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OA Practice Model
OA Practice Model
OA Practice Model
OA Practice Model
OA Practice Model
OA Practice Model
OA Practice Model
OA Practice Model
OA Practice Model
OA Practice Model
OA Practice Model
OA Practice Model
OA Practice Model
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OA Practice Model

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  • 1. PEDIATRIC CEREBRAL PALSY AND ASSISTIVE TECHNOLOGY An Occupational Adaptation Practice Model Angie Boisselle, OTR, ATP Texas Woman’s University School of Occupational Therapy April 20, 2012Sunday, April 29, 12
  • 2. TREATMENT GOAL Child’s self-directed use of assistive technology to meet the demands of the occupational environment and improve the child’s internal adaptive process for role participation.Sunday, April 29, 12
  • 3. THE CHILD • Sensorimotor--visual motor deficits, issues with movement and proprioception, issues with speech/ Adaptive Adaptive Adaptive language. This area predominates the Energy Response Response Mode Behavior adaptation gestalt for most children with Primary Existing Hyperstabilized cerebral palsy. • Psychosocial--learned helplessness, impaired social interactions, behavioral issues. • Cognitive--mild to severe performance in Sensorimotor cognitive activities. Child may also be Psychosocial Cognitive perceived as cognitively impaired due to severe motoric and speech delays.Sunday, April 29, 12
  • 4. CASE STUDIES Two Paths of TreatmentSunday, April 29, 12
  • 5. OA INTERVENTION The therapist uses assistive technology to promote meaningfuland real-world opportunities for the child within the occupational environment •Sunday, April 29, 12
  • 6. OA INTERVENTION The therapist uses assistive technology to promote meaningfuland real-world opportunities for the child within the occupational environment •Sunday, April 29, 12
  • 7. OA INTERVENTION The therapist uses assistive technology to promote meaningfuland real-world opportunities for the child within the occupational environment •Sunday, April 29, 12
  • 8. OA INTERVENTION The therapist uses assistive technology to promote meaningfuland real-world opportunities for the child within the occupational environment •Sunday, April 29, 12
  • 9. OA INTERVENTION The therapist uses assistive technology to promote meaningfuland real-world opportunities for the child within the occupational environment •Sunday, April 29, 12
  • 10. INTERVENTION • Just Right Challenge • Provide Experiences and Sense of Mastery • Windows of Opportunity • Thinking Outloud • Hiearchial PromptsSunday, April 29, 12
  • 11. PHASES • Phase I~Case-history; define occupational challenges; development of interest repertoire; implementation of occupational readiness • Phase II~Selection of devices; introduce personally meaningful occupational activities • Phase III~Implementation of devices within occupational environment; continue occupational readiness and activities • Phase IV~Self-initiated participation and generalization to a variety of occupational roles and contextsSunday, April 29, 12
  • 12. TECHNIQUES Through the use of AT: • Therapist sets up the environment for the child (pre- programs software, customizes fit of device) • Child progressively directs the selection of activities • Therapist creates new environments for the child to experience a positive role performance • Child performs more complex/challenging yet personally meaningful activities (higher-level academics, more advanced daily routines)Sunday, April 29, 12
  • 13. OUTCOMES •Child uses AT to efficiently meet •Satisfaction: Measured by (PEGS, the demands of the environment Miller Function and Participation •Generation of novel activities using Scales) and/or responses from the assistive technology child •Generalization of the assistive Adaptive Energy Adaptive Response Adaptive Response Mode Behavior technology use for role Primary for Modified and New Hypermobile and performance in a variety of contexts Cognitive activities transitional Sensorimotor Psychosocial CognitiveSunday, April 29, 12

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