Rebound Therapy

Practitioners' distance module assessment

Candidate Assessment Record

This document, when completed, should be either emailed to info@reboundtherapy.org

or posted to:

Rebound Therapy International Ltd,

Saplings, Felcourt Road, Felcourt, W Sussex, RH19 2LA, UK

This questionnaire is saved as a Word template.

You may print the form, complete it longhand and then mail it to us

OR

Complete it on a computer, save it as a Word document and email it back to us.

To complete on a pc:

Start on page 2

The text that says ‘type your text here’ will disappear when you type your own text.

The boxes (or cells) have been limited in size so you will need to ensure that you answer the question within the space provided.

When you have finished all the questions, save as a Word document (press File, Save As and rename the document – maybe just add your name to identify yourself – click on Word Document and save.)

You will then need to email your saved document as an attachment.

If you have any problems please contact us on email: info@reboundtherapy.org

or Tel: +44 (0)330 122 5684.

Health and safety considerations for

Rebound Therapy

Worksheet

Please complete all sections of this document

Date
26/01/2021
Candidate name
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Address line 1
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Address line 2
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Address line 3
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Post code
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Email address
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Date of Birth
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Occupation
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1	Identify 3 types of emergency that may occur in a Rebound Therapy environment.
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
2	Describe likely roles and responsibilities of the following during an emergency:
You	Click here to enter text.
Nominated first aider	Click here to enter text.
Emergency services	Click here to enter text.

3	Explain the importance of following emergency procedures calmly and correctly
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4	Describe how to maintain the safety of people involved in typical emergencies, including
Students / Service users	Click here to enter text.
Colleagues / Parents / Carers / Assistants	Click here to enter text.

5	Give three reasons why health and safety is important in Rebound Therapy.
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
6	Identify three requirements for health and safety relevant to Rebound Therapy
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.

7	Describe duty of care, professional responsibilities and boundaries in relation to:
Adult students / service users	Click here to enter text.
Child student / service users	Click here to enter text.
8	Explain what is meant by safeguarding the welfare of children and special population groups
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9	Describe the responsibilities and limitations of a Rebound Therapy Instructor in regard to safeguarding children and special population groups
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10	Identify signs of abuse. Complete the table below:
Abuse	Physical indicator	Behavioural indicator
Physical	Click here to enter text.	Click here to enter text.
Emotional	Click here to enter text.	Click here to enter text.
Neglect	Click here to enter text.	Click here to enter text.
Bullying	Click here to enter text.	Click here to enter text.
Sexual	Click here to enter text.	Click here to enter text.
11	Outline the procedures to follow to protect yourself from potential accusations of abuse
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12	Outline how to maintain the confidentiality of information and why this is important
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13	Describe Hazards and Control Measures to minimise risk relating to:
Facilities	Click here to enter text.	Click here to enter text.
Equipment	Click here to enter text.	Click here to enter text.
Working practices, including lifting & handling of equipment	Click here to enter text.	Click here to enter text.
Participant behaviour	Click here to enter text.	Click here to enter text.
Hygiene	Click here to enter text.	Click here to enter text.
14	Identify the appropriate person to contact within your environment when hazards and risks cannot be controlled personally.
Appropriate person:	Click here to enter text.

Planning Rebound Therapy sessions

1	Describe the process of screening as it applies to:
Students / Service users
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Colleagues / Parents Carers / Assistants
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2	Explain the process of informed consent as it applies to:
Students / Service users
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3	Give three reasons why it is important to collect accurate and up-to-date information about a participant
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
4	Identify three pieces of information that need to be collected about a participant prior to participation in a Rebound Therapy session
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
5	Explain the importance of displaying sensitivity and empathy to a participant and parent/carer
Participant:
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Parent/carer:
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6	Describe how to determine which methods of measuring and recording progress and recording outcomes are appropriate to the participant / student
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7	Please list & describe the six absolute contra-indications specific to Rebound Therapy
1	Click here to enter text.
2	Click here to enter text.
3	Click here to enter text.
4	Click here to enter text.
5	Click here to enter text.
6	Click here to enter text.
8	Describe three precautionary measures which could be taken when a student has medical consent in place but whose conditions or needs indicate increased risk
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
9	Give three examples of how the participant information you receive could affect your planning of that person’s Rebound Therapy session
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
10	Explain two occasions when it may be necessary to refer a participant to other professionals
a)	Click here to enter text.
b)	Click here to enter text.
11	Give three reasons for temporary deferral of Rebound Therapy
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
12	Give an example of when, in a Rebound Therapy scenario, it may be necessary to liaise with other agencies / services
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13	Explain the importance of following a development programme or exercise plan in a Rebound Therapy session
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Participant information:	This can be simulated for the purpose of this assessment paper and does not have to be a real person
Name of student:	Click here to enter text.
Date of birth	Click here to enter text.
Medical questionnaire and consent form completed	YES / NO Click here to enter text.
Doctor’s note required:	YES / NO Click here to enter text.
Doctor’s note received:	YES / NO Click here to enter text.
Temporary referral:	YES / NO Click here to enter text.
Outline of participant’s specific disability	This can be simulated for the purpose of this assessment paper and does not have to be a real student
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Objectives:
Session objectives:
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Environmental checks – list the health and safety checks to be made to the following:
Sports hall:	Trampoline:
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Fire exits:	Temperature, Ventilation, Cleanliness and other key environmental factors
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Organisation of equipment/resources:
Equipment requirements:	List of health and safety checks made to equipment:
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Rebound Therapy session plan
Overview of content	Equipment/additional aids	Duration	Adaptation or alternatives
Click here to enter text.	Click here to enter text.	Click here to enter text.	Click here to enter text.

