Directions: Read the 3 case scenarios and answer the five questions following each case. Case Scenario #1 Bobby is a 20-month-old Hispanic boy with a history of developmental delays. He displays...

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Directions: Read the 3 case scenarios and answer the five questions following each case. Case Scenario #1 Bobby is a 20-month-old Hispanic boy with a history of developmental delays. He displays characteristics similar to a child with autism; however, a formal diagnosis has not been made. Bobby lives in a trailer home with both of his parents and four siblings. Bobby is the youngest of the five children. His father works full-time as a mechanic and his mother stays home with the children. The older children attend school and Bobby stays home during the day. Bobby has a very short attention span and only sits with an activity for a few minutes at a time. When sitting in a chair, he engages in repetitive behaviors with toys he is playing with (spinning, lining up). He occasionally spins his body around and bangs his head into the wall. Toy use is limited. Those toys he does play with he seems to do so for their heavy weight and visual and auditory effects. Bobby does not allow others to touch him and becomes combative during bath times, refusing to have his hair washed. Tooth brushing is out of the question. He will wear only particular items of clothing, none with fasteners or straps. Bobby self-feeds but only finger foods and will not eat anything with a crunchy texture. He is unable to tolerate the vacuum cleaner running. When over-stimulated he begins to cry. Bobby will kick, bite and scream when he is really upset and it takes over 45 minutes to calm him. When a little bit upset, he crawls under the dining room table. Bobby communicates with two to three word repetitive sentences. Bobby will cry or bite to communicate his needs when becoming frustrated. He has difficulty following directions and moving on to new activities. He spends most of his day staring at the television. His mother is not happy letting him do this all day, but she has run out of ways to cope and control his behavior. 1. List Bobby’s strengths in each area: a. Posture/Balance b. Gross motor c. Fine motor d. Sensory e. Cognitive-behavioral f. Social-emotional 2. List Bobby’s challenges in each area: a. Posture/Balance b. Gross motor c. Fine motor d. Sensory e. Cognitive-behavioral f. Social-emotional 3. What area do you see as Bobby’s biggest need? 4. What information will be important for you to communicate to the family? Locate one resource and cite here you would use to help Bobby’s family understand typical development. 5. What are important contextual influences to consider and possible obstacles to goal setting involving the family? Case Scenario #2 Jason is a seven-year-old child who has a diagnosis of cerebral palsy with quadriplegic flexor spasticity with moderate lower extremity involvement and mild upper extremity involvement. Jason sits independently in a small chair with armrests and an abductor pummel.  He requires upper extremity support to circle sit without positioning assistance.  He cannot maintain long leg sitting.  He prefers to tailor or W-sit because these positions are more stable.  Parachute and tilting (righting) reactions in sitting are slow, so if he does not have positioning support (such as his chair), Jason falls over if knocked off balance.  He is able to reach, grasp, and manipulate a variety of objects about the size of a golf ball.  Whenever possible, objects are "built up" to improve hand function and control.  Jason rolls or crawls (combat style) for mobility, rolls to a sidelying position and props himself up on one arm.  He has difficulty pushing himself into sitting.  He has difficulty alternating the use of the right and left sides of his body.  He is just learning to walk with Loftstrand crutches.  Poor spatial/perceptual skills interfere with his cognitive performance.  Jason is considered to have a mild learning disability. He lives with his mother and two siblings (he is the middle child). His mother works at a local pharmacy as a cashier to support their single-income family. Jason loves dinosaurs and anything that he can build and knock down. He is very motivated by his peers and loves watching them and playing with them. Jason’s typical day includes riding the bus to and from school, where he is in 2nd grade. He is in regular education for academic activities with some special education tutoring for writing and math skills.  After school he works on homework and plays with his siblings. He frequently spends time with his extended family while his mother works. He receives PT and OT as related services.  Jason has difficulty alternating each side of his body; he is unable to crawl and struggles to use both hands together. He has poor upper extremity coordination during play and ADL activities. 1. List Jason’s strengths in each area: a. Posture/Balance b. Gross motor c. Fine motor d. Sensory e. Cognitive-behavioral f. Social-emotional 2. Given Jason’s current development, what skills might you target next? 3. List one goal for a problem area identified for Jason. 4. Use the OTPF to determine which intervention approach should be used to address the goal identified #2. 5. Describe how the strengths identified in #1 can be used to help Jason achieve his goals. Case Scenario #3 Amy is a 15-year-old with a diagnosis of Down’s Syndrome. She is an only child and lives with her father and mother. Amy’s parents have expressed that they plan for her to live at home as long as possible as an adult. The family has one cat; Amy is in charge of feeding the cat each day. She currently attends the local high school. Despite hypotonia (low muscle tone) and joint laxity, she has a tendency to seek out movement activities.  The result is Amy frequently bumping into a lot of things and falling. Her motor milestones were attained late and she has a limited repertoire of slow movement patterns and has difficulty learning new skills, particularly those with a motor component.  Amy is impulsive and distractible.  She does not tend to explore objects, but rather picks them up and puts them down again.  Amy also does not tend to visually explore her environment.  She has difficulty finding objects in the classroom and tends to focus her attention on the teacher or other people in the class rather than classroom materials.  Her language skills are delayed, although she can converse on a simple level. At this point in time she can dress herself using simple clothing with minimal fasteners.  She is able to brush her teeth and comb her hair but needs some prodding and cues to complete these tasks.  Amy recently had an OT evaluation as part of her triennial eligibility evaluation. Because Amy will be turning 16, the team needs to formally address her transition to adulthood. During the evaluation, Amy indicated goals of being able to take off her jewelry to participate in physical education class and to avoid getting in trouble for talking during class when she isn’t supposed to. As the OTA you have been asked to work with Amy on the identified problem areas of 1) poor gross/fine motor skills and 2) decreased communication/social interaction skills with peers. 1. List at least 3 of Amy’s strengths and describe how they can be used to help her achieve her goals. 2. List one goal for each problem area identified for Amy. a. Poor gross/fine motor skills b. Decreased communication/social interaction skills with peers 3. In order for Amy to be more independent with dressing for physical education, Amy has identified putting on jewelry as an area she would like to work on. Other areas of concern are tying shoes, as well as buttoning and zipping clothes. a. How can dressing be utilized as an intervention to help Amy with other fine-motor skills? b. What are some modifications the OTA could make to assist Amy with jewelry? Buttoning? Zipping? c. What social skills can be incorporated into her fine-motor tasks? (eg asking for assistance) 4. Self-determination for adolescents and young adults with disabilities focuses on ensuring that individuals have support and opportunities to create change in their lives. Fostering choice-making skills is one way to do this. How can the OTA foster Amy’s self-determination and unique physical, cognitive, and psychosocial development as an adolescent during the OT process? 5. What other activities could the OTA try with Amy at school to increase the variety of IADL and/or work tasks that Amy can participate in?
Answered Same DayMar 06, 2021

