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172 Cards in this Set

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Astereognosis
Inability to recognize objects by touch *also called tactile agnosia
Ataxia
Inability to coordinate muscle activity during voluntary movement.
Athetoid (dyskinetic)
Resembling athetosis or repetitive involuntary, slow, sinous, writhing movements. Classification of cerebral palsy in which involuntary purposeless movement occurs when an individual attempts purposeful motion. The abnormal movements may not only occur in the limb being moved but also involve an "overflow" of activity to all other limbs with an exaggeration of reflexes
Clonus
Alternate involuntary muscular contraction adn relaxation in rapid succession
Contracture
Abnormal shortening of muscle tissue that renders the muscle highly resistant to stretching which can lead to permanent disability
Deformity
Distortion of any part or general disfigurement of the body
Diplegia
Paralysis of like parts on either side of the body. In cerebral palsy, diplegia describes involvment of the lower extremities predominately, with only mildy affected upper extremities
Dysarthria
imperfect articulation of speech caused by disturbances of muscluar control resulting from central or peripheral nervous system damage
Graphesthesia
The ability by which outlines, numbers, words, or symbols, traced or written on the skin are recognized
Hemiplegia
Paralysis of one side of the body, usually caused by a brain lesion, such as a tumor, or a CVA. Paralysis occurs on the side opposite the lesion, or infarct, because of decussation of most of the fibers in the motor tracts of the brain.
Homonymous hemianopsia
loss of one half of the visual field, on the same side in both eyes
hypertonicity (spasticity)
abnormal muscle tone felt as too much resistance to movement as a result of hyperactive reflexes and loss of inhibiting influences from higher brain centers
hyperflexia
overflexion of limb
hypoxemia
insufficient oxygenation of the blood
kernicterus
A form of hemolytic jaundice of the newborn.
kinesthesia
The ability and sense by which position, weight, and movement are perceived
Quadriplegia
Paralysis of all four limbs
scoliosis
lateral curvature of the vertebral column
nystagmus
Involuntary, rapid, rhythmic movement (horizontal, vertical, rotatory, or mixed, i.e., two types) of the eyeball
primitive reflexes
Innate primary reactions found in newborns and indicative of severe brain damage if present beyond their usual time of disappearance. Adult patients with closed head injury or stroke may manifest these signs; absence on reevaluation is a sign of progress in recovery. Examples include placing reactions, moro reflex, grasp reflex, rooting reflex, and sucking reflex.
Strabismus
Deviation of the eye in which the visual axes assume a position relative to each other different from that required by the psychological conditioning also called squint.
Topagnosis
Loss of ability to localize site of tactile sensations
Stretch Reflex
Reflex contraction of a muscle in response to passive longitudinal stretching.
Ambiguous hand preference
Absence of a dominant hand preference; the switching of hand within the same activity.
Amygdala
A structure that is part of the limbic system and is involved in the emotions of aggression and fear.
Auditory Processing
The process of the brain recognizing and interpreting sounds in the environment. This process is responsible for the comprehension of language.
Autistic Disorder
A neurobiologic disorder with an unknown etiology, characterized by significant delay or deviation in social interaction, communication, and repetitive or stereotyped behaviors
Aspergergers disorder
A neurobiologic disorder of unknown etiology in which cognitive and communicative skills develop normally or nearly normal during
Casein
A protein found in cows milk. A theory in the field of autism suggests that children with autism do not digest this protein appropriatly, leading to a buildup of morphine-like substances in the body and causing social withdraw and abnormal behaviors
Cerebellum
A region of the brain that is found at the rear of the head and is above the brainstem. It has been traditionally known for its role in the coordination of movement, but recent research suggests the cerebellum may also have a role in cognitive, sensory, language, and abstract-thinking skills
Childhood Disintegrative Disorder
A rare neurobiologic disorder that develops in children who had appeared completely normal during their first few years of life. Following its onset, language, social interaction, and self care skills are lost and autistic like symptoms appear
Echolalia
The automatic and meaningless repetition of anothers words or phrases. In autism this may be immediate or delayed
Frontal Lobes
Region of the brain located at the front of the cerebrum. This region is responsible for social behavior, spontaneous production of language, initiation of motor activity, processing sensory stimuli and then planning reaction as a result of the input, abstract thinking, problem solving, and judgement.
