Only $35.99/year

Pediatric Assessment and Intervention

Terms in this set (191)

Defect that decreases pulmonary blood flow; characterized by pulmonary valve or artery stenosis, a ventricular septal deficit, right ventricular hypertrophy, and override of the ventricular septum.

Symptoms include central cyanosis, coagulation defects, clubbing of fingers and toes, feeding difficulties, failure to thrive, and dyspnea

Tachydysrhythmia

is characterized by an abnormally fast heart rate (>200-300 beats/min)
can lead to congestive heart failure
Typical presentation is marked by irritability, poor eating habits, and pallor

Bronchopulmonary Dysplasia

a result of the prolonged use of mechanical ventilation and other traumatic interventions to treat acute respiratory problems

It results in airway thickening, the formation of excess mucus, and restricted alveolar growth

Children with bronchopulmonary dysplasia are at a greater risk of respiratory infections and problems

Cystic Fibrosis

A degenerative condition cause by an inherited autosomal recessive disorder related to a gene on chromosome 7

CF affects multiple systems and is characterized by the muscle-producing glands malfunctioning and producing secretions that are thick, viscous, and lacking in water; these secretions block the pancreatic duct, the bronchial tree, and the digestive tract

Symptoms:
Abdominal distension
Greasy, foul-smelling stools

complication- chronic pulmonary disease- characterized by a chronic cough, wheezing, and lower respiratory infections
CF may cause an enlarged right side of the heart, which could lead to heart failure

Hemophilia

a blood disorder that commonly affects males, characterized by the absence or reduction go one of the clotting blood proteins
resulting in longer bleeding time or bleeding episodes

Achondroplasia (chondrodystrophia or dwarfism)

an autosomal dominant trait that results in the stunting of epiphyseal plate growth and cartilage formation

Barlow Test

Detects developmental dysplasia of the hip (congenital hip dislocation)
The Barlow test examines whether clicking is present when the child's leg is abducted and pressure is place on the medial thigh

Trendelenburg's sign

hip drops to the opposite side of the dislocation and the trunk shifts toward the dislocated hip when the child is asked to stand on one foot

Amelia

the absence of a limb or distal segments of a limb

Phocomelia

a fully or partially formed distal extremity and absence of one or more proximal segments

Paraxial deficiencies

proximal segments of the limb are correctly developed, but wither the medial or later side of the rest of the limb is missing

Transverse hemimelia

amputation of a limb segment across the central area; it is common for bilateral or hemilateral presentations

Strain

a muscle injury that is caused by using too strong an effort or excessive use of a particular body part and is characterized by trauma to the muscle or muscle-tendon insertion

Sprain

a ligament injury caused by trauma to a joint and is characterized by rapid swelling, heat, and impaired function

Bruise/ contusion

caused by an injury with diffuse impact into the subcutaneous tissue and is characterized by skin discoloration

Systemic Juvenile Rheumatoid Arthritis/ Still's Disease

is polyarticular, and organ involvement is present.
Symptoms include high fever, rash, anorexia, elevated white blood count, and enlargement of the liver and spleen

Kyphosis in adolescents is referred to as

Scheurmann's disease

typically the result of faulty posture; that is, skeletal growth outpaces muscular growth

Cerebral palsy characteristics

difficulty maintaining normal muscle postures because of lack of muscle coactivation and the development of abnormal compensatory movement patterns

Hemiplegia

affects the upper and lower extremities on one side of the body

Quadraplegia or Tetraplegia

affects the upper and lower extremities on both sides of the body

Diplegia

Quadriplegia with mild upper-extremity involvement and significant involvement in the lower extremities

Spasticity

Increased flexor or extensor tone

Athetosis

Fluctuation of tone from low to normal with little spasticity

Choreoathetosis

constant fluctuations from low to high tone, without cocontractions; typically appears as jerky movements

Flaccidity

marked low tone (will usually progress to spasticity)

Ataxia

Tone usually within the normal range but involving lower-extremity flexion patterns

Strabismus

eye alignment deviation

Nystagmus

A reflexive back-and-forth movement of the eyes when the head moves

Dysarthria

Difficulty pronouncing or articulating words

Aphasia

associated with poor language development; functionally looks as though the person has difficulty comprehending the meaning of certain words

Tonic clonic seizures

most frequent type; the person experiences a sensation that the seizure is about to begin; usually followed by a loss of consciousness and rhythmic clonic contractions; the seizure may last as long as 5 minutes; incontinence is common; the child may be drowsy or sleep for the next 1-2 hours

Absence seizures

A brief lapse of loss of awareness along with the absence of motor activity (including eye blinking); lasts 30 seconds or longer; may be mistaken for daydreaming

Myclonic seizures

contractions of single muscle or muscle groups

akinetic seizures

loss of muscle tone for more than 30 minutes

status epilectus

extended seizures; prompt medical intervention needed to maintain body functions and hydration

Complex partial seizures

originate in the temporal lobe and appear as lip smacking, chewing, or buttoning and unbuttoning clothing; characteristics similar to absence seizures

Simple partial seizures

originate in the motor cortex and result in clonic activity of the face or extremities; the person may experience visual or auditory hallucinations or olfactory sensations

Neural tube deficits
Encephalocele

a protrusion in the occipital region of the brain

Typically associated with severe defects, such as cognitive impairments, hydrocephalus, motor impairments, and seizures

Neural tube deficits
Anencephaly

Neural development above the level of the brain stem is lacking
children with anencephaly do not survive infancy

Neural tube deficits
Spina Bifida

Most common type of Neural tube defect
a congenital defect of the vertebral arches and spinal column

Spina bifida occulta

mild form of spina bifida
consists of one or two affected vertebrae with no involvement of the spinal cord.
No symptoms may be present

Meningocele Spina Bifida

involves an extensive spinal opening with an exposed pouch of cerebrospinal fluid and the meninges

Myclomeningocele Spina Bifida

the most severe form of spina bifida, In addition to an excessive spinal opening with an exposed pouch of cerebrospinal fluid and meninges, the nerve roots are also exposed

-Children with myclomeningocele usually display sensorimotor problems at or below the level of the lesion
-Lower extremity paralysis and loss of sensation is common
-Some children also have hip, spinal, or foot deformities
-Complications include hydrocephalus and Arnold-Chiari syndrome

Erb- Duchenne palsy

caused by an injury to the upper brachial plexus (the C5 and C6 nerve fibers), such as extreme shoulder flexion (with arm overhead)
- common with breech deliveries
- characterized by weakness or wasting of the small muscles of the hands and sensory discrimination in the hand and arm
"Waiter's tip position"- shoulder adduction and internal rotation, elbow extension, forearm pronation, and wrist flexion

Klumpke;s palsy

injury results from compression or traction of the lower brachial plexus (C8 and T1)
"Claw hand" deformity is characterized by paralysis of the hand and wrist muscles

