Term
| Impairment level of intervention |
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Definition
| determine key impairments affecting activity/participation |
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Term
| Activity level of intervention |
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Definition
| learning or relearning tasks |
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Term
| Participation level of intervention |
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Definition
| supporting people in "what they do", normal routines and activities |
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Term
| Internal resources of learning skills |
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Definition
| (within patient): body systems, internal feedback recognition, motivation, attn, cognition/memory, process and organize info, ability to generalize info to new situations/limitation |
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Term
| External resources of learning skills |
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Definition
| (provided by PT, env't): feedback (verbal, manual cues), practice env't, provide assistance as needed (manual, biomechanical), routines and expectations |
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Term
| Basis of learning should be... (3 things) |
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Definition
1. selecting tasks that are age-appropriate, relevant to the dx and cognitive/physical capabilities of the pt, and work towards the goals/outcomes of the intervention
2. PRACTICE and EXPERIENCE! learning new skills should be incorp. & practiced during routines and everyday activities.
3. meaningful and important to person and family |
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Term
| Neurofacilitation approach to learning |
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Definition
| focus on the "how" of the mov't and give components that are missing thru tactile cues (manual guidance, brushing, and tapping); emphasis on using TOUCH in a specific way to facilitate organization of mov't and provide answers on "how" to move; focus on DEFICITS (missing components); focus on KINEMATICS OF MOV'T (how it looks); framework used is "normal" mov't (what looks right from kinematic perspective) |
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Term
| Examples of "neurofacilitation" approaches |
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Definition
| Bobath (hand placement, kinematics) or NDT, Rood (brushing/tapping in SCI pts), Brunnstrom (stages of recovery in arms/legs post stroke), PNF, sensory integration (system overload) |
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Term
| Goals of neurofacilitation model |
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Definition
1. integrate primitive reflexes
2. inhibit abnormal tone (dec/inhibit hypertonicity; inc low tone/hypotonicity)
3. facilitate normal reflexes and rxns |
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Term
| Neurofacilitation approach assumptions |
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Definition
| normal muscle tone or postural control is basis of all mov't; brain controls mov't not muscles; disordered mov't associated w/ CNS not weakness/paralysis of indiv. muscles; abnormal mov't from lesion not pt's compensation; sensory stim by PT directly accesses CNS and produces lasting effects; recovery from brain damage follows predictable sequence that mimics normal motor development |
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Term
| Criticisms of neurofacilitation approach |
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Definition
| mov't is gen. internally and not as result of sensory stim cues; mov't emerges from interactions of systems and adapts to constraints of the env't; mov't must be self-initiated to develop skill; learner is integral part of learning a skill |
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Term
| Contemporary approach to learning |
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Definition
| task-oriented, fxnal, ecological (natural env't), routines-based, coaching; focus on END-GOAL and person organizing own mov't and generating own sol'tns (PT role is to set up activities that help generate variability/flexibility of sol'tn); focus on finding MOTIVATING activities, safe env't and practice conditions, task analysis, least amt of assistance needed to engage in task, address impairments IN task activity; focus on activity and participation |
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Term
| Task-Oriented approach to learning (aka Systems/fxnal approach) |
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Definition
| new model that PTs are moving toward; multiple factors contribute to mov't; mov't is goal-directed and overall aim of therapy is to improve person's fxnal ability during goal-oriented tasks; focus on DEVELOPING HIGHEST POSSIBLE SKILL LEVEL for that person instead of improving performance; PTs will structure sessions, use feedback, and modify env't/task as needed; REPETITION/INTENSITY are crucial; resolve, reduce, or prevent impairments |
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Term
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Definition
| policies, philosophy of learning, theories exposed to |
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Term
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Definition
| planning session around learning activities, remediation or compensation for impairments, selection of "procedural" interventions to assist in learning tasks or remediation of impairments; selection of equipment for assistance in learning task |
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Term
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Definition
| an individual's ability to consistently achieve a goal under a wide variety of conditions |
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Term
| Characteristics of skilled mov't |
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Definition
| task-specific, meet demands of task, able to achieve under variety of env'ts, variable and adaptable, performed w/ min energy expenditure, consistent in performance, performed w/ optimum biomech. and physiologic efficiency, able to complete task automatically (w/o having to conc. on each mov't) |
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Term
| Motor learning definition |
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Definition
| Set of internal processes associated w/ practice or experience leading to a relatively permanent change in the capability for motor skill |
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Term
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Definition
| inferred by observing changes in skilled mov't relative to some baseline performance (mov'ts become smoother, more skilled and accurate) |
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Term
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Definition
| memory of factual knowledge; what can be "verbalized" about the mov't; cognitively driven choices related to mov't |
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Term
| How does motor learning occur in children? |
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Definition
| practice, exposure to various env'ts, random, PT sessions |
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Term
| What is the single most important variable for motor learning? |
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Definition
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Term
| 3 types of service delivery models of intervention |
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Definition
1. direct therapy
2. monitoring
3. consultation |
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Term
| Direct therapy characteristics |
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Definition
| (i.e. see pt 3x/week for 2 mo.) includes initial exam, det. of approp. goals and intervention procedures, training other team members (including family), det. of appropriateness of procedures and revises where necessary |
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Term
| Direct therapy indications/limitations |
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Definition
Indications: meet child's individualized needs (1 on 1 teaching) thru use of specialized intervention to improve child's skill and fxn.
