Teaching and Learning * active processes = stimuli, respond to stimuli * patient - active doer * 2 way process, just like

communication * motivation (inner drive) --> values (guide actions and efforts) --> goals * in PH, home instructional programs (practical and family support) * in USA, institution Learning * clients = difficulty + loss of recent or short term memory + severe receptive aphasias + disorientation to time and place + ideational apraxia + ideomotor apraxia + depression + anxiety (reduce anxiety = low challenge axs) + pain + different language (interpreter) + low literacy + **persons who cannot follow directions and who cannot remember --> not a candidate --> family, reeval if any improvements Effective Teaching Basic Principles 1. Determine what the learner knows - determine what routines and skills learner has retained - basis on where to start - focus on certain areas/skills that need to be developed - timely, safely - determine whether the learner figures out adapted methods independently - screening, IE, RE --> Occupational Profile 2. Establish the learning objective - STG - find out what the learner needs to know - learning objective --> is a goal expressed in behavioral terms - ABCCD - audience (who involved), behavior (what u want px to do), condition (prompts, cues, assistance), criteria (how well you expect a client to do), degree/duration (time frame) - Goal: SMART - specific, measurable, attainable , realistic, timebound - ex. Px will be able to brush teeth... 3. Choose teaching techniques congruent with what is to be taught - existing abilities and developing skills - present material = congruent with objective

- energy conservation = auditory, visual methods such as discussion with slides or videotaped examples, problem solving and app'n of ideas to the px's own situation - motor task - best in demo, simulation and actual doing of ax - motor task (dressing, esp in hemiplegic) = motor learning principles: + understand the task + visually pay attention to steps of task + begins to pay attention to proprioceptive feedback while doing task + does task skillfully - 1st learning ax = challenge --> low (then gradually increase) = avoid anxiety, promote success - lessons --> structured = early success + ex. Eating: adapted utensils, sticky foods, difficult 4. Adapt the presentation to the learner's capabilities - given his/her abilities and deficits - w/o brain damage: + thx-px collaboration + start with open-ended questions to give discussions + demonstrations + printed instructions (simple and direct) + describing helpful methods + strategies and trained in various contextual situations = independent problem solvers (identify prob, understand principle involved, match solutions that have been found helpful in the past or that others have used, give suggestions (respected & encouraged)) + if px suggestion is not directed to goal, let it do his way then give verbal cues and give suggestions that'll lead to goal - w/ brain damage + more attention to actual teaching process + diff w/ abstract & large chunks of info + Behavior Modification (can't do task automatically using old habit programs = learn new skills by repetition and motivation (by giving fb)) * step by step structure (memorize and verbalize --> effective for PD) * shaping * verbal cues * physical/manual cues * social praises * instructions (short, concise, consistent verbal cues --> one, two-word concrete =) + some pxs can only do a task if the whole chain is completed + (px w/ dementia) context must be consistent, once in a while inject variety (depends on stage of px) - #1: promote safety + may or may not be transferred --> other tasks or contexts + practice task until learned within all contexts requires + may not become problem solvers + slow with regressions

+ prognosis for independence outside a sheltered or familiar envt = limited + precautions = prevent injury + Backward Chaining (Skinner) - thx assist until last procedure, so px does last step first (have sense of accomplishment) + lesions in dominant hemisphere = diff processing verbal or written language --> demonstration or pictorial instruction + non-dominant hemisphere = diff w/ spatial relationships 5. Provide opportunities for practice, considering context and schedule - motor skills are learned only through practice - random practice - contextual interference - blocked practice - repetitive drill 6. Offer useful feedback at the right time - motivational feedback --> benefit - what thx do: give specific feedback --> definitive benefit - diff bet MF, SF - time it's given - occasional feedback (performance) --> helpful when offered immediately after the trial - call attention if not aware of efforts --> gain knowledge of the results (requirement for learning) 7. Test the learner in the appropriate context or contexts to confirm that learning has occurred - require that it has to be done independently at the appropriate time and place 8. Discuss progress towards goals and revise teaching strategy or goals - progress --> goals - RE - revise teaching strategy or goal as indicated