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Pediatric PT
n/a
190
Health Care
Not Applicable
11/10/2011

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Term
Cerebral Palsy
Definition
Non-progressive but often changing impairment syndrome caused by non-progressive defect, anomaly, or lesion of the developing brain
Term
Diplegic CP
Definition
Whole body involved LE's more involved than UE's
Term
Quadriplegic CP
Definition
Whole body involved

trunk and extremities
Term
Hemiplegic CP
Definition
Only one side of body is involved
Term
Monoplegic CP
Definition
Only one UE or one LE involved

very rare
Term
Triplegic CP
Definition
Three extremities involved

often one UE spared
Term
Paraplegic CP
Definition
Both LE's involved

true form very rare

usually diplegia with UE involvement so mild it isnt noticed
Term
Characteristics of Spastic CP (Hypertonic)
Definition
-Decreased tone neck and trunk

-increased tone in extremities excessive sustained muscle contractions with certain muscle groups tending to overpower others co-contraction occurs with voluntary effort movements slow

-labored but mostly accurate - small ranges
Term
Characteristics of Athetoid CP
Definition
-global decrease tone

-proximal to distal fluctuating

-muscle tone in extremities

-very low to high movements occur between one extreme of range to the other

-little control in midranges

-difficulty co-activating to get smooth reciprical motion movement tends to be very asymmetrical and forceful
Term
characteristics of Ataxic CP
Definition
-muscle tone fluctuates from low to low normal

-disturbance in balance and kinesthesia

-may have tremor and dysmetria

-disorganized movements

-movement away from midline is difficult because cannot control center of mass
Term
Characteristics of Hypotonic CP
Definition
-start out hypotonic and develop patterns of spastic or athetosis

-if remained hypotonic are called "floppy babies"

-hypotonia ranges from mild to severe

-have difficulty generating, grading and sustaining movement
Term
What is the 2nd most common birth defect after Down's syndrome
Definition
Myelomeningocele
Term
What is a Myelomeningocele
Definition
vertebral arch fails to close

spinal cord herniates through the vertebral column resulting in injury to the spinal cord
Term
what determines the degree of loss of motor and sensory function
Definition
the level of herniation and the resulting spinal nerve injury
Term
Associated problems with Myelomeningocele
Definition
Arnold-Chiari malformation
Hydrocephalus
Orhtopedic deformities
Bowel and Bladder dysfunction
Tethered cord
Term
Arnold-Chiari Malformation
Definition
Herniation of part of the brain downward towards the foramen magnum
Term
Hydrocephalus
Definition
CSF is obstructed and accumulates

causes pressure on the surrounding tissues
Term
Signs and symptoms of shunt malfunction in infants
Definition
bulging fontanelle
high-pitched cry
sunset sign of the eye
Term
signs and symptoms of shunt malfunction in adults
Definition
edema and redness along shunt tract
Term
examples of orthopedic deformities in a patient with Down's syndrome
Definition
club foot

dislocated hips and congenital contractions

deformities resulting from lack of movement, asymmetrical or absent muscle function, the force of gravity, and congenital predisposing situations
Term
Why does a person with spina bifida have an increased chance of latex allergy
Definition
many years of catheterization and other medical procedures
Term
What is Tethered cord
Definition
fixation of the spinal cord in an abnormal location

usually associated with scar tissue

usually associated with scar tissue

as the person grows the spinal cord is stretched and distorted resulting in ischemia
Term
What is the treatment apporach for myelomeningocele
Definition
aproach in a manner of:

a child with developmental delay
and
a child with a spinal cord injury
Term
What are the major PT goals for Myelomeningocele
Definition
-Prevent contractures and skin breakdown

-facilitate normal sensorimotor development

-increase independent mobility

-introduce compensatory strategies

-increase independence in ADLs

-parent education
Term
What does Down's syndrome present as?
Definition
a child with:

developmental delay

Hypotonia

Ataxia
Term
Associated problems with Down's syndrome
Definition
Cardiovascular anomalies (40%), Immune defeciency, hearing loss, visual loss, Orthopedic problems, Speech and language delays, cognitive delays, feeding problems, cerebellar dysfunction, respiratory problems
Term
Visual problems associated with Down's syndrome
Definition
Myopia