Class I traumatic injuries of peripheral nerves
Neuropraxia

some degree of paralysis is present, but no peripheral degeneration

Class II traumatic injuries of peripheral nerves
Axonotmesis

the endometrium is intact, but the axon degenerates distal to the lesion

Class III traumatic injuries of peripheral nerves
Neurotmesis

these injuries are the most severe type, in which both the axon and the endometrium are severed

Ranchos Los Amigos
Level I

No response

Ranchos Los Amigos
Level II

Generalized response

Ranchos Los Amigos
Level III

Periods of being awake, can follow simple commands

Ranchos Los Amigos
Level IV

confused & agitated

Ranchos Los Amigos
Level V

Confused, short attention span, may need step-by-step directions, and may respond inappropriately

Ranchos Los Amigos
Level VI

Memory and cognitive processing problems; still confused

Ranchos Los Amigos
Level VII

Attention still a concern
actions are appropriate
breakdown in skills may occur during stress
Client should be able to complete self-care routines

Ranchos Los Amigos
Level VIII

Actions are purposeful and appropriate
more flexibility in thinking and better problem solving

Mild intellectual disability

IQ between 55 and 70; ability to learn academic skills at the third-to seven-grade level; able to work with minimal support

Moderate intellectual disability

IQ between 40 and 55; able to learn academic skills to at least the second-grade level and able to perform unskilled as well awn some skilled work tasks

Severe intellectual disability

IQ between 25 and 40; able to communicate and perform some basic ADLs and health habits; often requires support to complete routines

Profound intellectual disability

IQ below 25; requires caregiver assistance for basic tasks; also generally has neuromuscular, orthopedic, or behavioral deficits

Formal diagnosis of intellectual disability

usually made when the child enters school because of emphasis on performance on psychoeducational assessments

Prosody

using variation in the pitch, emphasis, or rhythm of speech

Rett Syndrome

A progressive neurologic disorder cause by a genetic mutation that is found only in girls.
-Development appears normal for the first 6 months of age
- In childhood, the child's head growth begins to slow; she loses hand skills and demonstrates poorly coordinated trunk and gait coordination
- Initially a loss of social skills occurs, but social skills reemerge later
- common comorbidities include microcephaly, spasticity, and seizures,
- A characteristic behavior of girls with Rest syndrome is handwringing and other repetitive behaviors; in addition, waking hyperventilation is common
Girls with Rest syndrome are usually non ambulatory and nonverbal by late childhood

OT intervention for ADHD

-Cognitive-behavioral therapy: challenging automatic thoughts, reducing cognitive distortions, challenging underlying beliefs and assumptions, mental imagery, controlling recurrent thoughts, controlling behavior
- Behavior modification
- Educational interventions, including safety awareness
-Social skills training
- Modifying classroom environments, especially organization of space and objects
- Self- management techniques
- Interventions to enhance sensory modulation and support organizational routines

Implications for OT intervention- Early childhood

sensory integration, play, socialization, and self-help

Implications for OT intervention- School age

sensory integration, perceptual-motor integration, writing skills

Implications for OT intervention- Early adolescence

Independent living skills, social skills, and the development of compensatory and adaptive techniques

Cognitive Orientation to Daily Occupational Performance (CO-OP)

-a client- centered problem solving approach
-a way to coach the child through self-discovery and devise solution for everyday life situation that are affected by motor performance
-The CO-OP is characterized by a cooperative relationship between he OT practitioner and the child
- The child helps to formulate and select goals and work on ways to generalize skills to other contexts
-The outcome of intervention is skill acquisition, generalization, transfer, and positive gains in self-efficacy and independent strategy development

STORCH infections

Infections transmitted from mother to child
-Syphilis
-Toxoplasmosis
- Other Infections
-Rubella
-Cytomegalovirus
- Herpes simplex virus-2

Toxoplasmosis

is contracted through handling of cat feces or eating raw meats.
Stillbirths are commonly associated with this condition.
However, children born with toxoplasmosis have intellectual disabilities, hydrocephalus, and chorioretinitis.
Other common comorbidities include cerebral palsy, seizures, cardiac and liver damage, and gastrointestinal problems

Rubella

can be very harmful if contracted in the first trimester. Many fetuses will not survive the duration of pregnancy.
When babies are born after their mother has contracted rubella, they often have intellectual disabilities, hearing loss, microcephaly, congenital heart defects, seizures, and problems with their liver and spleen.

Encephalitis

inflammation of the brain

Caused by bacteria, spirochetes, or a viral infection

Can ultimately lead to brain damage, ranging from mild tp severe

Meningitis

an infection of the tissue that covers the brain and the spinal cord

most commonly has a bacterial cause

Backward chaining

therapist performs the first several steps of the task and allows the child to complete the last step of the task

Forward chaining

Therapist encourages the child to complete the first step of the task, and they practice this step until it is mastered. In the meantime, the therapist completes the rest of the task

Visual perception

the process of being able to understand what is being seen

Visual- receptive dysfunction

Difficulty completing work tasks in a timely manner
Avoidance of reading or writing tasks
Visual fatigue
Distraction of inattention to visual material

Refractive errors

The inability of the eye to adjust to different lighting conditions, visual-field problems, accommodations, and other oculomotor function

Presbyopia

When accommodation for near objects is poor

Strabismus

When one eye turns in, out, up, or down as a result of muscle imbalance; can result in blurred or double vision

Phoria

A tendency for one eye to move slightly in, out, up or down without overt misalignment

Sensory Diet (Wilbarger)

A sensory diet is an individualized plan that provides a specific child with the optimal sensory experiences tat the child needs to be functional in her or her environment

Proprioceptive input may have a mediating effect on vestibular input

the OT practitioner will often offer both types of input at the same time

An occupational therapist is working with a child with dysgraphia on school work. Which intervention strategy might the OTR® use?
A. Provide the child with a magazine that is of high interest and at his reading level
B. Provide the child with a copy of partially completed notes so that he only has to fill in key words
C. Provide the child with a lab partner during science experiments
D. Provide the child with a calculator

B. Provide the child with a copy of partially completed notes so that he only has to fill in key words

Dysgraphia is a learning disability associated with difficulty producing written language. This option is correct because it requires that the child focus on writing less during instruction.

An OTR® is using suspended equipment in working with a child who has vestibular issues. The OTR® is worried that the child might be receiving too much input. What physical indicator suggests that the child might be receiving too much vestibular input?
A. Hyperactive behavior
B. A flushed face
C. An expression of hunger
D. Efficient motor coordination

When providing vestibular input, the therapist looks for warning signs that too much input is being provided. Warning signs include the child's report of nausea or dizziness, blanching, hyperactivity, and lethargy.

An OTR® is providing intervention to a 4-year-old with developmental delays and is working on sorting. What outcome would be the result of a goal for this child if the intervention focused on sorting eating utensils according to type and size?
A. To be able to note key features or attributes and relate them to what is already kept in one's memory
B. To be able to categorize objects by similarities and to note differences
C. To be able to note the similarities among objects
D. To be able to determine the spatial relationship between objects

B. To be able to categorize objects by similarities and to note differences

Being able to sort by type and size would support the child's ability to categorize objects on the basis of similarities and to note differences among objects. This skill is an important precursor to successful participation in ADLs and educational occupations.

