Occupational Therapy Essay On Spastic Quadriplegia Interventions.

Identifying Desired Outcomes for Jerry and His Family

Identify the Desired Outcome for Jerry and his family. What would you like to see as a result of your intervention? Which performance areas would you target first and why?

Jerry and his family's desired outcome is to reduce spasticity through various occupational therapy interventions enabling Jerry to master basic activities of his daily living, increasing the chances of independence. Therefore, I would like to see the stability in Jerry's posture as a desired outcome for the intervention. The intervention also intends to ensure that Jerry's father has some assistance to Jerry, like a nurse aide who would be much easier after the occupational therapy normalizing Jerry's muscle tone through optimizing upper body functions, improving coordination of the small muscles, prolonged muscle stretching, positioning and enhancing preparatory activity with using the therapy ball which targets Jerry's posture and his attention completing the intervention I would have to get Jerry attention.

 In intervention, give an example of a preparatory method you would use with Jerry to normalize his muscle tone?

The preparatory method I would use in occupational therapy to normalize Jerry's muscle tone includes regular exercises to relax Jerry's muscles, strength training, muscle stretching for tightness and pain, and weight training. Enhancing the stretching exercises can prevent contracture and increase flexibility using home interventions like placing a mat on the floor and placing a round ball on the mat to enable Jerry to stretch the muscles. It's a more efficient intervention as it can take place at home and in any natural environment where I will place Jerry on top of the ball in a prone crawling position and rock the ball back and forth, enhancing full extension to strengthening and weight-bearing through the arm.  

Give an example of an occupation-based or therapeutic activity you would use to help establish new skills.

The occupational therapy that I would use to establish the new regular and prolonged exercise program using the round ball and the mat to improve the strength, extension, muscle stretching for tightness, and weight training would include using a tablet that is strapped to a power wheelchair that has a harness for safety. The tablet can be attached to the Power Wheelchair with a head switch to control the tablet with Maximum Assistance completely. He can listen to cello music on the tablet since it helps him relax.

Articulate your major concerns regarding possible limitations/liabilities in the future. What can you do now to prevent them from developing later? Give an example of an activity to maintain Jerry's current function and prevent these problems from developing.

 The use of regular physical exercises would significantly help Jerry address the condition, but there are possibilities of future limitations and liabilities for Jerry like difficulties in learning, mobility, hearing, vision, increased dependency, antisocial behaviors, anxiety, and hyperactivity (D'Aquino et al., 2018). However, to prevent these issues from occurring and affecting tJerry's life, it's essential as an occupational therapist to perform several interventions to increase his body fitness and control. The major concerns that Jerry presents include spastic, which is characterized by the inability to dress, bathing and holding objects due to muscle stiffness, Athetoid, characterized by the inability to regulate muscle tone, causing trouble in posture, and speaking, where Jerry is in verbal and lastly Ataxic characterized by issues of balance and coordination which if not managed, it would be difficult for him in future (Kruijsen?Terpstra et al., 2014). therefore, as an occupational therapist, I will prevent such issues through occupational therapy exercises that strictly focus on fine motor control skills like improving hand dexterity by working on hand muscle strength, in-hand manipulation, pincer grasp, and finger isolation. I will also focus on bilateral coordination, teaching him to control the body, like positioning and pulling apart. I will also focus on upper body strength and stability skills like crawling on the round ball and lastly by crossing the midline skills like making figures like eight with steamers.

Take Jerry's developmental life tasks into account; what does a typical two 1/2-year-old do? What are major psychosocial issues (Erikson)? Modify the environment to help him obtain a sense of autonomy.

Considering the developmental tasks of spastic quadriplegia children, at the age of two and a half years, these children gain some level of independence and self-confidence. They cooperate with caregivers, drink from the cup, eat, and chew very well independently. However, the psychosocial issues include anxiety, prone to conflicts with their peers, having antisocial behaviors, being dependent, hyperreactive, and headstrong (Alaee et al., 2015). Therefore, helping Jerry attain autonomy, independence, self-reliance, and sufficiency. I will be carrying occupational therapy, physical therapy, and speech therapy, enabling him to communicate, use the wheelchair, and access what he needs. I will provide special nutrition to help him grow, essential for his development.

References

Alaee, N., Shahboulaghi, F. M., Khankeh, H., & Mohammad Khan Kermanshahi, S. (2015).

Psychosocial challenges for parents of children with cerebral palsy: A qualitative study. Journal of Child and Family Studies, 24(7), 2147-2154. D’Aquino, D., Moussa, A. A., Ammar, A., Ingale, H., & Vloeberghs, M. (2018). Selective dorsal rhizotomy for the treatment of severe spastic cerebral palsy: efficacy and therapeutic durability in GMFCS grade IV and V children. Acta  Neurochirurgica, 160(4), 811-821.

Kruijsen?Terpstra, A. J., Ketelaar, M., Boeije, H., Jongmans, M. J., Gorter, J. W., Verheijden, J., ... & Verschuren, O. (2014). Parents’ experiences with physical and occupational therapy for their young child with cerebral palsy: a mixed studies review. Child: care,  health and development, 40(6), 787-796.