Strabismus

Cataracts: congenital and adult onset
Term
What causes the orthopedic problems in Down's syndrome
Definition
generalized hypotonia

ligamentous laxity
Term
What joint has a propensity for instability in Down's syndrome patients
Definition
atlantoaxial joint

subluxation or dislocation with flexion motion
Term
what contributes to the delayed development of mobility and fine motor skills in Down's syndrome
Definition
problems at hips, knees and other joints from ligamentous laxity and hypotonia
Term
What is a common cerebellar dysfunction with Down's syndrome
Definition
Ataxia
Term
Treatment focus for INFANTS with Down's syndrome
Definition
developing early motor skills

parent/caregiver education for consistent carryover
Term
Treatment focus for TODDLERS/PRESCHOOL age children with Down's syndrome
Definition
Gaining quality of movement

locomotion: proximal control over distal coordination
Term
Duchenne Muscular Dystrophy
Definition
Hereditary myopathy characterized by progressive muscular weakness, deterioration of muscle fiber, and replacement of muscle fiber with fibrous & fatty tissue
Term
Characteristics of DMD
Definition
Cardiac and GI muscles involved

Tendon reflexes regress to weak and then none

NO SENSORY LOSS

Muscle innervated by cranial nerves are spared(except SCM)

Bowel and bladder spared
Term
Weakness in DMD
Definition
symmetrical and progresses proximal to distal
Term
Phase I DMD
Early Phase
Definition
- early signs of muscle weakness begin to be noticed
- gradual delay in developmental milestones, often between ages 2-6
- delayed coordination
- slow, labored gross motor activities
- walking becomes slower
- child tires more easily
Term
Goals for Phase I DMD
Definition
- Maintain strength in proximal muscles
- Maintain flexibilty
- good nutrition
- parent education important to accomplish goals
Term
Phase II DMD
"Postural change"
Definition
- will continue muscle weakness and functional loss
- will see anterior pelvic tilt, wide base of support, shoulders and head arched to balance in standing
- child moves using momentum and lateral sway rather than weight shifts
Term
Goals for Phase II DMD
Definition
- Maintain muscle strength as lon as possible
- position becomes very important as child moves less
- start considering alternative mobility and AD to conserve effort
- flexibilty becomes greater concern as mobility decreases
- scoliosis may begin showing
- respiratory management become important
Term
Phase III DMD
"Non-ambulatory phase"
Definition
- 90% of day using a wheelchair
- UE weakness more apparent
- accelerated development of joint contractures secondary to sitting for long periods of time and to decreased independent mobility
- marked difficulty with ADL's
Term
Goals for Phase III DMD
Definition
- positioning to promote as much function as possible
- Scoliosis may progress from flexible to fixed
- prevent subluxation of shoulders
- promote all possible active joint movement
- ambulation vs non-ambulation
- weight control and good nutrition important
- more assistive technology
- respiratory care paramount concern
Term
pathological reflex
Definition
- persists beyond when it should be integrated
- reappears after having been integrated
- absent when it should be present
Term
Obligatory reflex
Definition
- dominates movement when it should have been integrated
- individual is unable to volitionally change the response
- reflex become part of the motor learning process
Term
time frame Moro reflex
Definition
28 wks gestation - 5 months
Term
time frame Asymmetrical Tonic Neck Reflex (ATNR)
Definition
birth - 6 months
Term
time frame Symmetrical Tonic Neck Reflex (STNR)
Definition
6 - 8 months
Term
Time frame Tonic Labyrinthine Supine Reflex
Definition
birth - 6 months
Term
time frame Optical Righting
Definition
2 - 3 months and remains
Term
Time frame Labyrinthine Righting
Definition
2 - 3 months and remains
Term
Time frame Parachute reflex
Definition
~ 6 months
Term
persistant Moro interferes with
Definition
- balance reactions in sitting
- protective reaction in sitting
Term
Persistant ATNR interferes with
Definition
- feeding
- bilateral & midline use of hands
- rolling
-development of crowling
Term
persistent STNR interferes with
Definition
- ability to prop on arms in prone
- attaining & maintaining hand-and-knees
- reciprocal creeping
Term
persistant TLR interferes with
Definition
- segmental rolling
- come to sit from supine
- prop on arms in prone with extended hips
Term
persistent positive support, flexor withdrawal, extensor thrust interfere with
Definition
- standing and walking
- blanance reaction and weight shift in standing
Term
Atypical development
Definition
development characterized by limited variation of motor strategies and limited ability to vary motor behavior to address a specific situation
Term
Factors that increase the likelihood that a child will have some kind of developmental problem
Definition
- established risks
- environmental risks
- biological risks
Term
Established risks
Definition
- hydrocephalus
- microcephaly
- chromosomal abnormalities
- musculoskeletal abnormalities
- multiple births >twins
- brachial plexus injuries
- myelodysplasia
- congential myopathies and myotonic dystrophy
- inborn errors of metabolism
Term
Environmental risks
Definition
- single parent
- parental age less than 17 years
- poor quality infant-parent attachment
- maternal problems: drug or alcohol abuse
- mother's health
- behavioral state abnormalities
Term
Biological risks
Definition
- muscle tone abnormalities
- feeding dysfunction
- meningitis
- intracranial (intrventricular) hemorrhage
- TORCH
- ventilator >36 hours
- asphyxia
- prematurity
- recurrent neonatal seizures (3 or more)
-
Term
What is TORCH
Definition
intrauterine or earlier neonatal infections in the mother
Term
What does TORCH stand for
Definition
Toxoplasmosis
Other: syphilis, Hep B, Lyme Dz, HIV
Rubella
Cytomegalovirus
Herpes simplex type II
Term
Intraventricular Hemorrhage
(IVH)
Definition
Graded I-IV