Need to consider where to hold therapy to meet needs of child/family.
Limitations: families may become DEPENDENT ON SERVICES (PT) and have difficulty transitioning to other service delivery models when appropriate. |
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Term
| Monitoring characteristics |
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Definition
(i.e. follow child over time but not necessarily directly; once a mo.; ongoing)
therapist is responsible for dev. intervention plan to meet child/family needs and is responsible for the outcome, however, someone else implements the program (parent, teacher, etc.) |
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Term
| Monitoring indications/limitations |
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Definition
Indications: specialized procedures not needed and another person/group/setting is available to carry out intervention program.
Need to consider what is most approp. way to carry out plan (special rec, playgroup, home prog.,etc.) and how often need to check in w/ child/family |
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Term
| Consultation characteristics |
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Definition
(have specific purpose, i.e. equip check, screening for dev. delay)
consult w/ child/family/another health care professional to discuss needs of child/family (usually specific to setting - i.e. what child needs to participate in school or community); less frequent contact w/ child/family (may be one time only) |
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Term
| Determination of frequency |
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Definition
MORE IS NOT ALWAYS BETTER: need to adequately meet goals, more therapy may mean less time for other opportunities for learning and participation and peer interaction, can be overwhelming if many professionals involved in care, can create unnecessary dependencies.
GOAL: find approp. amt and type of service delivery to achieve goals for child/family |
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Term
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Definition
| ALL ACTIVITIES SHOULD BE INCORPORATED INTO CHILD'S ROUTINES AND DAILY ACTIVITIES!! |
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Term
| Multidisciplinary team model |
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Definition
| professionals work INDEPENDENTLY in their own domains; each applies the expertise and techniques of their discipline in isolation from other disciplines while working concurrently w/ a child/family; little to no communication occurs among professionals |
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Term
| Interdisciplinary team model |
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Definition
| professionals from various disciplines work COOPERATIVELY in both planning and delivering services to child and family; emphasis on TEAMWORK AND INTERACTION AMONG TEAM MEMBERS who help and rely on each other to provide well coord., integrated services for the indiv. although each discipline ultimately delivers the services in its own domain; families considered integral part of team |
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Term
| Transdisciplinary team model |
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Definition
| professionals from various disciplines work together cooperatively by education one another in the skills and practice of their disciplines so that ONE TEAM MEMBER can act as the SINGLE AGENT for carrying out services w/ child/family |
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Term
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Definition
| interactive process of observation, reflection, and action in which a coach promotes, directly and/or indirectly, a learner's ability to support a child's participation in family and community contexts OR mutual conversation b/t service provider and parent about child growth and development, specific intervention strategies, enhancement of skill development w/in capacity of child w/ disability |
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Term
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Definition
| ensures focus is on supporting child's participation in family and community life and not just what therapy services they need; identifies learning opportunities and strategies for the child and "teachable moments" for the parents; coach is knowledgeable about child development, adult learning, and building relationships (individualizes info and resources for each learner/parent); shares characteristics w/ mentoring, teaching, and tutoring |
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Term
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Definition
| reciprocal learning (coach and family); observe family routines and chooses action (hands-on strategies); reflect w/ family on how well implemented strategies are addressing concerns/needs of child; based on info that learners are self-directed problem solvers that learn best when they can relate new info to past experiences |
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Term
| Learning by parents influenced by: |
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Definition
| motivation, respectful env't, past/current experiences, achieving self-direction and active involvement, learning styles/coping strategies, critical/reflective thinking, transition time to integrate new ideas |
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Term
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Definition
1. recognize what family is already doing that promotes learning of child
2. create on-going learning experiences
3. assist/support parent in increasing child's participation in family and community life |
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Term
| General coaching skills (4) |
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Definition
| Observe, listen, respond, plan |
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