A 6-year-old child has hypotonia and poor sitting balance. Which activity would be MOST BENEFICIAL to include in the initial intervention for facilitating the child's active trunk extension?
A. Gentle rocking on a 22-inch (56 cm) diameter ball in a supine position
B. Going down a ramp in a prone position on a standard-size scooter board
C. Rolling forward and backward in a 20-inch (51 cm) diameter carpet-lined barrel
D. Sitting upright and spinning in a ceiling-suspended net hammock

B. Going down a ramp in a prone position on a standard-size scooter board

The prone position will facilitate an active trunk extension posture as the child works to hold the head and limbs away from the ground. Though this activity provides movement, the child's body position is starting from a point of stability in prone.

An OTR® is working with a toddler in early intervention who has a diagnosis of a developmental delay. The OTR® suspects that the child may have an intellectual disability. Which item in the child's history is an early indicator of an intellectual disability?
A. A Incomplete fibrous ankylosis
B. Jaundice and vomiting
C. Breech presentation
D. Limited reactions to play

Limited reactions to play, delays in meeting typical milestones, unresponsiveness to physical contact or handling, feeding difficulty, and neurological soft signs are all early indicators of intellectual disabilities.

An OTR® is working with a child on tooth brushing. The OTR® lets the child brush the teeth for a minute. The child fails to brush the majority of the teeth. Next, the OTR® uses the toothbrush to brush all of the child's teeth. What strategy is the OTR® using with this child?
A. Forward chaining
B. Modifying
C. Grading
D. Backward chaining

Forward chaining involves the therapist encouraging the child to complete the first step of the task, and then the therapist completes the rest of the task

An OTR® is conducting an evaluation with a child on the pediatric intensive care unit. While observing the child's heart monitor, the OTR® notes that the child may be experiencing tachydysrhythmia and alerts the nurse immediately. What are the implications of tachydysrhythmia?
A. The child's heartbeat is less than 60 beats per minute.
B. The child has an atrioventricular block.
C. The child's heart beat is between 200 and 300 beats per minute.
D. The child has a pacemaker.

Tachydysrhythmia is fairly common in children with cardiac conditions. In extreme cases and when complications are present, it can lead to congestive heart failure. It is characterized by fast heart rate of 200-300 beats per minute.

An OTR® is working in a pediatric developmental follow-up clinic and learns that a new client has a diagnosis of congenital club hand. When the child and the parent enter the room, the OTR® attempts to gain more information about the client's diagnosis through observation. For what should the OTR® be looking?
A. Partial or full absence of the capitates and hamate and muscle hypertrophy
B. Dislocation of the humerus and signs of nerve damage
C. Bony malformations and underdeveloped musculature
D. Partial or full absence of the radius and bowing of the ulnar shaft

Congenital club hand is associated with partial or full absence of the radius and bowing of the ulnar shaft. In addition, the upper extremity nerve and musculature are either absent or underdeveloped.

An OTR® is evaluating a student's desk for the optimal position for handwriting. Which option describes the optimal desk position?
A. The desk should be positioned at least 3 inches away from the child's abdomen and allow for shoulder internal rotation and forearm supination.
B. The desk should be positioned 2 inches above the child's flexed elbows when the child is seated in the chair with the feet on the ground.
C. The desk should be positioned 1 inch below the child's wrist when the child is standing with both feet on the floor.
D. The desk should be positioned so that the part closest to the child is angled up and the writing surface slopes downward.

B. The desk should be positioned 2 inches above the child's flexed elbows when the child is seated in the chair with the feet on the ground.

This position allows for weight shifts and postural adjustments as well as optimal muscle synergy and symmetry during seatwork.

Which occupation might a child with arthrogryposis multiplex congenital likely have difficulty with?
A. Being fed.
B. Socializing with friends
C. Listening to a teacher's instructions.
D. Donning a shirt.

Children with arthrogryposis multiplex congenital have incomplete contractures or fibrous ankylosis of all or many of their joints, which would make donning a shirt, the only occupation that involves the use of the extremities, difficult without adaptive equipment or modified techniques.

An OTR® is working on life skills training with a client who has Prader-Willi syndrome. Given the nature of Prader-Willi syndrome, which life skills may present more of a problem?
A. Buying a greeting card for a friend and remembering who the intended recipient is.
B. Vacuuming the floor and needing to move light objects to vacuum under them.
C. Going to a movie and sitting through the previews.
D. Preparing a meal and waiting to serve it until lunchtime.

Individuals with Prader-Willi syndrome often present with food-seeking behaviors, which might make waiting to eat until lunchtime difficult.

Prader-Willi Syndrome

Children with this disorder present with moderate intellectual disabilities, food-seeking behaviors, hypotonia, poor thermal regulation, underdeveloped sex organs, and a long face with slanted eyes

A student with a developmental delay ay is participating in a prewriting group with other kindergarten students. The student has achieved the goals of successfully copying a cross, an oblique line, and a square. Which copying task should be included during the NEXT phase of the student's prewriting program?
A. Series of vertical lines on wide-ruled paper
B. Monosyllabic words posted on a whiteboard
C. Person figure consisting of various shapes
D. Letters of the student's first name

Once a child is successful in copying a cross, an oblique line, and a square, the next progression of handwriting skill includes the child printing his or her own name.

An OTR® is working with a child with retinopathy of prematurity and wants to provide the child's parent with activities to work on between sessions. Which activity would be appropriate for an OTR® to recommend?
A. Encourage the parent to attend to the infant's social smile by smiling back.
B. Encourage the parent to attach a nonbreakable mirror to the infant's crib.
C. Encourage the parent to introduce toys to the infant that can be touched, listened to, and tasted.
D. Encourage the parent to reduce auditory stimuli and refrain from talking or singing when playing with the infant.

C. Encourage the parent to introduce toys to the infant that can be touched, listened to, and tasted.

Infants with visual impairments need to be supported to promote development in play and should learn to incorporate their other senses.

Explanations of Incorrect Answers

A: It is likely that a child with a significant visual impairment would not be able to see the parent's smile.

B: It is likely that a child with a significant visual impairment would not be able to see his or her reflection in the mirror.

D: It is likely that the OTR® would recommend that the parent of a child with visual impairment increase vocalizations around the child to support the development of the child's auditory sense.

A student in kindergarten is 5 years old and has Asperger syndrome. The student typically avoids classroom activities requiring the use of manipulatives, has occasional verbal outbursts in class, and becomes agitated during physical education class and other group activities. Evaluation results indicate the student has a mild sensory processing deficit. Which school-based occupational therapy service delivery model would be MOST EFFECTIVE to initially use when providing intervention for this student?
A. Consultative
B. Integrated
C. Pull-out
D. Prevention

B. Integrated

The Individuals With Disabilities Education Act (IDEA) provides support that school-related services are provided in the least restrictive environment. An integrated service delivery model allows for the practitioner to provide intervention in the child's natural classroom environment and allows the practitioner to also instruct staff members to meet the child's outcomes.

