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Risk Factors for Atypical Development
Risk Factors for Atypical Development
201
Medical
Professional
11/09/2011

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Term
Define:

Development characterized by limited variation of motor strategies and limited ability to vary motor behavior to address a specific situations
Definition
atypical development
Term
What are the 3 factors that increase the likelihood that a child will have some kind of developmental problem.
Definition
Established Risks
Environmental Risks
Biological Risks
Term
What are some Established Risks for developmental problems

( events that have occurred that can pose obvious problems
Definition
-hydrocephalus
-microcephaly
-chromosomal abnormalities (e.g., Down’s)
- musculoskeletal abnormalities (e.g., congenitally dislocated hips, -arthrogryposis, limb deficiencies, developmental dysplasias)
-multiple births greater than twins
-Brachial plexus injuries
-myelodysplasia
-congenital myopathies and myotonic dystrophy
-inborn errors of metabolism ( e.g.Tay Sachs disease: abnormal metabolism of fats)
Term
what are the 6 environmental risk factors for developmental problems
Definition
-single parent
-parental age less than 17 years
-poor quality infant-parent attachment
-maternal problems: drug or alcohol -abuse (includes smoking)
-mother’s health
-behavioral state abnormalities (lethargy, excessive irritability
Term
what are the 9 Biological risk factors for developmental problems
Definition
-muscle tone abnormalities (hypo, hyper asymmetry of tone/mvmt)
-feeding dysfunction (e.g., cleft palate; gastroesophageal reflux)
-meningitis
-recurrent neonatal seizures (3 or more)
-TORCH
-intracranial (intraventricular) -hemorrhage (IVH
-ventilator requirement for 36 hours or more
-asphyxia
-prematurity
Term
What does TORCH stand for?
Definition
t = toxoplasmosis
o = other, such as syphylis; Hep B; Lyme disease; HIV
r = rubella
c = cytomegalovirus
h = herpes simplex type II
Term
what is a term used for intrauterine or early neonatal infections in the mother?
Definition
TORCH
Term
What is makes up the O in TORCH
Definition
syphylis; Hep B; Lyme disease; HIV
Term
What is the grading scale for Intraventricular Hemorrhage
Definition
1 - 4
Term
what is the most common IVH grade in infants < 32 weeks gestation
Definition
3 and 4
Term
40 – 60 % of children with this problem associated with CP have a neurodevelopmental abnormality identified within the first 3 years of life
Definition
Intraventricular Hemorrhage (IVH)
Term
What Grade IVH?

Hemorrhage in germinal matrix; minimal ventricular bleed
Definition
Grade 1
Term
What Grade IVH?

Bleed in 10-15% of intraventricular area
Definition
Grade 2
Term
What grade IVH?

Bleed in greater than 50% of ventricular area with distention
Definition
Grade 3
Term
what grade IVH?

