Foundations for OT Practice Pediatric Populations Infants-Adolescents
Jan 13, 2015
Foundations for OT Practice
Pediatric Populations
Infants-Adolescents
Core Beliefs
All people need to be able or enabled
to
engage in occupations of their need and choice,
to
grow through what they do
and
experience independence or interdependence, equality, participation, security, health, and well-being
(Wilcock and Townsend, 2008)
Participation in Occupation
Participation in Occupation
Participation in Occupation
Occupation Based Pediatric Practice
The Occupational Therapy Practice Framework (OTPF)
Why OTPF?
Designed to explain how occupational therapy contributes to health and participation
of people, organizations, and populations
through engagement in occupation.
OTPF
Core belief in the positive relationship between occupation and health
People are “occupational beings”
FORMATIVE DOCUMENT
• Another Review in 5 yrs (2013)
• Changes will emerge from AOTA
2017 Centennial Vision
• Grounded in 1917 founding principles
2 Major Components of OTPF
D
O
M
A
I
N
THE OT PROCESS
Areas of Occupation
ADL
IADL
REST AND SLEEP
EDUCATION
WORK
PLAY
LEISURE
SOCIAL PARTICIPATION
Client Factors
Values, Beliefs and Spirituality
Body Functions
Body Structures
Client Factors
Body Functions and Structures
Impairments
Anatomy
Physiology
Disabling Conditions
Neurokinesiology
Impairment• ROM
• Strength
• Sensory Processing
• Praxis
• Manipulation
• Eye Hand Coordination
• Visual Perceptual Skills
Performance Skills
Sensory Perceptual Skills
Motor and Praxis Skills
Emotional Regulation Skills Cognitive Skills
Communication and Social Skills
Performance Skills
Communication and Social
Motor and Praxis
Emotional Regulation
Cognition
Performance Patterns
Habits Routines
Roles
Rituals
Activity Demands
Objects Used and Properties
Space Demands
Social Demands
Sequencing and TimingRequired Actions
Required Body FunctionsRequired Body Structures
EVALUATION
OCCUPATIONAL PROFILE
ANALYSIS OF OCCUPATIONAL PERFORMANCE
INTERVENTION
PLAN IMPLEMENTATION
REVIEW
OUTCOMES
TYPES OF INTERVENTION
OCCUPATION BASED
PURPOSEFUL ACTIVITY
ADVOCACY
CONSULTATION
EDUCATION
PREPARATORY METHODS
Person
Person
Organizations
Populations
INTERVENTION APPROACHES
CREATE AND PROMOTE HEALTH
ESTABLISH AND RESTORE
MAINTAIN
MODIFY
PREVENT
Context
• Physical
• Social
• Cultural
Cultural Values and Styles
• Family Composition
• Decision Making/Primary Caregiver
• Independence/Interdependence
• Feeding Practice
….APPLIED VIA ETHNOGRAPHIC INTERVIEW
Cultural Values and Styles
• Sleeping Patterns
• Discipline
• Perception of Disability
• Help Seeking
• Communication and Interaction
THE Process…
Types of Clinical Reasoning
• Scientific
• Narrative
• Pragmatic
• Interactive
• Ethical
• Conditional
Legitimate Tools of Practice
For OT With Children
B. Atchison, 9/08
Legitimate Tools…
• Specific tools used to bring about change
• Held in high regard
• Symbolic
What are LT’s for OT’s?
• Conscious Use of Self
• The Nonhuman Environment
– Toys– Technology– PAMS– Pets!
And…
• Purposeful Activities
• Activity Analysis and Adaptation
• Activity Groups
• Teaching Learning Process
Application of LT’s to Frames of Reference
Psychosocial/Psychodynamic
Parent-Child Interaction– Parent-Child Activity Groups:
• Games, constructional play, gross motor activities
Activity groups and peer interactions• Grading Levels: Parallel, Project, Cooperative• Choosing Activities: Art, constructional, social skills, work
skills• Club Model: use of rituals and depersonalized controls • Skills for Living Group (OT Clinic, WMU)• School Intervention Project (CTAC, WMU)
Psychosocial
• Off The Shelf Programs– TARGET
– School Intervention Project (SIP)
OT-SI
• Environmental Engineering:– Physical Safety:
• Space• Mats• wooden floor is best, • tile on floor non-distracting, • overhead suspension system—load of 500 lbs
OT-SI• Clinical Equipment
– scooter board – ramp– hammock net– assorted large therapy balls– mats– air mattress– a bolster– mini- trampoline– foam rubber pillows– mouth toys– sucking and chewing items– *large box with styrofoam packing material (“Ball Pool”)– any active toys– CD player
OT-SI
• Off the Shelf Programs– Alert Program– Astronaut Program– Henry’s OT for Students and Teachers– School Intervention Program (SIP)– Handwriting Without Tears– Ready, Set, Go
NDT
• Handling-– Hands of the therapist, various sized balls, rolls,
benches, hard mat (plinth)
• Positioning and Adaptive Equipment– To facilitate postural alignment via external
stabilization– Prone wedge, prone lyer, sidelyer, adapted chair
(Rifton) harness in a wheelchair, angled work surface, prone stander, scooter board, adaptive tricycle, adapted potty seat
Visual Processing
• Also referred to as Visual Perception and Visual Information Analysis, Visual Discrimination, depending on source
• Visual Cognitive Triad fits with Visual Discrimination concept in SPD
Reference
American Occupational Therapy Association (2008). Occupational Therapy Practice Framework, Domain and Process. (2nd ed.) American Journal of Occupational Therapy, 62, 625-683.