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Sleep/ Toileting & Dressing
| Term | Definition |
|---|---|
| sleep effects on well being | Cortisol Growth Appetite/ obesity/ diabetes Immune system CV Fertility Concentration/ learning & memory Anxiety & depression Balance Sensory processing |
| sleep cycle | Stage 1 Stage 2 Stage 3 Stage 4/ REM |
| stage 1 vs. stage 2 | Light sleep, muscle activity slows down Occasional twitch 4-5% vs. Breathing & HR slows Decrease body temp 45-55% |
| stage 3 vs. stage 4 | Deep sleep Rhythmic breathing Delta waves Limited muscle movement 16-21% vs. REM Faster brainwaves & dreaming HR & breathing faster 20-25% |
| when do we physically heal vs. when do we cognitively do stuff | Stage 3 vs. REM. Work on emotional regulation, memory, cognition |
| environmental modifications for sleep | Light Sound Temperature Bedding |
| screening for sleep | 2 questions: Is sleep restorative? Does fatigue interfere w/ daily activities? 5W's & how Avoid instantly giving sleep hygiene handouts |
| bears screening tool | From 2-18 years Assesses Bedtime problems, Excessive daytime sleepiness, Awakening during night, Regularity & duration, Snoring |
| sleep is a system composed of | Biological forces Beliefs & values (hard to alter) Social forces (society doesn't value sleep) Env forces (less threatening) Outcome behaviors & feedback |
| opportunities to change sleep | Repetition Environmental change Traumatic Continuous Circularity |
| conditions with disordered sleep | MSK FASD Autism Down syndrome (sleep apnea) ADHD |
| snoring | Sign of sleep apnea At risk for behavioral, hyperactivity, aggression, depression, and attention problems |
| tx options for snoring | Adenotonsillectomy Mask ventilation |
| sleep disorders in older adults | Increased likelihood More time in bed, less sleep Longer in stage 1 & 2 REM decreases (memory) Stage 3 decreases (lower healing) |
| consequences of insufficient sleep | Falls QoL Balance & ambulation Cognitive function, insight, memory Reaction time Wound healing Increased risk of CV & endocrine |
| dementia & sleeping | Disturbances in community dwelling (19-44%) Institutionalized people have more sleep disturbances |
| evidence based risk when people w/ dementia are sleep deprived | More institutionalization Reset body clock Decrease physical function Irritability & aggression Mood disorders, decreased cognition, insight & new learning Impact on caregivers |
| sleep and fall risk factors | Longer naps & shorter night sleeping is 3x more likely to fall Increased sleep fragmentation Nocturia |
| potential adverse effects of caffeine | General toxicity CV Ca balance & bone health Behavioral effects in adults & kids Reproduction Link to cancer |
| caffeine intake limit for adults vs. kids | 400mg vs. 40mg. At risk for possible behavioral effects due to caffiene |
| toileting | Kids become more independent during the day at 2-4 yrs At ~6yrs is when fully independent (dry overnight, effective wiping, managing fasteners) |
| OT role in toileting | Educate Explain Collaborate Plan |
| toileting signs of readiness | Sits on toilet 1-3 minutes Holds pee for 1-2 hours Awareness of wetness Attempts to follow & understand simple directions No constipation/ medical issues No major life disruptions |
| clothing & toileting | Diapers pill wetness away from body, can't feel wet Diapers can be worn on underwear Use elastic waistbands/ skirts |
| is sitting or standing better if anatomically male? | Can child distinguish when needing to pee/ poop? Is there a role model? Do they have control & coordination? |
| trip training vs. self-initiated | Child goes to bathroom at scheduled increments. Creates association with feeling & results vs. Child goes to bathroom on own. Often after trip training. |
| rapid toilet training | Shortcut, very intensive Needs guidance from professional & support 8-10 days, 8-10 hours 30 min on toilet, then 5 minute rest. Gradually reduce toilet time and increase rest Great or deteriorates |
| toilet training weekly record | Record how often child is wet by checking every 30 min, 3-7 days If dry do nothing, if wet then change Calculate average length of dry time: hours recorded/ wet # = avg dry time |
| toilet learning strategies | Tell, don't ask Provide physical assistance, small words Wait to offer praise Same language in all contexts Reward behavior Set environment up for success |
| successful toileting environment | Sounds, lights, smells, touch Size of toilet seat, smaller inserts Feet supported & knees slightly higher than hips |
| toilet seating | Back & foot support Regular toilet with special seat Use stool/ rails |
| key notes for toileting | Learn to pee first Daytime training is first Long process Provide reinforcements Don't punish accidents |
| enuresis | Urinal incontinence Void in inappropriate places 2+/ week for 3 months Affects 2-10% of kids Risk factors: anxiety, developmental delay, ADHD, medical conditions Leads to: Low self esteem, shame, parents worry, good prognosis |
| primary vs. secondary enuresis | When they have never been toilet trained vs. Child regresses after being taught |
| encopresis | Fecal incontinence Intentional or involuntary (little amounts of stool leaking out) 1% of kids More often in males |
| risk factors for encopresis | Abuse Diet in fat/ sugar Inadequate water intake Chaos Lack of physical exercise Refusal to use bathroom Neuro impairment Hx of constipation OCD, ADHD Learning disability, autism |
| fecal smearing | Can range from little smear to full artwork May be a way to show control |
| AADL ax for toileting | 3 day bladder diary Behavioral modifications have tried Pediatrician/ urologist further ax |
| AADL & toileting | Will provide diapers for kids 36+ mo who have daily, chronic, non resolving urinary/ bowel incontinence Neurogenic, neurological diagnosis |
| autism and toileting | Train at 5+ years Have enuresis & encopresis May not feel wetness or urge to go Impact of rigidities (routines) Constipation more often Communication & motor diff Feeding difficulties |
| interventions to support self care participation | Grade Modeling Prompting Feedback Chain Visual support Task & env modification Consistency |
| 1 yo vs. 2yo dressing skills | Remove socks, don/doff hat, help with dressing vs. Remove shoes, simple clothing removal, can push arms into shirt |
| 2.5yo vs. 3yo dressing skills | Put socks on, unbuttons large buttons, put on easy clothing vs. Mostly able to put shirt on, don shoes, don socks, pull down simple clothing, button large buttons, zip & unzip jacket once connected |
| 3.5yo vs. 4yo dressing skills | Unzip jack & separate shank, able to button 3-4 buttons, unbuckle belt, can find front & dress self w/ supervision vs. Insert zipper & zip up, lace shoes, place socks on |
Created by:
craftycats_
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