Bleed extends into parenchyma; most severe
Definition
Grade 4
Term
What are the 4 suspected causes of IVH?
Definition
Suspected causes of IVH
-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 are the 4 related problems of a Ventilator Requirement of 36 hours or more
Definition
-inadequate lung inflation
-inadequate air circulation
-chronic lung problems
-incidence for cerebral palsy higher in infants with BPD than for other premature infants
Term
40-45% of VLBW babies sustain what?
Definition
IVH
Term
A fetus is Generally viable around how many weeks
Definition
26
Term
lung function for a fetus is complete by about how many weeks
Definition
28
Term
have reflexes and functional systems developed to full potential by 37 weeks gestation?
Definition
no
Term
what does APGAR assess
Definition
physical condition of the newborn
Term
what are the 5 signs accessed in APGAR?
Definition
hear rate
respiratory rate
muscle tone
reflex irritability
color
Term
what is the grading scale on APGAR
Definition
0 = Absent, limp, no response, or blue/pale
1 = slow, irregular, some flexion, grimace, half blue/pale
2 = normal, crying, normal flexion, cough/sneeze, all pink
Term
when is APGAR performed?
Definition
Done at 1 minute after the birth and again at 5 minutes
Term
Score of 8 or better at 1 minute = what on APGAR?
Definition
everything seems OK
Term
a Score of 3-4 on APGAR =
Definition
bag & mask ventilation to resuscitate
Term
For an infant needing resuscitation...how is the APGAR scoring performed?
Definition
scoring is repeated every 5 minutes until a score of greater than 6 is attained
Term
what are the 7 problems Associated with Prematurity
Definition
Asphyxia
IVH
Ventilator requirement and RDS
BPD
Feeding problems
NEC
PDA
Term
what are the 3 points that make up a pathological reflex
Definition
-Persists beyond when it should be integrated
-Reappears after having been integrated
-Absent when it should be present
Term
what are the 3 points that make up the Obligatory reflex:
Definition
-Dominates movement when it should have been integrated
-Individual is unable to volitionally change the response (decreased selective movement)
-Reflex becomes part of the motor learning process (it is learned, not integrated)
Term
What are the 2 ways pathological and obligatory reflexes can impact development?
Definition
-Postural reactions cannot develop fully
-Compensatory patterns will develop in the presence of primitive reflexes and in the absence of postural reactions
Term
What months are a Moro Reflex present?
Definition
28 weeks gestation – 5 months
Term
When is a positive Moro reflex acceptable in development?
Definition
28 weeks gestation – 5 months
Term
what months will you see a Asymmetrical Tonic Neck Reflex
Definition
(birth – 6 months)
Term
what months should you see a Symmetrical Tonic Neck Reflex?
Definition
(6 – 8 months)
Term
When should you see a Tonic Labyrinthine Supine Reflex
Definition
birth to 6 months
Term
is it good if you have a negative Optical Righting reflex at 6 - 12 months
Definition
No - you want a positive righting reflex at 2-3 months and older
Term
what months should you see a positive righting reflex?
Definition
2-3 months and older
Term
what months should you see a Labyrinthine Righting
Definition
2-3 months and older
Term
an abnormal persistent moro reflex can interfere with what
Definition
-Balance reactions in sitting
-Protective reactions in sitting
Term
an abnormal persistent ATNR reflex can interfere with what
Definition
-Feeding
-Bilateral & midline use of hands
-Rolling
-Development of crawling
Term
an abnormal persistent STNR reflex can interfere with what
Definition
-Ability to prop on arms in prone
-Attaining & maintaining hands-and-knees
-Reciprocal creeping
Term
an abnormal persistent TLR reflex can interfere with what
Definition
-Segmental rolling
-Come to sit from supine
-Prop on arms in prone with extended hips
Term
an abnormal persistent Positive support, flexor withdrawal, and extensor thrust
Definition
-Standing and walking
-Balance reactions and weight shift in standing
Term
Name this disease:

Nonprogressive but often changing impairment syndrome caused by nonprogressive defect, anomaly, or lesion of the developing brain

May occur before, during, or after birth
Definition
Cerebral Palsy
Term
What are the classification by Pattern of Motor Involvements for the flowing?

diplegia =
hemiplegia =
monoplegia =
tetraplegia=
paraplegia=
Definition
diplegia = whole body involved but LE’s more involved than UE’s
quadriplegia = whole body involved - trunk and extremities
hemiplegia = only one side of the body is involved
monoplegia = only one UE or less frequently one LE; very rare
triplegia = three extremities involved; often one UE spared
paraplegia = both LE’s involved; true form very rare; usually a diplegia with involvement of UE’s so mild it is not noticed
Term
what is the most common type of muscle tone classification for CP
Definition
Spastic CP
Term
What causes different types of CP
Definition
Damage in different parts of the brain
Term
What are the 4 general clinical manifestations for spastic CP
Definition
-decreased tone neck & trunk; increased tone in extremities
-excessive sustained muscle contractions with certain muscle groups tending to overpower others
-co-contraction occurs with voluntary effort and/or there is excessive stiffness as a compensatory strategy to control posture or prevent uncontrolled movement
-movements slow and labored but mostly accurate – small ranges of movement
Term
What are the 5 general clinical manifestations for 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 extreme with little control in midranges
-difficulty co-activating to get smooth reciprocal motion
-movement tends to be very asymmetrical and forceful
Term
Define this CP:

decreased tone in neck & trunk; and increased tone extremities
Definition
Spastic
Term
Define this CP:

excessive sustained muscle contractions with certain muscle groups tending to overpower others
Definition
Spastic CP
Term
describe this CP:

co-contraction occurs with voluntary effort and/or there is excessive stiffness as a compensatory strategy to control posture or prevent uncontrolled movement
Definition
Spastic CP
Term
define this CP;

movements slow and labored but mostly accurate – small ranges of movement
Definition
Spastic CP
Term
define this CP; global decrease in tone, proximal to distal
Definition
Athetoid CP
Term
define this CP

