Psychiatric And Cognitive Disorders

Front 1

SCHIZOPHRENIA

Back 1

Criterion A: The presents of two or more of the following symptoms:
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly Disorganized or catatonic behavior
5. Negative symptoms

Criterion B: Disturbances in one or more ares of function such as work, interpersonal relations, or self care

Criterion C: Continuous signs of the illness for 6 months including at least one more of symptoms that meet criterion A

Positive Symptoms: Criterion A

Negative Symptoms: Restricted emotions, decreased thought and speech, lack of motivation and initiative, inability to relate to others

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SUB TYPES OF SCHIZOPHRENIA

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Paranoid Type: Characterized by preoccupation with one or more delusions of persecution or grandeur; auditor hallucinations are frequently present; Individuals with paranoid type schizophrenia tend to exhibit fewer of the negative symptoms

Disorganized Type: Distinguished
by marked regression demonstrating primitive, disinhibited, and disorganized behavior

Catatonic Type: Characterized by severe disturbances in motor behavior involving stupor, negativism, rigidity, excitement or posturing

Undifferentiated Type: Used to classify those patients who do not clearly fit into one of the other categories

Residual Type: Used when there is continued evidence of schizophrenic behavior in absence of a complete set of diagnostic criteria

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SCHIZOPHRENIFORM DISORDER

Back 3

The individual meets the criteria for schizophrenia; however, the episode lasts more than one month but less than six months required for a diagnosis of schizophrenia

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SCHIZOAFFECTIVE DISORDER

Back 4

The person has an uninterrupted period of illness during which, at some time, there is a major depressive episode, a manic episode, or a mixed episode concurrent with symptoms that meet criterion A symptoms for schizophrenia

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DELUSIONAL DISORDER

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The individual's predominant symptoms are non-bizarre delusions with the absence of other criterion A symptoms of schizophrenia

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BRIEF PSYCHOTIC DISORDER

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The individual experiences at least one day but less than one month with one or more criterion A symptoms of schizophrenia which results from severe psychological stress

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PSYCHOTIC DISORDERS - IMPACT ON FUNCTION

Back 7

1. Deficits in the processing of sensory information
2. Socially inappropriate behaviors
3. Lost or failed to develop social and communication skills necessary for effective and satisfying interpersonal interactions and relationships
4. Deficits in cognitive function due to thought disorders and difficulties with the performance of basic skills interfere with all areas of occupation
5. Important to assess and continue to monitor the degree of assistance and structure needed to maintain optimum independence

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PSYCHOTIC DISORDERS - SPECIFIC OT CONSIDERATIONS

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1. OT needs to communicate simply, clearly, and concretely
2. External structure to organize the individual's thinking, environment, and daily activities is often required
3. The provision of supports and tools to enable recovery is essentials (eg WRAP - Wellness and Recovery Action Plan)

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MAJOR DEPRESSIVE DISORDER

Back 9

Mood disorder
One or more depressive episodes
May be a single episode or recurrent episode

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BIPOLAR I DISORDER

Back 10

Mood disorder
One or more manic episodes
May be combined with depressive episodes

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BIPOLAR II DISORDER

Back 11

Mood disorder
One or more major depressive episodes
There must be at least one hypomanic episode

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DYSTHYMIA

Back 12

Characterized by at least 2 years of a depressed mood, most days, with depressive symptoms that are not severe enough to meet the criteria for a major depressive pisode

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CYCLOTHYMIC

Back 13

Characterized by at least 2 years with numerous periods of hypomanic and depressive symptoms that do not meet the criteria for a manic episode or a major depressive episode

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MANIC EPISODE

Back 14

A distinct period of abnormally and persistently elevated, expansive or irritable mood lasting at least one week

During this period, three or more of the following symptoms must persist:
1. Inflated self-esteem or grandiosity
2. Decreased need for sleep
3. More talkative than usually or pressured to keep talking
4. Flight of idea or feeling that thoughts are racing
5. Distractibility
6. Increased in goal-directed activity or psychomotor agitation
7. Excessive involvement in pleasurable activities that have high potential in painful consequences

Behavior often associated with a manic episode:
1. Treatment-resistant resulting from failure to recognize illness
2. Suggestive or flamboyant dress
3. Gambling, promiscuity, excessive spending, or giving things away
4. Irritable, assaultive or suicidal behavior

