrumental Activities of Daily Living and Community Participation
  1392. OBJECTIVES
  1393. KEY TERMS
  1394. INTRODUCTION
  1395. OCCUPATIONAL DEVELOPMENT OF IADL AND COMMUNITY PARTICIPATION
  1396. Late Adolescence (16 to 18 Years)
  1397. BOX 17-1 Instrumental Activities of Daily Living and Community Participation: Older Adolescent (16 to 21 Years)
  1398. MEAL PREPARATION AND CLEAN-UP
  1399. COMMUNITY MOBILITY
  1400. HEALTH MANAGEMENT AND MAINTENANCE
  1401. HOUSEHOLD MAINTENANCE AND MANAGEMENT
  1402. CLOTHING MANAGEMENT
  1403. USE OF COMMUNICATION DEVICES
  1404. SHOPPING AND MONEY MANAGEMENT
  1405. SAFETY AND EMERGENCY RESPONSE
  1406. COMMUNITY PARTICIPATION
  1407. PERFORMANCE SKILLS
  1408. Early Adolescence (12 to 15 Years)
  1409. Middle Childhood (6 to 11 Years)
  1410. BOX 17-2 Instrumental Activities of Daily Living and Community Participation: Younger Adolescent (12 to 15 Years)
  1411. MEAL PREPARATION AND CLEAN-UP
  1412. COMMUNITY MOBILITY
  1413. HEALTH MANAGEMENT AND MAINTENANCE
  1414. HOUSEHOLD MAINTENANCE AND MANAGEMENT
  1415. USE OF COMMUNICATION DEVICES
  1416. SHOPPING AND MONEY MANAGEMENT
  1417. SAFETY AND EMERGENCY RESPONSE
  1418. COMMUNITY PARTICIPATION
  1419. PERFORMANCE SKILLS AND PATTERNS
  1420. Preschool (3 to 5 Years)
  1421. BOX 17-3 Instrumental Activities of Daily Living and Community Participation: Middle Childhood (6 to 11 Years)
  1422. MEAL PREPARATION AND CLEAN-UP
  1423. COMMUNITY MOBILITY
  1424. HEALTH MANAGEMENT AND MAINTENANCE
  1425. HOUSEHOLD MAINTENANCE AND MANAGEMENT
  1426. USE OF COMMUNICATION DEVICES
  1427. SHOPPING AND MONEY MANAGEMENT
  1428. SAFETY AND EMERGENCY RESPONSE
  1429. COMMUNITY PARTICIPATION
  1430. PERFORMANCE SKILLS AND PATTERNS
  1431. PERSONAL AND ENVIRONMENTAL INFLUENCES ON IADLS AND COMMUNITY PARTICIPATION
  1432. Personal Influences
  1433. Environmental Influences
  1434. FIGURE 17-1 Adolescents participate in afterschool sports and recreation programs.
  1435. EVALUATION OF IADL AND COMMUNITY PARTICIPATION
  1436. Team Evaluations
  1437. Measurement of Outcomes
  1438. TABLE 17-1 Instruments for Assessing IADLs and Community Participation for Children and Youth
  1439. FIGURE 17-2 Examples of CHORES items and ratings for the Children Helping Out: Responsibilities, Expectations, and Supports (CHORES) Program.
  1440. INTERVENTION PLANNING AND IMPLEMENTATION
  1441. INTERVENTION MODELS AND STRATEGIES
  1442. Client-Centered Intervention
  1443. Adaptation/Compensation
  1444. Contextualism
  1445. CASE STUDY 17-1 Kayla
  1446. VOLITION SYSTEM
  1447. HABITUATION
  1448. PERFORMANCE CAPACITY
  1449. Evaluation
  1450. INTERVENTION STRATEGIES
  1451. Reverse Inclusion
  1452. TABLE 17-2 Adapted Instrumental Activities of Daily Living
  1453. CASE STUDY 17-2 Brenda
  1454. Supported Inclusion
  1455. Family Activities
  1456. Community Participation
  1457. Client-Centered Ecological/Experiential
  1458. Focus on Ability and Success
  1459. Incorporation of Sexuality and Body Image
  1460. Mentoring and Role-Modeling a Positive Future
  1461. Inclusive Programming for Youth with Disabilities
  1462. Social Skills Training
  1463. Support Groups
  1464. SUMMARY
  1465. TABLE 17-3 The Developmental Role Continuum
  1466. REFERENCES
  1467. CHAPTER 18 Play
  1468. OBJECTIVES
  1469. KEY TERMS
  1470. PLAY THEORIES
  1471. Form
  1472. FIGURE 18-1 A first type of sensory motor-exploratory play is the infant’s exploration of his or her own body.
  1473. FIGURE 18-2 Play today is often highly structured; for example, this play date takes place at the ice-skating rink.
  1474. Function
  1475. Meaning
  1476. Context
  1477. FIGURE 18-3 “Reading” books is an early play activity even before the child is able to actually read.
  1478. FIGURE 18-4 Mom’s enthusiasm and encouragement add to the playfulness experienced in bowling.
  1479. PLAY IN OCCUPATIONAL THERAPY
  1480. PLAY ASSESSMENT
  1481. Skills
  1482. Development
  1483. CASE STUDY 18-1 Ellen
  1484. BOX 18-1 Play Status Worksheet
  1485. EXPECTED DESCRIPTION
  1486. BOX 18-2 Knox Preschool Play Scale
  1487. SPACE MANAGEMENT: 6- TO 12-MONTH LEVEL
  1488. MATERIAL MANAGEMENT: 12 TO 18 MONTHS
  1489. PRETENSE/SYMBOLIC: 12-MONTH LEVEL
  1490. PARTICIPATION: 12 MONTHS
  1491. Experience
  1492. Advantages and Disadvantages of Evaluating Play
  1493. Interpreting Play Assessments
  1494. FIGURE 18-5 The occupational therapist assesses motor, cognitive, and social skills during a play activity.
  1495. CONSTRAINTS TO PLAY
  1496. Effects of Disability on Play Behavior
  1497. FIGURE 18-6 Impaired fine-motor skills limit exploratory play of this infant with cerebral palsy. Toys that activate to imprecise (full arm) movements are a good choice in play activities.
  1498. FIGURE 18-7 Matthew, who has cerebral palsy, participates in the pregame rally by playing the drum.
  1499. PLAY IN INTERVENTION
  1500. FIGURE 18-8 Matthew takes to the ice using an adapted sled.
  1501. Play as a Modality
  1502. Play as an Intervention Goal
  1503. Facilitating Playfulness
  1504. FIGURE 18-9 Mom adapts kickball so that Matthew can play with his brother.
  1505. Adaptations
  1506. Parent Education and Training
  1507. Societal Concerns
  1508. REFERENCES
  1509. CHAPTER 19 Prewriting and Handwriting Skills
  1510. OBJECTIVES
  1511. KEY TERMS
  1512. THE WRITING PROCESS
  1513. Preliteracy Writing Development of Young Children
  1514. Writing Development of School-Aged Children
  1515. TABLE 19-1 Development of Prewriting and Handwriting in Young Children
  1516. Handwriting Readiness
  1517. Pencil Grip Progression
  1518. TABLE 19-2 Activities to Promote Handwriting Readiness
  1519. HANDWRITING EVALUATION
  1520. Occupational Profile
  1521. Interviews
  1522. FIGURE 19-1 Mature pencil grips in elementary school children. A, Dynamic tripod; B, lateral tripod; C, dynamic quadrupod; and D, lateral quadrupod.
