Additional observation and information that is required to start planning treatment
First, I would get information on any associative conditions specifically behavior since I want to enhance Riley ability to socialize with the fellow students. I would gather this information by observing his social interactions.
Determining if Riley has eating problems is also important in planning treatment.
I will get this information by giving him some food to chew and then observing the process. This information is important since it will help the Teacher Assistant in training Riley on how to feed himself.
Finding if Riley has sitting problems associated with abnormal postures or hip subluxation is important. I would get this information by observing him for any gestures of uncomfortable sitting posture. This information would help the Teacher Assistant to know whether they require changing the posture of the child in the wheelchair often.
More information is required to ascertain if the child has hearing impairment since he can only convey “yes” and “no.” I would get this information by inspecting his ears and asking questions to see his response.
I would request to know if Riley is experiencing a vision problem. I would get this information from Riley’s parent. Then I would use an eye chart to test his vision ability. This information is important because I want to confirm if Riley can see well when writing in class and performing other daily activities.
Why the Teacher Assistant is having a hard time changing Riley’s diaper
A primary cause of the difficulty in changing the diapers is Riley’s hips which are tight making it hard for the Teacher Assistant to wedge his legs apart when changing the diaper. Also, Riley is wheelchair bound and the Teacher Assistant is experiencing difficulties moving him when changing the diapers. It is notable that Spastic Quadriplegia impacts the muscle stiffness which constricts movement. The motor function is adversely affected which has led to deformities (Gormley Jr, Krach, and Piccini, 2001). It is notable that Riley’s limbs lack voluntary control and the Teacher has to force the diapers when changing them.
Features essential in Riley’s splints
The specific features that need to be integrated into the splints include comfort and fitting features. Also, the splints require features that minimize skin irritation and make them simple to clean. Further, the splints should be simple to put on Riley arms and limbs to avoid giving the Teacher Assistant a burden of using them on the child. These features are essential since splints may worsen the situation of Riley’s hands and wrists if they are too tight, cause skin rashes or are difficult to clean. Another justification for these features is the need to train Riley how to move his limbs and arms without inflicting pain on him.
Toilet training for Riley
Riley’s mother should be concerned about movement problem and involuntary muscle spasms. Notably, Riley is wheelchair bound and thus, cannot move to use the normal toilets like the fellow students. Another area of concern is the communication problem. Riley can only convey “Yes” and ”No” verbally which means he cannot communicate when he requires assistance to visit the toilet. Thus, the mother should be concerned about training Riley on how to behave, express himself or inform the Teacher Assistant when he requires using the toilet.
Based on the situation of Riley, I would recommend a mobile potty chair. This chair is ideal since it can be used in a room that has limited space and will not strain the child. Additionally, the Teacher Assistant will only have to place Riley on the potty chair during toilet sessions. The mobile potty chairs that Riley can use include the BABYBJORN toilet trainer, Summer Infant Lil’ Loo Potty and Fisher-Price Potty.
The problems linked to CP that might affect Riley’s reading progress
Cerebral palsy results in brain dysfunction which causes cognitive problems such as learning disorders. It is notable that Riley has problems speaking and writing. Participation in learning requires good communication skills including handwriting, speaking, painting and keyboarding which are conspicuously lacking in Riley. The learning disorder in Riley has been manifested through acquisition which causes challenges in reading progress (Asbell, Donders, Van Tubbergen, and Warschausky, 2010). For this reason, the teacher is experiencing difficulties in impacting various skills to the child.
Focus of High School students with CP
The issues of athetoid CP that may interfere with Ana’s independence
The issues that might interfere with Ana’s independence include the stiff or rigid body that constrains voluntary movements, floppiness in the limbs and issues with the posture. One occupation for Ana will be grasping objects such as pencils and books. One specific action that will be very difficult for her is feeding since she is unable to hold objects properly. Due to this challenge, Ana requires performing activities that improve motor movement such as typing, playing.
Physical manifestations of CVA in Abigail
Weakness and numbness are the most common physical manifestation that will likely occur to Abigail. Her left side including face, limb, and arm might be paralyzed when she beings out-patient rehab. One side of her mouth might also drop when she attempts to smile. I also expect to see difficulties in her walking. As she starts out-patient rehab, Abigail might require assistance to visit the toilet due to the problem of movement. The left CVA might cause Abigail to experience loss of control and balance when walking which lead to falls.
The occupational area I would concentrate on for Abigail
I would focus on adjusting for issues with memory, concentration, and confusion by suggesting formal and informal educational activities. These activities include reading letters, keyboarding, drawing, painting, training her to adhere to feeding routines, playing with pets, and using the toilet. Abigail is young and requires cognitive assistance since her brain is rapidly developing. Additionally, these activities would minimize dependence in her early years.
The impacted performance skills: The specific examples of impacted performance skills within this occupation include reading and writing letters. Notably, after a CVA, the cognition ability of an individual is affected adversely.
The concern of Ali’s in treatment planning for Down syndrome
The issues of concern for Ali will be low muscle tone in her cheeks, tongue and lips, and loose alignments at her joints. Ali might also have visual and auditory deficits which should be considered when planning for treatment (Bruni, 2001).
Five activities important to Ali that will be impacted:
Feeding
Dressing,
Handwriting,
Speaking,
Reading letters
Andrew will be affected by the following issues;
The Inability of maintaining attention. This problem will occur because Fragile X might cause attention deficit disorder.
Difficulties focusing on the artwork. Individuals with Fragile X have problems focusing on a single task for long hours.
Problems in communication. Fragile X tends to cause autism spectrum disorder that impairs the ability to communicate.
Social interaction problems. Autism spectrum disorder might also result in social interaction problems.
Coping issues. The physical appearance of people with Fragile X is different from normal people since they have a long face, large ears and flat feet (“Fragile X syndrome,” 2017). These differences may cause coping problems.
What I expect to see physically in Alex and the 2 questions that I have
Alex should be wheelchair bound or wearing orthotic devices such as splints. Additionally, I assume that Alex should have a problem with his sitting posture. I expect these observations since Alex should have impaired limbs and arms.
Question1: Can Alex grasp a pen and form letters? I will get this answer by asking him to write his name on a piece of paper.
Question 2: Does Alex have a problem speaking? I will get the answer by asking him to pronounce letters A, B, C and D. I will also ask him to count number 1 to 9.
References
Bruni, M. (2001). Occupational therapy and the child with Down syndrome. Retrieved January 14, 2017, from <http://www.ds-health.com/occther.htm>
Asbell, S., Donders, J., Van Tubbergen, M., & Warschausky, S. (2010). Predictors of reading comprehension in children with cerebral palsy and typically developing children. Child Neuropsychology, 16(4), 313-325.
Bochek, K. (2016). Is cerebral palsy genetic, congenital, or acquired? Retrieved January 14, 2017, from http://www.cerebralpalsy.org/about-cerebral-palsy/cause/when
Fragile X syndrome. (2017, January 10). Retrieved January 14, 2017, from <https://ghr.nlm.nih.gov/condition/fragile-x-syndrome>
Gormley, M., Krach, L., & Piccini, L. (2001). Spasticity management in the child with spastic quadriplegia. European Journal of Neurology, 8(s5), 127-135.
Mike, D. (1995). Literacy and cerebral palsy: Factors influencing literacy learning in a self-contained setting. Journal of Literacy Research, 27(4), 627-642.