grades III or IV most common brain lesion in infants
Term
Grade I IVH
Definition
hemorrhage in germinal matrix

minimal ventricular bleed
Term
Grade II IVH
Definition
bleed in 10-15% of inraventricular area
Term
Grade III IVH
Definition
bleed in greater than 50% of ventricular area with distention
Term
Grade IV IVH
Definition
bleed extends into parenchyma

most severe
Term
Suspected causes of IVH
Definition
- low oxygenation and structural support of blood vessels
- changes in blood pressure during the birth process
- asphyxia
- stress of too much handling and invasive medical procedures
Term
what is considered premature/ preterm
Definition
gestational age less than 37 weeks
Term
when is a fetus considered viable
Definition
around 26 weeks

lung function is not complete until 28 weeks
Term
What does APGAR test?
Definition
Heart Rate
Respiatory effort
Muscle Tone
reflex Irritability
Color
Term
When is the APGAR test performed?
Definition
1 and 5 min after birth
Term
What does a score of 8 mean on APGAR
Definition
everything seems okay
Term
what does a score of 3-4 on APGAR mean?
Definition
bag and mask ventilation to resuscitate
Term
Problems associated with prematurity
Definition
- aphyxia
- IVH
- Ventilator requirement and RDS
- BPD
- feeding problems
- NEC
- PDA
Term
Goals of positioning
Definition
-prevent skin breakdown
-minimize contractures and improve alignment
-provide a stable postion while allowing active movement where active movement is possible (dynamic positioning)
-allow interaction with the environment
-provide a position for relaxation (static positioning)
Term
What are the negative effects of staying in a position for too long
Definition
-skin breakdown
-contractures
-boredome and discomfort
-learned helplessness
Term
Hwat are the general guidelines for positioning
Definition
-position for a specific environment and activity
-head, trunk, and extremities kept in midline as much as possible
-extremities supported, as neede, and encourage to come to midline
Term
Pelvis and hip position in supine
Definition
-pelvis in line with trunk
-hips in 30 to 90 degrees of flexion
-neutral rotation of pelvis
-hips symmetrically abducted 10 to 20 degrees
Term
Trunk position in supine
Definition
-straight
-shoulders in line with hips
-neutral rotation of trunk
Term
Head and neck position in supine
Definition
-head in neutral position
-facing forward
-slight cervical flexion
Term
Shoulder and arm position in supine
Definition
-arms fully supported
-arms forward of trunk
-forearms rest on trunk or pillow
Term
legs and feet position in supine
Definition
-knees supported in flexion
-feet held at 90 degrees
Term
Hips and pelvis position in prone
Definition
-pelvis in line with trunk
-hips in extension
-neutral rotation of pelvis
-hips symmetrically abducted 10 to 20 degrees
Term
trunk position in prone
Definition
-straight
-shoulders in line with hips
-neutral rotation
Term
head and neck position in prone
Definition
-head in neutral position
-facing to one side
-slight cervical flexion
Term
shoulders and arms position in prone
Definition
-arms fully supported
-arms forward of trunk
-flexion at shoulders
-flexion at elbows
Term
Legs and feet position in prone
Definition
-knees extended
-feet supported at 90 degrees
Term
pelvis and hip position in sidelying
Definition
-pelvis in line with trunk
-hips in flexion
-neutral rotation
-hips in 10 to 20 degrees abduction
Term
trunk position in sidelying
Definition
-straight
-shoulders in line with hips
-slight sidebending okay
Term
head and neck position in sidelying
Definition
-head in neutral position
-facing forward
-slight cervical flexion
Term
shoulders and arm position in sidelying
Definition
-both arms supported
-lower arm forward
-not lying on point of shoulder
-lower arm neutral rotation
-upper arm may have 0 to 40 degrees internal rotation
Term
legs and feet position in sidelying
Definition
-knees in flexion
-feet positioned at 90 degrees
-pillow between knees
Term
Pelvis and hip position in sitting
Definition
-pelvis in line with trunk
-hips at 90 degrees flexion
-neutral rotation of pelvis
-hips symmetrically abducted 10 to 20 degrees
Term
trunk position in sitting
Definition
-straight
-shoulders over hips
-not rotated