  1523. BOX 19-1 Questions to Facilitate Discussion among Educational Team Members
  1524. Analysis of Occupational Performance
  1525. Work Samples
  1526. File Review
  1527. Direct Observation
  1528. FIGURE 19-2 A girl completes a written assignment at her desk.
  1529. MEASURING HANDWRITING PERFORMANCE
  1530. FIGURE 19-3 Cursive handwriting sample exemplifies improper letterforms and disproportionate letter size.
  1531. Domains of Handwriting
  1532. Legibility
  1533. FIGURE 19-4 Word legibility percentages are calculated using a simple mathematical formula.
  1534. Writing Speed
  1535. Ergonomic Factors
  1536. HANDWRITING ASSESSMENTS
  1537. Factors Restricting Handwriting Performance
  1538. CASE STUDY 19-1 Natasha
  1539. EDUCATOR’S PERSPECTIVE
  1540. Writing Process
  1541. Handwriting Instruction Methods and Curricula
  1542. TABLE 19-3 Evidence on Classroom Instruction
  1543. Manuscript and Cursive Styles
  1544. TABLE 19-4 Handwriting Programs Research
  1545. HANDWRITING INTERVENTION
  1546. Planning
  1547. Models of Practice to Guide Collaborative Service Delivery
  1548. Neurodevelopmental
  1549. TABLE 19-5 Assistive Technology That Supports Handwriting Skills
  1550. TABLE 19-6 Computer-Assisted Handwriting Instruction
  1551. FIGURE 19-5 A girl demonstrates an arm pushup in her school chair.
  1552. FIGURE 19-6 Two children participate in a yoga game to get ready for writing.
  1553. Acquisitional
  1554. TABLE 19-7 Evidence on Modeling for Teaching Handwriting*
  1555. FIGURE 19-7 Lined paper with diagrams helps with letter size and the placement of text.
  1556. Sensorimotor
  1557. TABLE 19-8 Strategies for Handwriting Problems
  1558. FIGURE 19-8 A girl works on a homework assignment that is taped to a vertical surface (i.e., kitchen cupboard).
  1559. Biomechanical
  1560. Sitting Posture
  1561. Paper Position
  1562. Pencil Grip
  1563. FIGURE 19-9 A rubber band sling allows for a slanted, relaxed pencil position.
  1564. Writing Tools
  1565. Paper
  1566. TABLE 19-9 Evidence on Writing Instruments
  1567. Psychosocial
  1568. TABLE 19-10 Evidence on Behavioral Techniques to Improve Handwriting
  1569. Evidence of Occupational Therapy Intervention on Handwriting
  1570. Service Delivery
  1571. FIGURE 19-10 An angled strip is attached to a student’s desktop.
  1572. SUMMARY
  1573. REFERENCES
  1574. Appendix 19-A Handwriting Assessments
  1575. CHILDREN’S HANDWRITING EVALUATION SCALE (CHES-C)
  1576. CHILDREN’S HANDWRITING EVALUATION SCALE FOR MANUSCRIPT WRITING (CHES-M)
  1577. EVALUATION TOOL OF CHILDREN’S HANDWRITING (ETCH)
  1578. MINNESOTA HANDWRITING ASSESSMENT (MHA)
  1579. TEST OF HANDWRITING SKILLS
  1580. THE PRINT TOOL
  1581. APPENDIX 19-B Handwriting Methods in Schools
  1582. D’NEALIAN HANDWRITING PROGRAM
  1583. ITALIC HANDWRITING SERIES
  1584. PALMER METHOD OF HANDWRITING
  1585. ZANER-BLÖSER HANDWRITING
  1586. Appendix 19-C Handwriting Curriculum Programs
  1587. Big Strokes for Little Folks
  1588. Callirobics
  1589. First Strokes
  1590. Getting It Write
  1591. Handwriting Without Tears
  1592. LOOPS AND OTHER GROUPS
  1593. A Kinesthetic Writing System
  1594. Peterson Directed Handwriting
  1595. Trics for Written Communication: Techniques for Rebuilding and Improving Children’s School Skills
  1596. CHAPTER 20 Influencing Participation Through Assistive Technology
  1597. OBJECTIVES
  1598. KEY TERMS
  1599. INTRODUCTION
  1600. Influencing Childrens’ Growth and Development with Assistive Technology
  1601. Definition and Legal Aspects of Assistive Technology
  1602. Models for Assistive Technology Assessment and Decision Making
  1603. TABLE 20-1 Other Legislation Related to Assistive Technology
  1604. Human Activity Assistive Technology
  1605. Student Environment Task Tool
  1606. FIGURE 20-1 The Human Assistive Technology (HAAT) model.
  1607. TABLE 20-2 SETT Framework Questions
  1608. Matching Person and Technology
  1609. Child- and Family-Centered Approach
  1610. Abandonment
  1611. BOX 20-1 Cultural Factors That Affect Assistive Technology Delivery
  1612. Learned Helplessness and Self-Determination
  1613. SETTING THE STAGE FOR ASSISTIVE TECHNOLOGY SERVICE PROVISION
  1614. Practice Settings
  1615. Occupational Therapy Process and Assistive Technology in the Schools
  1616. TABLE 20-3 Practice Settings In Which Assistive Technology (AT) Services Are Provided
  1617. BOX 20-2 Roles and Responsibilities of School Assistive Technology (AT) Teams
  1618. The Transdisciplinary Team
  1619. RESEARCH NOTE 20-1
  1620. ABSTRACT
  1621. IMPLICATIONS FOR PRACTICE
  1622. Assistive Technology Evaluation and Intervention: A Dynamic Process
  1623. Evaluation
  1624. Decision Making
  1625. BOX 20-3 Guiding Questions In Evaluating a Child for Assistive Technology
  1626. MOTOR
  1627. SENSORY AND PERCEPTUAL
  1628. COGNITIVE AND COMMUNICATION
  1629. PSYCHOSOCIAL
  1630. CONTEXT
  1631. TABLE 20-4 Assistive Technology (AT) Assessments
  1632. BOX 20-4 Criteria for Evaluating Assistive Technology Devices
  1633. FIGURE 20-2 AT products available from the Technology and Media (TAM) Division of the Council for Exceptional Children, Reston, VA.
