Stage of Learning & Motor Learning
Mr. Lewis is relearning breakfast preparation after his stroke and must actively problem-solve to determine how to complete the task. What stage of learning does this MOST resemble?
EARLY STAGE OF LEARNING
Mr. Lewis sees coffee spill onto the counter while pouring. What type of feedback is this?
INHERENT/INTRINSIC FEEDBACK
Mr. Lewis repeatedly practices pouring from the same coffee pot into the same cup. What type of practice is being used?
BLOCKED PRACTICE
Which treatment activity is MORE consistent with TOA for Mr. Lewis?
A. Repeatedly completing isolated shoulder exercises
B. Practicing pouring coffee during breakfast preparation
B. Practicing pouring coffee during breakfast preparation
According to TOA, should the therapist focus only on Mr. Lewis's impaired right upper extremity when determining why he has difficulty preparing breakfast?
NO
During this stage of learning, would Mr. Lewis generally experience high or low cognitive demands while performing the task?
HIGH COGNITIVE DEMANDS
After he spills, the OT says, “You tilted the coffee pot too quickly.” What type of feedback is this?
AUGMENTED/EXTRINSIC FEEDBACK
Later, he practices pouring from several different containers in changing order. What type of practice is this?
RANDOM PRACTICE
Mr. Lewis begins successfully initiating the breakfast task independently. Should the OT continue providing unnecessary assistance or allow him greater opportunity to problem-solve and practice?
Allow greater opportunity for independent practice and problem-solving.
According to TOA, should the therapist focus only on Mr. Lewis's impaired right upper extremity when determining why he has difficulty preparing breakfast?
THE ENVIRONMENT/CONTEXT
Mr. Lewis tries several different ways to open a cereal container before finding one that works. What motor-learning process from the lecture does this demonstrate?
Trial and error/problem-solving to identify an effective movement strategy
Which instruction represents an external focus of attention?
A. “Keep your elbow close to your body.”
B. “Keep the coffee flowing toward the center of the cup.”
B. Keep the coffee flowing toward the center of the cup.
Mr. Lewis practices for 5 minutes and rests for 5 minutes because he fatigues easily. What practice schedule is this?
DISTRIBUTED PRACTICE
Mr. Lewis tells the therapist, “I want to choose whether I practice coffee or toast first today.”
Allowing him to make this choice supports what motor-learning factor discussed in the lecture?
Motivation through autonomy
At home, Mr. Lewis's bowls and cereal are stored in high cabinets. The therapist moves frequently used breakfast items to an accessible lower shelf.
Is the therapist changing the person, task, or environment?
THE ENVIRONMENT
The therapist clearly explains the goal of the task and points out important features of the environment before Mr. Lewis begins. Why is this particularly appropriate for him?
Clear instructions and cues regarding important environmental/regulatory features are useful during the early stage of learning.
Mr. Lewis repeatedly asks, “Am I doing this right?” The therapist begins asking, “What did you notice about that attempt?” before providing feedback. What is the therapist encouraging him to use?
His inherent/intrinsic feedback
Mr. Lewis is preparing an entire breakfast involving cereal, toast, coffee, and several sequential steps. The OT initially practices specific difficult portions of the activity separately. What practice method is being used?
PART PRACTICE
Mr. Lewis's wife immediately completes any portion of breakfast preparation whenever he begins to struggle.
Why might the OT discourage her from immediately taking over the task?
t reduces opportunities for repetition, problem-solving, practice, and development of effective task-specific movement strategies.
Mr. Lewis stabilizes the cereal box against the counter and opens it using a different strategy than he used before his stroke. The method is safe and successful.
According to TOA, should the therapist automatically stop him because the movement is compensatory?
NO
TOA allows experimentation and recognizes that behavioral changes may represent compensatory strategies used to achieve successful task performance.
After several weeks, Mr. Lewis no longer has to determine what strategy to use to prepare breakfast. Instead, he is concentrating on making his performance smoother and more efficient. What change in learning has occurred?
He has progressed into a later stage of learning in which the focus shifts toward adjusting/refining how the skill is performed.
The lecture emphasizes that patients in early learning have high cognitive demands and use trial and error to identify an effective strategy, whereas later learning focuses more on refining performance.
The therapist says:
“Straighten your elbow, extend your wrist, and control your shoulder.”
Is this primarily an internal or external attentional focus?
INTERNAL FOCUS
Mr. Lewis can successfully pour coffee from the same pot and cup in the clinic. The OT now wants to improve retention and generalization.
Should the therapist continue primarily with blocked practice or introduce more random practice?
INTRODUCE MORE RANDOM PRACTICE
Random practice is more supportive of retention and generalization, while blocked practice often improves performance during initial skill acquisition.
The OT has 30 minutes with Mr. Lewis.
Give four features that would make the intervention consistent with the Motor Learning and Task-Oriented Approach lecture.
Name the five main areas the OT should assess according to the Task-Oriented Approach.