18-Month-Old David in a Clinic Setting (GROSS MOTOR (ADL impaired:…
18-Month-Old David in a Clinic Setting
Picky-eater: only eats mechanized/pureed food
An 18-month old child should be able to eat coarsely chopped table food, some raw fruits, and most cooked meats. They should also have controlled and sustained bites, chew with their lips closed, and demonstrate rotary chewing.
ADL impaired feeding
ST Goal: The client will eat food that is partially pureed in 3 weeks with minimal assistance using less than 3 physical cues in 2/5 opportunities during meal or snack time.
LT Goal: In 9 weeks, the child will eat one solid food item with less than 3 verbal cues in 4/5 opportunities during meal or snack time.
Does not ambulate at 18 months
Should consider postural control and balance (vestibular functions)
At 18 months of age, a child should be able to perform gross motor activities such as kicking a ball, run, and climb on chairs
ADL impaired: functional mobility
ST Goal: In 6 weeks, the client will take 10 steps with less than 3 verbal cues, during play. LT Goal: In 12 weeks, the client will walk independently.
Does not utilize utensils to eat
ST Goal: In 3 week, the child will have a spherical grasp when using a utensil with less than 3 physical cues. LT Goal: -In 11 weeks, Daniel will feed independently using utensils without any physical cues.
At 18 months, a child should be able to scoop food with a spoon and bring it to their mouth. Their wrist and shoulder should be stable enough to perform this percise movement.
ADL impared: Feeding
Intervention ideas: use fork and spoon (of child’s choosing when presented with a variety of handles) during play activities to teach function of feeding (create game where child stabs fork into marshmallow and fills one plate to another, use spoon with dry cereal with bowl)
Person-Environment-Occupation-Performance Model (PEOP)
: Focus on independent feeding and functional mobility. Encourage walking with play.
Model of Human Occupations (MOHO):
For volition, incorporate toys to build fine motor skills. For habituation, modify his feeding habits (less pureed food). For performance, create opportunities for client to use utensils.
Frame of Reference
Sensory Integration FOR:
Address hypersensitivity to sensory stimuli (solid foods) and improve vestibular functions.
Lifespan Development FOR
: Establish age-appropriate occupations (walking independently and self-feeding).
By: Ashley Abrego, Kaitlyn Bean, Chelsea Forse, Naomi Huynh, Linda Mai, Caroline Marin, Laura Ponder, Christine Tran, Melissa Williams