fluctuating muscle tone in extremities - very low to high
Definition
Athetoid CP
Term
Define this CP

movements occur between one extreme of range to the other extreme with little control in midranges
Definition
athetoid CP
Term
define this CP

difficulty co-activating to get smooth reciprocal motion
Definition
Athetoid
Term
define this CP

movement tends to be very asymmetrical and forceful
Definition
athetoid
Term
define this CP

muscle tone fluctuates from low to low normal – decreased muscle force generation
Definition
ataxic
Term
define this CP

disturbance in balance and kinesthesia - faulty sense of position in space
Definition
ataxic
Term
define this CP

may have tremor and dysmetria
Definition
Ataxic
Term
Define this CP:

movement disorganized due to unreliable proprioceptive and vestibular information
Definition
ataxic
Term
define this CP

movement away from midline is difficult because cannot control center of mass
Definition
ataxic
Term
what type of CP do many neonates/infants with CP start out in and later develop movement patterns of spasticity or athetosis
Definition
hypotonic
Term
define this CP

have difficulty generating, grading, and sustaining movement
Definition
hypotonic
Term
All types of CP present with some degree of
Definition
-Problems with neuromuscular control
-Musculoskeletal problems
-Respiratory problems
-Sensory/perceptual deficits
-Fine motor, gross motor, and oral motor
Term
what is the 2nd most common birth defect after Down’s syndrome
Definition
Myelomeningocele
Term
A birth defect in which the backbone and spinal canal do not close before birth?
Definition
Myelomeningocele
Term
What type of birth defect is this?

-Vertebral arch fails to close.
-The spinal cord herniates through the vertebral column resulting in injury to the spinal cord.
Definition
Myelomeningocele
Term
what determines the degree of loss of motor and sensory function in a baby with
Definition
The level of herniation and the resulting spinal nerve injury at that level
Term
what is the age to be considered a premature baby
Definition
less than 37 weeks
Term
how many weeks gestation is a baby viable
Definition
26 weeks
Term
what are the APGAR acronym
Definition
appearance
pulse
grimace
activity
resperation
Term
name this disorder associated with Myelomeningocele

herniation of part of the brain downward
CSF is blocked.
Definition
Arnold-Chiari malformation
Term
name this disorder

As brain tissue moves downward toward the foramen magnum brain tissue in other parts of the brain may be impinged resulting in various signs & symptoms: vocal cord paralysis, apnea, swallowing problems, UE weakness, spasticity
Definition
Arnold-Chiari malformation:
Term
name this disorder

-CSF is obstructed and accumulates, causing pressure on surrounding tissues
VP shunt (ventriculoperitoneal)
VA shunt (ventriculoatrial)
Definition
Hydrocehalus
Term
these are signs or symptoms of what?

Bulging fontanelle
High- pitched cry
Sun-set sign of the eye: indicates
raised intracranial pressure
Edema & redness along shunt tract
Definition
Infant Shunt Malfunction
Term
what are some common Orthopedic deformities (congenital and acquired)of Myelomeningocele
Definition
-club feet and other foot deformities -dislocated hips & congenital contractures, -deformities resulting from lack of movement, asymmetrical or absent muscle function, the force of gravity, and congenital predisposing situations, such as kyphoscoliosis
Term
After many years of catheterization and other medical procedures, a person with spinabifida has in increased chance of developing why type of allergy?
Definition
Latex
Term
The amount of involvement with Bowel & bladder dysfunction and genitourinary infections is determined by what?
Definition
The level of spinal cord involvement
Term
name this disorder:

fixation of the spinal cord in an abnormal location, usually associated with scar tissue
as the person grows, the spinal cord is stretched and distorted resulting in ischemic
Definition
Tethered cord
Term
name this disorder:

signs and symptoms = decreasing strength, new spasticity, back pain, changes in urological function, changes in coordination
solution is surgical release; may re-occur
Definition
Tethered cord
Term
How do you approach treatment with Myelomeningocele
Definition
Approach treatment in manner of
- a child with developmental delay and
- a child with a spinal cord injury
Term
How is the treatment type determined for Myelomeningocele
Definition
by the level of spinal cord damage and the presence of associated problems.
Term
what are the 4 Myelomeningocele Physical Therapy Goals
Definition