  1634. Device Procurement
  1635. Funding
  1636. Implementation of AT Services
  1637. Measuring Progress and Outcomes
  1638. TABLE 20-5 Assistive Technology (AT) Outcome Measures
  1639. UNIVERSAL DESIGN AND ACCESS
  1640. FIGURE 20-3 Examples of readily available, universally designed low-tech tools.
  1641. Access
  1642. Universal Design
  1643. BOX 20-5 Principles of Universal Design
  1644. PRINCIPLE ONE:
  1645. Equitable Use
  1646. PRINCIPLE TWO:
  1647. Flexibility in Use
  1648. PRINCIPLE THREE:
  1649. Simple and Intuitive Use
  1650. PRINCIPLE FOUR:
  1651. Perceptible Information
  1652. PRINCIPLE FIVE:
  1653. Tolerance for Error
  1654. PRINCIPLE SIX:
  1655. Low Physical Effort
  1656. PRINCIPLE SEVEN:
  1657. Size and Space for Approach and Use
  1658. Positioning and Ergonomics
  1659. FIGURE 20-4 One size does not fit all. It is important to adjust learning environments to promote health and productivity.
  1660. BOX 20-6 ERGONOMICS: Budget-Minded Solutions/Tips for Home and School
  1661. PARTICIPATION: SUPPORTING LIFE SKILLS WITH ASSISTIVE TECHNOLOGY
  1662. FIGURE 20-5 An example of a vibrating snake attached to a switch as a means to provide independent control of sensory input.
  1663. FIGURE 20-6 A, An example of a touch switch: the jelly bean switch. B, An example of a switch that is activated by pulling on the multicolored ball.
  1664. Alternative and Augmentative Communication
  1665. FIGURE 20-7 A, The Sensitrac flat pad switch. Switch is activated by a simple touch. B, The Sensitrac flat pad switch can be easily positioned for a child to access.
  1666. FIGURE 20-8 A, The child uses the switch to play with the water toy. B, The child uses the switches to participate in a gardening activity with her peers. C, The child uses the switch to turn on the Bed Bugs game.
  1667. BOX 20-7 Basic Communication Rights
  1668. FIGURE 20-9 Example of a low-tech communication board.
  1669. BOX 20-8 Strategies to Facilitate Communicative Interaction
  1670. FIGURE 20-10 Multiple means of representation clockwise from left: an object, a TOBI, a photo, a picture symbol, and a word.
  1671. FIGURE 20-11 Example of a tactile symbol communication board.
  1672. FIGURE 20-12 AAC devices. A, BigMac communication device. B, Using the BigMac to participate in circle time. C, Talk Trac communication device. D, Using the Talk Trac and Step-by-Step communication devices to go shopping. E, Supertalker.
  1673. FIGURE 20-13 Example of a dedicated, dynamic display augmentative and alternative communication device.
  1674. FIGURE 20-14 Examples of symbol systems. A, Blissymbols. B, Rebus. C, Picsyms.
  1675. FIGURE 20-15 Visual scene display versus grid.
  1676. BOX 20-9 Communication Competence
  1677. Computers
  1678. TABLE 20-6 Benefits of Computers for Young Children
  1679. Input
  1680. FIGURE 20-16 Example of low-tech keyboard modifications including color-coding and enlarging letters on keys.
  1681. TABLE 20-7 Problem Solving for Computer Access (Starting with a Standard Computer Workstation)
  1682. FIGURE 20-17 An example of a keyguard for an alternative keyboard. Keyguards also are available for standard keyboards.
  1683. Switches
  1684. Alternate Keyboards
  1685. Mouse Emulators
  1686. Voice Recognition
  1687. FIGURE 20-18 Examples of alternate keyboards. A, IntelliKeys with alphabet overlay. B, KeyLargo and overlay examples. C, KeyLargo used with a powerbook.
  1688. Other Input Systems
  1689. Output Systems and Information Processing
  1690. Software
  1691. Electronic Aids for Daily Living
  1692. CHANGING THE LANDSCAPE IN EDUCATION: PLANNING FOR EVERY STUDENT IN THE 21st CENTURY
  1693. Universal Design for Learning
  1694. Instructional Technology
  1695. FIGURE 20-19 Schematic of an EADL setup with the Powerlink.
  1696. Assistive Technology for Literacy Skills
  1697. BOX 20-10 Key Features to Consider In Evaluating Accessibility of Instructional Software
  1698. Reading Skills
  1699. FIGURE 20-20 Example of an adapted book with tactile and rebus symbol support.
  1700. Assistive Technology for Writing
  1701. Assistive Technology for Math
  1702. FIGURE 20-21 Writing tools continuum created with graphic organizer software by Judi Sweeney, Onion Mountain Technology (http://www.onionmountaintech.com).
  1703. FIGURE 20-22 Example of word prediction software.
  1704. FIGURE 20-23 Examples of no-tech, low-tech math supports including TouchMath®, number lines and counters, coin calculators, a calculator with enlarged buttons, a Time Timer, and a standard Judy Clock math manipulative.
  1705. Assistive Technology and Transition
  1706. BOX 20-11 Components of Effective Transition Plans for Assistive Technology (AT) Users
  1707. Evidence-Based Practice and Assistive Technology
  1708. SUMMARY
  1709. TABLE 20-8 Continuum of Assistive Technology Devices
  1710. CASE STUDY 20-1 AT Problem Solving
  1711. JEREMY
  1712. LINNEA
  1713. MARGY
  1714. REFERENCES
  1715. CHAPTER 21 Mobility
  1716. OBJECTIVES
  1717. KEY TERMS
  1718. DEVELOPMENTAL THEORY OF MOBILITY
  1719. FIGURE 21-1 Development of locomotion. A, Infant bears full weight on feet by 7 months. B, Infant can maneuver from sitting to kneeling position. C, Infant can stand holding onto furniture at 9 months. D, While standing, infant takes deliberate step at 10 months. E, Infant crawls with abdomen on floor and pulls self forward, and then (F) creeps on hands and knees at 9 months.
  1720. IMPAIRED MOBILITY
  1721. FIGURE 21-2 The Pommel Walker allows an 18-month-old child with a developmental delay to explore his environment.
  1722. FIGURE 21-3 The Mini-Bot provides early, exploratory, self-initiated mobility experiences. A 2-year-old child with arthrogryposis stands and moves in the Mini-Bot using a joystick or switches.
  1723. AUGMENTATIVE MOBILITY
  1724. ASSESSMENT AND INTERVENTION
  1725. Classification of Mobility Skills
  1726. Mobility Assessments
  1727. Mobility Evaluation Team Models
  1728. MOBILITY DEVICES
  1729. CASE STUDY 21-1 Brian
  1730. Alternative Mobility Devices
  1731. Tricycles
  1732. Prone Scooters
  1733. FIGURE 21-4 The Discovery Trike can fit a child as young as 12 months. An adult can assist the child by steering the front wheel with the push handle.
  1734. Caster Carts
  1735. FIGURE 21-5 Prone scooter mobility devices.
  1736. FIGURE 21-6 A, Caster cart mobility device. B, Joystick- or switch-controlled multi-directional scooter board.
  1737. Aeroplane Mobility Device
  1738. Mobile Stander
  1739. FIGURE 21-7 The aeroplane mobility device can be handmade and is designed for children younger than 3 years of age.