Term
head and neck position in sitting
Definition
-head in neutral position
-facing forward
-head evenly on shoulders
Term
shoulder and arm position in sitting
Definition
-arms fully supported
-elbows in flexion
-zero to 45 degrees internally rotated shoulders
Term
legs and feet position in sitting
Definition
-knees at 90 degrees
-ankles at 90 degrees
-feet fully supported
-thighs fully supported
Term
Pelvis and hips position in standing
Definition
-pelvis in line with trunk
-hips neutral sagittal plane
-neutral rotation of pelvis
-hips neutral frontal plane
Term
trunk position in standing
Definition
-trunk straight
-shoulders over hips
-no rotation
Term
head and neck position in standing
Definition
-head in neutral position
-facing forward
-head evenly on shoulders
Term
arms and shoulders position in standing
Definition
-arms supported
-shoulders in neutral rotation
Term
knees and feet position in standing
Definition
-knees fully extended, not hyperextended
-ankle neutral
-subtalar joint neutral
Term
special position for low tone
Definition
-do not leave the child in positions that require "fighting" gravity
-use gravity to assist in maintaining a position
-support the extremities
-provide postural support
Term
special position for high tone
Definition
-avoid positions that stimulate primitive reflexes
-avoid positioning the pelvis in posterior tilt
-provide postural support that conforms to the child in order to contact and support areas of the body that will not conform to the support
Term
what does sec 504 of PL 93-112 passed in 1973 provide
Definition
facilitated the passage of legislation for provideing services for children with disabilities in public schools
Term
what is FAPE
Definition
Free Appropriate Public Education

passed in 1975 in PL 94-142
Term
what age group is covered by PL 94-142 passed in 1975
Definition
6-21 or 5-21 depending on the state laws for when children start school
Term
What is an IEP
Definition
Individualized Education Program
Term
what does least restrictive environment mean
Definition
to the maximum extent possible, children are educated with their non-disabled peers
Term
What is the IDEA law passed in 1991 and 1997 stand for
Definition
Individuals with Disabilities Education Act Amendments

-included all children
Term
What doe part C of IDEIA provide for
Definition
children from birth to 3 years old
Term
What does part B of IDEIA provide for?
Definition
children from ages 3 - 21
Term
What does ECI stand for
Definition
Early Childhood Intervention
Term
What is the ECI model's goal
Definition
promote development and learning while providing support to families
Term
What does IFSP stand for
Definition
Individualized Family Service Plan
Term
What is the eligibility for the ECI model
Definition
Has a high probability for eligibility

-developmental delay

-atypical development

-many medical diagnoses
Term
Are PT and OT considered primary services in the ECI model
Definition
YES

therapists are part of the decision-making team
Term
What is the goal of the School model
Definition
to assist the student in accessing the educational setting to overcome barriers to achieving desired educational outcomes
Term
how is the decision made for services in the school model
Definition
on multidisciplinary evaluation to determine if the child has a disability and needs special education or related services
Term
What is the eligibility for the School model based on
Definition
disability groups

-physical disability
-other health impaired
-mental retardation
-emotional disturbance
-learning disability
-autism
-speech disability
-TBI
-Visual and auditory impaired
Term
which disabilty is eligible for services in the school model from 0 - 21 years old
Definition
Visually and Auditory Impairment
Term
What does ARD stand for
Definition
Admission, Review, and Dismissal meeting
Term
Are PT and OT primary service in the school model
Definition
NO
Term
What are considered related service in the school model
Definition
transportation and such developmental, corrective and other supportive services as are required to assist a child with a disability to benefit from special education
Term
How is service delivered in the school model
Definition
collaborative and integrated