Prevent contractures and skin breakdown

Facilitate normal sensorimotor development

Increase indipendent mobility

Introduce compensatory stratagies

Term
What are 4 ways toPrevent contractures and skin breakdown with a patient with Myelomeningocele
Definition
ROM
positioning
age appropriate weight bearing
splinting
Term
how do you Facilitate normal sensorimotor development in a patient with a Myelomeningocele
Definition
Focus on facilitating functional mobility skills through the stages of mobility, stability, dynamic postural control, & skill (developmental sequence)
Term
What are some ways to increase mobility in a pt with mylomenocele
Definition
Introduce assistive technology, such as Orthoses Walking assistive devices Wheelchairs
Term
what are the 9 common problems associated with down syndrome?
Definition
Cardiovascular anomalies
Immune deficiency
Hearing loss
Visual defects
Orthopedic problems
Speech and language delays
Cognitive delays
Feeding problems
Cerebellar dysfunction
Term
what are the two most common cardiovascular abnormalities seen in down kids?
Definition
atrioventicular canal defect
ventriculoseptal defects
Term
immune deficiencies in down kids usually results in what?
Definition
Results in frequent respiratory and other infections
Term
what are 3 visual defects seen in down kids
Definition
Myopia
Stabismus
Cataracts – congenital & adult onset
Term
orthopedic problems in down kids is most likely secondary to what
Definition
generalized hypotonia and ligamentous laxity
Term
what is a common instability with down syndrome kids
Definition
atlantoaxial
Term
Down kids have Problems at hips, knees, and other joints causing a delay in developmental mobility. These joint problems happen why ?
Definition
ligamentous laxity and hypotonia
Term
when does a PT stop seeing down children
Definition
after early childhood except for specific problems such as a surgery or orthopedic problem – then on short-term basis
Term
what is the PT focus with a Down Syndrome infant?
Definition
head & trunk anti-gravity control
pre-mobility skills – with positioning, facilitated movement, and active movement
Postural responses
Parent/caregiver education for consistent carry over
Term
what is the PT focus with a Down Syndrome toddler or pre schooler?
Definition
Gaining quality of movement
Stability – proximal control
Motor planning and coordination
Endurance and strength
Locomotion – also needs proximal control and distal coordination
Term
what month on average will a down child roll over?
Definition
6 months
Term
what month on average will a down child sit?
Definition
9 months
Term
what month on average will a down child creep
Definition
13 months
Term
what month on average will a down child stand
Definition
16 months
Term
what month on average will a down child walk?
Definition
20 months
Term
what month on average will a down child talk?
Definition
14 months
Term
define this disorder?

Hereditary myopathy characterized by progressive muscular weakness, deterioration of muscle fiber, and replacement of muscle fiber with fibrous & fatty tissue
Definition
Duchenne Muscular Dystrophy
Term
name this disorder:

Weakness is symmetrical & progresses proximal to distal, hence the Gower’s sign
Definition
Duchenne Muscular Dystrophy
Term
What are the 3 PT goals for Muscular Dystrophy in phase one
Definition
Maintain strength in proximal muscles
Maintain flexibility
Good nutrition is important
Term
what are 3 early signs of MD seen in phase 1?
Definition
Delayed coordination
Slow, labored gross motor activities
Walking becomes slower
Term
what are two signs that a MD patient is in the 2nd phase?
Definition
Postureal changes:

-You Will see anterior pelvic tilt, wide base of support, shoulders & head arched to balance in standing

-Child moves using momentum and lateral sway rather than weight shifts
Term
What are the 5 PT goals for Muscular Dystrophy in phase two
Definition
Maintain muscle strength as long as possible BUT must avoid excessive fatigue that can damage remaining muscle fibers

Positioning becomes very important as child moves less: orthoses, adaptive seating, sleeping positions

Start considering alternative mobility and AD’s to conserve effort, although do want to maintain walking if no adverse effects are noted

Flexibility becomes an even greater concern as mobility decreases.

