RileyA new student has been referred to Occupational Therapy. Riley is a 7 year old male child who will attend the integrated Grade 2 classroom at this neighborhood elementary school. He has a diagnosis of moderate Cerebral Palsy, Spastic Quadriplegia type. Riley is cognitively on par with his classmates, but is wheelchair bound and cannot speak clearly enough to communicate easily with them. He is able to convey ‘Yes’ and ‘No’ verbally, and is beginning to learn to use a single panel switch at his head to control a Dynavox communication board. The latest Occupational Therapy evaluation states that Riley has gross, directed reach bilaterally, is able to utilize a gross grasp and release bilaterally, and can grossly isolate his left index finger for pointing. He can utilize a thick pencil for gross movements, but cannot form letters with control or speed to make writing an academic option at this time. He also presents with moderate deficits in VP skills in the areas of position in space and figure ground awareness. Riley has a one to one Teacher Assistant, who was recently hired to be with him in the classroom, and to provide assistance with feeding and toileting needs. http://www.youtube.com/watch?v=4-FgffVaNv4
His Occupational Therapy IEP Goal is:
Given assistive technology, Riley will demonstrate improved VP and VPM skills to allow completion of academic tasks on target with his peers.
Objective 1: Riley will demonstrate improvement in quality of keyboarding skills through his ability to independently complete a five sentence daily journal entry with < 10 typing errors using his adapted computer within the 20 minute writing circle session.
Objective 2: Riley will demonstrate improvement in VP skills through his ability to review and edit his written work for errors given <5 verbal cues.
Objective 3: Riley will demonstrate improvement in his use of adaptive equipment through his ability to complete a multi-step art project using a variety of classroom tools (glue stick, stapler, paint brush, etc.) given set up and minimal physical assist.
1. What further assessments, observations, and/or information is needed to begin planning treatment, and how will you get this information. List 5 and justify . (10 pts)
2. The Teacher Assistant is finding it very difficult to put on Riley’s pants after his diaper change. What is the primary cause? Explain and justify. (5 pts)
3. The OT has decided to order splints for Riley’s wrists and hands for daily use. What features should be incorporated and why. (5 pts)
4. Riley’s mother would like to start toilet training. Keeping in mind the issues due to his diagnosis, what are the areas of concern that must be considered to promote safe and successful toileting. Using on-line catalogues as a base, specifically describe and justify the equipment you will recommend. Cite all examples as needed. (10 pts)
5. Riley’s teacher is concerned because his reading skills are not progressing as quickly as those of his classmates. What are the issues associated with CP that may be interfering with his progress? Be specific. (10 pts)
6. In thinking about the areas of occupations that will be affected by spastic quadriplegia type CP, what would should the focus be for a student in High School? Be specific and justify. (5pts)
7. Ana has the same profile as Riley, except she has athetoid CP. In thinking about the areas of occupation important to Ana, consider the issues of athetoid CP that may interfere with her independence. State one area of occupation and give one specific example of an activity that will be a great challenge and justify. (5 pts )
8. Typically developing two year old Abigail recently experienced a left CVA as a result of an accident at daycare. Specifically describe the physical manifestations you expect to see as she begins out- patient rehab? (10 pts)
9. In thinking about her age and the specific challenges Abigail’s condition, which area/s of occupation will you focus on? Give two specific examples of affected performance skills (OTPF S25) within the area of occupation and justify. (10 pts)
10. Ali is a 13 year old student with Down Syndrome who is functioning at moderate level of cognitive impairment. What are the issues, precautions, and/or concerns typical of her diagnosis that should be considered in treatment planning. List 5 activities important to Ali that will be impacted and justify. (10 pts)
11. Andrew is a 7 year old student with Fragile X who will be joining a fully integrated class for art. What are the precautions and/or issues that will affect success in planning for his participation? List 5 and justify each. (10 pts)
12. Alex is a 16 year old young man with a diagnosis of CP, spastic quadriplegia type, and profound intellectual disability. Based on his diagnosis, what do you expect to see physically and what are 2 questions you have as you go to his classroom to observe him for the first time. How will you get the answers? (10 pts)

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