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82 Cards in this Set
- Front
- Back
OT referral
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basic request for OT services
aka: order or consultation |
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OT Referral Sources
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the individual, the family/caregivers, doctors, any member of multidisciplinary team, teachers, administrators, insurance companies, employers, public and private agencies
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Who decides when an OT can act upon a referral?
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state licensure laws and third party reimbursers
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screening
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brief, easy to administer, and preliminary measures used to determine the need for a full OT evaluation
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what do screening tools measure?
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broad performance abilities via:
-chart review -structured observations/checklists/interviews with the individual, family, and caregiver |
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what does a screening outcome determine for client?
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determines:
client factors, areas of occupation, performance skills, & patterns and contexts that requite in depth evaluation. |
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evaluation
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comprehensive process of obtaining and interpreting the data necessary to understand the individual, system, or situation
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1st consideration in choosing an appropriate evaluation
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-individuals baseline functional level
-client's major concerns& pressing needs as determined through screening process |
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2nd consideration in choosing appropriate evaluation
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environmental context assessment will be conducted in:
-length of stay -focus/ resources (space, equipment, supplies) of setting -legislative guidelines/restrictions |
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3rd consideration in choosing an appropriate evaluation
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clients current and expected environment:
-sociocultural aspects (roles, values, norms, supports) -physical environmental barriers/ assets |
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4th consideration in choosing an appropriate evaluation
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temporal context of person and their disability:
-chronological/ developmental age -duration of disability (acute vs. chronic) -stage of illness |
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5th consideration in choosing an appropriate evaluation
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consider:
-tools compatibility with frame of reference guiding the intervention -consider ethical concerns and potential conflicts |
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1st step of interpreting assessment results
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integrate referral, screening and diagnostic information and data gathered from assessment
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2nd step of interpreting assessment results
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relate all information to functional abilities of client relevant to person's roles and environmental contexts
--identify functional deficits that are relevant to individual |
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additional school based assessment considerations
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must be related to educational performance:
-academic -mobility -psychosocial/behavioral -self care |
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3rd step of interpreting assessment results
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collaborate with individual, family, caregivers, and other team members to put results into a larger context
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4th step of interpreting assessment results
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prioritize problems by collaborating with individual to develop intervention plan
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after completing the assessment what should you do?
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-document and communicate eval findings with relevant parties (client team members, 3rd party payors)
-refer to other disciplines as needed for further evaluation |
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what is a standardized evaluation
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it is:
-uniform and well-established -always the same in content, administration, and scoring |
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what are the components of a standardized evaluation
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1. description of purpose
2. administration and scoring protocol 3. established norms and validity |
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standardized assessment administration protocol
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-provides instructions to ensure assessment is consistently administered
-identifies materials needed for assessment -provides exact wordings for directions to give to client |
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standardized assessment scoring protocol
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-provides ratings and criteria for determining ratings
- provides norms for the range of ratings for a specific population |
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types of normative data
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-age
-gender -diagnostic groupings |
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purpose of normative data
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-used for comparative analysis of a clients score
-client's normative data must match population's normative data or scores will not be accurate |
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assessment validity
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measures the assessment's accuracy to determine if tool measures what it is intended to measure
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face validity
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how well the assessment appears to meet its stated purpose
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content validity
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content included in evaluation is representative of clients needs
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criterion validity
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compares assessment to another one with established validity
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types of criterion validity
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-concurrent
- predictive |
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concurrent validity
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compares results of 2 instruments given around the same time
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predictive validity
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compares the degree to which an instrument can predict performance on a future criterion
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how is criterion validity reported
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by a correlation
-high correlation = increased criterion validity |
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reliability
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establishes the consistency and stability of the evaluation.
-scores are the same from time to time, place to place, evaluation to evaluation |
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inter-rater reliability
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different raters using same tool will get the same results
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test-retest reliability
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the same results will be obtained when the evaluation is administered twice by the same administrator
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how is reliability reported
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by a correlation or percentage
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Observational assessment
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-visual assessment of an individuals occupational performance
-assesses physical and sociocultural contextual barriers and supports |
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interview assessment guidelines
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-establish purpose of interview
-establish rapport with client -ask questions in organized manner -observe for nonverbal communication -practice active listening strategies to get needed info |
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types of intervention
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-prevention
-meeting health needs -the change process -management -maintenance |
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preventive interventions
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-promote wellness
-prevent disability/illness -maintain health |
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secondary prevention intervention
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reduce duration of disease& minimize its effects through early diagnosis, referral, and intervention in populations at risk.