Scoliosis may begin showing, but usually is flexible at this point (stretching, positioning, and walking can help control it)
Term
what happens in Phase 3 of MD
Definition
Non - Ambulatory

May spend 90% of the 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
what are the 7 PT goals in Phase 3
Definition
Positioning
Scoliosis Bracing
Prevent shoulder subluxation
Active Joint Movement
Ambulation
Weight Control and Good Nutrition
Defining Assistive Technology
Term
what are the 4 broad goals that apply to most diagnoses
Definition
Prevent deformity or minimize deformity
Promote a variety of movement possibilities for that child
Increase function
Train caregivers to help accomplish goals 1,2, and 3
Term
these 4 problems are mostly seen in what disorder but not inclusive to

Proximal low tone and weakness masked by spasticity and excessive contraction or co-contraction in the extremities

movement restricted to midranges with predictable patterns, often seen as patterns of persistent reflexes

incomplete righting, equilibrium, and protective reactions secondary to limited range of movement
very high risk for orthopedic

deformities secondary to muscle shortness, joint contractures, and spasticity
Definition
SPASTICITY (HYPERTONIA)
Term
what are the 4 spasticity treatment objectives?
Definition
increase sustained control of postural muscles while decreasing excessive contraction

increase range of joint movement

avoid reflex stimulating positions

avoid static postures

help to accommodate changes in speed and direction
Term
these 4 problems are mostly seen in what disorder (not inclusive)

decreased proximal control and ability to co-contract around joints
Definition
HYPOTONIA
Term
what are the treatment objectives for hypotonia?
Definition
facilitate functional head and trunk alignment and static control, especially stability around joints

increase ability to move anti-gravity
Term
These are two problems of what disroder?

lack of sustained co-contraction and proximal stability

asymmetrical posturing and movements, often as an attempt to stabilize
Definition
ATHETOSIS
Term
Name This Disorder

uncontrolled righting and equilibrium reactions
persistent early reflexes
difficulty with selective control of head, eye, jaw, and arm movements
Definition
ATHETOSIS
Term
What are the treatment objectives for ATHETOSIS
Definition
increase sustained proximal control with emphasis on gaining and maintaining midline control
improve ability to hold postures while controlling symmetry of extremity movement away from midline
improve ability to time and grade muscle contraction
provide support to some areas of the body to encourage controlled movement in other areas
Term
name this disorder:

jerky, disorganized movements with impaired force and power output
poor coordination and sequencing of movement
poor sense of position in space
Definition
Ataxia
Term
name this disorder:

decreased movement away from midline secondary to poor equilibrium; therefore movement options limited
mild hypotonia with fluctuations toward normal tone
Definition
ATAXIA
Term
What are the treatment strategies for Ataxia
Definition
increase proximal muscle control using sustained, deep somatosensory input and visual cueing to build stability

work on transitions while giving guidance for initiation and increased excursion of movement

emphasize building eccentric control followed by shifts between eccentric and concentric muscle contractions
Term
What are the goals for positioning?
Definition
Prevent skin breakdown
Minimize contractures and improve alignment
Provide a stable position while allowing active movement where active movement is possible (dynamic positioning)
Allow interaction with the environment
Provide a position for relaxation (static positioning)
Term
4 Negative effects of staying in a position for too long:
Definition
skin breakdown
contractures
boredom & discomfort (leads to negative behaviors)
learned helplessness
Term
What are the 3 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 needed, and encouraged to come toward midline
Term
recommended positioning of pelvis and hips in prone
Definition
pelvis in line with trunk
hips at 30 to 90 degrees of flexion
neutral rotation of pelvis
hips symmetrically abducted 10 to 20 degrees
Term
recommended positioning of trunk in prone
Definition
trunk straight
shoulders in line with hips
neutral rotation of trunk
Term
what does FAPE stand for
Definition
free appropriate public education
Term
what ages qualify for FAPE
Definition
to children 6-21 or 5-21 in states where 5 years was the age to enter public school
Term
what does IEP stand for
Definition
individualized education program
Term
define "least restrictive environment":
Definition
to the maximum extent possible... children are educated with their non-disabled peers
Term
what does IDEA stand for?
Definition
Individuals with Disabilities Education Act
Term
what is the difference in part B and C of IDEIA?
Definition
Part C children ages birth-3

