Your child’s arms should be held out in front of them, then moved slowly backward. Ask your child to repeat this motion (front to back, back to front) the whole time. Demonstrate this movement, and encourage your child to try.  It may feel more natural to your child to move their arms up and down, but this is not an effective way to tread water and will tire them out quickly. Try pretending you and your child are in the jungle, using your arms to part the vines. The palms of your child’s hands should be facing in the direction their arms are moving. When their arms go as far as they can comfortably go toward your kid’s back, they should rotate their hands so that the palms face forward while moving their arms toward the front.  Ask them to pretend they are parting grass or vines and pushing them to the sides so they can get through. These motions should be done slowly and evenly to conserve energy. Once your kid has mastered the proper arm motions, you can move on to teaching the proper leg motions. Although breathing and arm-only exercises can be practiced standing up, in order to do leg exercises your child will need to sit, lie down, or try other positions.  Practicing at a playground is ideal because your kid can be helped into a position where their feet are not on the ground. You can help your kid hang from a horizontal bar or suspended rings on the climbing tower. To demonstrate these motions, suspend your own body off the ground. You may need to maneuver your child’s legs for them until they can do the motions on their own. One of the easier leg motions to learn is known as the "scissor kick."  To do this, ask your child to move their legs apart (one toward the front and one toward the back) then reverses them. Demonstrate this move for your child. Then ask them to pretend their legs are scissors cutting through a piece of paper. The "frog kick" is a move where your child will bend both legs, with the knees pointed outward. Then they will extend both legs at the same time. Demonstrate this for your child, then ask them to pretend like they are a jumping frog. The most efficient leg motion for treading water is called "the rotary" or "eggbeater." Unfortunately, this move can be difficult. For this one, one of child’s legs will make slow clockwise circular motions, while the other leg makes slow counterclockwise motions. Demonstrate this for your kid, then ask them to imagine they are mixing eggs with each foot. Have them try to do each leg independently, and work up to doing both at the same time.
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One-sentence summary -- Emphasize a front-to-back arm motion. Pay attention to your child’s palms. Get your child into a position with their feet off the ground. Try a scissor kick. Do a frog kick. Work up to the eggbeater.


Each table will have one primary key that is unique for each entry. By default, Access creates an ID column that increases in number for each entry. This is set as the primary key. Tables can also have foreign keys. These are fields that are linked with another table in the database. The linked fields would contain the same data.  For example, in your Orders table, you may have a Customer ID field to track which customer ordered which product. You can create a relationship for that field with the ID field in your Customer table. Using relationships helps keep your data consistent, efficient, and readable. Click the Relationships button in the Relationships section. This will open a new window with an overview of all of the tables in the database. Each field will be listed underneath its table’s name. You will need to have created the field for the foreign key before you create the relationship. For example, if you want to use the Customer ID on the Orders table, create a field in the Orders table called Customer and leave it blank. Make sure it is the same format as the field you are linking (numbers in this case). Drop it to the field that you created for the foreign key. Click Create in the window that appears to set the relationship for the fields. A line will appear between the two tables, connecting the fields. Check the box to “Enforce Referential Integrity” when creating the relationship. This means that if data is changed in one field, the other field is automatically updated. This will help keep your data accurate.
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One-sentence summary -- Understand how keys work. Click the Database Tools tab. Drag the field you want to use as a foreign key.


This is an expansive written interpretation of the information collected and how all of the elements recorded contribute to the patient's presenting problem. Recognize that every component of the patient's history is significant and will impact the patient's treatment, from the patient's chief complaint to the patient's family history. Include  current symptoms and behavior.  Include a description of the onset of the presenting problem, its duration and intensity.  Look for non-verbal clues from the client such as an inability to make eye contact and nervousness. Observe and note the patient's hygiene, cleanliness, choice of clothing, behavior, mood and physical abnormalities. Include birth, childhood, family history and social relationships.  Describe the patient's family history and current relationships.  Indicate the patient's medical history and current status. Example "Jim is HIV positive and has been for three years, with a T-cell count within the normal range."  Address a wide-ranging list contributing factors from the patient's support system to education and employment.  Note the patient's strengths and weaknesses. Does the patient seem willing to work on the presenting problems? Will the patient work with a support system in place? Does the patient have medical issues or financial problems that might prevent them from completing treatment? Provide detailed information that offers an assessment of the risk factors as determined by information gathered during the interview. Examples of risk factors: Suicidal, homicidal, homelessness, trauma, neglect, abuse, domestic violence. This will include thought content (obsessive, hallucinations, delusions), affect, mood and orientation.  Your comments and descriptions will be required. Example: Behavior: "Appropriate," "Inappropriate," and follow with a description of the behavior. In this section of the assessment, you will need to describe the patient's impairments. The categories include health,daily activities, social relationships and living arrangements. They'll require detailed descriptions if  selected.
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One-sentence summary --
Complete a narrative summary of your findings. Describe the patient's presenting mental health problem. Assess the patient's psychosocial history. Assess risk factors for the patient. Complete the Mental Status Exam checking all boxes that apply. Complete the Medical Necessity Criteria.