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MANIC EPISODE - IMPACT ON FUNCTION

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1. Lack of inhibition experienced during a manic phase may lead to excessive sending, impulsive travel, flamboyant and promiscuous dress and/or behavior

2. Individuals may be euphoric in early phases, but may become labile, threatening and assaultive

3. Individuals may have high, often undirected, energy levels and require little sleep

4. Poor judgment can lead to dangerous situations, poor self care, problems in relationships, and decreased or irresponsible work performance

5. The incidence of substance abuse is increased

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MANIC EPISODE - OCCUPATIONAL THERAPY CONSIDERATIONS

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1. Limit-setting to reduce the individual's fears of losing control, increasing participation in the intervention process, and promote safety

2. Engagement in activities that provide for release of excess energy in a positive therapeutic manner

3. Periods between episodes should be used to educate the individual, the family and significant others on symptom management

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MAJOR DEPRESSIVE EPISODE

Back 17

A two week period of depressive mood or loss of interest or pleasure

Five or more of the following symptoms:
1. Depressed mood most of the day
2. Markedly diminished interest or pleasure
3. Weight loss/gain, increased/decreased appetite
4. Insomnia/hypersomnia
5. Psychomotor retardation/agtiation
6. Fatigue, loss of energy
7. Feelings of worthlessness or guilt
8. Diminished ability to concentrate/make decisions
9. Recurrent thoughts of death/suicide (with or without a plan), suicide attempt

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MAJOR DEPRESSIVE EPISODE - BEHAVIORS

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1. Irritability, anxiety, phobias, and obsessive thinking
2. Difficulties in social interactions, relationships, and sexual function
3. Self-destructive behavior including suicide and substance abuse
4. There may be an increased use of medical services

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MAJOR DEPRESSIVE EPISODE - IMPACT ON FUNCTION

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1. Individuals are often tearful, brooding, and isolative

2. Anxiety leads to excessive concerns about physical health, complaints of pain, and alcohol abuse

3. Hopelessness, lack of energy, and slow thought processing lead to limited interest in activity and difficulty performing tasksin all areas of occupation

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MAJOR DEPRESSIVE EPISODE - OCCUPATIONAL THERAPY CONSIDERATIONS

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1. The provision of a safe environment and the management of behaviors that threaten the safety and well being of the individual are paramount
a. Individuals must be closely monitored for self-destructive and/or suicidal behavior
b. The most dangerous time may be when the depression being to life and the person becomes mobilized

Front 21

MIXED EPSIODE

Back 21

The criteria are met for both a manic episode and a major depressive episode for at least one week

Front 22

HYPOMANIC EPISODE

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Symptoms are the same as for a manic episode; however, they are not severe enough to cause marked impairment in social or occupational function or to require hospitalization

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SUBSTANCE DEPENDENCE

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There must be evidence of tolerance and withdrawal
1. Tolerance to ta substance results in diminished effects from taking the same amount of a substance and the need to use increasing amounts to experience the desired effect
2. Withdrawal refers to the symptoms (specific to the substance) that occurs with decreased or discontinuation; substance is then used not for pleasure but to prevent or relieve the withdrawal symptoms

Individual continues to use the substance depsite serious consequences

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SUBSTANCE ABUSE

Back 24

There must be continued use despite serious consequences

Front 25

SUBSTANCE RELATED DISORDERS - IMPACT ON FUNCTION

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The impact of substance use has on the individual depends on the type of substance used and on whether the individual is abusing the substance, or is dependent upon it

Results of disorders of use
1. Disinterest and inability to care for self
2. Difficulty with and loss of person relationships
3. Inability to be productive and/or hold a job
4. Involvement of the legal system

Prolonged use may lead to severe physical, cognitive and psychiatric problems and can result in death

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SUBSTANCE RELATED DISORDERS - CONSIDERATIONS FOR OCCUPATIONAL THERAPY

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Due to the presence of learned "survival skills", the individual's abilities and potential may be overestimated
1. The OT apprises the team of the person's actual skills and deficits as evident during eval and treatment
2. OT assists the team in identifying realistic expectations and discharge plans

The individual's identification of the reasons for substance use, is important to address during the evaluation process

The development of the skills necessary to cope with life stressors without substance use is critical for a substance-free lifestyle, skills needed include:
1. Communication and social skills
2. Skills to engage productivity in work or education
3. Skills to use leisure time without using substances