Gastrointestinal Disorder
disorder of the GI tract
Gene
a region of DNA that carries the instructions for cells
Gluten
A protein found in wheat products. A theory in the field of autism suggests that children with autism do not digest this protein appropriatly, leading to a buildup of morphine like substances in the body and causing social withdrawal and abnormal behaviors
Hippocampus
A structure that is part of the limboc system and is involved in long term memory functions
Hyperlexia
The ability to read words above age-level expectation. Usually children with this ability have difficulty understanding the meaning of the words they read
Inferior Olive
region of the brainstem that transmits error signals to the cerebellum
Joint Attention
the ability to use eye contact and gestures in order to share experiences with others
Limbic system
This group of subcortical structures is involved in various emotions and memory functions
neurobiological
Of or relating to the biologic study of the nervous system. The cause of autism is considered to be an abnormality in the structure or function of the brain
neuron
A nerve cell that is specialized in transmitting and receiving electrical signals to communicate information between different regions of the body
purkinje cells
cells that form a layer near the surface of the cerebellum and convey signals away from the cerebellum
retts disorder
A rare neurobiologic disorder that primarily affects females and is caused by a deviation on the methyl-CpG- binding protein 2 gene. This disorder has a distincitive course since early development in children is typical, followed by the deceleration of head growth, loss of purposeful hand movements, and appearnace of autistic like symptoms
rote memory
The process of memorizing and using language overheard from others rather than producing spontaneously generated language
tactile defensiveness
A type of sensory defensiveness in which a person overreacts or avoids touching certain textures
theory of mind
The ability to understand another persons thoughts feelings or intentions
Mild MR
IQ 50-70
Moderate MR
IQ 35-50
Severe MR
IQ 20-35
Profound MR
IQ Below 20
5 Diagnostic Criterias for Autism Spectrum Disorder
Autistic Disorder
Pervasive Developmental Disorder (PDD-NOS)
Aspergers
Retts
Childhood Disintegrative Disorder
Hydrocephaly
The abnormal accumulation of cerebrospinal fluid in the brain
cortical tubers
form on surface of brain
subependymal nodules
form in walls of the ventricles
giant-cell astrocytomas
tumor blocking flow brain fluids
Classification of Mental Retardation 3 Compnents
Significantly subaverage intellectual functioning
An impairment resulting from an injury, disease, or abnormality that existed before age 18
An impairment in adaptive abilities
Associated Impairments of Mental Retardation (4)
Cerebral palsy
Seizure disorders
Sensory impairments (vision, hearing, tactile etc.)
Psychological / behavioral
Angelman Syndrome
Chromosomal
Severe MR
Speech impairment
Ataxia, poor balance
Behavior – laughter, smiling, apparent happy, excitable
Poor attention
Hand flapping, hypermotoric
May have
Small head, Seizures, Abnormal EEG, strabismus, tongue thrust/swallowing disorder, uplifted flexed arms when walking, prominent mandible, inc. sensitivity to heat, wide mouth, wide-spaced teeth, sleep disturbance, drooling, chewing/mouthing behaviors, flat back of hea
Cru-Du-Chat Syndrome
chromosomal abnormality
learning difficulties (most severe, some only mildly affected
1:50 000 people world-wide
cat cry = characteristic cry of newborns similar to mewing of a kitten
Cornelia de Lange Syndrome
low birthweight (often under five pounds),
slow growth and small stature, and small head size (microcephaly). small hands and feet
thin eyebrows which frequently meet at midline (synophrys), long eyelashes, short upturned nose and thin, downturned lips.
Less common characteristics:
excessive body hair (hirsutism),
partial joining of the second and third toes, incurved fifth fingers,
gastroesophageal reflux, seizures, heart defects, cleft palate, bowel abnormalities, feeding difficulties, and developmental delay
missing limbs or portions of limbs, usually fingers, hands or forearms
Praeder-Willi Syndrome
disorder of chromosome 15
Prevalence: 1:12,000- 15,000 (both sexes, all races)
Major characteristics: hypotonia, hypogonadism,
hyperphagia, cognitive impairment, difficult behaviors,
small hands and feet, morbid obesity
Sotos Syndrome
taller, heavier and have larger heads
sometimes called cerebral gigantism - distinctive head shape and size
delayed motor, cognitive and social development
low muscle tone
speech impairment
as child matures, many of these gaps narrow: the rate of growth slows down, muscle tone improves and with it speech and other motor skills improve.
Willliams Syndrome
Characteristic facial appearance
Dev Delay, LD, ADD
overly friendly (excessively social)
musculoskeletal problems
heart, blood vessel, kidney problems
hypercalcemia , hyperacusis
low birth-weight / low weight gain
feeding problems
irritability (colic during infancy)