Part B children ages 3-21
Term
according to the ECI model where should therapy take place?
Definition
Home based with family as focus; child’s “natural environment
Term
what is the goal of the ECI model?
Definition
Goal: promote development and learning while providing support to families
Term
what is an IFSP and what model is it apart of?
Definition
Individualized Family Service Plan = IFSP
Term
in general who is eligible for the ECI model?
Definition
Eligibility: developmental delay; atypical development; many medical diagnoses; high probability for eligibility
Term
what are the primary services in the ECI model?
Definition
PT and OT
Term
Who is apart of the decision-making team in the ECI model
Definition
OT, PT Speech, social work, family, educator
Term
when and how long do you see a child in the ECI model?
Definition
1-2 times per week to monthly
for
Duration: 1 time to up to turning age 3
Term
what does a patient need to to receive treatment in the ECI model
Definition
physician referral
Term
what is the goal of the school based model
Definition
Goal: to assist in accessing the educational setting to overcome barriers for positive educational outcomes
Term
how is the decision made for services in the school model?
Definition
based on multi-disciplinary evaluation to determine if the child has a disability and needs special education or related services
Term
who develops the IEP in the school model?
Definition
Team develops Individualized Education Program – IEP
Term
where is the IEP presented in school model?
Definition
presented at an ARD (Admission, Review, & Dismissal meeting)
Term
what does ARD stand for?
Definition
ARD (Admission, Review, & Dismissal meeting)
Term
in what model is the PT and OT considered related services
Definition
School Model

Related services = “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
2collaborative, integrative
Direct
Consultative
Monitoring
Training to instruction personnel
Term
what is the frequency of treatment in the school model?
Definition
Variable
Term
what does a patient have to have to be treated in the school model?
Definition
physicians referal
Term
what two things MUST have a direct relationship in the school model?
Definition
PT intervention/goals and Instructional outcomes
Term
who determines what the "least restrictive environment" is in the school model?
Definition
the educational agency and parents
Term
what is the ARD time spent on?
Definition
Time is spent on behalf of the student
Term
how can Strength, flexibility, endurance, and weight control can be addressed with a child with a movement disorder?
Definition
Through play
Term
What is sensory integration (SI)?
Definition
neurological process that organizes sensation from one's own body and from the environment
Term
define praxis
Definition
the ability to understand what needs to be done, plan how to do it, and get it done

(or planning and organizing behavior)
Term
At birth, a child's actions are primarily what?
Definition
Reflexive
Term
As a child matures what becomes increasingly important and are integrated with the other sensory systems.
Definition
the auditory and visual systems
Term
what early sensation systems are used to organize movement and contribute to the development of muscle tone, automatic reactions, body scheme, and motor learning.
Definition
Tactile, proprioceptive, and vestibular systems
Term
what is the concept of plasticity?
Definition
The CNS can be changed or be modified
Term
Does the CNS system function as a whole or in segmental parts?
Definition
The CNS functions as a whole with multiple interacting systems
Term
Learning function of the brain is dependent on what 3 things?
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
How would you define this sensory reponse?

a response that matches the demands of the task

purposeful and goal directed result from sensory input
Definition
Adaptive response
Term
Utilizing opportunities for enhanced sensory integration improve what 3 things?
Definition
-ability of the nervous system to process and integrate sensory input.
-ability to interact with the environment.
-enhance adaptive skills and competence.
Term
Disorganized processing of sensory information results in
Definition
inadequate, excessive, or inaccurate information from muscles, tendons, & joints
Term
dyspraxia causes dysfunction in what 4 areas of movement?
Definition
- The awareness of a need to accomplish a task
- The concept of how to go about doing the task (ideation)
- The internal plan devised (ideomotor) based on body schema and past experience
- The Ability to carry out the plan
Term
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
- Later in development, hyper or hypo responses to visual, auditory, olfactory, and gustatory
Term
what are 3 characteristics of Disorders of sensory discrimination
Definition
-Failure to interpret the characteristics of sensory stimulation
- Dysfunctional responses
- Often associated with hyporesponsivenes
Term
What are some of the results of a Sensory Integrative Dysfunction
Definition
disorganized behavior
poor attending & concentration
arousal disregulation (decreased or increased)
emotional lability
difficulty in learning
immature or inappropriate social skills
clumsiness and slow reactions
difficulty manipulating things in the environment
difficulty coping with the environment
Term
What is the therapists role in modifying the environment when working with sensory dysfunction?
Definition
Use sensory systems to help increase or decrease alertness and arousal
Carefully increase stimulation from the environment
Initially provide visual & auditory assists
Offer limited choices by structuring the environment
Use spontaneous movement
Use real life situations
Term
What is the purposes of The Proprioceptive System?
Definition
Gives information about the body positions in space