Front 27

PANIC ATTACKS

Back 27

Panic attacks are symptoms of anxiety, they are not coded for diagnoses

Panic attacks are discrete period of intense fear or discomfort, in which four or more symptoms develop abruptly and reach a peak within ten minutes: palpitations/accelerated heart rate, sweating, trembling, sensations of shortness of breath, feeling of choking, chest pain, nausea, feeling dizzy, derealization, fear of losing control/going crazy, fear of dying, parethesias, chills/hot flashes

Front 28

AGORAPHOBIA

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Agoraphobia associated with panic attacks.
1. Anxiety about being in places or situations from which escape may be difficult or embarrassing, or in which help may not be available if needed
2. Situation are avoided or endured with anxiety about having a panic attack

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PANIC DISORDER

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Recurrent panic attacks followed at least once by concern for recurrence

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SPECIFIC PHOBIA

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A clinically significant anxiety from a specific object or situation leading to avoidant behavior

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SOCIAL PHOBIA

Back 31

A clinically significant anxiety from certain types of social or performance situations leading to avoidance

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OBSESSIVE-COMPULSIVE DISORDER

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1. Obsessions are recurrent and persistence thoughts, images, or impulses that are disturbing, intrusive, and inappropriate
2. Compulsions are repetitive behaviors that the person is driven to perform to reduce anxiety or prevent a dreaded event of situation
3. The obsessions or compulsions are time-consuming and distressing despite the individuals awareness of their irrationally

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POST-TRAUMATIC STRESS DISORDER

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1. The persistent re-experiencing (for more than one month) of extremely traumatic event that produces symptoms of increased arousal
2. Results in avoidance of stimuli associated with the traumatic event

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ACUTE STRESS DISORDER

Back 34

1. Similar to post-traumatic stress disorder, however, it immediately follows the event
2. The symptoms do not persist beyond one month

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GENERALIZED ANXIETY DISORDER

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1. Consists of 6 months of persistent and excessive unfocused anxiety and worry

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ANXIETY DISORDERS - IMPACT ON FUNCTION

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1. The degree of impact varies with the severity and type of anxiety disorder
2. Reactions may vary from temporarily discomfort to severely avoidance and paralyzing behavior

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ANXIETY DISORDERS - CONSIDERATIONS FOR OCCUPATIONAL THERAPY

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1. Skills training and using cognitive behavioral approaches may reduce avoidant behavior
2. Developing relaxation and stress management skills may decrease the incidence and severity of symptoms
3. Providing graded activities designed to promote self-efficacy may increase self-confidence, motivation and participation in intervention

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PERSONALITY DISORDERS - CLUSTER A

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1. Peranoid, schizoid, and schizotypical
2. Individuals with these disorders are often perceived as odd and eccentric

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PERSONALITY DISORDERS - CLUSTER B

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1. Antisocial, borderline, histrionic and narcissistic
2. Individuals with these disorders are often perceived as dramatic, emotional, and erratic

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PERSONALITY DISORDERS - CLUSTER C

Back 40

1. Avoidant, dependent, obsessive-compulsive, and those not otherwise specified
2. Individuals with these disorders are often perceived as anxious or fearful

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PARANOID PERSONALITY DISORDERS

Back 41

Cluster A

1. Persons with this disorder are characterized by long-standing suspiciousness and mistrust of people in general
2. They refuse responsibility for their own feelings and assign responsibility for them to others
3. They can often appear hostile, irritable and angry

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SCHIZOID PERSONALITY DISORDERS

Back 42

Cluster A

1. This is frequently diagnosed in individuals who display a lifelong pattern of social withdrawal
2. Their discomfort with human interaction, their introversion, and their bland, constricted affect are noteworthy
3. Persons with schizoid personality disorder are often seen by others as eccentric, isolated , or lonely

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SCHIZOTYPAL PERSONALITY DISORDER

Back 43

Cluster A

1. Persons with this disorder appear odd or strange in their thinking and behavior to those who come into contact with them
2. Magical thinking, peculiar ideas, idea of reference, illusion, and derealization are part of this individual's everyday world

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ANTISOCIAL PERSONALITY DISORDER

Back 44

Cluster B

1. This disorder is characterized by continual antisocial or criminal acts, but is not synonymous with criminality
2. It is an inability to conform to social normal that involves many aspects of the individual's adolescents and adult development
3. Persons with anitsocial personality disorder have no regard for the safety or feelings of others and they lack remorse

