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Occupational Behavior focus

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Prevent/Reduce disruptions in occupational behavior that result from injury or illness. *Childhood play->WORK Productive activity in adulthood*

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Occupational Behavior author

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Mary Reilly

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Occupational Behavior theoretical base

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Man has need to master, alter, and improve his environment. Clients show capacity for self-direction and self-actualization. What is meaningful and interesting to client to motivate them?

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Occupational Behavior function

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Person can seek and engage in occupation to personal and societal satisfaction.

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Occupational Behavior disability, defined

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Person suffers from lack of occupational fulfillment, competency, achievement.

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Occupational Behavior change

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Person's intrisic drive toward mastery is greatest driver of change

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Occupational Behavior motivation

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Person must find something rewarding and meaningful about process

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Occupational Behavior evaluation

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no formal assessment tools

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Occupational Behavior interventions

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use of occupations to promote adaptation and life satisfaction

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MOHO

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Model of Human Occupation

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MOHO focus

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Importance of mind/body connection in describing how motivation and performance of occupations are interconnected. Human occupation="doing" Open System Cycle

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MOHO author

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Gary Kielhofner

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MOHO theoretical base

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Humans are biologically mandated to be active. Spontaneous action is the most fundamental characteristic of all living things. Human is open system. Input, throughput, output, feedback. Clients learn about themselves by experimenting with behaviors and receiving feedback about this behavior (output)

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MOHO Function

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uses the word "order" to describe function. A person is able to choose, organize and perform occupations.

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MOHO disability, defined

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"disorder"-inability to perform occupations. Helplessness. Incompetence. Inefficacy.

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MOHO change occurs

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Any shift in the open system cycle will result in change in overall system

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MOHO motivation

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Person's interests, values, and personal causation (volition subsystem)

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MOHO Evaluation

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Client-centered assessment. Observations, self-reports, questionnaires, checklists, interviews

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MOHO intervention

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enhance open system cycle to encourage adaptive performance

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OA

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Occupational Adaption

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OA focus

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Interaction between person and his environment. Occupations Adaptive Capacity Relative Mastery OA Process

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OA author

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Schkade & Schulz

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OA theoretical base

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When a person responds to occupational challenge, one's internal adaptation process is auto re-enacted. (internal process) Person influenced by 3 systems: sensorimotor, cognitive, and psychosocial.

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OA function

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person able to engage in occupations within a specific environment w/ sense of mastery and accomplishment

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OA disability, defined

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Persons ability to adapt has been challenged to point performance demands are not satisfactorily met

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OA change occurs..

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Client report of improved mastery Observation of client and adaptive responses initiation of adaptations not previously seen

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OA Motivation

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Influenced by desire for mastery, demand for mastery and press for mastery

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OA Evaluation

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Determine strengths and weaknesses Analyze role expectation Evaluate client's capacity to perform Utilize standard OT assessments to determine one's ability for internal adaptation.

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OA Intervention

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NO specific. "Facilitate the client's ability to make his own adaptations"

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EHP

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Ecology of Human Performance

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EHP focus

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Developed for use by various disciplines-not just OT. Role of context in task performance Person Tasks (occupations) Context (environment)

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EHP author

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Winnie Dunn

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EHP Theoretical base

answer

Ecology: interaction between persons and their environment Persons use their skills and abilities to "look through" the context and select the preferred tasks. Performance range (number and types of tasks available) is determined by interaction b/w person's variables( skills, abilities, motivations) and the context variables (supports & barriers). Everyone is individual with unique skills and abilities within the areas of sensorimotor, cognitive, and psychosocial.

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EHP function

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Persons have a high performance range of tasks

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EHP disability defined

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Incongruency between within the transaction between person, context and task

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EHP change occurs..

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Person is the "agent of change"-capacity to be primary decision-maker Therapist can adapt task or the environment

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EHP motivation

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Asking person what he wants or needs

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EHP Evaluation

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Checklists Sensory profile

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EHP Intervention

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Establish/Restore Alter Adapt/Modify Create

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PEOP

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Person Environment Occupation Performance (Canadian model)

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PEOP Focus

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Focus on occupations and performance Occupations Performance Person Environment

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PEOP author

answer

Christiansen & Baum

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PEOP Theoretical base

answer

People need adequate emotional maturity and problem-solving ability to set and meet goals that will satisfy their needs over a life-span.1. Person 2. Unique Environment 3. Occupations. Disruption in any of these components can lead to negative outcome in performance. Person, rather than on disability

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PEOP function

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Person expresses level of competency in his ability to perform and master occupations

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PEOP disability, defined

answer

Person's occupational performance is limited and restricted

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PEOP change occurs..