Explanations of Incorrect Answers

A: Consultation may focus on implementing a specific program for a student or educating the teacher to enhance knowledge and skills to facilitate the child's performance in class. This child would require more direct intervention by the practitioner; therefore, consultation is not appropriate.

C: Pull-out services remove the child from the classroom setting and should only be used if the child is working on a skill at a level far below classroom peers or when the intervention that is being provided is distracting to others in the classroom.

D: The child has already developed difficulties in classroom performance areas, and a prevention focus of intervention would not be appropriate for this child.

An OTR® is working with a baby in the neonatal intensive care unit who was exposed to a STORCH infection (syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus, herpes simplex virus-2) at birth. Which STORCH infection would require the OTR® to use universal precautions to prevent the OTR® from contracting an infection when working with the infant and mother?
A. Cytomegalovirus
B. Rubella
C. Toxoplasmosis
D. Syphilis

Cytomegalovirus can be transmitted to the infant before, during, or after birth. The therapist needs to use universal precautions because the virus could remain dormant, and the therapist could contract it.

An adolescent with Down syndrome is applying for a part-time job and completing an online job application. Which visual-perceptual skill would this adolescent need to use to locate the appropriate tab to click on to submit the application?
A. Form constancy
B. Depth perception
C. Visual-spatial orientation
D. Figure-ground recognition

D. Figure-ground recognition

Figure-ground recognition allows a person to distinguish between the foreground and the background so as to focus on the essential information (or objects) and not be distracted by other information.

An OTR® is working with an infant who is recovering from a brachial plexus injury. What type of sling should the OTR® fabricate?
A. A sling that fits proximally around the humerus
B. A sling that fits proximally around the radius
C. A sling that fits proximally around the ulna
D. A sling that fits proximally around the clavicle

A. A sling that fits proximally around the humerus

A sling that fits proximally around the humerus will prevent the child from sustaining further injury to the brachial plexus during ADLs.

An OTR® is working on the playground with a child who has sensory integration dysfunction. The OTR® is trying to foster an adaptive response, which is best described by which statement?
A. The behavioral manifestation of optimal sensory organization that results in an efficient goal-directed action
B. Engagement in rough-and-tumble play and other activities that provide the child with muscle resistance
C. A reflection on primitive neural functions in children with sensory processing problems
D. An individualized plan that provides a specific child with optimal sensory experiences

An adaptive response is the result of optimal organization and leads to efficient goal-directed action. As tasks become more complicated and children continue to demonstrate adaptive response, their sensory integration becomes more effective and efficient. Adaptive responses are thought to lead to changes at the neuronal synaptic level; these changes alter the brain through a process called neural plasticity.

An OTR® is working with a 2½-year-old child on age-appropriate fine motor skills. Which activity would be most appropriate to support development?
A. Unbuttoning large buttons
B. Lacing a shoe
C. Cutting out shapes with scissors
D. Drawing shapes

A 2½-year-old child would likely be working on unbuttoning large buttons.

An OTR® is working with a child with juvenile rheumatoid arthritis (JRA). The child is having difficulty carrying the therapist's recommendations over to school. Which strategy would help the child to carry the recommendations over to school?
A. Provide training to the child's sibling related to the ROM program.
B. Provide the child with a second set of textbooks to keep at home.
C. Provide training to the school nurse on how to assist the child with managing pain.
D. Provide the child with a color-coded folder to put homework in

Children with JRA benefit from energy conservation techniques that put less stress on their joints. Allowing the child to have a second set of textbooks would mean that the child would not need to transport heavy books to and from school, thus protecting the joints.

An OTR® is working on an inpatient unit with a child who has a congenital heart defect. Before admission, the child was able to complete a basic self-care routine. Currently, despite wanting to complete the activities independently, the child requires assistance because of compromised endurance. What compensatory strategy or technique should the OTR® use to minimize the impact of the condition on the child's occupational performance?
A. Pacing of activities
B. Backward chaining of activities
C. Forward chaining of activities
D. Delegating activities

Children with congenital heart defects may want to be independent in play and self-care tasks. Pacing activities and selecting appropriate activities are two ways to promote their independence.

Which intervention strategy would be MOST appropriate for a child with thoracic kyphosis?
A. Teaching a child to don pants with a reacher
B. Teaching a child how to perform toilet hygiene while wearing a Milwaukee brace
C. Teaching a child how to self-feed while using a plate guard
D. Teaching a child to bathe while using a tub chair

The Milwaukee brace is recommended for children with kyphosis or a posterior convexity.

An OTR® is evaluating a child with Down syndrome who is transitioning from early intervention to the school system. The OTR® wants to collect relevant information regarding the child's developmental trajectory. Which method is the BEST to obtain this information?
A. Observation
B. Consultation with another provider
C. Standardized assessment
D. Parent interview

Because parents have intimate knowledge of their children's development, parent interview is the best way to obtain specific information about the child's developmental trajectory, including when the child achieved different developmental milestones.

An OTR® is working with a child who has a diagnosis of cerebral palsy. The child demonstrates an extreme startle response on hearing a loud noise coming from another treatment space. Which key marker of cerebral palsy is this behavior associated with?
A. Retention of primitive reflexes
B. Abnormal or variable tone
C. Clonus
D. Involuntary movements

A. Retention of primitive reflexes

An extreme startle may be associated with a retained Moro reflex.

An OTR® is working in early intervention with a toddler with developmental delays. The child is just beginning to actively cooperate during dressing. What is the next "just-right" challenge for this child?
A. Pulling off shoes and socks
B. Locating the armholes of a shirt
C. Pulling down pants with an elastic waistband
D. Dressing with minimal assistance

A. Pulling off shoes and socks

Around age 1, children begin cooperating during dressing. The next developmental challenge would be to encourage the child to remove shoes and socks.

A student in the first grade has illegible handwriting. Results of a standardized assessment indicate the student scored 0.5 standard deviations from the mean on a gross motor subtest and 2.0 standard deviations from the mean on a fine motor subtest. What do these results indicate?
A. Activities to improve handwriting should be included as part of the intervention.
B. Ninety-eight percent of the student's peers would score better on the fine motor test.
C. Fine and gross motor skills are within an acceptable range from the norm.
D. Fine motor and gross motor skills are moderately delayed compared to the norm.

A. Activities to improve handwriting should be included as part of the intervention.

Standard deviations less than 1.5 suggest a need for occupational therapy services; in this case, the gross motor standard deviation does not suggest a delay, whereas the fine motor standard deviation should be addressed through an intervention plan that addresses the student's handwriting.