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BOARDERLINE PERSONALITY DISORDER

Back 45

Cluster B

1. Individuals with borderline personality disorder experience extraordinarily unstable affect, mood behavior, relationships and self-image
2. Fear of real or imagined abandomnment leads to frantic efforts to avoid it
3. Recurrent self-destructive or self-mutilating behavior may be threatened or carried out
4. Majority of patients have a history of trauma

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HISTRIONIC PERSONALITY DISORDER

Back 46

Cluster B

1. This disorder is characterized by colorful, dramatic, extroverted behavior in excitable, emotional persons
2. An inability to maintain deep, long-lasting attachments with accompanying flamboyant presentation is often characteristic

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NARCISSISTIC PERSONALITY DISORDER

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Cluster B

1. Person with this disorder are characterized by a heightened sense of self-importance and a grandiose feeling that they are special in some way

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AVOIDANT PERSONALITY DISORDER

Back 48

Cluster C

1. Person with this disorder show an extreme sensitivity to rejection, which may lead to a socailly withdrawn life
2. These individuals are not, however, asocial. They show a great desire for companionship but consider themselves inept or unworthy
3. Individuals with avoidant personality disorder need unusually strong repeated guarantees of uncritical acceptance
4. These persons are commonly refered to as having an inferiority complex

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DEPENDENT PERSONALITY DISORDER

Back 49

Cluster C

1. Persons with this disorder subordinate their own needs to those of others and need other to assume responsibility for major areas in their lives
2. Individuals with dependent personality disorder lack self-confidence
3. They may experience discomfort when alone for more than a brief period

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OBSESSIVE-COMPULSIVE PERSONALITY DISORDER

Back 50

Cluster C

1. Characterized by emotional constriction, orderliness, perseverance, stubbornness and indecisiveness
2. The essential feature is a pervasive pattern of perfectionism and inflexibility
3. It should not be confused with OCD

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PERSONALITY DISORDERS NOT OTHERWISE SPEFICIED

Back 51

1. Passive-aggressive
2. Depressive
3. Sadomasochistic
4. Sadistic

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PERSONALITY DISORDERS - CONSIDERATIONS FOR OCCUPATIONAL THERAPY

Back 52

1. Assist the individual to identify degree of impact on daily occupations may result in increase commitment to treatment and behavioral change
2. Cognitive behavioral approaches can (including DBT) can increase functional and coping skills and may decrease symptomatic behavior

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DELIRIUM

Back 53

1. A disturbance of consciousness (awareness of environment) with a decreased ability to attend

2. There is a change from previous cognition and/or perception

3. It covers a short period of time and tends to fluctuate

Front 54

DEMENTIA

Back 54

1. Disturbances of memory and multiple cognitive deficits: aphasia, apraxia, agnosia, disturbance of executive functioning

2. Often includes personality disturbances

3. Must lead to functional problems

4. Represents a decline in the person's previous level of cognitive

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AMNESIC DISORDER

Back 55

1. Difficulty with memory only, but sufficient to cause functional difficulty

2. Causes: CVA, MS, Korsakoff's syndrome, alcoholic blackouts, electroconvulsive therapy, TBI, transient global amnesia

Front 56

COGNITIVE DISORDERS - IMPACT ON FUNCTION

Back 56

1. The degree of impact varies according to the nature and severity of symptoms

2. The individual may require intervention varying from education in compensatory strategies to the need for total care

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COGNITIVE DISORDERS - CONSIDERATIONS FOR OCCUPATIONAL THERAPY

Back 57

1. Maintenance of quality of life through activity adaptations and environmental modification

2. Family education to understand the nature of the person's disorder and improve the management of its symptoms and functional effects

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ANOREIXA NERVOSA

Back 58

Diagnostic Criteria:
1. Refusal to maintain body weight at or above normal weight, or failure to make expected weight gain during a period of growth

2. Intense fear of gaining weight or becoming fat

3. Disturbance in the way in which one's body weight or shape is experience

4. Absence of menstrual cycle

5. Anorexia includes a food restrictive type and a binge eating/purging type

Individuals often exhibit obsessive/compulsive behaviors, depression, anxiety, rigidity, perfectionism, and poor sexual adjustment

