Ranchos Los Amigos Level I
No response
Ranchos Los Amigos Level II
Generalized response: exhibits inconsistent and nonpurposeful reactions to stimuli
Ranchos Los Amigos Level III
Localized response: reacts specifically to stimuli, though inconsistently
Ranchos Los Amigos Level IV
Confused/agitated: has heightened state of activity with severely decreased ability to process information
Ranchos Los Amigos Level V
Confused, inappropriate nonagitated: appears alert with fairly inconsistent reactions, although increased complexity of commands causes more random responses
Rancho Los Amigos Level VI
Confused, appropriate: exhibits goal-directed behavior but is dependent on external input for direction
Ranchos Los Amigos Level VII
Automatic/appropriate: behaves appropriately and is oriented to place and routine but frequently displays shallow recall
Ranchos Los Amigos Level VIII
Purposeful and appropriate: is alert and oriented and is able to recall and integrate past and recent events
-Still may have some attention issues
Glasgow Coma Scale
Assesses level of consciousness post-TBI (scores of 3-15)
- Scores below 8 indicate severe TBI
- Scores between 9-12 indicate a moderate brain injury
- Score above 14 indicate a minor brain injury
Parkinson’s disease stages of progression
- Stage 0: no signs of disease
- Stage 1: unilateral disease
- Stage 2: bilateral disease without impairment of balance
- Stage 3: Mild to moderate bilateral disease; some postural instability; physically independent
- Stage 4: Moderate to severe bilateral disease; frequent loss of balance; 50% dependent
- Stage 5: Non-ambulatory; 80-100% dependent for ADLs
ACL (Allen’s Cognitive Level) 1
Automatic actions/awareness
- Profoundly impaired with brief attention, requiring total assist and 24 hour supervision
- Treatment for this level= sensory stimulation
ACL 2
Gross body movement/postural actions
- require max assist and 24 hour supervision
- memory/ attention lasts about 2-3 min
- May wander and get lost
- Treatment options= multisensory activities
ACL 3
Manual actions/repetitive actions
- memory and attention last around 30 min
- tactile cues elicit response, requiring mod assist and cueing to perform repetitive actions/ ADLs
ACL 4
Familiar activity/ goal directed
- Require visual cues to perform activities
- Client may be able to live alone (around level 4.8) with daily visits and assistance
- Attention and memory up to about an hour
ACL 5
Learning new activities/exploration
- Learning generalized information achievable
- do require standby assist and can be impulsive and show poor judgement
ACL 6
Planning new activities/ conceptualizing
- Can anticipate outcomes of actions
- no need for check-ups; independent
Decorticate rigidity
Abnormal flexion:
- Upper extremities are in spastic flexion w/ internal rotation and adduction; lower extremities are in spastic extension, internal rotation and adduction
- Level 3 Glascow Scale
Decerebrate rigidity
Extensor response:
- Upper and lower extremities are in spastic extension, adduction and internal rotation
- indicates severe brain damage; Glascow level 2
Spastic Cerebral Palsy
Most common type of cerebral palsy, characterized by clonus (uncontrollable, rhythmic, shaking movements) muscle tone and slow and awkward movement
Athetoid Cerebral Palsy
AKA dyskenetic: Characterized by fluctuating tone, lack of co-contraction in muscles; movement either athetoid (slow, writhing) or choreiform (fast, jerky) movement patterns
- Commonly child will present with movements that are involuntary (excessive), tremors, poor posture, unsteadiness, and abrupt movements, grimacing and drooling can be a feature.
- some overflow of movements seen
- joint hypermobility common
Ataxic Cerebral Palsy
Characterized by low muscle tone with impaired balance and incoordination of arms and legs
- Often overshoot or exaggerate movements
- Tremors can be present
Pre-writing developmental stages
- 10-12 months: scribbles on paper
- 2 yrs: imitates vertical, horizontal and circular marks on paper
- 3 yrs: copies vertical and horizontal lines
- 4 yrs: Copies cross, diagonal line, square, x, and some letters
- 5-6 yrs: copies a triangle, prints name, writes most uppercase and lowercase letters
Model of Human Occupation (MOHO)
MOHO addresses how occupation is motivated, patterned and performed
-Looks at volition (motivation), habituation (how occupation is organized into patterns and routines) and performance capacity (physical and mental abilities that underlie skilled occupational performance)
Occupational Adaptation (OA)
Looks at the interaction between person, environment and person-environment interaction
-Primary goal of OA is to achieve mastery over the environment
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Occupational Rehab/Return to Work46
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Standards of practice24
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Cardiopulmonary Conditions18
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Neurological impairments19
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Musculoskeletal impairments and Other14
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Wheelchair seating, mobility, and driving19
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Neurodegenerative diseases, vision and upper extremity28
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Pediatric assessment and intervention35
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mental health19
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General items to memorize32
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Memorization part 234
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Therapy Ed info13