dental abnormalities , hernias
Trisomy 13
severe MR
seizures
microcphaly
microphthalmia
micrognathia
scalp defects (absent skin)
cleft lip and/or palate
hypotelorism, iris defects
low set ears
simian crease on palms
polydactyly
hernias
undescended testicle
hypotonia
limb skeletal abnormalities
Trisomy 18
USUALLY DIE IN UTERO OR SHORTLY AFTER BIRTH
Heart defects:
Kidney problems
Intestinal problems
Excess amniotic fluid (polyhydramnios)
Clenched hands
Pocket of fluid on the brain (choroid plexus cysts)
Rocker bottom feet
Delayed growth
Small jaw (mycrognathia)
Small head (microcephaly)
Low-set ears
Strawberry-shaped head
Severe developmental delays
Umbilical or inguinal hernia
Noonans Syndrome
Developmental delay variable
Short stature
Congenital heart defect
Broad or webbed neck
Unusual chest shape
Apparently low-set nipples
Cryptorchidism
Ears
low-set
posteriorly rotated
fleshy helices
Eyes
wide-spaced
epicanthal folds
thick or droopy eyelids
Facial appearance striking
in new born period &
middle childhood, and
more subtle in the adul
Turners Syndromw
Only Females – one missing sex chromosome
Symptoms:
Neck webbing, congenital edema, cardiac problems infertile, visual perceptual problems, short stature
Klinefelters Syndrome
Males only - One or more extra x
chromosomes (XXY, XXXY, etc.)
Symptoms:
Learning disabilities
Emotional and behavioral problems
Tall, slim, hypogonadism, and infertile
There is also an XYY syndrome
Symptoms, may have:
Mild MR, tremors, decreased coordination, radioulnar stenosis, behavior issues
What chromosome is 95% of the time affected in Down Syndrome
Trisomy 21
Tourettes Syndrome
More common in boys than girls
Genetic (not completely understood)
Neurologic and behavioral symptoms -may have:
Involuntary vocal and motor tics (most characteristic symptom)
Obsessive -compulsive behavior
hyperactivity, distractibility, impulsivity
Tuberous Sclerosis
rare genetic neurological disease
benign tumors in brain and other vital organs
kidneys, heart, eyes, lungs, and skin
other common symptoms include:
seizures, mental retardation, behavior problems, and skin abnormalities
may be present at birth, however can be subtle and full symptoms may take some time to develop
three types of brain tumors associated :
cortical tubers, form on surface of brain;
subependymal nodules, form in walls of the ventricles; and
giant-cell astrocytomas
Neurofibromatosis (von Recklinghausen’s disease
Boys > girls
Causes multiple tumors (usually neurofibromas) on central and peripheral nerves, café au lait spots, and lesions in blood vessels and organs
Symptoms:
Mild MR or learning disabilities
Speech disorders
Hypertension, vision and hearing issues
Musculoskeletal anomolies, short stature
Phenylketonuria (PKU)
METABOLIC SYNDROME
Inability to metabolize
phenylalanine
Tested for at birth
If untreated results in severe cognitive and behavioral disabilities
Most common in Caucasian children
Tay-Sachs disease
METABOLIC SYNDROME
Absence of enzyme, hexosaminidase A
Common to Jewish people from Mediterranean region
Results in death in childhood (can be tested for – both parents need to carry gene)
Galactosemia
METABOLIC SYNDROMEI
nability to convert galactose into glucose
Without treatment may result in reduced cognitive, perceptual problems, tremors, choreoathetosis, and ataxia
Lesch-Nyhan syndrome
METABOLIC SYNDROME
Boys only – inability to metabolize purines
Progressive neuromuscular condition resulting in MR, spasticity, and self mutilation
What are the four metabolic diseases?
PKU
TAY SACHS DISEASE
GALACTOSEMIA
LESCH-NYHAN SYNDROME
Bayley Scale of infant development
psychological test for IQ
Verbal, motor and behavior development
1 – 42 months
Stanford Binet Intelligent Scale
psychological test for IQ
Verbal reasoning, visual reasoning, quantitative and short term memory.
11/2 years – adult
Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI – R)
Information, similarities, arithmetic, vocabulary, comprehension, sentences, object assembly, picture completion, geometric design block design, animal pegs, mazes. Motor and processing.
3-7 years
Wechsler Intelligence Scale for Children – Third Ed (WISC –III
Information, similarities, arithmetic, vocabulary, comprehension, digit span, picture completion, picture arrangement, block design, object assembly, symbol search, coding, mazes. Problem solving.
6 – 17 years
Leiter International Performance Scale – Revised (Leiter-R)
Measures intelligence and cognitive abilities nonverbally
Removes language bias
Shown not to have social or cultural bia
Anencephaly
lack of developmentof brain in utero- baby does nor survive
Encephalocele
incomplete closure of the cranium resulting in the protrusion of the nervous tissue and meninges
Dandy Walker Malformation
Location of hydrocephalus
Progressive cystic enlargement of the 4th ventricle
Chiari II malformation
Location of hydrocephalus
protrusion of cerebellar material into the foramen magnum
Syrinomyelia
Location of hydrocephalus
Fluid filled cavity in the spinal cord
Symptoms of increased cranial pressure in infant and child
infant: bulginf funtanelle and irritability

