Please enable JavaScript.
Coggle requires JavaScript to display documents.
Barret- 2.5 y/o (Interventions (Impaired Visual Guided Reach (Use bright…
Barret- 2.5 y/o
Interventions
-
-
-
-
Independent Feeding
- Give Barrett adapted utensils (norco universal cuff utensil) to allow him to scoop foods and release
- Practice thera-puddy exercises for hands to practice grasp and fine motor patterns
Bathing/Showering
- Quick showers to prevent long periods of stress on trunk
- Allow Barrett to choose toys and items to use during bathing time
Client Assessment
History
- Born 39 weeks gestation via C-section and was resuscitated at birth due to true-knot in umbilical cord reducing blood flow.
- Diagnosed with cerebral palsy, cortical visual impairment by age 1 y/o.
- 2 years of age diagnosed with quadriplegic cerebral palsy with dystonia
-
Method of Feeding
- Uses plastic patterned utensils for eating
- Needs hand over hand assistance with scooping and letting go
- Eats purees and soft foods
- Drinks nectar thick liquids
Caregiver Priority
- independent feeding
- lack of communication with peers/family
- functional mobility
- not consistent with grasping utensils during feeding
- inability to sit for long periods during bathing and dinner time
Client Factors
- Impaired strength – unable to maintain unsupported sitting; poor head/neck control
- Retained ATNR and STNR; absent protecting reactions
- Hypotonia in core with hypertonia in extremities
- cognitively appears intact
Grading Activity
Feeding
- UP: Once food preference is established, allow Barrett to practice using adapted utensils to feed himself independently with no cuing. Use bright colored utensils and plates that are visually appealing to Barrett so that he will be able to visually grab objects.
- DOWN: Use hand over hand techniques to assist Barrett in scooping food and placing into mouth using adapted utensils.
Communication
- UP: Give Barrett communication board with multiple options to communicate with family/peers independently
- DOWN: Give Barrett less choices on communication board to allow him to practice communicating basic needs/wants.
Bathing/Showering
- UP: Use toys as a reward for good behavior during bathing time; only given after bath is complete.
- DOWN: Present him with toy options to play with before and during bathing time. Use positive reinforcement to encourage Barrett that he only gets to play with toys during bathing time.
-
-
Goals
Baseline: Barrett is unable to reach for sippy cup with straw 5/5 due to impaired visual guided reach.
Short Term Goal
Within 3 weeks, Barrett will independently reach and drink from sippy cup, 5/5 during family dinner, as per parent report.
Baseline: Barrett is unable to maintain seated position during family dinner 5/5 due to truncal hypotonia.
Long Term Goal
Within 12 weeks, Barrett will maintain seated position through duration of family dinner 4/5 dinners, with minimal assist, as per parent report.
Approach to Intervention
- establish/restore- increase truncal strength, decrease hypertonicity in extremities, establish communication strategies
- modify- use adaptation devices and options during feeding, modify bathing routine
References:
Morris, S.E. & Klein, M.D. (2000). Treatment Strategies and Activities. In Pre-Feeding skills, 2nd ed. (pp. 402-410). USA: Therapy Skill Builders