top-down and bottom-up approach – Flashcards
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top-down goal
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is to maximize person's intact and remaining skills
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bottom-up goal
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recover underlying skills
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bottom-up assumptions
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is person will be able to generalize skills to OP which are at higher level; fix the cause and the problem goes away
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Top-down assumption
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person will be able to master the tasks necessary for OP
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Bottom -Up major therapeutic approaches
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-remedial -restorative -retraining -rehabilitative
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top-down major therapeutic approaches
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-adaptive -compensatory -rehabilitative
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bottom-up the approach to therapy
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direct attack on the assumed cause of the problem
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Top-down the approach to therapy
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indirect attack on the cause but a direct attack on attaining functional performance however attained
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bottom-up assumes
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the cause should be addressed
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top-down assumes
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OP should be addressed
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bottom-up assessment is focused
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on identifying the cause
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top-down assessment is focused
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on identifying the type and level of OP
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bottom-up intervention
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is at the level of impairment
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top-down intervention
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is at the level of disability
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bottom-up purpose
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is to rectify problem in subcomponents of performance
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top-down purpose
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is to achieve function, mastery or competency and to neutralize the effects of impairment
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bottom-up therapist assumes
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the brain can repair itself by establishing new neural connections
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top-down therapist assumes
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the brain cannot repair itself (degenerative disorder) or the effort involved in not cost effective
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bottom-up focus
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is on recovery of lost capacities of the development of alternative functions
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top-down focus
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is on being able to perform roles and tasks needed or cin the brain, environment, by whatever means available
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bottom-up
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uses micro perspective of the person, environment and task
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top-down
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uses macro perspective of the person environment and task
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bottom-up tends to be
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more mechanistic (reductionism)
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top-down tends to be
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more organismic (expansive)
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bottom-up approach can be viewed
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as time consuming, unresponsive to immediate needs
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top-down approach can be viewed
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as putting a inefficient, and "band aid" on the problem and too quick to "go with what you got"
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top-down models and frames of reference
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-Canadian model of occupational and performance -contemporary task oriented -ecology of human performance -model of human occupation -person environment occupational performance
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bottom-up models and frames of reference
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-biomechanical -cognitive disabilities -neurodevelopment treatment -proprioceptive neuromuscular facilitation -sensory integration