Child: headaches, vomitting, irritability, lethargy, strabismus, decreased vision
Treatment of Hydrocephalus
implantation of a shunt
OT treatment for hydrocephalus
OT treats residual symptoms not the actual hydrocephalus and monitoring of the shunt for infections, clogging, kinking or displacement
Spina Bifida
Congenital defect of vertebral arches & spinal column
Most common in lower thoracic, lumbar, or sacral area
Symptoms fo spina bifida occulta
Dimpling or pigmentation of skin or tufts of hair over lesion

Lipomas (soft moveable subcutaneous nodules) or tethering of the cord

Mild motor impairment or bowel and bladder problems
Spina Bifida Cystica
abnormality of the vertebra with protruding sac
Meningocele
meninges and CSF in sac occurs in spina bifida cystica
Myelomeningocele
nerve roots, meninges, and CSF in sac occurs in spina bifida cystica
OT treatment for spina bifida
Treatment of motor and sensory disturbances
Equipment and adaptations
Skill training
A seizure is.... and its symptoms are....
abnormal, unregulated electrical discharge that occurs within the brain‘s cortical gray matter and transiently interrupts normal brain function

Altered awareness / consciousness
Abnormal sensations,
Involuntary movements / convulsions
A generalized seizure....
– involve both hemispheres and consciousness is usually lost
Infantile spasms
Last between 6 and 24 months. Result in developmental delay
Absence seizure
Momentary loss of awareness (may appear as blink, glazed look, abrupt cessation of an activity)
No aura or recovery period
Tonic-clonic seizure
Aura or sensation followed by rigidity (tonic) then rhythmic contractions (clonic)
May last up to 5 minutes followed by sleep for few hours
Usually incontinent
Atonic/akinetic seizure
Loss of muscle tone
Myoclonic seizure
Contractions small groups
of muscles
OT treatment for seizures
address resultant symptoms

education adn environmental modifications
Medical treatment of seizures
medications