Delivering Rebound Therapy Sessions
1	Describe Rebound Therapy and give a brief history
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2	Identify five potential benefits of Rebound Therapy
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
d)	Click here to enter text.
e)	Click here to enter text.
3	Give three reasons why it is important to present a positive image of yourself and the organisation to the participant and parent/carer
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
4	Give three examples of how you may adapt Rebound Therapy exercises to meet participants’ needs
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
5	Outline three principles of behaviour management when working with a participant
a)	Click here to enter text.
b)	Click here to enter text.
c)	Click here to enter text.
6	Explain the importance of creating an environment that is sensitive to different cultures, ethnicities and values
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Example Medical Questionnaire and informed consent form
This may be simulated for the purpose of this assessment paper and does not have to be a real student
Participant’s name:	Click here to enter text.
Date of birth:	Click here to enter text.
Does the participant have any of the following?	YES	NO	Comments
Spinal rodding	Click here to enter text.	Click here to enter text.	Click here to enter text.
Dwarfism	Click here to enter text.	Click here to enter text.	Click here to enter text.
Brittle bones	Click here to enter text.	Click here to enter text.	Click here to enter text.
Pregnancy	Click here to enter text.	Click here to enter text.	Click here to enter text.
Atlanto-axial instability (confirmed)	Click here to enter text.	Click here to enter text.	Click here to enter text.
Detaching retina(s)	Click here to enter text.	Click here to enter text.	Click here to enter text.
Detached retina(s)	Click here to enter text.	Click here to enter text.	Click here to enter text.
Osteoporosis	Click here to enter text.	Click here to enter text.	Click here to enter text.
Haemophilia	Click here to enter text.	Click here to enter text.	Click here to enter text.
Cardiac or circulatory problems	Click here to enter text.	Click here to enter text.	Click here to enter text.
Epilepsy	Click here to enter text.	Click here to enter text.	Click here to enter text.
Arthritis or Still’s Disease	Click here to enter text.	Click here to enter text.	Click here to enter text.
Asthma or other respiratory problems	Click here to enter text.	Click here to enter text.	Click here to enter text.
Cystic Fibrosis	Click here to enter text.	Click here to enter text.	Click here to enter text.
Muscular Dystrophy	Click here to enter text.	Click here to enter text.	Click here to enter text.
Spina Bifida or Hydrocephalus	Click here to enter text.	Click here to enter text.	Click here to enter text.
Changeable muscle tone	Click here to enter text.	Click here to enter text.	Click here to enter text.
Dislocated hip(s) or other joint problems	Click here to enter text.	Click here to enter text.	Click here to enter text.
Vertigo, blackouts, nausea	Click here to enter text.	Click here to enter text.	Click here to enter text.
Hernia / prolapse	Click here to enter text.	Click here to enter text.	Click here to enter text.
Open wound(s)	Click here to enter text.	Click here to enter text.	Click here to enter text.
Gastrostomy	Click here to enter text.	Click here to enter text.	Click here to enter text.
Incontinence	Click here to enter text.	Click here to enter text.	Click here to enter text.
Tracheostomy	Click here to enter text.	Click here to enter text.	Click here to enter text.

Does the participant have any of the following?	YES	NO	Comments
Recent serious illness or surgery	Click here to enter text.	Click here to enter text.	Click here to enter text.
Tender or fragile skin	Click here to enter text.	Click here to enter text.	Click here to enter text.
Implant (eg baclofen pump)	Click here to enter text.	Click here to enter text.	Click here to enter text.
Are there any other conditions of which we should be aware? (continue overleaf if necessary)
Click here to enter text.
Name of adult completing this form: (print)	Click here to enter text.
Profession or relationship to participant:	Click here to enter text.
I give my consent for the person on this form to take part in Rebound Therapy sessions and I understand that it is my responsibility to inform the session organisers of any changes to the participant’s condition.
Signature:	Click here to enter text.
Date:	Click here to enter text.

I confirm that the information within this worksheet is entirely my own work.
Candidate signature:	Click here to enter text.	Date:	Click here to enter text.
Assessor’s signature:	Click here to enter text.	Date:	Click here to enter text.