  1740. FIGURE 21-8 Mobile standers. A, The Dynamic Stander’s large push wheels can be propelled by the child or easily removed to position the child close to a table or counter top. (Manufactured by Rifton.) B, The powered Standing Dani by Davis Made, a motorized standing device.
  1741. Walkers
  1742. FIGURE 21-9 Walkers. A, The Crocodile posterior walker is designed for children from 2 to 14 years of age. (Manufactured by Snug Seat.) B, A young child helps with chores while using the Walkabout, a hands-free, weight-relieving walker. (Manufactured by Mulholland Positioning Systems, Inc.) C, A 2-year-old boy with spastic cerebral palsy uses the Pommel Walker in a forward pitch position, with a widely padded seat and a tray and hand grip to provide upper body support while pushing a toy vacuum.
  1743. Alternative Powered Mobility Devices for Young Children
  1744. WHEELED MOBILITY SYSTEMS
  1745. FIGURE 21-10 Strollers. A, The KidSert. B, The Mountee.
  1746. FIGURE 21-11 The Advance Contour Hi Low chair.
  1747. Manual Wheelchairs
  1748. FIGURE 21-12 Manual wheelchairs. A, Chelsea, age 9 years with paraplegia at the L1 level, selects a TiLite TR for its features of lightweight, durability, and smooth ride. B, Quickie Kidz manual wheelchair features wider rear wheels for maximum pushing surface so that the chair can be propelled with either a push or pull motion. C, Quickie Xtender provides power assist to a manual wheelchair by designing a motor unit into the hub of the quick release wheel. D, The LEVO KID wheelchair provides a sit-to-stand feature in a manual wheelchair with the touch of a button. E, Kids ROCK wheelchair.
  1749. Power Wheelchairs
  1750. FIGURE 21-13 Power wheelchairs. A, Q610. B, Permobil 450. C, Skippi power wheelchair.
  1751. FIGURE 21-14 Useful features for a power wheelchair. A, The Chairman 2K Stander. Standing can be achieved from a sitting position or gradually from supine. B, K450 from Permobil Playman Robo’s seat will lower to the ground and elevate, covering a total of 25 inches height difference for vertical mobility. (Lebanon, Tenn.) C, Permobil K300PS Jr. with tilt. Chairman 2K front- wheel drive power wheelchair with the Corpus seating system and 45° of tilt in space.
  1752. Selection of Wheelchair Features
  1753. POWERED MOBILITY EVALUATION AND INTERVENTION
  1754. CASE STUDY 21-2 Trevor
  1755. CASE STUDY 21-3 Amanda
  1756. FIGURE 21-15 11-year-old girl in Power Tiger from ASL.
  1757. SEATING AND POSITIONING
  1758. Understanding the Biomechanics of Seating
  1759. Seating Guidelines
  1760. BOX 21-1 Exercises to Understand the Biomechanics of Seating
  1761. SITTING IN POSTERIOR PELVIC TILT
  1762. PELVIC POSITION STABILITY
  1763. FIGURE 21-16 A, Infinity DualFlex 10 by Invacare. The Infinity DualFlex 10 is a modular seating system that accommodates a wide range of position needs. B, Ride designs cushion can be custom molded for an individual.
  1764. FIGURE 21-17 Hip Grip, a dynamic pelvic stabilization device.
  1765. Evaluation
  1766. FIGURE 21-18 Prairie Seat simulator.
  1767. TRANSPORTATION OF MOBILITY SYSTEMS
  1768. FACTORS THAT INFLUENCE THE SUCCESSFUL USE OF MOBILITY DEVICES
  1769. SUMMARY
  1770. CASE STUDY 21-4 Stephanie
  1771. CASE STUDY 21-5 David
  1772. CASE STUDY 21-6 Jason
  1773. REFERENCES
  1774. SUGGESTED READING
  1775. SECTION IV Areas of Pediatric Occupational Therapy Services
  1776. CHAPTER 22 Neonatal Intensive Care Unit
  1777. OBJECTIVES
  1778. KEY TERMS
  1779. EVOLUTION OF NEONATAL INTENSIVE CARE
  1780. Nursery Classification and Regionalization of Care
  1781. FIGURE 22-1 Newly born, extremely preterm twins in a NICU. These 24-weeks-gestation infants, in Z-Flo fluidized positioners and on radiant warmers, are receiving nasal continuous positive airway pressure (NCPAP), total parenteral nutrition (TPN), and phototherapy.
  1782. Inclusion of Developmental Specialists in the NICU
  1783. Sensory Deprivation versus Stimulation
  1784. CHANGING FOCUS OF NEONATAL OCCUPATIONAL THERAPY
  1785. Traditional Occupational Therapy: Rehabilitation and Stimulation
  1786. State-of-the-Art Occupational Therapy: Developmental Support
  1787. FIGURE 22-2 A, This infant has seizures, bowel pathology, and infections; “traditional” therapeutic positioning, pre-feeding oral stimulation and developmental therapy will be included as part of her OT treatment plan. B, This infant was born at 22 weeks’ gestation; multiple organ system vulnerabilities from extreme prematurity warrant protective developmental support from birth.
  1788. DEVELOPING A MEDICAL FOUNDATION
  1789. Abbreviations and Terminology
  1790. Classifications for Age
  1791. Classifications by Birth Weight
  1792. Thermoregulation
  1793. Medical Conditions and Equipment
  1794. NICU ENVIRONMENT
  1795. “Mismatch” of Immature Infant in High-Tech Environment
  1796. TABLE 22-1 Common Medical Equipment in the NICU
  1797. TABLE 22-2 Comparison of Intrauterine and Extrauterine Sensory Environments
  1798. Light in the NICU
  1799. Lighting Considerations for NICU Staff and Infants
  1800. Lighting Guidelines for the NICU
  1801. FIGURE 22-3 Neonatal intensive care unit infant is receiving eye examination by an ophthalmologist to check for development of retinopathy of prematurity. Swaddling and sucking on a pacifier dipped in 24% sucrose solution provide some relief for procedural discomfort.
  1802. Sound in the NICU
  1803. Environmental Modifications of Sound in the NICU
  1804. Caregiving in the NICU
  1805. Modifications of Caregiving in the NICU
  1806. FIGURE 22-4 24-week-GA infant on high-frequency oscillating ventilation (HFOV). Efforts to protect sleep include placement of the infant in an incubator to decrease random handling and stimuli, clustered care, covering the Isolette to block overhead light (cover folded back for this picture), and supportive positioning in an individually contoured Z-Flo fluidized positioner.
  1807. FAMILIES IN THE NICU
  1808. Families in Crisis
  1809. TABLE 22-3 Newborn States and Considerations for Caregiving
  1810. FIGURE 22-5 Swaddled bath. Swaddled preterm infant is immersed in a tub of warm water for a developmentally supportive bath.
  1811. Family Inclusion in Developmental Support
  1812. FIGURE 22-6 Assessment of this stable preterm infant includes evaluation of neuromotor and neurobehavioral functioning. The assessment can be a valuable teaching tool when performed jointly with the infant’s parents.