An OTR® is working with a child with bradydactyly. Which occupation might the child have difficulty with?
A. Eating a sandwich.
B. Talking with a friend on the phone.
C. Ordering at a restaurant.
D. Buttoning shirt buttons

A child with bradydactyly has overly large digits and may have difficulty with ADLs that require fine motor manipulation.

bradydactyly

a medical term which literally means "shortness of the fingers and toes" (digits)
which results in overly large digits

An OTR® is working in the neonatal intensive care unit with a 28-week-old infant and the infant's mother. The infant has bronchopulmonary dysplasia (BPD). Which occupation would be affected by this condition?
A. Bathing
B. Dressing
C. Feeding
D. Socializing

Infants with BPD may require the use of mechanical ventilation and other traumatic interventions to treat acute respiratory problems. In addition, they may experience excess mucus and airway thickening that may make feeding difficult.

An OTR® is working with a child on shoe tying. The OTR® is using backward chaining. Which statement describes this technique?
A. The therapist downgrades the activity so that the child is able to complete the task with fewer activity demands.
B. The therapist models the task for the child and encourages the child to imitate what he or she observes.
C. The therapist performs the first several steps of the task and allows the child to complete the last step of the task.
D. The therapist encourages the child to complete the first step of the task, and the therapist then completes the rest of the task.

C. The therapist performs the first several steps of the task and allows the child to complete the last step of the task.

This option accurately describes backward chaining.

An OTR® has recommended that a student with a learning disability use an assignment notebook to write down homework assignments for each class. Which factor related to learning disabilities does this compensatory strategy address?
A. Disorders of sequencing and adapting prioritization and problem solving
B. Disorders of social skills and concentration
C. Disorders of sensory integration and perception
D. Disorders of thinking and memory

People with learning disabilities often have difficulty with short- and long-term memory. Using an assignment notebook would mean that the student would not have to recall the assignments after leaving the class.

A student in kindergarten has dyspraxia and frequently falls when playing at recess and during gym class. When completing at-desk art and writing activities, the student often reverses numbers and letters and holds the pencil with an immature grasp. What should be the INITIAL focus of intervention sessions with this student?
A. Identifying assistive devices for improving handwriting legibility
B. Using parquetry activities for improving visual-spatial and visual-motor skills
C. Engaging in fine motor games to increase pinch and grip strength
D. Providing a just-right challenge during gross motor play activities

Improving the child's safety during recess and gym class should be the first priority of the intervention plan, so addressing gross motor play skills is most appropriate. Providing the just-right challenge will allow the child to participate in tasks that do not overwhelm yet are also not so simple that the task is routine or uninteresting. This challenge will allow the child to develop praxis with gross motor play.

A child with attention deficit hyperactivity disorder (ADHD) is seeing an OTR® to work on developing on-task behaviors in the classroom. Which intervention strategy would be appropriate to support the child in developing on-task behaviors?
A. Modifying the classroom environment so that the child is not sitting near close friends and will have a tendency to talk less to the surrounding students.
B. Introducing the child to other students with ADHD so that they can discuss what it feels like to have this condition.
C. Requesting that the teacher not penalize the student for off-task behavior until the student's medication has been adjusted.
D. Developing a behavior modification program in which the child is rewarded for being on task at different intervals throughout the day.

Developing a behavior modification program in which the child is rewarded for being on task at different intervals throughout the day would be an appropriate occupational therapy intervention to support the child in developing consistently on-task behaviors.

An OTR® chooses to incorporate the use of preparatory activities to modulate muscle tone, promote proximal joint stability, and improve hand function during a handwriting intervention session. Which model of practice is guiding the OTR®'s intervention?
A. Neurodevelopmental
B. Acquisitional
C. Sensorimotor
D. Biomechanical

A neurodevelopmental approach to handwriting would ideally be used for children who have tone issues, poor postural control, poor limb function, poor automatic reactions, and poor proximal stability. These preparatory activities would help mitigate the child's underlying deficits, promote better hand control, and ultimately lead to better handwriting.

A school-age child has a sensory integrative disorder and is participating in occupational therapy. During a session, the child is sitting on a platform swing and the OTR® is gently rotating the swing clockwise. When the OTR® stops the swing, the child reports feeling sick and becomes pale. What action should the OTR® take during future sessions to prevent these symptoms from recurring when the child participates in this activity?
A. Lower the swing so it is a close to the ground as possible.
B. Move the swing back and forth in a slow, linear motion.
C. Provide firm proprioceptive input just prior to the swing activity.
D. Have the child roll forward and backward in a carpet-lined barrel.

B. Move the swing back and forth in a slow, linear motion.

Rotational swinging is a more intense form of vestibular input. Linear motion provides a less intense form of vestibular input and may reduce the child's symptoms in response to vestibular input.

Explanations of Incorrect Answers

A: Changing the height of the swing will not reduce the intensity of the vestibular input received through the rotation of the swing, although it would be an effective modification for gravitation insecurity.

C: Proprioceptive input inhibits the effect of vestibular input; therefore, the swinging activity would be ineffective.

D: This activity will still provide vestibular input through rotation and will not prevent the child's symptoms.

An OTR® is observing a 6-year-old child who has a sensory modulation disorder. The OTR® notes that the child maintains foot contact with the ground at all times whenever playing on moving playground equipment. What do the child's behaviors suggest?
A. Gravitational insecurity
B. Sensation-seeking behaviors
C. Somatodyspraxia
D. Tactile defensiveness

Gravitational insecurity results from vestibular sensation, and a child may attempt to keep feet in contact with the ground in response to the overresponsiveness of the vestibular system with the moving playground equipment.

During a standardized assessment of developmental motor skills, a 5-year-old child is unable to stack 1-inch (2-cm) cubes as per the standardized instructions. Based on this finding, the OTR® plans to include intervention activities for increasing the child's motor control. Which goal related to this objective would be MOST ACHIEVABLE within a 60-day time period?
A. After playing with toys, the child will clean up the play area by placing five small toys in a container with minimal verbal cues.
B. The child will consistently fasten the bottom three buttons of a front-opening shirt when prompted during dressing activities.
C. The child will score at age level when asked to stack blocks during readministration of the fine motor skills assessment.
D. The child will throw a bean bag onto a target with 90% accuracy from 4 feet (1.2 m) away.

A. After playing with toys, the child will clean up the play area by placing five small toys in a container with minimal verbal cues.

This goal is linked to the child's acquisition of hand skills through engagement in occupational activities and is a reasonable goal in the given time frame.

Explanations of Incorrect Answers

B: Goals must be feasible for the child to accomplish given the current status of hand function. If the child is having difficult stacking 1-inch cubes, it is likely the child is unable to button, and achieving this goal within the 60 days is not reasonable.

C: This goal is not relating the acquisition of the child's hand function to engagement in occupational activities, which is necessary in all goals for children developing hand skills.

D: This goal does not relate to the development of the child's hand skills in relation to occupational engagement (throwing bean bags at a target is not a direct occupational performance task).

An OTR® is using cognitive-behavioral therapy strategies to help an adolescent client with attention deficit hyperactivity disorder regulate behavior so the client is able to get to work on time. Which strategy is related to cognitive-behavioral therapy?
A. Encouraging the client to take a movement break when the client begins to feel off task while getting ready for work.
B. Encouraging the client to set an alarm clock so that the client is able to get up for work on time.
C. Encouraging the client to visualize completing the prework routine without getting distracted and arriving to work on time.
D. Encouraging the client to call the boss when the client is running late instead of sneaking in through the back door.