Develops through weight bearing and movement and is Critical in maturation of reflexes, particularly righting and equilibrium responses.
Term
What 10 things might you see in Hyporesponsiveness to Proprioceptive
Definition
appear clumsy – stumble & bump into things 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 are the 3 purposes of the vestibular system in sensory integration?
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 Two types of vestibular dysfunction when it comes to sensory intergration?
Definition
hyporeactivity (hyporesponsiveness) to vestibular input
hyperreactivity (hyperresponsiveness) to vestibular input
Term
what are 6 clinical manifestations might see with Hyporesponsiveness to Vestibular
Definition
-decreased autonomic responses to vestibular stimulation
-appear clumsy - stumbling & falling more than other children
-decreased antigravity extension & flexion and decreased control of postural adjustments
-poor eye/head coordination
-decreased altertness/arousal
-seek a great deal of movement experience – more than the typical child
Term
what are 4 treatment option considerations when working with a child with Hyporesponsiveness to Vestibular
Definition
-Utilize hanging equipment in conjunction 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 5 clinical manifestations might you see in a child with Hyperresponsiveness to Vestibular
Definition
-gravitational insecurity: extreme fearfulness with changes in head and body position even when adequately supported (differentiate from "posturally unstable")
-fear everyday, generic movement experiences
-unusual fear of falling, heights, backward movement
-unexpected/exaggerated autonomic responses to rotation and linear movement (vertigo, nausea, vomiting)
-Increased alertness/arousal
Term
what are 4 treatment option considerations when working with a child with Hyperesponsiveness 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 and only progress to rotary movement when the child has begun to utilize linear input more appropriately
-monitor delayed effects of vestibular input (Is the child okay when he leaves and what effects were there an hour later?)
Term
when working with sensory intergration problems what activities should you start with first?
Definition
Start with Most Tolerable Activity
and Progress to More Movement
Term
what are the 5 purposes of The Tactile System
Definition
-alerts the person to danger (protection)
-gives information about the immediate surroundings (discrimination)
-guides the exploration of the environment
-assists in developing body scheme
-associates with emotions via the limbic system
Term
what are the two types of dysfunction in the tactile system?
Definition
-hyporesponsiveness to tactile input (poor tactile descrimination)
-hyperresponsiveness (tactile defensiveness) to tactile input
Term
what are 6 clinical manifestations you might see in Hyporesponsiveness to Tactile
Definition
-decreased awareness or reaction to touch, pain, temperature
-poor touch discrimination (e.g. stereognosis, 2-point discrimination)
-poor manipulation skills
-under reaction to bumps, falls
-seeks /craves touch experiences
-decreased body scheme
Term
what are 4 treatment option considerations when working with a child with 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 are 6 clinical manifestations you might see in Hyperesponsiveness to Tactile
(tactile defensiveness)
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 of fingertips to manipulate objects
Term
what are 4 treatment option considerations when working with a child with Hyperresponsiveness to Tactile (tactile defensiveness)
Definition
-encourage activities in which the child applies tactile input to himself
-start with deep touch not light touch
-incorporate touch into basic activities that the child can enjoy, perhaps a distraction
-use proprioceptive input along with the tactile to make it more tolerable
Term
Treatment often results in a ___________ of stimuli targeting several systems. Activities may target proprioception, tactile, and vestibular all at once.
Definition
Combination
Term
The ultimate goal of sensory integration treatment is to what?
Definition
use this information in successfully planning and carrying out a meaningful activity -- praxis
Term
Sensory processing (sometimes called "sensory integration" or SI) is a term that refers to the way the nervous system receives messages from the senses and turns them into what?
Definition
appropriate motor and behavioral responses.
Term
What does SPD stand for?
Definition
Sensory Processing Disorder
Term
what is a Sensory Processing Disorder
Definition
a condition that exists when sensory signals don't get organized into appropriate responses
Term
what does a person with SPD find it difficult to do?
Definition
process and act upon information received through the senses
Term
In children whose sensory processing of messages from the muscles and joints are impaired what can be affected?
Definition
posture and motor skills can be affected
Term
Children with Sensory Processing Disorder often have problems with motor skills and other abilities needed for what?
Definition
school success and childhood accomplishments
Term
How are children with Sensory Processing Disorder (SPD) treated
Definition
In a sensory-rich environment to foster appropriate responses to sensation in an active, meaningful, and fun way so the child is able to behave in a more functional manner.
Term
What does BPD stand for
Definition
Bronchopulmonary dysplasia
Term
What is BPD?
Definition
Most common lung disease from the immaturity of infants lungs
Term
Define (ideation)
Definition
The concept of how to go about doing the task
Term
what helps regulate vestibular and tactile input
Definition
Proprioception
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