  1813. Skin-to-Skin Holding (Kangaroo Care)
  1814. FIGURE 22-7 Father using skin-to-skin holding technique (kangaroo care) while preterm infant undergoes a head ultrasound to rule out intraventricular hemorrhage.
  1815. Discharge Planning
  1816. INFANTS IN THE NICU
  1817. Evaluation of the NICU Infant
  1818. Neurobehavioral Organization of the Preterm Infant
  1819. Synactive Theory of Development
  1820. FIGURE 22-8 Beginning at conception, emerging and expanding capabilities of developing infant are illustrated in this model of synactive organization of behavioral development.
  1821. TABLE 22-4 Synactive Theory of Development: Neurobehavioral Subsystems, Signs of Stress and Stability*
  1822. TABLE 22-5 Neurobehavioral Development of Preterm Infants by Gestational Age
  1823. Preterm Neurobehavioral Organization: In-turning, Coming-out, and Reciprocity
  1824. States of Arousal
  1825. TABLE 22-6 Stages and Characteristics of Behavioral Organization in Preterm Infant
  1826. Sensory System Development and Sensory Stimulation
  1827. Sensory System Development
  1828. Supplemental Sensory Stimulation
  1829. BOX 22-1 Fetal Sensory System Development: Implications for Environmental and Caregiving Modifications
  1830. BASIC BRAIN DEVELOPMENT
  1831. MOST FETAL SENSORY SYSTEMS (TACTILE, VESTIBULAR, TASTE, SMELL) ARE FUNCTIONING AT THE AGE OF VIABILITY
  1832. NICU Implications
  1833. AUDITORY/VISUAL SENSORY SYSTEM FETAL DEVELOPMENT (AT AGE OF VIABILITY) WITH NICU IMPLICATIONS
  1834. Auditory System
  1835. NICU Implications
  1836. Visual System
  1837. NICU Implications
  1838. FIGURE 22-9 The support provided by containment, sucking, and grasping helps this preterm infant establish eye contact with her mother for a time of quality interaction.
  1839. Auditory Stimulation
  1840. Visual Stimulation
  1841. Traditional Developmental Stimulation
  1842. Infant Massage
  1843. Evidence-Based Potentially Better Practices (PBPs) to Support Neurodevelopment in the NICU
  1844. Neuromotor Development and Interventions
  1845. Reflex Development
  1846. Muscle Tone
  1847. TABLE 22-7 Potentially Better Practices to Support Neurodevelopment in the NICU
  1848. Posture and Movement Patterns
  1849. Therapeutic Positioning
  1850. FIGURE 22-10 Continuously restless infant (1000 grams, small for gestational age) unable to settle in cloth bunting. She relaxed and fell asleep in minutes after being positioned on a Z-Flo full-body positioner with a smaller Z-Flo pad used as a prone roll.
  1851. FIGURE 22-11 Hypotonic posture of premature infant. Without therapeutic positioning, “W” configuration of arms, “frogged” posture of legs, and asymmetrical head position may lead to positional deformities.
  1852. Range of Motion
  1853. FIGURE 22-12 Illustrated developmental cause and consequences lack of therapeutic positioning and subsequent positional deformities in the NICU population. Hospital-acquired positional deformities are largely avoidable with good positioning. References can be found on the Sundance Solutions website listed in the credit.
  1854. FIGURE 22-13 A, Blanket rolls are often too shallow and too wide to provide secure boundaries and postural support. B, Commercial positioning devices such as the Snuggle-Up. (Children’s Medical Ventures) made positioning easier; this small preterm infant is supported in sidelying position with midline orientation and flexion of extremities.
  1855. Splinting
  1856. Feeding
  1857. A Word about Breastfeeding
  1858. Bottle Feeding
  1859. Non-nutritive Sucking
  1860. FIGURE 22-14 A, NICU infant in drug withdrawal needing firm circumferential boundaries. The Z-Flo tube’s elasticized Velcro closure and the adjustable cross strap maintain the integrity of the positioner, while Z-Flo’s fluidized properties allow the infant to move within the boundaries. His peripheral intravenous line and feeding tube are easily accommodated. B, Complex positioning on Z-Flo for a critically ill infant with a genetic syndrome including a short proximal esophageal atresia and a hypoplastic diaphragm. He has a gastrostomy tube; the large oral tube is hooked to wall suction for drainage of secretions, with variable effectiveness. The infant required frequent deep manual suctioning and was often extremely agitated with significant oxygen desaturations. Positioning increased calming and sleep, facilitated correct placement of the oral tube with more effective suctioning and less aversive vagal response from the infant, reduced the need for manual suctioning, and delayed intubation. An esophagostomy (spit fistula) was surgically placed the next week.
  1861. Nutritive Sucking Patterns
  1862. FIGURE 22-15 Newborn infant with congenital muscular dystrophy, a right humeral fracture, and obvious hand deformities. Bilateral soft splints (fabricated from foam pencil grips, small Velfoam straps, and Velcro) had no pressure points. Movement was not restricted; corrected alignment actually increased the infant’s active movement.
  1863. FIGURE 22-16 A, Preterm infant with transitional sucking pattern is fed in modified side-lying (breast-feeding) position. B, Infant’s feeding is externally paced as the caregiver tips the bottle to force a breathing break.
  1864. Stripping from the Nipple in Nutritive Sucking
  1865. Nutritive Sucking and Respiration
  1866. Nutritive Sucking and Aspiration
  1867. Feeding Readiness and Cue-Based Infant-Driven Feeding
  1868. SUMMARY
  1869. REFERENCES
  1870. APPENDIX 22-A Medical Abbreviations Commonly Used in the Neonatal Intensive Care Unit
  1871. A
  1872. B
  1873. C
  1874. D
  1875. E
  1876. F
  1877. G
  1878. H
  1879. I
  1880. K
  1881. L
  1882. M
  1883. N
  1884. O
  1885. P
  1886. Q
  1887. R
  1888. S
  1889. T
  1890. U
  1891. V
  1892. W
  1893. NICU Case Study: “King” James
  1894. CHAPTER 23 Early Intervention
  1895. OBJECTIVES
  1896. KEY TERMS
  1897. WHAT IS EARLY INTERVENTION?
  1898. Legislation Related to Early Intervention
  1899. Occupational Therapy Services in Early Intervention Systems
  1900. TABLE 23-1 Comparison of Educational Programs by Age Group
  1901. CURRENT PRACTICE IN EARLY INTERVENTION
  1902. Partnering with Families
  1903. BOX 23-1 Questions to Foster Cultural Competence
  1904. Partnering with Professionals
  1905. BOX 23-2 Principles of Family-Centered Intervention
  1906. FIGURE 23-1 A music therapist helps children enhance their body awareness, a goal that is a primary responsibility of the occupational therapist.
  1907. Provision of Early Intervention Services
  1908. Assessment and Intervention Planning
  1909. Evaluation and Planning
  1910. Eligibility Determination
  1911. FIGURE 23-2 The therapist can assess perceptual motor skills through observation of puzzle completion.
  1912. Development of the IFSP
  1913. FIGURE 23-3 Important assessment data are gathered through structured observations of the child’s play in his or her everyday environment.