-Direct
-consultative
-monitoring
-training to instruction personnel
Term
what is the relationship between PT intervention/goals and the instructional outcomes in the school model
Definition
Must be direct relationship
Term
What are the uses for pediatric equipment
Definition
-help support and maintain alignment

-help facilitate movement

-helps challenge movement when a challenge is needed

-helps with ADL's

-motivates, educates, and provides sensory motor input needed to develop movement
Term
How does equipment help facilitate movement
Definition
may decrease gravitational demands to help movement occur and/or may provide a position to inhibit abnormal tone and reflexes
Term
What are precautions to the use of equipment
Definition
-overuse/misuse

-negative effects: skin breakdown, contractures, boredom and discomfort, learned helplessness

-do not use equipment as a "baby sitter"

-Ill-fitting equipment

patient not aligned in the equipment
Term
What should you do why you are treating with equipment
Definition
Explain --> Demonstrate --> have parent try --> make corrections --> repeat as needed
Term
What should you do why you are treating with equipment
Definition
Explain --> Demonstrate --> have parent try --> make corrections --> repeat as needed
Term
Area of brain affected in Hypertonic CP
Definition
Motor Cortex
Term
Area of brain affected in Ataxic CP
Definition
Cerebellum
Term
Area of brain affect in Athetoid CP
Definition
Basal Ganglia
Term
Goals for treating children with altered tone and movement dysfunction?
Definition
-prevent/minimize deformity

-promote a variety of moevemtn possibilties for that child

-increase function

-train caregivers to help accomplish goals 1,2 and 3
Term
Goals for treating children with altered tone and movement dysfunction?
Definition
-prevent/minimize deformity

-promote a variety of moevemtn possibilties for that child

-increase function

-train caregivers to help accomplish goals 1,2 and 3
Term
General problems with a child who has Spasticity
Definition
-proximal low tone and weakness masked by spasticity and excessive contraction or co-contraction in the extremities
-movement restricted to midranges with predictable pattern, often seen as patterns of persistent reflexes
-incomplete righting, equilibrium and protective reaction secondary to limited range of movement
-very high risk for orthopedic deformities secondary to muscle shortness, joint contractures, and spasticity
Term
what are the treatment objectives for SPASTICITY?
Definition
-increase sustained control of postural muscles while decreasing excessive contraction or extremities
-increase range and variety of joint movements
-avoid positions that stimulate reflexes or stereotyped movement patterns
-avoid static postures: work toward concentric/eccentric movement
-help them to accomodate to changes in spped and direction of movement - requires more reciprocating movement
Term
General problems with Hypotonia
Definition
-decreased proximal control and ability to co-contract around joints
-decreased grading and sustaining of muscle contractions
-decreased response to input secondary to decreased incomeing sensory-motor info secondary to lack of movement
hypermobility secondary to decrease muscle activation and decreased joint stability, but at risk for tightness due to lack of movement
-postural responses usually absent or severely diminished
Term
Treatment objectives for HYPOTONIA
Definition
-facilitate functional head and trunk alignment and static control, escpecially stability around joints
-increase ability to move anti-gravity - may need to start gravity eliminated to build strength and control
-provide support to some areas of the body to encourage movement in other areas
-facilitate automatic reactions
-increase sensory input, especially proprioceptive, to increase registration of sensory information
Term
general problems with Athetosis
Definition
-lack of sustained co-contraction and proximal stability
-asymmetrical postruing and movement, often as an attempt to stabilize
-uncontrolled righting and equilibrium reactions
-persistant early reflexes
-difficulty with selective control of head, eye, jaw, and arm movements
Term
treatment objectives for ATHETOSIS
Definition
-increase sustained proximal control with emphasis on gaining and amintaining midline control
-improve ability to hold postures while controlling symmetry of extremity movemnt away from midline
-improve ability to time and grade muscle contraction
-provide support to some areas of the body to encourgae controlled movement in other areas
Term
general problems with Ataxia
Definition
-jerky, disorganized movments with impaired force and power output
-poor coordination and sequencing of movement
-poor sense of position in space
-decreased movement away from midline secondary to poor equilibrium; therefore movement options are limited
-mild hypotonia with fluctuations toward normal tone
Term
Treatment strategies for ATAXIA
Definition
-increase proximal muscle control using sustained, deep sematosensory input and visual cueing to build stability
-work on transitions while giving guidance for initiation and increased excursion of movement
-empahsize proximal movement away from midline secondary to poor equilibrium; therefore movment options limited
-mild hypotonia with fluctuations toward normal tone
Term
Area of the brain affected in Hypotonia
Definition
Cerebellum
Term
What is involved in caregiver training for rehab equipment
Definition
-treating patient to learn to move in a functional way

