MEMORY

Memory can be divided into long term and short term memory(working memory).

• There are three main components of working memory: central executive, phonological loop, visuospatial sketchpad. Central executive controls the processing in other components of working memory by the allocation of attention to each one. (control for shared attention) ex: listening to a conversation while reading the newspaper.

Phonological loop stores speech based information in a phonological store (inner ear) and verbally rehearses it in the same order (inner voice). In speaking and reading, several words are held long enough make sense of the words that follow. Words can enter the phonological store directly from ear, from rehearsal of written or spoken words, and from LT memory for names of object or people. (cth: macam kalau kite buat homework byk kali, sambil menulis kita sebut dalam hati (innervoice) jadi, ape yang kite sebut akan masuk dalam phonological store kite.)

The visuospatial sketchpad stores visual and spatial information entering from the eye over few seconds in time. ( cth: macam guna flashcard utk blajar ttg object, use visual to know the shape, characteristic and name of the object).

The working memory model offers an account of how the abundance of sensory information comtinually entering the brain is processed over a brief period of time before passing on to the other components of the perceptual and cognitive system.

• For long term memory, can be divided into semantic, episodic and procedural. Semantic is the general knowledge of facts and episodic is about time and place. Procedural is knowledge that we got through doing something. It related with "knowing how". Autobiographical memory is memory about time and place also but it is about significant event for the person. As an OT, we must know in which type of memory is impaired to assist us in knowing functional problem and planning intervention for patient.

Lost in autobiographical memory may lead to low self-esteem, and distressed.

Experience doing clinical in Psychiatric area..

HIDDEN SECRET IN PSYCHIATRY

Psychiatric is an interesting area between the three area (physical, paeds and psy).Doing clinical practice in psychiatric is a very valuable moments that I have ever had.

In psychiatric, as all normal people know, we can see variety of abnormal behavior such as screaming, talking to self, sudden laughing and harm self or others. But what normal people doesn't know is these patient is stable when they get their medicine. They can be like other people and sometimes we will misunderstood them as normal people.

The question is, why this people can make friend aith the other patient in the institution but they cannot make even one close friend in normal surrounding? From my observation, these people is a victims. Victim of stress situation that can lead to mental ilness. Situation such as cheat by other especially closed people (e.g. spouse, beloved, friend). Some patient comes from good background and have history of working as an engineer, teacher and policeman. Due to bankruptcy, beloved death and work stress, these people got stress and unable to deal with stesss, they got mental illness.

Before doing practice in this area, I will never know that these patient can recover although not fully recover. Some of the patient in the institutionalization that has live in the institution for a long time has not only develop good behavior, ut they also has send to work by an occupational therapist. I am so amazed to see some of them have develop a close and unbreakable bond between them that we call frinedship. Their friendship is really uniqe. One of the example that I can see is a pair of female patient that always together whereever they go.I represents these patient as X and Y. X speaks with low voice and sometimes unable to understand by others. However, due to long time friendship that have exist,Y can understand every single word that X say. so, whenever I want to talk with X, I will ask her friend to translate for me. Sometimes, I could see Y encourage X during activity. Y also explain to X sometimes when X difficult to understand my instruction. During mealtime, X save half of her fried fish to gives to Y's cat that she lokk after in the ward. How beautiful their friendship are.

Well, by this short article, I hope some of normal people will realize that these patients are also people like us. They also have their needs, wants and they also develop as a people day after day. So, for family that doesn't want to accept the patient's back, do visit patient because they also needs your love.

-WITH HEART, WE CARE-

My Montage 11/26/09 at OneTrueMedia.com

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Methods Used in OT Evaluation in Psychosocial Rehab

The most basic methods used by OT:

1. clinical observation - therapist observe patient's verbal and non-verbal cues. Verbal cues such as comments that the patient makes as an aside or to family members, other clients or directly to the therapist. Non-veerbal cues included patient facial expression, body language, gestures, or signs of depression, anxiety, sadness and pleasure.
2. projective testing - use unstructured but standardized procedure to gain insight into client's personality structure and dynamics of behavior.
3. machine monitoring - this procedure involves the recording of physiological and motor responses, such as in biofeedback training and muscle reeducation. Examples of machine monitoring include heart rate monitor, Electromyogram(EMG), and blood pressure cuff.
4. initial interview- this method provides opportunity to establish alliance between therapist and client. During initial interview, therapist evaluating the client's personal strengths and weaknesses, interests and level of motivation.
5. functional task-this method require client to accomplish simulated tasks. this method used to evaluate client's ability to perform Activity of Daily Living and self-care activities with or without assistance. Such activities might include personal hygiene, feeding or cooking and driving a mobile.
6. work sampling- this methods needs client to do well-defined activities that similar to those performed on actual job. This method can be used to assess vocational attitude, vocational interest, and work characteristics. Examples of work samples include test published by Valpar.
7. behavioral assessment-these assessment rates the clients as he or she perform the task in unstructured manner or non-standardized setting.
8. standardized test- These are published and unpublished test that have standardized procedure, normative data, validity and reliability.
9. computerized assessment- A number of instruments has been adapted to computer to ease of scoring and analysis.
10. self-report inventories- checklists and surveys filled out by the client either alone or in company of the therapist comprise this method. The information gathered are 'self-reporte' by the client.