  1914. Writing Goals and Objectives
  1915. BOX 23-3 Required Components of the Individualized Family Service Plan
  1916. BOX 23-4 Questions to Discuss with Families When Establishing Activities for Services in Natural Environments
  1917. FIGURE 23-4 Adapted seating promotes good postural alignment for fine-motor play at a table.
  1918. FIGURE 23-5 The occupational therapist and child use an activity to enhance fine-motor skills.
  1919. FIGURE 23-6 Sample Outcomes Sheet from an IFSP.
  1920. Transition Planning
  1921. TABLE 23-2 Plan of Strategies Worksheet
  1922. CASE STUDY 23-1 Jeremy
  1923. BACKGROUND
  1924. ASSESSMENT
  1925. INTERVENTION
  1926. INDIVIDUAL FAMILY SERVICE PLAN REVIEW
  1927. ANNUAL REASSESSMENT
  1928. SUMMARY
  1929. Payment for Occupational Therapy Services
  1930. Working in Natural Environments
  1931. Settings
  1932. FIGURE 23-7 The therapist encourages a child to participate in sensory motor activities on the playground.
  1933. FIGURE 23-8 Family involvement supports the child in the natural environment.
  1934. FIGURE 23-9 The occupational therapist uses preschool materials to achieve the child’s fine-motor goals.
  1935. Occupational Therapy in Natural Environments
  1936. FIGURE 23-10 Young children learn through peer interaction and peer imitation.
  1937. FIGURE 23-11 Participation in community-based family activities promotes developmental skills.
  1938. FIGURE 23-12 Play with peers in natural environments helps the child generalize newly learned skills.
  1939. FIGURE 23-13 Peer play helps the child generalize newly learned skills.
  1940. FIGURE 23-14 In an inclusive program, a peer models, encourages, and supports the child with developmental delays.
  1941. Challenges to Implementing Therapy in Natural Environments
  1942. FIGURE 23-15 A, Sensory motor play in the sandbox. B, Children learn many skills through imitation of their peers.
  1943. OCCUPATIONAL THERAPY INTERVENTION
  1944. Addressing Family and Child Needs in Natural Environments
  1945. Family-Centered Intervention
  1946. RESEARCH NOTE 23-1
  1947. ABSTRACT
  1948. IMPLICATIONS FOR PRACTICE
  1949. Intervention Approaches
  1950. FIGURE 23-16 The Coaching Process.
  1951. CASE STUDY 23-2 Alana
  1952. BACKGROUND
  1953. INTERVENTION
  1954. FOLLOW-UP
  1955. BOX 23-5 Example of How Coaching Is Not a Linear Process
  1956. Working with Medically Fragile Children
  1957. FIGURE 23-17 The occupational therapist integrates speech goals into toilet training.
  1958. Areas of Intervention
  1959. Play
  1960. Motor Performance
  1961. TABLE 23-3 Relevant Research on Play Skills and Young Children
  1962. FIGURE 23-18 Exploratory, sensory motor play enhances development of body scheme, coordination, and a range of motor skills.
  1963. FIGURE 23-19 Observation of play with age-appropriate materials is used to assess fine motor skills.
  1964. Sensory Processing
  1965. TABLE 23-4 Examples of Research on Motor Skills and Young Children
  1966. CASE STUDY 23-3 Alex
  1967. BACKGROUND
  1968. ASSESSMENT
  1969. SUMMARY AND INTERPRETATION
  1970. INTERVENTION
  1971. Self-Care/Adaptive
  1972. Adapted Equipment and Positioning
  1973. SUMMARY
  1974. FIGURE 23-20 The therapist assesses feeding skills during the lunchtime routine in preschool.
  1975. FIGURE 23-21 Adapted seating enables a child with postural instability to play with a peer at the table.
  1976. REFERENCES
  1977. Suggested Readings
  1978. Evolve Table
  1979. TABLE 23-e1 Relevant Research on Caregiver-Child Relationships
  1980. CHAPTER 24 School-Based Occupational Therapy
  1981. OBJECTIVES
  1982. KEY TERMS
  1983. SPECIAL AND GENERAL EDUCATION LEGISLATION
  1984. Individuals with Disabilities Education Act (IDEA)
  1985. FIGURE 24-1 Timeline of important legislation and developments influencing occupational therapy’s role in schools.
  1986. BOX 24-1 Principles of the Individuals with Disabilities Education Act (formerly EHA [P.L. 94-142])
  1987. Least Restrictive Environment
  1988. Evolution of IDEA
  1989. Section 504 of the Rehabilitation Act and the Americans with Disabilities Act
  1990. No Child Left Behind
  1991. OCCUPATIONAL THERAPY SERVICES FOR CHILDREN WITH DISABILITIES
  1992. Occupational Therapy Domain in School-Based Practice
  1993. Occupational Therapy Process in School-Based Practice
  1994. Referral
  1995. Evaluation
  1996. FIGURE 24-2 Special Education Process.
  1997. Evaluation Strategies
  1998. FIGURE 24-3 Top-down versus bottom-up approaches to evaluation and intervention.
  1999. BOX 24-2 The School Function Assessment: A Top-Down Measure of Student Participation
  2000. SCHOOL FUNCTION ASSESSMENT (SFA)
  2001. TABLE 24-1 School-Related Occupational Performance Addressed During Evaluation and Intervention
  2002. FIGURE 24-4 The playground is one environment to be evaluated, emphasizing accessibility and safety. Although schools are constructing playgrounds with wheelchair accessibility, many remain only partially accessible. Playgrounds should include equipment that requires a range of skills and a range of sensory input.
  2003. Assessment Measures
  2004. FIGURE 24-5 Preschool classrooms tend to have high levels of visual and auditory stimuli.
  2005. TABLE 24-2 Types of Assessment Tools
  2006. Documentation
  2007. Eligibility
  2008. Individualized Education Program
  2009. TABLE 24-3 Process Depicting the Development of the Individualized Education Program (IEP)
  2010. TABLE 24-4 Educationally Relevant Levels of Performance and Educational Need
  2011. BOX 24-3 Evaluation of Performance As It Relates to Participation in School
  2012. FIGURE 24-6 A child with left hemiparesis uses a touch window on the classroom computer. Despite her left-side motor impairments, she did not qualify for related services under IDEA because she was fully functional and met all standards for kindergarten performance.