Ketogenic diet

Surgery
Tachypnea
Rapid breathing, often because of pulmonary congestion
cardiomegaly
enlarged heart
cyanosis
bluish discoloration of the skin, generally throughout the body, which indicates lack of oxygen
congenital heart disease
heart disease from birth
acquired heart disease
heart disease that develops later on in life
Respiratory Distress syndrome
Premature birth
Difficulty with O2 absorption
Due to surfactant deficiency in babies born before 34 weeks
Bronchopulmonary dysplasia
premature birth
Thickened airways and mucus production
Usually due to mechanical ventilation needed at birth
hemophilia
Prolonged clotting & excessive bleeding
Osteogenises Imperfecta
Hereditary collagen disorder resulting in brittle bones and loose joints (variation in severity)
OT treatment for OI
Protective equipment, splints
Education and lifestyle adjustment
Marfans Syndrome
Excessive growth at the epiphyseal plates resulting in:
long thin arms, legs, fingers etc.
Misalignment of joints and malformation of sternum
Malformations of the aorta
Ocular problems
(myopia and detached retina
OT treatment for Marfans Syndrome
OT treatment would be for
symptoms of poor
coordination, postural
stability, & scoliosis,
as well as possible cardiac
endurance issue
Achrondroplasia
genetic form of dwarfism
OT treatment for Achondroplasia
OT treatment may be for pain associated with bone deformities or adaptations for independence in a taller world
Arthrogryposis mutiples congenita
Arthrogryposis means ‘curved or hooked joints’ & describes multiple joint contractures at birth
Abnormal development in womb caused by:
Lack of movement
Abnormal, nerve, muscle or connective tissue development
Numerous fetuses
A genetic disorder like spinal muscular atrophy or trisomy 18
Most common form of arthrogryposis
Amyoplasia
Is cognition affected in arthrogryposis or amyoplasia
No cognition is not affected
OT treatment for Arthrogryposis
Maintenance & increasing functional ROM & strength
Serial casts, surgery, splints, ROM exercises
Adapted equipment & training for occupational performance in ADL’s, work, school, play and leisure
how do you dplint for congenital hip dislocation
splinting in abducted and flexed position
Congenital gip dislocation affects boys or girls more
Girls
A spica cast would be used for.....
congenital hip dislocation
Muscular Dystrophy
Progressive degeneration of the surface and internal membranes of the muscle cells
Cause – genetic
Symptoms – progressive muscle weakness
Most common muscular dystrophy and deadliest
Duchennes
Pseudohypertrophy
large weak muscles due to fat deposits
Beckers dystrophy
mild form of duchennes muscular dystrophy
OT treatment for Duchennes
maintenance of function
compensatory and adaptations to maximize participation
Facioscapulohumeral muscular dystrophy
Autosomal dominant
Usual onset between 7 and 20 years of age with slow progression (normal life expectancy)
Is an infantile onset variety with rapid progression
Symptoms – weakness of facial muscles and shoulder girdle
Difficulty whistling, closing eyes and raising arms
OT treatment for Facioscapulohumeral muscular dystrophy
maintenance of strength and function and compensation for weakness
Emery-Dreifuss dystrophy
Only males (females carrier)
Onset anytime before 20
Muscle weakness in biceps, triceps and distal leg muscles
Myotonic dystrophy
Males and females
Onset adolescence or young adulthood
Myotonia (delayed relaxation after muscle contraction), weakness facial and distal limb muscles
Congenital muscular dystrophy
Any MD present at birth or first year
Usually present as ‘floppy’ baby
Developmental Coordination Disorder
Also referred to in literature
Clumsy child syndrome
Congenital maladroitness
Specifically gross and fine motor problems
No other primary diagnoses such as sensory or intellectual impairment
May lead to secondary problems
Academic
Social
Participation
Often linked with speech and language disorders
Sensory Integrative Disorder
Also known as Sensory Integrative Dysfunction or Sensory Integrative Problems
Hetrogeneous group of problems presumed to be due to subtle neural differences in using multisensory systems to produce an adaptive motor output
Problems seen could involve skills in:
Motor
Sensory processing / modulation
Behavior / Social
Learning
Spasticity develops due to damage to the ?
Motor cortex
Spasticity
Increased muscle tone
When attempt to move tend to use attractor patterns (primitive reflexes)
Continued use of these patterns results in contractures in the agonists and weakness in the antagonists
Maintain fixed stable postures but lack mobility
Ataxic
Damage in cerebellum
Tremorous movements
Have mobility but not stability
Not usually at risk for contractures
hypotonia
decreased muscle tone (floppy baby)
Selective Dorsal Rhisotomy
procedure for CP, surgical snipping of SOME of the sensory nerve roots
OT treatment for CP
Remedial and compensatory strategies for promoting maximum participation in areas of occupation including:
Development of sensorimotor skills
Feeding
Assistive technology
ADLs, IADLs
Family education and support
PT treatment for CP
Remediation of sensorimotor skills
Mobility devices
Most common type of learning disorder
Reading
Most common neurobehavioral condition of childhood
ADD/ADHD
Symptoms of ADD
Present before age 7
Present in 2 or more settings
Causes impairment in functioning
Not better accounted for by another mental disorder
Subtypes of ADD/ADHD
Predominantly inattentive type
Predominantly hyperactive-impulsive type
Combined type
Retts disorder affects males or females
females only
The hallmark sign of childhood disintegrative disorder
Apparantly normal development for at least the first 2 yrs after birth then a significant loss of previously acquired skills before age 10
ABA (applied behavioral analysis) therapy
Intensive behavioral approach
One on one with trained worker
Up to 40 hours per week
Targets specific behavior – reward desired behavior
Positives – literature shows success in training specific behaviors
Criticisms – does not address socioemotional or sensory issues or generalize well
Developmental Individual-Difference, Relationship-Based Model (Floor Time)
Goals of treatment are to develop social communication and emotional thinking
Developmental approach using interactive experiences, which are child directed in a low stimulus environment.
Stages of Relating and communicating
Engagement (Birth to 8 months)
Two-way communication (6 to 18 months)
Shared Meanings (18-36 months)
Emotional Thinking (3 to 5 years)
SCERTS Model Social Communication, Emotional Regulation and Transactional Support
Treatment goals
Social communication
Enhance capacities for joint attention
Enhance capacities for symbol use
Emotional regulation
Enhance capacities for self-regulation
Enhance capacities for mutual regulation
Enhance capacity to recover from dysregulation
Transactional support
Educational and learning supports
Interpersonal supports
Family support
Support among professionals
TEACCH
A structured teaching approach used in North Carolina school systems
Structured teaching strategies individualized according to the strengths, skills, interests and needs of each child
Elements
Physical structure
Daily schedule
Work systems
Routines
Visual structure
Miller Method Language and Cognitive Development Center (Boston, Mass.)
Theorize children with ASD have system-forming disorders.
Development of body-world awareness combining motor cognitive and communicative strategies
Treatment goals are to expand the child’s systems by keeping the child on task and transforming stereotypic behaviors into functional interactions
Associated equipment = platforms, Swiss cheese boards and large swinging balls
Use symbol accentuation reading program and American sign language to teach communication
Son-Rise Program Options Institute
Option process = loving as non-judgmental method for resolving unhappiness and discarding self-limiting beliefs
Institute offers training for families to provide home based program
No scientific studies
Sensory Integration
Intervention to improve nervous system function.
Provide the child with enhanced levels of sensory information during physical activities that are meaningful to the child and that elicit adaptive behaviors
Key terms
Artful vigilance
Child-centered approach
Adaptive response
Just right challenge
Holding therapy
Child is held by parent in attempts to make contact with child.
During holding attempts are made to make eye contact and verbal connections
Child’s is held whether their response to the contact is positive or negative
Has been criticized as traumatic
Facilitated Communication
Hypothesis that individuals with ASD have a motor deficit that prevents them from expressing themselves but possess sophisticated symbolic language
Trained facilitators hold individual’s hand, wrist or arm to help them spell on message board or keyboard
Peer-reviewed, empirically-based research studies have not supported this approach
Berard approach
Auditory integration