-help the caregiver know how to help the child learn to move
Term
What is snesory integration
Definition
the neurological process that organizes sensation from one's own body and from the environment and makes it possible to use this information to plan and organize behavoir
Term
What is praxis
Definition
the ability to understand what needs to be done, plan how to do it and get it done
Term
What is involved in the sensory integration theory
Definition
brain/behavior relationships, assessment techniques and intervention strategies
Term
Who developed the snsory integration theory
Definition
A. Jean Ayres
Term
why was the sensory theory developed
Definition
to explain the relationship between deficits in interpreting sensory information and deficits in learning in people with learning disabilities and clumsiness
Term
What is the intention of the theory
Definition
to explain problems in learning and behavior that could not be attributed to CNS or PNS damage or abnormality
Term
What 3 systems are emphasized in the Sensory Integration Theory
Definition
Tactile

Proprioceptive

Vestibular
Term
What are a child's actions at birth primarily
Definition
reflexive
Term
What are the Assumptions of the sensory integration theory
Definition
-CNS functions as a whole
-CNS can be changed or modified
-Learning is a function of the brain
-Adaptive response
-Opportunities for enhanced sensory integration
-
Term
Learning is a function of th ebrain dependent on what?
Definition
-taking in sensory information from the environment and from the body

-processing and integrating the information

-using the information to plan and organize behavior to produce an ADAPTIVE RESPONSE
Term
Adaptive response
Definition
-a response that matches the demands of the task

-purposeful and goal directed result from sensory input
Term
What will opportunities for enhanced sensory integration do?
Definition
-improve the ability of the nervous system to process and integrate sensory input

-impact the ability to interact with the environment

-enhance adaptive skill and competence
Term
What is Sensory Integrative dysfunction
Definition
-disorganized processing of sensory information resulting in inadequate, excessive or innaccurate information from muscles, tendons and joints

-Failure in the process of organizing information and directing and adaptive response
Term
What is ideation
Definition
the concept of how to go about doing the task
Term
What is ideomotor
Definition
An internal plan that is devised based on bady schema and past experience
Term
What is dysfunction in praxis
Definition
-dysfunction in the awareness of the need to accomplish a task

-dysfunction of the concept of how to go about doing the task

-dysfunction in the abilty to form an internal plan

-Inability to carry out the plan
Term
What is dysfunction in sensory modulation
Definition
-failure to regulate and organize the intensity and nature of a response to sensory input

-hyper or hypo responses to proprioceptive, vestibular, and tactile input early in life

-hyper or hypo responses to visual, auditory, olfactory and gustatory sensations later in life
Term
What are disorders of sensory discrimination
Definition
Any combination of

-failure to interpret the characteristics of sensory stimulation

-results in a dysfunction response

-often associated with hyporesponsiveness
Term
What are some results of disorders of sensory integration
Definition
-disorganized behavior
-poor attending and concentration
-arousal disregulation
-emotional lability
-difficulty learning
-immature or inappropriate social skills
-clumsiness and slow reaction
-difficulty manipulating things in the environment
-difficulty coping with the environment
Term
What is the therapist's role in treating sensory disorders
Definition
-choose the skill

-modify the environment
Term
How ight a therapist modify the environment to treat for sensory integraion disorders
Definition
-use sensory systems to help increase or decrease alertness and arousal
-CAREFULLY increase stimulation from the environment
-initially provide visual and auditory assists
-offer limited choices by structuring the environment
-use spontaneous movement
-Use real life situations
Term
What is the purpose of the proprioceptive system
Definition
-give info about body positions that arise as a result of an individual's own movement

-develops through weight bearing and movement

-critical in maturation of reflexes, particularly righting and equilibrium
Term
What might one see with hyporesponsiveness to proprioception
Definition
-appear clumsy

-poor placement of extremities for weight bearing

-poor muscle co-contraction and holding against gravity; lock joints for stability