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clients are more likely to persiste through change if they perceive their occupational performance as competent & meaningful. Client needs to experience success to reinforce the process.

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PEOP motivation

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Person's innate desire to explore his environment and demonstrate mastery in it (human agency) needs to be activated.

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PEOP evaluation

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top-down approach. (Canadian Occupational Performance Measure) Occupational Self Assessment Activity Card Sort Interest Checklist Role Checklist

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PEOP Intervention

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Appreciate restorative benefits Recognize role of environment Structure occupations for meaningful participation & mastery Enhance role functioning through sill development

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Frames of Reference

answer

define the populations. Describe continuum of function and dysfunction Provide assessment tools Describe treatment modalities Describe intervention techniques Define role of practitioner Suggest outcome measures

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FOR used in practice

answer

evidence based practice, Use when evaluating client's progress toward established goals. When not successful, another FOR should be used

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FOR considerations

answer

Practice setting Need for consistency of treatment Time frames Condition/prognosis/age

question

Lifespan Development-Development FOR

answer

sample pops: Down syndrome Intellectual Disability Failure to Thrive Cerebral Palsy Pervasive development disorder

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Development FOR Treatment/Intervention

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Identify current level of fnx. Work on next step to achieve skill. Practice, repetition, education, and modeling of skills.

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Biomechanical FOR

answer

Sample Pops: Children with cardic concers Brachial plexus Cerebral Palsy Juvenile Rheumatoid Arthritis (JRA) Down syndrome

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Biomechanical FOR Treatment/intervention

answer

Strength-increase weight of toys or repetitive use Endurance- increase time engaged in occupation ROM-repetitively provide slow sustained stretch to increase end range

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Sensory Integration FOR

answer

Sample Pops: Sensory Integrative dysfunction Developmental coordination disorder Sensory Modulation disorder Pervasive Developmental disorder

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Sensory Integration FOR Treatment/intervention

answer

Provide controlled sensory input. Suspension equipment and "Just right challenge" Provide activities that are Child directed

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Motor Control FOR

answer

Sample Pops: Cerebral Palsy Developmental coordination disorder Down Syndrome

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Motor Control FOR Treatment/Intervention

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Task oriented approach: children learn best by repetition in most natural setting, varying requirements. Children learn from their motor mistakes

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Neurodevelopmental FOR

answer

Sample pops: cerebral palsy traumatic brain injury

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Neurodevelopmental FOR Treatment/Intervention

answer

handling techniques and key points of control to inhibit abnormal muscle tone and facilitate normal movement patterns. Learn through feeling normal patterns and thus should not make motor mistakes

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MOHO FOR

answer

Sample pops: All diagnosis/conditions

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MOHO FOR Treatment/interventions

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Human is an open system Volition drives system OT intervenes to facilitate engagement in occupations.

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Rehabilitation FOR

answer

Sample pops: Acquired brain injury Trauma Stroke

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Rehabilitation FOR Treatment/Interventions

answer

Regain function for independence in occupations Help children practice and improve strength, ROM, endurance

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Psychosocial FOR

answer

collaborating with child, family, health care team, or educational team. Capitalizes on child's psychological, social and behavioral strengths to determine intervention planning.

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Cognitive Behavioral Principles

answer

How one thinks and how one believes influences behavior and emotions. A change in thinking can lead to an improvement in function and reduce emotional distress. Basic core and conditional beliefs are learned and become the personal rules that guide life. Focus on present problems Individual/group therapy focus on specific condition

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Cognitive Behavioral Strategies

answer

Identify patterns of thinking and how they affect feelings and behavior Cognitive restructuring/reframing thinking Self monitoring and self talk Stress reduction skills Problem solving skills to address client identified problems. Hwk to consolidate and transfer learning beyond therapy setting

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Skill Acquisition Principles FOR

answer

emphasizes learning. Develop, modify, and regine specific skills through instructional methods such as role play, practice, groups, modeling, feedback and generalization of skill performance.

