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Continuity Clinic Notebook:

 Chapter II. The Evaluation of the Sick Child

Chapter 2 Index

A. Evaluation by system:

1. General

2. HEENT

3. Cardiopulmonary

4. GI

5. GU

6. Orthopedics

7. Neurological
--Breath-Holding Spells
--Benign Febrile Seizures
--Treating Children with Seizures
--ADHD 

  

Occupational Therapy

Kelly Laird - OTR

Definition of OT: The therapeutic use of work, self-care, and play activities to increase independence, enhance development and prevent disability.  Focus is more on fine motor, while PT focuses more on gross motor development. 

Evaluation/Screening Methods: Means of evaluating developmental levels, visual perceptual skills, basic cognitive abilities, and sensory-motor coordination of infant/toddlers, preschool, and school age children.  Often combine efforts with PT and speech therapy - e.g. milestones developmental stimulation group, which is focused on the preschoolers.

Treatment Modalities:

1. Adaptive Equipment: can be used in both the developmentally delayed and the neurologically impaired children:     

Description of Adaptive Equipment Indications for Use
Self Feeding Aides such as:  
        - extended handle Limited elbow motion
        - swivel handle spoon Decreased wrist range of motion
        - universal cuff Poor grasp
Benik Splint- pre-fab made of neoprene Poor opposition of thumb to fingers; decreased wrist extension
Orthoplast Splint –thermoplastic Prevent deformity, prolonged stretch, or rest an inflamed or over-used joint
Adaptive dressing/bathing equipment such as elastic shoelaces, button hooks, zipper pulls Motor needs
Writing aids such as wanchick writer, klick pencil holder, pencil grips, one-handed scissors, inclined writing table Poor grasp, decreased range of joints.

2. Developmental Stimulation and Caregiver Instruction: Children are given developmentally appropriate activities, and parents are given instructions on how to do them at home.

3. Group Treatment: Milestones group for developmental stimulation - children in this group have some type of motor, speech or social delay.

4. Biomedical Approach: Used primarily for rehabilitation for those who have some sort of injury or insult.  Goal is to increase strength and regain coordination.

5. Sensory Integration Approach: defined as the organization of sensation for use.  This approach helps the child control sensory input so that the child can form an adaptive response that integrates sensation.

6. Rehabilitation Approach: This approach teaches children with disabilities to adapt to their conditions, by re-training and instruction in adaptive techniques and use of equipment.

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Department of Pediatrics  |  Medical College of Georgia
 Please email comments, suggestions or questions to:
John T.  Benjamin M.D.,  jbenj@mcg.edu

February 27, 2004