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Brook -15 months old (2 Models/FOR (Biomechanical FOR for positioning…
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Assessment (history, functional performance, full picture of the child)
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poor strength & endurance, limited UE WB
3 mo- Seizure activity, medications administered
low tone, poor posture in supported sitting, no protective reactions
Diagnosed with panhypopituitarism, adrenal insufficiency (Addison’s Disease), growth
hormone deficiency (GHD), and hypothyroidism
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1 mo, G tube & Nissen surgergies
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Spent 6 weeks in NICU due to insufficient feeding, fatigue, jaundice
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Grading, 1 intervention per problem
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Grading UP: Brook will imitate feeding with stuffed animal and "feed" the stuffed animal as well as caregiver or OT with spoon from plate to mouth for 5 minutes.
Grading UP: Brook will sit on the floor and work on postural muscles with minimal support and reach laterally for objects for 10 minutes.
Grading DOWN: Introducing deep pressure and sensory items around Brook's mouth and arms but not inside mouth yet.
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References:
Morris, S.E., & Klein, M.D. (2000). Creating the mealtime plan. In Pre-feeding Skills,
(2nd ed.) (pp, 230-233). San Diego, CA: Therapy Skill Builders
Elliott, C. (2012). Transitioning to spoon feeding and solids. In K.VanDahm (Ed.),Pediatric Feeding Disorders: Evaluation and Treatment (pp. 143-169). Framingham,MA: Therapro, Inc.
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1 LTG based on one problem, include baseline
Baseline: Brook does not attempt to use Utensils to feed herself.
LTG: Within 3 months Brook will use a utensil to feed herself with 25% spillage, independently, 2/3 attempts a day for 2 weeks as observed by parents, to improve independent feedings.
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Model of Human Occupation, MOHO
MOHO reflects three parts, the volition, habituation and performance of someone. Due to the stated facts that Brook has many preferred items, occupations as well as performance. Volition shows the interest in occupations and Brook displays interest in preferred toys but refuses to pick up new toys.
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