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BULIMIA NERVOSA

Back 59

Diagnostic Criteria:
1. Recurrent episodes of binge eating defined as a lack of control over discrete periods of excessive eating of an abnormally large of food

2. The purging type includes recurrent, inappropriate compensatory behavior in order to prevent weight gain: self-induced vomiting, use of laxative and/or diuretics, fasting, excessive exercising

3. Binge eating and purging behaviors both occur, on average, at least twice a week for three months

4. Self-evaluation is unduly influenced by body shape and weight

5. The disturbance does not occur exclusively during episodes of anorexia nervosa

Individuals are often obsessed with their appearance and attractiveness to the opposite sex and they are likely to be sexually active and maintain a normal weight

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EATING DISORDERS - IMPACT ON FUNCTION

Back 60

1. ADL such as self care, eating, and feeding can be severely disrupted

2. IADL such as shopping for clothing and food, meal preparation and cleanup, and health management and maintenance can be significantly affected

3. Work skills can be intact unless food-restricting behaviors and/or medical problems interfere with skill development

4. Leisure skills can be intact unless affected by food-restricting behaviors and/or medical complications

5. Social participation can be greatly impacted by the excessive use of food-restricting behaviors

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EATING DISORDERS - CONSIDERATIONS FOR OCCUPATIONAL THERAPY

Back 61

1. The building of trust is essential to effective intervention

2. OT must be honest, supportive and gently confrontational when indicated

3. Evaluation and intervention must include identification of the socio-emotional needs the eating disorder had fulfilled for the person so that health-promoting occupation-based alternatives can be explored and developed

4. Education about nutritional food management and development of healthy leisure time

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OPPOSITIONAL DEFIANT DISORDER (ODD)

Back 62

Negativistic, hostile and defiant behaviors that result in functional impairment

Onset: school age

Front 63

CONDUCT DISORDER

Back 63

Disregard for the rights of others leading to aggression towards people and animals, destruction of property, deceitfulness, theft, or serious violation of rules

Front 64

DISRUPTIVE BEHAVIOR DISORDERS - IMPACT ON FUNCTION

Back 64

1. Children with distruptive behavior disorders have difficulty at school and with the formation of healthy social and familial relationships

2. Difficultly within the family affects not only the child but all family members and their role performance

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DISRUPTIVE BEHAVIOR DISORDERS - CONSIDERATIONS FOR OCCUPATIONAL THERAPY

Back 65

1. The child's goals, stressors, and family and socail relationships should be considered

2. Skill development may improve emotional adjustment

3. Behavioral approaches must be consistent through out all programming

4. OT should assist the parents, other family members, teachers and other school personnel to understand the nature of the child's condition and develop strategies for behavioral management

Front 66

AUTISM

Back 66

Presents of at least six items from the listing below including two or more from (1) and at least one from (2) and (3)

(1) Impaired social interaction and in most cases cognitive disabilities
A. Impaired nonverbal behaviors (poor eye-contact, impaired attachment, anxiety with changes in atypical routines)
B. Difficulty relating to other and forming relationship at an age appropriate level
C. Lack of spontaneous social seeking behavioral interactions other others and awareness of others' bids for attention
D. Lack of social reciprocation due to decreased ability to infer feeling and intentions of others

(2) Difficulty with communication
A. Lack of initiation, reflection, development of spoken language or alternative means for communication
B. If speech is developed, difficulty in initiating or engaging in conversation and lack of appropriate context
C. Stereotyped echolalia and/or use of indiscernible language
D. Lack of spontaneous pretend, imitative, or exploratory play

(3) Repetitive and stereotyped behaviors and movements in one or more of the following
A. Ritualistic nonfunctional routines, preoccupation
B. Rigid observance of nonfunctional routines or behavioral patterns
C. Repetitive motor actions (e.g. flapping, head banging, etc)
D. Restrictive fixation on part of a whole object (eg wheel of a toy car)

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ASPERGER'S DISORDER

Back 67

Diagnostic Characterization
1. Difficulty with social interaction
2. Restricted interests and behaviors
3. Characterized by clumsiness
4. Delayed developmental motor milestones
5. Differentiated from autism by adequate language and the level of social interaction and engagement in activities with others