C. Encouraging the client to visualize completing the prework routine without getting distracted and arriving to work on time.

Cognitive-behavioral therapy techniques include challenging automatic thoughts, reducing cognitive distortions, challenging underlying beliefs and assumptions, visualization, controlling recurrent thoughts, and self-monitoring (or controlling) behavior.

A 6-year-old student is being evaluated by an OTR® because of difficulty with completing writing tasks and worksheets. The OTR® conducts an observation during class time. Which functional writing activities should a child this age be able to complete without adult assistance?
A. Writing the upper- and lowercase letters of the alphabet without a model
B. Copying a triangle, printing own name, and copying most letters
C. Writing the numerals 1-10 without a model
D. Copying a pentagon and an octagon, printing own address, and drawing a house with 12 details

B. Copying a triangle, printing own name, and copying most letters

Typically, children between the ages of 5 and 6 are able to copy a triangle, print their own name, and copy most letters from a model.

Explanations of Incorrect Answers

A, C, D: These options represent more advanced skills that a 6-year-old would not typically be expected to have mastered.

An OTR® is working on postoperative discharge plan for a school-age child with neurofibromatosis. The OTR® recommends that the parents move the child's clothes from the top drawer so that the child can access them independently. Why might the OTR® make this recommendation?
A. Children with neurofibromatosis have weakened shoulder girdles and reduced upper-extremity strength.
B. Children with neurofibromatosis are of short stature and have skeletal anomalies.
C. Children with neurofibromatosis have decreased sensation and often drop things.
D. Children with neurofibromatosis have difficulty initiating routines.

B. Children with neurofibromatosis are of short stature and have skeletal anomalies.

Children with neurofibromatosis are of short stature and have skeletal anomalies. Because of their reduced height, they may benefit from environmental modifications that allow them to reach objects independently.

An OTR® is working on life skills with a teenager who has achondroplasia. Which of the following tasks might pose a challenge for the client?
A. Reaching an upper cupboard to obtain a box of cereal
B. Transporting silverware from the dishwasher to the silverware drawer
C. Sweeping the kitchen floor after a meal
D. Making toast using a toaster

A. Reaching an upper cupboard to obtain a box of cereal

People with achondroplasia (often referred to as dwarfism) usually grow be to 4 feet tall or less in height. Their limbs have typical width but are usually shorter in length. A client with this condition might have difficulty reaching an upper cupboard to obtain an item.

An OTR® is working with a client who has difficulties with visual skills as a result of damage to the central nervous system (CNS). Which visual skill is related to CNS damage?
A. Visual memory
B. Stereopsis
C. Figure-ground
D. Kinesthesia

Stereopsis, or binocular depth perception, is a visual skill that would be affected by CNS damage.

A school-aged child has myelomeningocele resulting in symptoms associated with an upper motor neuron bladder. The child is participating in a bowel and bladder program to learn to manage self-toileting tasks. Despite completing intermittent catheterization as recommended, the child continues to have only partial control of bladder function. Frequent bladder leaks result in skin irritation of the perineum and odor. In addition to recommending a follow up evaluation with the child's primary care provider and teaching personal hygiene skills, what action should the OTR® take?
A. Advise the child to wear an absorbent incontinence pad or a youth-size disposable diaper.
B. Suggest restricting the child's fluid intake during the day to limit urine production.
C. Recommend the child apply manual pressure on the abdomen while emptying the bladder.
D. Educate the parent and child about alternative means of collecting the child's urine.

Using an incontinence pad or disposable diaper will provide the child with skin protection by having the pad absorb any leaked urine, and the pad may also minimize odors associated with leaking.

Explanations of Incorrect Answers

B: Restricting fluid intake will make the child susceptible to bladder infections and is not an appropriate recommendation. Note that fluid restriction prior to bowel program sessions will prevent bladder distention; however, it should not be a daily practice.

C: Because the child has an upper motor neuron bladder, the training program is focused on developing an automatic response for voiding. Pressure on the abdomen would be a method used for lower motor neuron bladders where the bladder requires assistance to empty because of low tone.

D: The child is currently using the least restrictive method of catheterization, and modifying the catheterization schedule or assistive devices to protect from accidents is more beneficial than seeking a more restrictive method that requires surgical intervention.

A 4-year-old child with bilateral congenital limb deficiencies at the transhumeral level was recently fitted with new prostheses. Which activity should be introduced FIRST as part of the prosthetic program with the child?
A. Self-feeding using standard eating utensils
B. Coloring pictures in an oversized coloring book
C. Stacking 1-inch (2.54-cm) wooden blocks
D. Pushing an 18-inch- (45-cm-) diameter exercise ball

Once an individual is fit with a prosthetic, use training should begin so the client can understand how to operate and control the prosthetic. The client is able to implement practice with pre-positioning the limb to more effectively approach an object, such as pushing a ball.

An OTR® is working with a child who was recently identified as having vestibular issues. The OTR® would like to use suspended equipment in the session. What type of vestibular input should the therapist first introduce?
A. Rotational movement
B. Vertical movement
C. Linear movement
D. Continuous movement

Suspended equipment provides the opportunity for children to gain vestibular input. Linear movement is usually tolerated the best and is introduced first.

An OTR® is working with a child who has scoliosis with a curve of 70°. The child would like to engage in sports activities. On the basis of this medical condition, which factor would most likely limit the child's ability to participate in sports?
A. The need to wear a therapeutic brace
B. Weak abdominal muscles
C. Cardiopulmonary function
D. Ability to manage pain

Children with a scoliosis curve between 65° and 80° may have reduced cardiopulmonary function.

Explanations of Incorrect Answers

A: The need to wear a brace would likely not have an impact on the child's ability to participate in sports.

B: Although weak abdominal muscles may be present, cardiopulmonary issues become the primary concern with children who have significant curvatures because they impact life functions.

D: Scoliosis is usually not painful.

An OTR® is working with a child on toilet training. The child is 2½ years old and has an intellectual disability. Which of the following strategies is appropriate to include during intervention?
A. Encourage the child to wash his hands after using the bathroom
B. Encourage the child to try buttoning and unbuttoning pants
C. Encourage the use of a toileting schedule
D. Encourage the use of a potty chair

Children are typically physiologically able to get on a regular toileting schedule at age 2½.

An OTR® is working with a teenager with autism on eating in the cafeteria using good table manners. Which strategy would be appropriate to meet this outcome?
A. Partially feeding the teenager and using a backward chaining technique
B. Requesting that the teenager take a time out or break to work on self-calming strategies
C. Delaying gratification by postponing lunch until the teenager can demonstrate good table manners
D. Encouraging the teenager to model the behavior of a peer who is eating with good table manners

A modeling strategy, which would consist of having a peer complete the task and then having the child copy the peer, is the most appropriate option.