  2013. Occupational Therapy Services
  2014. BOX 24-4 “Brownie Busters”: An Occupation-Based Work Group for Children with Multiple Disabilities
  2015. PROGRAM DEVELOPMENT
  2016. PARTICIPANTS
  2017. GROUP SESSIONS
  2018. QUALITATIVE RESEARCH FINDINGS
  2019. FIGURE 24-7 Brownie Buster group pictures.
  2020. Scientifically Based Instructional Practices
  2021. Integrated Service Delivery
  2022. TABLE 24-5 Recommended Fine Motor Activities to Improve School Functions
  2023. TABLE 24-6 Activities to Prepare Children for Writing
  2024. FIGURE 24-8 The occupational therapist may help the teacher establish learning centers for sensory exploration.
  2025. FIGURE 24-9 A fine-motor learning center may include hanging up T-shirts and pictures using clothespins.
  2026. Consultation
  2027. TABLE 24-7 Intervention Strategies When Consulting
  2028. Annual Review and Reevaluation
  2029. CASE STUDY 24-1 William
  2030. PARTICIPATION IN THE SCHOOL ENVIRONMENT
  2031. PERFORMANCE IN SCHOOL ACTIVITIES
  2032. OCCUPATIONAL THERAPY SERVICES
  2033. TABLE 24-8 Consultation by Interaction Style
  2034. NEW DIRECTIONS IN SCHOOL-BASED PRACTICE: PREVENTION-BASED MULTITIERED SERVICES AND SCHOOL MENTAL HEALTH
  2035. Prevention-Based Multitiered Services
  2036. FIGURE 24-10 Tiered model of education.
  2037. OCCUPATIONAL THERAPY’S ROLE IN SCHOOL MENTAL HEALTH
  2038. The School Mental Health Movement
  2039. Multitiered Public Health Model of School Mental Health
  2040. The Role of Occupational Therapy
  2041. Social-Emotional Learning
  2042. Positive Behavior Support
  2043. FIGURE 24-11 Academic and behavioral tiered levels of intervention.
  2044. BOX 24-5 Occupational Therapy Services Focusing on Social-Emotional Learning: Teaching Social Skills
  2045. TABLE 24-9 Sample Activities Provided by Occupational Therapy Under a Public Health Model of School Mental Health
  2046. SUMMARY
  2047. REFERENCES
  2048. CHAPTER 25 Service for Children with Visual or Hearing Impairments
  2049. OBJECTIVES
  2050. KEY TERMS
  2051. VISUAL IMPAIRMENT
  2052. RESEARCH NOTE 25-1
  2053. ABSTRACT
  2054. IMPLICATIONS FOR PRACTICE
  2055. CASE STUDY 25-1 Natalia, Nicholas, and Hannah
  2056. NATALIA
  2057. NICHOLAS
  2058. HANNAH
  2059. Developmental Considerations and the Impact of Visual Impairment
  2060. Participation in Co-occupations of Caregiving
  2061. Exploration and Play
  2062. Learning, Education, and Academic Performance
  2063. TABLE 25-1 Comparison of Motor Functioning, Degree of Visual Impairment, and Severity of Co-occurring Disabilities
  2064. Use of Information from Other Sensory Systems
  2065. Sensory Modulation
  2066. BOX 25-1 Postural and Motor Characteristics Seen in Children with Visual Impairment.
  2067. Activities of Daily Living and Instrumental Activities of Daily Living
  2068. Social Participation and Communication
  2069. Occupational Therapy Evaluation
  2070. Occupational Therapy Intervention
  2071. TABLE 25-2 Signs and Symptoms of Visual Problems*
  2072. FIGURE 25-1 Child with low vision tracking around a curb on a playground tricycle.
  2073. FIGURE 25-2 Child with severe visual impairment using a push toy as a mobility aid.
  2074. Issues in Critical Thinking and Decision Making
  2075. TABLE 25-3 Comparison of Characteristic Behaviors in Children with Visual Impairment and Autism to Typically Developing Children and Children with Visual Impairment
  2076. Special Techniques and Strategies
  2077. Preparation for Adulthood
  2078. HEARING IMPAIRMENT
  2079. BOX 25-2 Risk Indicators Associated with Permanent Congenital, Delayed-Onset, or Progressive Hearing Loss in Childhood
  2080. Developmental Considerations and the Impact of Hearing Impairment
  2081. RESEARCH NOTE 25-2
  2082. ABSTRACT
  2083. IMPLICATIONS FOR PRACTICE
  2084. Occupational Therapy Evaluation
  2085. BOX 25-3 Findings That Indicate the Possibility of Hearing Loss
  2086. Occupational Therapy Intervention
  2087. CASE STUDY 25-2 Tori
  2088. FIGURE 25-3 Child with behind-the-ear hearing aids working on balance and equilibrium skills.
  2089. FIGURE 25-4 Sisters communicating using sign language, discussing playing with their pet cat—a favorite shared occupation.
  2090. FIGURE 25-5 Child with a cochlear implant participating in an oral motor group to facilitate oral language skills.
  2091. Special Techniques and Strategies
  2092. RESEARCH NOTE 25-3
  2093. ABSTRACT
  2094. IMPLICATIONS FOR PRACTICE
  2095. BOX 25-4 Suggestions for Communicating with Hearing-Impaired Children
  2096. FIGURE 25-6 A, Diagram of a behind-the-ear hearing aid. B, Diagram of a cochlear implant.
  2097. Preparation for Adulthood
  2098. MULTISENSORY IMPAIRMENT
  2099. Diagnostic Information
  2100. Other Services
  2101. Occupational Therapy Evaluation and Intervention
  2102. Evaluation
  2103. Intervention Goals and Methods
  2104. Special Techniques and Strategies
  2105. Preparation for Adulthood
  2106. SUMMARY
  2107. REFERENCES
  2108. APPENDIX 25-A Vision Impairment
  2109. DIAGNOSTIC INFORMATION
  2110. Definitions and Prevalence
  2111. Visual System
  2112. Causes of Blindness and Visual Impairment
  2113. Identifying Children with Visual Impairment
  2114. Common Pediatric Eye Disorders
  2115. OTHER SERVICES
  2116. SPECIALIZED ASSESSMENT TOOLS
  2117. REFERENCES
  2118. Appendix 25-B Hearing Impairment
  2119. DIAGNOSTIC INFORMATION
  2120. Anatomy of the Ear
  2121. HEARING LOSS
  2122. Measurement of Hearing Loss
  2123. Functional Implications and Intervention
  2124. Table 25B-1 Therapy and Education Implications of Typical Hearing Loss Conditions
  2125. OTHER SERVICES
  2126. SPECIALIZED ASSESSMENT TOOLS
  2127. REFERENCES
  2128. CHAPTER 26 Hospital and Pediatric Rehabilitation Services
  2129. OBJECTIVES
  2130. KEY TERMS
  2131. HOSPITALIZATION
  2132. Characteristics of Children’s Hospitals
  2133. Region (Locations) Served
  2134. Missions of Children’s Hospitals
  2135. Research Regarding Systems and Care Outcomes
  2136. Family and Child-Centered Care
  2137. Accrediting and Regulatory Agencies
  2138. Reimbursement for Services
  2139. Occupational Therapy Services Within Children’s Hospitals
  2140. Functions of Occupational Therapists
  2141. Prevention
  2142. FIGURE 26-1 Active assistive range of motion exercises are performed several times each day to prevent joint and muscle contractures with this boy who sustained a severe closed head injury. Stretch is also applied to existing contractures, along with other joint mobilization techniques.