Answer To: Directions: Read the 3 case scenarios and answer the five questions following each case. Case...

Olivia answered on Mar 06 2021
136 Votes
Directions: Read the 3 case scenarios and answer the five questions following each case.
Case Scenario #1
Bobby is a 20-month-old Hispanic boy with a history of developmental delays. He displays characteristics similar to a child with autism; however, a formal diagnosis has not been made. Bobby lives in a trailer home with both of his parents and four siblings. Bobby is the youngest of
the five children. His father works full-time as a mechanic and his mother stays home with the children. The older children attend school and Bobby stays home during the day.
Bobby has a very short attention span and only sits with an activity for a few minutes at a time. When sitting in a chair, he engages in repetitive behaviors with toys he is playing with (spinning, lining up). He occasionally spins his body around and bangs his head into the wall. Toy use is limited. Those toys he does play with he seems to do so for their heavy weight and visual and auditory effects. Bobby does not allow others to touch him and becomes combative during bath times, refusing to have his hair washed. Tooth brushing is out of the question. He will wear only particular items of clothing, none with fasteners or straps. Bobby self-feeds but only finger foods and will not eat anything with a crunchy texture. He is unable to tolerate the vacuum cleaner running. When over-stimulated he begins to cry. Bobby will kick, bite and scream when he is really upset and it takes over 45 minutes to calm him. When a little bit upset, he crawls under the dining room table.
Bobby communicates with two to three word repetitive sentences. Bobby will cry or bite to communicate his needs when becoming frustrated. He has difficulty following directions and moving on to new activities. He spends most of his day staring at the television. His mother is not happy letting him do this all day, but she has run out of ways to cope and control his behavior.
1. List Bobby’s strengths in each area:
a. Posture/Balance – can maintain balance
b. Gross motor – Can stand or sit upright
c. Fine motor – can grasp and play with toys
d. Sensory – Can hear and see well
e. Cognitive-behavioral – Attracted towards certain visual and auditory effects in toys
f. Social-emotional - No such strength.
2. List Bobby’s challenges in each area:
a. Posture/Balance – No such challenge
b. Gross motor - No such challenge
c. Fine motor – cannot use clasps
d. Sensory – Dislikes certain textures
e. Cognitive-behavioral – Has a very low attention span, doesn’t allow people to touch him, communication is very limited, cannot follow directions and cannot engage in new activities.
f. Social-emotional - Impaired social and emotional development, shows signs of anxiety, frustration, repetitive behaviors, isolation.
3. What area do you see as Bobby’s biggest need?
Bobby biggest challenge lies in this social and emotional development. He suffers from anxiety and probable autism has has trouble understanding and communicating with others.
4. What information will be important for you to communicate to the family? Locate one resource and cite here you would use to help Bobby’s family understand typical development.
Bobby’s parents need to understand the developmental and cognitive difficulties that Bobby faces in the real world. Therefore, the best suggestion would be to get him to a doctor to have a proper diagnosis of the mental state. Since these disorders cannot be verifies with simple tests. The family needs to be vigilant in order to recognize and understand the problems. After proper diagnosis, specialist in the field can help Bobby to resume his daily life better (Screening and diagnosis of autism spectrum disorder, 2018)
5. What are important contextual influences to consider and possible obstacles to goal setting involving the family?
The most important obstacle to consider is the financial status of the family. According to the information...
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