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Behavior Modification

answer

changes or develops behaviors required for occupational performance interventions follow strict protocols. Targeted at specific behavior to be shaped, changed or developed Increase desired behaviors with rewards. Intermittent reinforcement strengthens a behavior. Teach, demonstrate and practice behavioral strategies.

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Psychoeducational Group Therapy

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Share info along common focus from experiences and knowledge of group members.

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Applied Behavior Analysis (ABA)

answer

systemic and individualized strategies for achieving social and learning outcomes. Goal: preventing problem behavior A: Antecedent B: Behavior C: Consequences If problems can be prevented they can be prevented all behaviors have a purpose for child Challenging behaviors are symptoms. Learning new skills takes time.

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Coaching Model

answer

children will be more successful at reaching goals that they develop themselves Children will learn life long strategies through setting goals and take steps toward meeting goals successfully Child directed model. OT provides directions, support, advice and strategies.

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Motor Control definition

answer

Ability to regulate or direct the mechanisms essential to movement. How central nervous system organizes movement how we quantify movement the nature of movement

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Common conditions with Motor Deficit

answer

Cerebral Palsy Developmental Coordination Disorder (DCD) Pervasive Developmental Disorder Down Syndrome Sensory Integration Disorders Acquired brain injuries

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Dynamical Systems Theory (Movement is dependent on)

answer

task characteristics & Interaction among systems (individual, task, environment)

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Dynamical Systems Theory dysfunction occurs..

answer

When flexibility or adaptability of movements is limited and can not accommodate task demands or environmental contraints

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Dynamical Systems Theory

answer

Degrees of freedom Synergistic movement Attractor State

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Application to OT Dynamical Systems Theory (how children learn)

answer

Movement is taught as a whole (versus part) Movement performed in variable situations Child allowed to actively problem solve the actions required Activity is meaningful to child

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Dynamical Systems Theory (Whole learning)

answer

entire task is more effective than learning part of task Whole-task activities require child to use multiple systems

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Dynamical Systems Theory Variability

answer

Requires children adjust their movements Essential to functional movement Performing movements in multiple requires children problem solve and self-correct (reinforces learning)

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Development of Motor Control

answer

3 stages: Cognitive Associative Autonomous

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Development of Motor Control Cognitive

answer

Skill acquisition -errors are common and movement is inefficient requires practice, reps and feedback

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Development of Motor Control Associative Stage

answer

Skill refinement increased performance, consistency, and efficiency decreased erros

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Development of Motor Control Autonomous Stage

answer

retains skills and performs functional movement skills are transferred to different settings and refined

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Factors affecting motor performance

answer

Social-emotional factors (learn best when challenged at level where success is achievable) Physical factors that can impair movement (limited ROM, hypotonicity/hypertonicity, strength limitations)

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Dynamical Systems Theory-->Balance

answer

Static balance balance when moving equilibrium vestibular, proprioceptive/somatosensory, visual. Postural reflexes (primitive reflexes, righting, equilibrium)

question

Balance control issues in children with DCD

answer

vision and proprioceptive delays in visual perception difficulty integrating proprioceptive or vestibular inputs intersensory organization

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Improving Balance Intervention Primary components

answer

static and dynamic balance use vision, provide visual support, practice without vision change external base of support (wide to narrow, rigid to compliant, stable to unstable, flat to tilted or inclined)

question

Improving Balance Intervention secondary components

answer

use body position to challenge balance change internal BOS through elevation

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Vision, Visual Perception and Motor Control

answer

Theoretical perspective (eye movement control) Body awareness (body scheme, body image) Laterality, sensory dominance, hand dom, body part identify, left/right, directionality, spatial awareness, object to object

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Motor Learning

answer

transfer of learning best when practiced in natural setting sequencing and adapting tasks (discrete tasks easier to accomplish than continuous tasks) closed tasks

question

Closed tasks

answer

the environment is stationary during task performance

question

Motor learning practice levels and types

answer

massed practice (blocked) distributed practice variable or random mental

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Motor Learning Error-based learning

answer

children learn by making errors encourage children to explore, adjust, and evaluate their performance

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Motor Learning concepts

answer

practice and feedback modeling and demonstration mental practice

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Dynamical Systems Theory components of movement

answer

postural control balance visual perception body awareness

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