-difficulty grading movement

-seeks proprioceptive sensations
Term
what might one see with hyperresponsiveness to proprioception
Definition
-overresponds to physical contact such as higs

-uncomfortable running, jumping, using large movements

-avoids activities requiring movement of body parts (jumping, hanging from a bar)
Term
What helps regulate vestibular and tactile input
Definition
proprioceptive input
Term
what is the purpose of the vestibular system
Definition
-awareness of position and orientation in space

-regulation of eye position during head movement to stabilize the image

-influences muscle tone for postural support - primarily extensor tone
Term
what is the purpose of the vestibular system
Definition
-awareness of position and orientation in space

-regulation of eye position during head movement to stabilize the image

-influences muscle tone for postural support - primarily extensor tone
Term
What are the 2 types of dysfunction in the vestibular system
Definition
-Hyporeactive (hyporesponsiveness) to vestibular input

-Hyperreactive (hyperresponsiveness) to vestibular input
Term
What might one see with hyporeaction in the vestibular system
Definition
-decrease autonomic responses to vestibular stim

-appear clumsy

-decreased antigravity extension and flexion and decreased control of postural adjustments

-poor eye/head coordination

-decreased alertness/arousal

-seek a great deal of mevement experience (more than the typical child)
Term
what are the treatment considerations for hyporeactive vestibular system
Definition
-utilize hanging equipment in conjuction with active movement to include linear and rotary activities early in treatment
-vary the type, speed and difficulty of adaptive responses
-allow the child to control the amount of stimulation but monitor for signs of adequate amount of input
-combine proprioceptive input with vestibular
Term
What might one see with hyperresponsiveness to vestibular
Definition
-gravitational insecurity

-fear everyday, geneeric movement experiences

-unusual fear of fallin, heights, backward movement

-unexpected/exaggerated autonomic responses to rotation and linear movement

-increased alertness/arousal
Term
what is gravitational insecurity
Definition
extreme fearfulness with changes in head and body position even when adequately supported
Term
treatment considerations for hyperresponsive to vestibular
Definition
-allow the child to control the movement as much as necessary to keep the child interacting with the environment
-utilize adaptive responses which gradually increase in difficulty
-utilize hanging equipment emphasizing linear activities
-only progress to rotary movment when the child has begun to utilize linear input more appropriately
-monitor delayed effects of vestibular input
Term
what is the purpose of the tactile system
Definition
-alerts the person to danger

-gives information about the immediate surroundings

-guides the exploration of the environment

-assists in the developing body scheme

-associates with emotions via the limbic system
Term
What are the 2 types of tactile dysfunction
Definition
-hyporesponsiveness to tactile input (poor tactile discrimination)

-hyperresponsiveness to tactile input (tactile defensiveness)
Term
What might one see with hyporesponsiveness to tactile
Definition
-decreased awareness or reaction to touch, pain and temp

-poor touch discrimination

-poor manipulation skills

-under reation to bumps, falls

-seeks/craves touch experiences

-decreased body scheme
Term
treatment considerations for hyporesponsiveness to tactile
Definition
-utilize light touch and facilitating touch experiences

-use tactile discrimination games and activities with a variety of textures

-emphasize tactile input with proprioceptive input

-use activities that emphasize body scheme
Term
What might one see with hyperresponsiveness to tactile input
Definition
-avoidance of being touched

-overreaction to bumps, falls

-preference for solitary play - avoid contact

-sensitivity to certain textures of clothing, food

-discomfort with face washing, tooth brushing, hair combing

-use fingertips to manipulate objects
Term
What is the ultimate goal of treating for sensory dysfunction
Definition
to use the information from the tactile, proprioceptive and vestibular systems to successfully plan and carry out a meaningful activity
Term
what illustrates an adaptive response
Definition
-respond to the stimulus

-hold and stay (tolerate the stimulus)

-muscle groups response appropriately

-move independently through the environment in a familiar way

-move through the environment in an unfamiliar way

-complete complicated activity requiring unfamiliar way, unfamiliar timing, or multiple adaptations
Term
what would the child with neuro-motor dysfunction be deprived of
Definition
movement experiences which contribute to the normal maturation of our sensory systems
Term
what are some examples of movement disturbances reported in both autism and non-autism movement disorders
Definition
-dystonias
-dyskinesia
-tics
-dyspraxia
-apraxia
-bradykinesia
-dysprosody
-dysphonia
-blepharospasm
-oromandibular dystonia
-torticollis
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