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The Developmental Frame of Reference

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by

Tara Robinson

on 5 December 2013

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Transcript of The Developmental Frame of Reference

Limitations of the FOR
Is often questioned if there is a Developmental FOR
No single developmental frame of reference
Influenced by a multitude of external forces
Is more of an overview of different sources
Therapist must use various tools of the profession to apply this FOR
The Developmental Frame of Reference
Erin McGreal & Tara Robinson

Evaluation
Developmental FOR Considerations
Neurodevelopmental skills
Gross, fine, and oral motor skills
Visual perceptual skills
Cognitive skills
Sensory skills
Treatment Principles
Major concern for OT in pediatrics is the child's ability to translate development into action
Being able to function in the environment to best of child's abilities
Focus him to put 100% of his effort into what he is doing
Provide him with a just-right-challenge
So he is forced to perform to his highest capability
Have him do work in a room with little distractions
Will improve his figure-ground deficits
Influence of Problem Areas on Occupational Performance
9 year old boy - 4th grade
Started inclusion program
Attends learning support class
Difficulty in completing assignments
Easily distracted in class
Often leaves class because of complaints of not feeling well
OT evaluation
low tone, poor cocontraction, and poor proximal stability
Interests: collecting baseball cards and keeping stats
Favorite classes: art, computers, and geography
Claims to have "failed" at traditional team sports
Brendan
Developmentally delayed
Gross motor coordination @ 6yr level
Fine motor skill @ 7yr level
Visual perception skills @ 5 to 6 yr. level
Periods of Instability/ Stability/ Instability
His periods of instability are too far ahead of his capability that he is unable to master stability
Level of Attentiveness
Brendan is less attentive in reading and math because he is not at his correct developmental period
This may not be the only reason
Acting out in gym class
He has high anxiety due to his developmentally delayed motor skills
Brendan compensates by acting out and gaining attention from his classmates
Visual Perception
Difficulty in figure ground &
spatial relationships
Figure ground deficit:
Brendan's environment is overwhelming him and he is hypersensitive to the environment distracting him from his tasks
He is having difficulty in spatial relationships because his visual perception has not developed from concrete to abstract
Brendan is not at his age group's proper developmental period
Function/Dysfunction
What are the causes of Brendan's gross and fine motor skill disabilities?
Is it related to visual perception?
Is it musculature?
Is it neurological?
what is his cognitive level?

What are the causes of his visual perceptual deficits?

What is his home environment like?
what is the role when nurturing in development

What activities does Brendan excel in?

Dynamic systems influence

Person/ environment/ activity factors
Which of these factors are inhibiting his success/ performance skills?
Additional Information Needed
Development proceeds from general to differentiated and towards integration
Address his weakest areas to get everything on the same level
Prioritize by the most important
Consider the child's and parents' wishes
Development proceeds proximo-distal
Strengthen his core muscles and the muscles of his shoulder before working on his fine motor skills
ex: to work on his immature pencil grip
Stability provides a basis for mobility
Strengthen Brendan's core muscles to improve his poor gross motor coordination
Movements Developed
1st - Vertical
2nd - Horizontal
3rd - Rotary
Due to Brendan's poor motor skills, it would be beneficial to develop his movements in vertical and horizontal planes and to then develop his rotary movements
Symmetrical movements develop before asymmetrical movements
To improve Brendan's bilateral deficits an OT must focus on getting him to use both his arms at the same time
Visual Perceptual
Develops from concrete to abstract
Work on his ability to apply concrete information abstractly
Especially to develop Brendan's spatial relations deficit
Environment

May distract or limit the individual from performing to the best of their abilities
ex. Brendan's priority of trying to fit in with his peers
Person

The disabilities of the person will affect their performance.
ex: Brendan has high anxiety in gym class because of his motor skill deficits
Task

Just-Right-Challenge
If task is too difficult the person may refuse to cooperate
If the task is too simple the individual may not feel motivated to complete it or may become disinterested
Task must be meaningful and purposeful to person
Questions?
Reference
Kramer, P. & Hinojosa, J. (2010). Developmental perspective: Fundamentals of developmental theory. In P. Kramer & J. Hinojosa (3rd ed.). Frames of reference for pediatric occupational therapy (p. 23-30). Baltimore, MD: Lippincott Williams & Wilkins.



Occupational Performance
Gross Motor
Bilateral deficits
Low tone
Poor stability
Poor coordination
Fine Motor
Brendan is having difficulties holding his pencil because he has poor stability affecting his mobility
Gross & Fine Motor Skills
Image retrieved from: http://www.school-ot.com/fine%20motor%20tools.html

Particular methods:
checklists, observations, inventories, interviews, and functional assessments
What assessments might be best?

DVPT-2
Purpose: Performance based on 8 subtests from 4 categories to assess visual perception
Population: 4-10 y.o.
MVPT
Purpose: assess visual perception w/o involving motor skills
Population: 4-10 y.o.
Particular Methods & Assessments
By Erin McGreal, OTS & Tara Robinson, OTS
Full transcript