An OTR® is working on toileting with a 3-year-old child with autism. The child is delayed approximately 1 year with toileting skills. When is it likely that this child can be expected to completely master this skill?
A. Ages 4-5
B. Ages 6-7
C. Ages 8-9
D. Ages 9-10

B. Ages 6-7

Typically, children are able to be independent with toileting, including washing hands and completing clothing management, between the ages of 4 and 5. If the child is a year behind, he will likely master the skill between age 6 and 7.

Explanations of Incorrect Answers

A, C, D: Although some children may completely master toileting before or after the ages of 4-5, this range is typical for skill development.

An OTR® is consulting with the physical education teacher regarding a child with asthma. Which statement BEST explains how the OTR® can support the child in maximizing participation in physical education?
A. Educate the child on breathing exercises, stretching, and controlled breathing.
B. Educate the child on sensory and emotional self-regulation.
C. Educate the child on energy conservation strategies.
D. Educate the child on AROM and active assistive ROM exercises.

Educating the child regarding breathing exercises, stretching, and controlled breathing may help to alleviate an asthma attack by helping the child to remain calm and deal with stress.

An OTR® is reviewing a chart on an infant who was referred to the developmental follow-up clinic. The OTR® notes that the mother transmitted syphilis to the baby during birth. Which impairments might be seen in the child?
A. Poor bladder control
B. Poor tolerance of passive range of motion
C. Poor balance
D. Poor feeding and vomiting

Congenital syphilis may result in osteochondritis at the joints, other bone anomalies, dental anomalies, and visual and auditory deficits. PROM may be painful.

An OTR® is working with a child who is recovering from a motor vehicle accident. During the session, the child seems to lose awareness and stops working on a puzzle for as long as 30 seconds at a time. On the basis of this information, what should the OTR be concerned about?
A. The client is having tonic-clonic seizures.
B. The client is having myoclonic seizures.
C. The client is having absence seizures.
D. The client is having akinetic seizures.

People having absence seizures look like they are "zoning out" or daydreaming; these seizures are characterized by a brief lapse or loss of awareness. In addition, clients who experience absence seizures will suspend all motor activity (even eye blinking) during a seizure. These seizures usually last less than 30 seconds.

Explanations of Incorrect Answers

A: With tonic-clonic seizures, people experience an "aura" or a sensation that the seizure is about to begin. During this type of seizure, people usually lose consciousness and their body goes through a series of rhythmic clonic contractions.

B: Myclonic seizures involve a single muscle group.

D: Akinetic seizures involve the loss of normal muscle tone for approximately 30 minutes or more.

An OTR® is working with a second grader with autism who is fully included in a general education classroom. The teacher has indicated that the child is "on yellow." On the basis of this information, what sort of support should the OTR® provide the child in terms of behavior?
A. The child may benefit from physical restraint.
B. The child may benefit from a time out.
C. The child may benefit from being removed from the classroom on a regular basis.
D. The child may benefit from environmental adjustments, cues, or facilitation.

Yellow-zone behavior is usually considered mildly problematic and does not pose a safety risk to the child or other people. This type of behavior can usually be addressed by making environmental adjustments or providing cues or facilitation

An OTR® is working in a preschool with a child who has a developmental delay in toileting. The child is beginning to show interest in toileting and can stay dry for more than 2 hours at a time. What is the next "just-right" challenge for this child?
A. Moving the bowels regularly
B. Wiping independently after having a bowel movement
C. Managing clothing during toileting
D. Telling someone when he or she has to go to the bathroom

At age 2, children typically begin to show interest in toileting, can stay dry for 2 or more hours, and can flush the toilet independently and urinate regularly. The next developmental challenges include telling someone that they have to use the bathroom, waking up dry after sleeping, wiping self after urinating, and washing hands independently.

A classroom teacher observes that a 7-year-old student consistently has difficulty finishing handwritten assignments and fine motor activities. An OTR® is consulted to assess the student's handwriting skills with a goal of improving classroom performance. After observing the student and collecting writing samples, which task should the OTR® complete NEXT?
A. Assess the student's perceptual-motor processing using standardized testing.
B. Determine the most appropriate desk set-up for the student to complete class assignments.
C. Instruct the teacher on ways to cue the student using kinesthetic learning techniques.
D. Provide worksheets for the student to practice letter formation during study group.

Comprehensive evaluation should include standardized testing in addition to observation and nonstandardized writing samples to determine a need for further intervention and to develop an appropriate intervention plan. Perceptual-motor processing may interfere with handwriting skills and is an appropriate area to assess.

An OTR® is working with a child with sickle cell anemia. Which intervention strategy would be appropriate when working with this child?
A. Joint protection
B. PROM
C. Pursed-lip breathing
D. Pain management

Children with sickle cell anemia may experience pain and may need support to manage their pain.

Which assessment tool would an OTR® administer to gain an understanding of how a child's sensory processing abilities are affecting the child's participation in daily life activities at home?
A. Sensory Integration and Praxis Test (SIPT)
B. Sensory integration clinical observations
C. Sensory Profile
D. Bruininks-Oseretsky Test of Motor Performance (BOT-2)

Interviews and caregiver questionnaires such as the Sensory Profile can be used to gain an understanding of how sensory problems influence a child's participation in daily activities.

An OTR® is evaluating a 7-year-old child with attention deficit hyperactivity disorder who has significant handwriting delays. Which assessment is BEST to use to compare this child's performance with that of same-age peers?
A. Beery-Buktenica Developmental Test of Visual Motor Integration
B. Print Tool Handwriting Assessment
C. Minnesota Handwriting Test
D. Peabody Developmental Motor Scales

Only the Minnesota Handwriting Test is a standardized, norm-referenced assessment specific to handwriting.

Explanations of Incorrect Answers

A, D: The Beery-Buktenica Developmental Test of Visual Motor Integration and the Peabody Developmental Motor Scales are commonly used as part of a handwriting evaluation but are not specific to handwriting.

B: The Print Tool Handwriting Assessment is not standardized or norm referenced.

An OTR® is working with a child on locating a link on a web page. The OTR® observes that the child has difficulty with visual scanning. Before moving forward with this intervention activity, what other visual skill should the OTR® assess?
A. Visual cognition
B. Visual memory
C. Visual attention
D. Visual recognition

According to Warren's hierarchy of visual-perceptual skills development, visual attention is foundational to visual scanning. The OTR® should determine whether the child has good visual attention before moving on to the more complicated visual scanning task.

Explanations of Incorrect Answers

A, B, D: According to Warren's hierarchy of visual-perceptual skills development, pattern recognition, visual memory, and visual cognition take place after visual scanning.

An OTR® is working on cooking skills with a client with a severe intellectual disability. Which activity would the client likely be able to complete with supervision?
A. Making a frozen pizza in the oven.
B. Preparing a cold salad.
C. Heating up a microwave meal.
D. Pouring juice from a pitcher to a cup.

D. Pouring juice from a pitcher to a cup.

Clients with a severe intellectual disability have an IQ between 25 and 40 and are able to perform some basic ADLs, but they often need supervision or caregiver assistance for basic tasks.