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tertiary prevention intervention
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elimination or reduction of the impact of dysfunction on an individual
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disability prevention
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interventions that address the needs of persons who are considered at risk for problems in occupational performance by minimizing the effects of barriers to occupational performance
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psychophysical interventions
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interventions that meet a persons need for adequate:
-food/shelter/material goods -physical activity and rest -sensory stimulation |
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temporal balance and regularity interventions
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interventions that meet a client's need for balanced:
-work activities -leisure/play -rest |
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interventions to promote love and acceptance
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type of intervention that meets a clients need to be accepted and loved for one's personal attributes and uniqueness instead of accomplishments
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group association interventions
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interventions that meet a clients need to feel a connection to others who share similar interests and goals.
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mastery interventions
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meets a client's need to successfully complete a chosen activity or meet a goal
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esteem interventions
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meets a client's needs to be recognized for one's accomplishments
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sexual interventions
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meets a clients needs for the satisfaction of sexual drives and recognition of ones own sexuality
-must address physical barriers through activity adaptations and environmental modifications |
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pleasure (leisure) interventions
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meets the client's needs to do things for fun
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self-actualization interventions
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meets the client's needs to engage in activities just for one's self and for personal satisfaction
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establish/restore/remediate interventions
(change process interventions) |
focus on establishing a skill or ability that a person never developed or lost due to illness/injury
-most common intervention type used -most reimbursable |
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modify/compensate/adaptation intervention
(management interventions) |
interventions that alter the context or demands of an activity to reduce distracting features and facilitate engagement in areas of occupation
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maintenance interventions
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interventions designed to support and preserve a client's current level of function
-not focused on improvement but preventing decline -maintenance interventions are often not reimbursable |
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steps of intervention planning
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-collaborate with client/family/caregivers
-prioritize problems areas to be addressed -develop written intervention plan |
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what should be considered when prioritizing for intervention planning?
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-values, interests, and needs of client
-current and expected roles and environmental contexts -length of stay, facility resources, likelihood of problem resolution within given setting |
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intervention plan content
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-long term goals
-short term goals -intervention methods -duration, frequency, number and type of sessions -referrals to other professionals |
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intervention implementation methods (1)
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purposeful activities and meaningful occupations are used therapeutically
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intervention implementation methods (2)
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environmental modifications and adaptations are used to enhance function
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intervention implementation methods (3)
health and wellness promotion |
promotion of engagement in valued occupations is used to promote health and wellness
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intervention implementation methods (4)
promoting function |
adaptive equipment, assistive technology, and orthotic devices are designed, fabricated, and applied to facilitate function
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intervention implementation methods (5)
promoting independence |
adaptive equipment, assistive technology, orthotics, and prosthetic use training are provided to promote independence
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intervention implementation methods (6)
role of PAMS |
physical agent modalities are used to prepare for, or as an adjunct to, engagement in therapeutic functional activities
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intervention implementation methods (7)
ergonomics |
ergonomic principles are applied to the performance of meaningful occupations
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intervention implementation methods (8)
precuations |
precautions are used to prevent nosocomial infections
-standard -airborne -droplet -contact |
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developmental intervention considerations (1)
intervention media |
all intervention media must be appropriate for child's developmental level
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developmental intervention considerations (2)
primary intervention focus |
play should be primary focus occupation intervention
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developmental intervention considerations (3)
family |
-identify environmental and psychosocial factors that promote development & respect cultural background
-provide advocacy training& community support |
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developmental intervention considerations (4)
school/education |
provide consultation/treatment to facilitate school performance and achieve educational goals
-positioning equipment -technological aides |
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re-evaluation/ intervention review
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assess client's progress and effectiveness of intervention
-interventions may be adjusted to improve progress -referrals can be sent if need is indicated -readiness for discharge is assessed/ predicted |
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reasons for discharge
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-goals are met
-functional plateau/maximum benefit is reached -higher level of care is needed -allotted length of stay has been reached |
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discharge plan content
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-referrals for OT or supportive services
-home program recommendations -caregiver training/ family education -community resources |
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occupation
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goal-directed pursuits that have purpose, value and meaning and involve multiple tasks. they are the ordinary and familiar things people do every day
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activities of daily living
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activities that involve care of self.
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instrumental activities of daily living
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activities that involve environmental interaction. they are more complex than self care and may be optional
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work
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all productive activities that contribute services, goods, or commodities to society, whether paid or on a volunteer basis
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education
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activities that involve the student role and participation in an educational environment
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play/ leisure
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all activities engaged in for pleasure, relaxation, amusement, and self-fulfillment
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social participation
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activities involving interactions with community, family, and peers/friends
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purposeful activities
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doing processes that are directed toward a desired and intended outcome and require energy and thought to engage in and complete--the goal directed tasks that make up occupations
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activity analysis
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-breaking down/identifying components of a task
-determining the abilities needed for each task -determining the therapeutic value of the activity/task |