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RETT'S SYNDROME

Back 68

Diagnostic Characteristic
1. Deterioration of language, receptive and expressive communication skills and social skills may plateau at a six month to one year developmental level
2. Muscle tone becomes hypotonic and then progresses to spasticity and then rigidity
3. Muscle wasting can make these children prone to scoliosis and eventually may necessitate the use of a wheelchair
4. Breathing patterns become irregular, marked by hyperventilation, apnea, and holding of breath
5. EEGs are abnormal and seizures are common

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PERVASIVE DEVELOPMENTAL DISORDER, UNSPECIFIED

Back 69

1. Disorders are similar with impairments seen in other Autism Spectrum Disorders

2. Impairments are evident in social interaction, communication, motor behavior, interests and activities; however, they cannot be classified as indicative of an autims spectrum disorder since not all diagnostic criteria are met

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AUTISM SPECTRUM/PERVASIVE DEVELOPMENAL DISORDERS - CONSIDERATIONS FOR OCCUPATIONAL THERAPY

Back 70

1. Evaluate developmental and functional levels
2. Develop sensoriomotor, social interaction, vocational readiness, and community participation skills relevant to the child's level
3. Provide sensory intergrated interventions, as needed
4. Provide adaptive and positioning equipment, as needed
5. Collaborate with the family and interdisciplinary team to promote occupational perfomance and social participation

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REACTIVE ATTACHMENT DISORDER (RAD)

Back 71

Inhibited Type:
1. Persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions
2. Interactions are excessively inhibited, hyper vigilant, or highly ambivalent and contradictory in nature

Disinhibited Type
1. Indiscriminate sociability with inability to exhibit appropriate selective attachments
2. Demonstrated by excessive familiarity with relative stranger or lack or selectivity

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REACTIVE ATTACHMENT DISORDER - IMPACT ON FUNCTION

Back 72

1. These children are frustrating to work with and difficult to parent
2. They have a high need to be in control
3. The frequently lie
4. Affectionate and related with strangers
5. Frequent episodes of hoarding or gorging on food without physical need
6. Deny responsibility/project blame for their actions

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REACTIVE ATTACHMENT DISORDER - CONSIDERATIONS FOR OCCUPATIONAL THERAPY

Back 73

1. Close and ongoing collaboration with the child's family facilitates successful outcomes
2. Actively involve parents in treatment
3. Assist children to form a more secure sense of self
4. Limit the child's exposure to multiple caregivers
5. Provide high levels of structure and consistency
6. Goals need to be specific, realistic and attainable

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ATTENTION-DEFICIT/HYPERACTIVITY DISORDERS

Back 74

Three Sub-types:
1. Predominantly inattentive
2. Predominantly hyperactive-impulsive type
3. Combined type

1. Presents of six or more symptoms of inactivity domain, the hyperactivity domain or both
2. Symptoms must interfere with occupational activities and be present for six months or more
3. Inattention symptoms: lack of attention to detail, poor listening, limited follow thoughts of tasks, difficulty with organization, avoidance of tasks that require sustained attention, tendency to lose things, predictability, and forgetfulness
4. Hyperactivity symptoms: fidgeting, inability to remain seated, inappropriate activity level, difficulty with quiet sedentary activities, frequent movements, and excessive talking
5. Impulsivity symptoms: answering questions before they are fully stated, difficulty with turn taking, and interrupting the conversations or activities of others
6. Visual-perceptual, auditory-perceptual, language and/or cognitive problems may be present
7. Symptoms must be present in two settings (ie school and home)

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ATTENTION-DEFICIT/HYPERACTIVITY DISORDERS - IMPACT ON FUNCTION

Back 75

1. Infants are over-active, difficult to sooth when crying, and demonstrate poor sleeping habits
2. Defensiveness to environmental stimuli, frequent irritability, aggressive behavior, emotinal lability, and fluctuating and unpredictable performance
3. Difficulty with delayed gratification in the school and home environment
4. Deficits in academic and/or social function
5. Deficits in perceptual motor tasks with disorders in reading, mathmatics, written expression and general coordination resulting
6. Disorders of memory, thinking, speech and hearing
7. Depression secondary to frusteration and difficulty with learning (often leads to low-self esteem)
8. Individuals with symptoms remaining in adolescence and adulthood are prone to antisocial personality disorders, and are at risk for substance-related disorders

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ATTENTION-DEFICIT/HYPERACTIVITY DISORDERS - CONSIDERATION FOR OCCUPATIONAL THERAPY

