Role of OT - Rett
Role of OT - Rett
Role of OT - Rett
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Berryman D and Barrett L. (2002). Hand management in Rett Syndrome. Rett Syndrome Association of Australia (RSAA) Newsletter July 2002. Kubas E (1992). Use of splints to develop hand skills in a woman with Rett Syndrome. The American Journal of Occupational Therapy 46(4); 364 368. Naganuma G and Billingsley F (1988). Effect of hand splints on stereotypic hand behaviours of three girls with Rett Syndrome. Physical Therapy 68 (5), 664-671 Tuten H and Miednaer J (1989). Effect of hand splints on stereotypic behaviour of girls with Rett Syndrome: A replication study. Physical Therapy 69 (12), 1099 1103. Woodyatt, G., & Sigafoos, J. (2000). Effects of amount and type of social interaction/activity on stereotyped hand mannerisms in individuals with Rett syndrome. Australasian Journal of Special Education, 23, 15-24.
b) Occupational Therapy and Rett Syndrome in the Rett Syndrome Multidisciplinary Management Clinic (CHW) ! ! ! ! ! Consultative approach Focus is on review and input regarding: o Generic Occupational Therapy issues o Rett Syndrome specific issues Frequently provided information listed Common interventions listed Support to community therapists
c) Occupational Therapy and Rett Syndrome in the Community ! ! ! Liaison and support to community therapists Provision of information to community therapists Provision of information to community groups
! Presentations at meetings, inservices and conferences when needed Therapy ideas: General principles ! Look for potential for example use of eye gaze, or initiation of movement towards a desired object ! Keep in mind the affect of dyspraxia. Often times there is a marked delay between a prompt and reaction. Video-recording a session may help identify patterns ! Progress is often very slow. Rett Syndrome is not a neurodegenerative disorder, and improvements in functional self care and hand skills can be achieved throughout the lifespan (Cass et al, 2003) Examples of goals (from Rett Syndrome Handbook): ! Identify and encourage use of head, elbows, or other body parts over which she may have better control ! Maximise hand use for functional activities ! Develop ability to access communication devices ! Develop ability to access a variety of assistive technology ! Improve ability to assist with dressing ! Improve ability to perform independent feeding skills ! Improve ability to assist with grooming activities ! Improve ability to tolerate sensory input in school setting Hints: (from Rett Syndrome Handbook) ! Focus on enjoyable hand activities during the regression phase (rather than on fine-motor skills) ! Provide physical assistance Orthoses and assistive devices to consider: (from Rett Syndrome Handbook) ! Splints can position thumb for grasp ! Adapt materials to make easier to grasp ! Consider cuffs and loops to assist with grasp, cut-out cups ! Switches for independence and leisure / pleasure Other therapy ideas: (Based on Van Ackler (1991)) ! Ideas to encourage functional hand use: o Sensory input for hands (eg massage, exposure to a variety of textures) ! For apraxia and ataxia o Weighted vests can be calming and decrease ataxia in some girls o Use of a therapy ball o Rotation and weight-shift activities o Vestibular movement activities (if tolerated) ! Spasticity o Positioning for safety (eg during mealtimes) and tone reduction o Tone reduction activities such as rotation, weight-shift, vibration can temporarily reduce spasticity ! Scoliosis o Positioning to ensure a symmetrical and erect posture in sitting (as far as possible)