  2143. Resumption
  2144. Restoration
  2145. Evaluation
  2146. Determining Intervention Goals
  2147. Interventions
  2148. Preventing Secondary Disability and Restoring Performance Skills
  2149. FIGURE 26-2 Splints are used to prevent or reduce contractures. The use of serial static splints requires regular monitoring and clear instructions for use by family members and other care providers.
  2150. Resuming and Restoring Occupational Performance
  2151. FIGURE 26-3 A, The occupational therapist provides the child with cues and performance feedback while he carries out an adapted personal ADL sequence. A helmet is required to protect the head because of an open skull fracture. B, Mobility is a fundamental part of ADL routines. After completing a morning care routine, this child walks to breakfast with assistance from the occupational therapist for safety and technique.
  2152. FIGURE 26-4 Adapted dressing routines are developed to achieve success and ease learning. For this boy, who has perceptual and cognitive deficits after brain injury, the occupational therapist cues him in a repetitive sequence of steps that accomplish the task.
  2153. Adaptations for ADL Skills
  2154. Documentation of Occupational Therapy Services
  2155. BOX 26-1 Basic Rehabilitation Strategies
  2156. MOTOR LIMITATIONS
  2157. Limited Range of Motion
  2158. Decreased Strength and Endurance
  2159. Incoordination
  2160. One-Handed Techniques
  2161. PERCEPTUAL AND COGNITIVE LIMITATIONS
  2162. Perceptual and Cognitive Deficits
  2163. Visual Impairment
  2164. Scope of Occupational Therapy Services
  2165. Organization of Hospital-Based Services
  2166. Rehabilitation Services
  2167. BOX 26-2 Examples of Rehabilitation Services
  2168. ACUTE MEDICAL CARE UNITS
  2169. SPECIALTY UNITS (E.G., ORTHOPEDICS, CARDIAC AND PULMONARY SERVICES, AND ONCOLOGY AMONG OTHERS)
  2170. ONCOLOGY AND BONE MARROW TRANSPLANT
  2171. REHABILITATION SERVICES
  2172. OUTPATIENT SERVICES
  2173. Rehabilitation Team
  2174. Team Interaction
  2175. Families
  2176. Transition from Rehabilitation to the Community
  2177. Medical Model and Team Interaction
  2178. CONSULTATION SERVICES
  2179. Intensive Care Unit Services
  2180. General Acute Care Unit
  2181. Failure to Thrive
  2182. CASE STUDY 26-1 Michael
  2183. PRESENTING INFORMATION
  2184. BACKGROUND INFORMATION
  2185. MEDICAL AND OCCUPATIONAL THERAPY INTERVENTION
  2186. CASE STUDY 26-2 Kevin
  2187. PRESENTING INFORMATION
  2188. BACKGROUND INFORMATION
  2189. MEDICAL AND OCCUPATIONAL THERAPY INTERVENTION
  2190. SPECIALTY UNITS
  2191. Oncology and Bone Marrow Transplant Units
  2192. Oncology Treatment
  2193. Transplant Procedures, Complications, and Interventions
  2194. CASE STUDY 26-3 Danielle
  2195. PRESENTING INFORMATION
  2196. BACKGROUND INFORMATION
  2197. MEDICAL AND OCCUPATIONAL THERAPY INTERVENTION: ONCOLOGY PHASE OF TREATMENT
  2198. REHABILTATION SERVICES: LEVELS OF REHABILITATION SERVICE
  2199. TABLE 26-1 Rapid Onset Conditions
  2200. TABLE 26-2 Complications in Children with Chronic Disorders
  2201. TABLE 26-3 Special Medical Procedures
  2202. Outpatient Services
  2203. CASE STUDY 26-4 Stephen
  2204. PRESENTING INFORMATION
  2205. REFERRAL HISTORY
  2206. CLINICAL FINDINGS
  2207. INTERVENTION ACTIVITIES
  2208. DISCHARGE FOLLOW-UP PLAN
  2209. FIGURE 26-5 A, The occupational therapist promotes the use of the hemiparetic arm to hold the paper while the child carries out a drawing and writing activity. B, The therapist provides guidance in using both arms while participating in a cookie-baking activity.
  2210. TABLE 26-4 Outpatient Clinics and Programs Often Served by Occupational Therapists
  2211. CASE STUDY 26-5 Stacie
  2212. SUMMARY
  2213. REFERENCES
  2214. SUGGESTED READINGS
  2215. CHAPTER 27 Transition Services: From School to Adult Life
  2216. OBJECTIVES
  2217. KEY TERMS
  2218. OCCUPATIONAL THERAPY CONTRIBUTIONS TO TRANSITION
  2219. THE INTERSECTION OF POLICY AND SCIENTIFIC EVIDENCE
  2220. Transition Policy
  2221. Individuals with Disabilities Education Act
  2222. Section 504 of the Rehabilitation Act
  2223. FIGURE 27-1 Career exploration through community volunteer opportunities.
  2224. Americans with Disabilities Act
  2225. Ticket to Work and Work Incentive Improvement Act
  2226. Evidence-Based Practice
  2227. BOX 27-1 The Complexities of Special Education Research
  2228. Collaborative Interdisciplinary and Interagency Teamwork
  2229. BOX 27-2 Family-Professional Partnerships
  2230. BOX 27-3 Collaboration: What Is It?
  2231. FIGURE 27-2 A real job in a daycare setting.
  2232. BOX 27-4 Examples of Outcome-Oriented Transition Goals
  2233. CASE STUDY 27-1 Mike
  2234. Ecologic Approaches
  2235. Self-Determination, Self-Regulation, and Social Competence Training
  2236. TABLE 27-1 Transition-Focused Evaluations and Services
  2237. BOX 27-5 Self-Determination and Student-Directed Planning Meetings
  2238. BOX 27-6 Social Competence and Job Performance for Adolescents with Emotional and Behavioral Disabilities
  2239. BOX 27-7 Youth Violence: Considerations for Transition Planning
  2240. BOX 27-8 Social Competence for Students with Autism As They Make the Transition to Postsecondary Education
  2241. BOX 27-9 Transitioning from High School to Postsecondary Education and Training Programs
  2242. Recommended Practice: Paid work experience during high school
  2243. CASE STUDY 27-2 Brian
  2244. FIGURE 27-3 Job carving. A, Creating a job focused on shredding office paper. B, Creating a job focused on cleaning menus.
  2245. CASE STUDY 27-3 Renee
  2246. Practice-Based Evidence
  2247. BOX 27-10 Practice-Based Evidence
  2248. BOX 27-11 Effective Practice in a Research Emergent Profession: Occupational Therapy
  2249. CASE STUDY 27-4 Todd
  2250. FIGURE 27-4 Real work in the community depends on being able to get to and from the job site.
  2251. FIGURE 27-5 Individual progress monitoring/performance analysis.
  2252. CASE STUDY 27-5 Amanda
  2253. FIGURE 27-6 Individual progress monitoring/performance analysis.
  2254. BOX 27-12 Universal Design for Learning
  2255. SUMMARY
  2256. REFERENCES