retrain the auditory system by correcting hearing distortions
Music modified and filtered
Listening 30 minutes, twice/day for 10–12 days
Tomatis Approach
Auditory integration

improve listening and communication skills directly
Classical music and nature sounds
Over 6-12 months, 100 hours in 8 hour ‘loops
Fast Forward
Auditory integration

discrimination of phoneme differences at increasing speeds
Vision therapy
Optometrists who practice vision therapy may use lenses, prisms, filters or occlusion to help with attention problems in focusing
Educational Kinesiology Brain Gym
Designed by Dr. Dennison (educator) to improve sensory function by enhancing neuropathways
Used in school setting by entire classes
Drink lots of water
Prescriptive exercise routines with names like:
Brain buttons
Cross crawls
Hook ups
Higashi Daily Life Therapy
Developed by Dr. Kitahara for school program for individuals with ASD in Japan
Focuses on physical exercise, arts and vocational training
No known research studies
Interactive Guiding Affolter Approach
Use of tactile and kinesthetic input (hand over hand guiding) to facilitate initiation of activities

Nonverbal

Initiated and removed by therapist as needed
Priming
Breaking down and practicing a task in advance of using it in a situation
Provides familiarity with tools and routines in advance to allow more attention to the salient features of the in class task
Picture Exchange Communication System (PECS)
Augmentative communication system
Child hands an adult a picture of an object or activity they want.
The physical handing of the picture is designed to develop communicative initiation
No verbal prompts are given. However as the child hands the picture language is attached “oh you want a _______”
Token Systems
Visual, tangible and predictable system of positive reinforcement
Can be modified for more immediate or delayed gratification