Back 76

1. Behavior's impact on school, home, play/leisure and social participation must be considered
2. Environmental modifications and activity adaptions to home, school and other environments
3. Training in social skills and self-management can improve adaptive behaviors
4. Sensory modulation
5. Consulting with parents, family members, teachers and employees
6. Ongoing collaboration with individuals education planning team members and parents is vital, in school practice

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INTELLECTUAL DISORDERS

Back 77

Diagnosis is based on the measurement of IQ, individuals with IQ below 70 (two standard deviations below the mean) are considered to have an intellectual disability

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MILD INTELLECTUAL DISABILITY

Back 78

IQ range: 55-69
Focus is placed on the individual acquiring social and vocational skills to function interdependently in desired occupational roles
Minimal support required
Additional intermittent support may be required in special circumstances

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MODERATE INTELLECTUAL DISABILITY

Back 79

IQ range: 40 - 54
Focus is usually placed on the individual acquiring independence in routine daily skills and skills necessary to perform in desired occupational roles with supports and structure
Limited support and assistance may be required in specific occupational performance areas on a daily basis
Supervised living is required

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SEVERE INTELLECTUAL DISABILITY

Back 80

IQ range: 25-39
Focus is usually placed on the individual acquiring communication skills and some basic health habits
Assistance is required for performance of most tasks
Supervised living is required
Significant impairments in motor functioning and physical development are typical

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PROFOUND INTELLECTUAL DISABILITY

Back 81

IQ range: 25 or below
Assistance and ongoing supervision are required for basic survival skills
Significant impairments in motor functioning and physical development are typical
Supervised living is required

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INTELLECTUAL DISABILITY - IMPACT ON DEVELOPMENT

Back 82

1. Cognitive development: slower learning, shorter attention span, difficulty with problem solving and critical thinking, difficulty with generalizing information
2. Motor development: slower attainment of physical milestones, uncoordinated movements, low muscle tone
3. Sensory development: diminished sensory modulation abilities, hyper- or hypo- sensitivity to all sensory stimuli
4. Language development: decreased ability in recalling and retrieving words, grasping and expressing concepts and difficulty with the motor aspects of speech
5. Pychosocial development: Impaired ability to respond to social cues, hyperactivity and distractability

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INTELLECTUAL DISABILITY - CONSIDERATIONS FOR OCCUPATIONAL THERAPY

Back 83

1. Self-determination and person-centered planning within the person's capabilities should be a priority
2. Support and assistance may be required to address performance skills and patterns in areas of occupation
3. Developmental community and social participation skills are a major focus
4. Interdisciplinary team and family collaboration is helpful to support the development of the person's functional and social skills and promote participation in areas of occupation
5. Collaboration of educational team`

Front 84

OCCUPATIONAL THERAPY MENTAL HEALTH EVALUATION

Back 84

1. Determine the values, interests, desired occupational roles and self-determined goals
2. Identification of cognitive, perceptual and psychosocial strengths and skills and their ability to facilitate recovery
3. Identification of cognitive, perceptual, and psychoscoial deficits and limitations and their impact on function and life style
4. Determination of functional problems associated with psychiatric symptoms (safety awareness, judgement, etc)
5. Treatment history and ability and interest to engage in recovery
6. Identification of coping skills, stressors, and environmental and social support

Front 85

OCCUPATIONAL THERAPY MENTAL HEALTH INTERVENTION ACUTE HOSPITAL

Back 85

1. Management of all behaviors that threaten the safety and well being of the indiviudal as well as that of others on the unit
2. Stabilization of behaviors to enable engagement in intervention
3. Engagement in activities that are 'do-able'/brief and structured to enable success and promote reality-based thinking (graded activities)
4. Engagement of the person in the treatment process
5. Development of the skilled needed to pursue desired occupational roles and attain self-determined goals
6. Engagement in activities to improve communication skills and self-expression
7. The gathering and sharing of ongoing assessment information with the treatment team
8. Assistance with discharge planning to support recvovery and a healthy life style

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OCCUPATIONAL THERAPY MENTAL HEALTH INTERVENTION LONG TERM HOSPITALIZATION

Back 86

1. Development and implementation of a plan for self-determined goal achievement
2. Provision of a normalizing environment that enables participation in meaningful and desired occupational roles
3. Engagement of the person in the treatment process
4. Provisions of graded activities to develop skills in all areas of occupation
5.