source:Psychosocial Occupational Therapy;A Hollistic Approach

(F.Stein,Susan K)

sensory profile

Sensory Profile is a standard method for professional to measure child’s sensory processing abilities and to profile the effect of sensory processing on functional performance of daily life of a child. SSP can be used for children 3-10 years old. In Sensory Profile, there is Caregiver Questionnaire that needs to be filled by the caregiver and interpreted by the examiner. There also Summary Score Sheet that need to be filled by the examiner to find out the exact problem of the child using the information filled by the caregiver in the caregiver questionnaire. In the Caregiver Questionnaire, the caregiver needs to check the box that best describes the frequency with which the child does the behavior that stated in the questionnaire.
SUMMARY SCORE SHEET
The examiner needs to fill the summary score sheet to interpret the caregiver questionnaire and find out the child’s exactly problem in sensory processing. In summary score sheet, there are four parts that needs to be filled by the examiner. First part provides space to record demographic data of the child. Second part is the factor grid. Each factor is divided into three columns. First column contains the icon to indicate the category from which the item originated. Second column contains the item number that corresponds to the item number in the caregiver questionnaire. The third column contains the item raw scores.
Item number that corresponds to the item number in the caregiver questionnaire.
Item raw scores.
One of the factor taken from the factor grid.
Icon to indicate the category from which the item originated. Ex: this icon indicate visual category








Third part is the Factor Summary. The factor summary provides an additional way to consider the child’s scores. The examiner has to transfer the child’s score for each factor to the corresponding Factor Raw Score total column on the Factor Summary. Plot the child’s factor raw score total by marking an ‘x’ in the appropriate classification column, that correspond to the raw score total for each factor.

Fourth part is the Section Summary. The section summary provides a summary for the child’s sensory processing, modulation and behavior/ emotional response abilities. The examiner have to transfer the child’s score for each section from the caregiver questionnaire to the corresponding column labeled section raw score total. Mark an ‘x’ in the classification column that correspond the raw score total for each section.


If the

If the child is classified as definite difference, the child is interpreted as having problem with the sensory processing. If the child classified as probable difference, the child has questionable areas of sensory processing abilities. Typical performance indicates that the child has typical sensory abilities (normal).



Sensory profile also provides Modul Category that contains of the interpretation of the score and helps the examiner to plan treatment based on the child’s problem. Example: (for sensory seeking category).
Modul Category
Associated Factor
Related Section Headings
Behavior Indicators
Intervention Approach
Sensation seeking
- Factor 1(sensory seeking)

- Section H (modulation related to body position and movement)
-active
-continuosly engaging
-fidgety
Excitable
Incorporate additional sensory input into the child’s routines so that thresholds can be met while conducting daily life.
In paediatrics area, an occupational therapist needs to use play therapy and behavior modification to cooperate with the patient. Be patient with the patient that always crying or don’t want to mplement treatment. Children needs time to suit themselves in new situation, people or place. That’s why OT is all about love, patient and empathy. That’s all that I can share with the readers. Good luck to all. Don’t afraid to ask your senior if you have any question.



For more information, log on to http://www.upanzi.com/index.php?option=com_content&task=view&id=3&Itemid=3, http://harcourtassessment.com/hai/Images/resource/samprpts/Sensory_profile_Sample_rpt.pdf,

CEREBRAL PALSY

DEFINITION-non-progressive motor disorder that causes by damage to the brain before, during or shortly after birth.

TYPES - spastic, hypotonia, athetoid and mixed.

1.spastic - increase in muscle tone. if not treated, can cause contracture.

2.hypotonia - diminish muscle tone. firstly, appear flaccid and gradually develop spasticity and sometimes athetoid. Can be easily see by the inability of the infants to gain any head control when pulled by the arms to sitting position.

3 athetoid - means fluctuates tone.

4.mixed - multiple syndromes with combination of the various forms of CP.

AETIOLOGY

-premature

-genetic disorder

-infection of the brain such as viral meningitis

-head injury from trauma(vehicle accident)

-child abuse

-congenital CP cause by faulty cell development in the embryo in the early stages of pregnancy.

-maternal infection with the rubella virus (German meascles) during pregnancy

-severe jaundice of the newborn

ROLES OT

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