Explanations of Incorrect Answers

A, B, C: A client with a severe intellectual disability would likely need more support than supervision to complete these tasks.

An OTR® is working with an 8-year-old client with developmental coordination disorder (DCD) in an outpatient clinic. Which option reflects the difficulty that this child may experience at school as a result of this condition?
A. The child may have difficulty with handwriting because of limited fine motor skills.
B. The child may have difficulty socializing with peers as a result of limited language skills.
C. The child may have difficulty attending to instruction because of limited self-regulation skills.
D. The child may have difficulty locating a word in the dictionary because of limited visual-perceptual skills.

Children with DCD have difficulty with fine and gross motor skills and often require accommodations and modification for written language.

An OTR® is working with a 10-month-old infant who has osteogenesis imperfecta (OI) and the infant's family. To reduce the child's occupational dysfunction, in what areas should the family receive training and education?
A. The family should receive training and education in pain management and how to cope with exacerbations.
B. The family should receive training and education in handling and positioning to prevent possible fractures.
C. The family should receive training and education in energy conservation and the use of adaptive equipment to prevent fatigue.
D. The family should receive training and education in donning and doffing the child's thoracic lumbar sacral orthosis to promote breath support.

Children with OI, or "brittle bones," are at risk for fractures after minor and accidental traumas. Parent education on handling and positioning can help to reduce the likelihood of fractures.

An OTR® is providing early intervention services to a 24-month-old child who has a pervasive developmental disorder. The parents' goal is for the child to be able to participate in age-appropriate activities with peers. Which of the following contexts is BEST for promoting progress toward this goal?
A. Organized play group in a community playground
B. Backyard of the child's home with siblings
C. Group session in the occupational therapy clinic with other children
D. Tumbling group for preschoolers in a community gymnasium

A. Organized play group in a community playground

The environment is important for supporting a child's play actions; the child perceives the interactions within various environments, then learns to act on those interactions. A play group that is organized will allow the child to be in a natural play environment while learning to adapt to or accommodate peers in interactions.

An OTR® receives a referral for a child who has difficulty with handwriting. The OTR® wants to determine whether the child has difficulty with the integrated process of handwriting rather than specific components that support the production of handwriting. Which of assessment methods would be appropriate to use for this purpose?
A. Print Tool
B. Developmental Test of Visual Motor Integration
C. Canadian Occupational Performance Measure
D. Child Occupational Self-Assessment

The Print Tool is a commercially available and standardized way of measuring a child's ability to produce handwriting.

An OTR® is working with a child who has a diagnosis of myclomeningocele spina bifida. Which ADLs might be difficult for a child with this condition?
A. Grooming at the sink
B. Feeding oneself lunch
C. Upper-body bathing
D. Toileting at school

Children with myclomeningocele spina bifida have sensorimotor problems at or below the level of their lesion. Lower-extremity paralysis and loss of sensation is common. Bowel and bladder programs may need to be implemented to help children with toileting across environments.

Which intervention strategy would be appropriate when teaching a compensatory approach for the production of written language to a child who has a diagnosis of developmental coordination disorder?
A. Provide the child with a pencil grip.
B. Encourage the teacher to provide a copy of the teacher's notes.
C. Instruct the child in keyboarding.
D. Allow the child to use print instead of cursive writing.

Instructing the child in keyboarding would provide the child with a compensatory way to produce written language instead of handwriting.

An OTR® is working with a 3-year-old with a developmental delay in preschool. The child is having a tantrum because it is time to stop playing and go to circle time. Which strategy might have prevented a tantrum?
A. Praising the child when the child is engaging in positive behaviors and making good choices
B. Teaching the child how to self-calm
C. Giving a warning before the preferred activity came to a close
D. Telling the child the rules and expectations and following them

Giving the child a warning when a preferred activity is coming to a close will help the child transition to the next activity and may reduce the likelihood of a tantrum.

A child receiving occupational therapy for handwriting holds a pencil with flexed fingers and a supinated forearm. According to the biomechanical model of practice, which piece of adaptive equipment would MOST LIKELY promote a more functional forearm position for handwriting?
A. A triangular pencil grip
B. A moldable pencil grip
C. A piece of raised-line paper
D. A rubber band sling

The scenario describes a transitional grasp. If applying the biomechanical approach, a rubber band sling (e.g., a Handi-Writer; www.handithings.com/handiwriter.htm) would promote a more neutral wrist position and pronated forearm position.

Explanations of Incorrect Answers

A, B, C: These options are appropriate pieces of adaptive equipment to use with children with handwriting needs. However, only the rubber band sling would address the child's forearm position.

An OTR® is working with a 10-year-old girl with Rett's syndrome. What can the OTR® expect by the time the girl reaches late childhood?
A. The child will be able to cook a simple meal.
B. The child will not be able to walk or speak.
C. The child will not be able to express discomfort.
D. The child will be able to put earrings on independently.

Girls with Rett's syndrome experience a decline in functional skills. Commonly, by the time a girl with Rett's syndrome reaches late childhood, she would no longer be able to walk or talk.

An OTR® is working with a high school student with juvenile rheumatoid arthritis (JRA). The OTR® suggests that the student stop using the arms and hands to carry heavy textbooks to class and instead use a backpack. What type of strategy did the OTR® recommend?
A. The OTR® recommended an energy conservation strategy.
B. The OTR® recommended a joint protection strategy.
C. The OTR® recommended a work simplification strategy.
D. The OTR® recommended a pacing strategy.

Using a backpack instead of arms and hands to carry heavy books will put less stress on the student's hand joints and is in line with a joint protection strategy.

An OTR® is working with a child with autism spectrum disorder who has a hard time engaging in positive social behaviors in the cafeteria. Which intervention strategy would be most appropriate to help the child learn how to behave in the cafeteria?
A. Using proximity control
B. Modeling the desired behavior
C. Giving the child a break
D. Giving the child a time out

Modeling the desired behavior and reminding the child of the behavioral expectations are two examples of gentle corrections that could be made in this situation.

What is the PRIMARY benefit of using the SETT (Student, Environment, Task, Tools) Framework to guide assistive technology (AT) evaluation and service delivery in a school-based setting?
A. Helps to reduce the incidence of learned helplessness and low self-esteem among students who have communication deficits
B. Meets specific standardized assessment requirements as outlined in the Individuals With Disabilities Education Improvement Act of 2004
C. Promotes educational team collaboration regarding students' AT needs throughout the school day
D. Provides a method for prioritizing students' occupational therapy intervention activities based on hierarchy of scores

The SETT allows for collaboration and communication among educational team members to support good decision making to determine the AT needs of a student.

Explanations of Incorrect Answers

A: The SETT is used to determine AT needs of a student, not just communication needs, and does not address learned helplessness or self-esteem of a student.

B: The SETT is a framework and does not meet standardized assessment criteria.

D: The SETT is a framework that results in qualitative information about a student's needs and does not provide a score.

An OTR® is working with a child who was identified as having sensory integrative dysfunction. What is the typical duration of Ayres Sensory Integration treatment?
A. Typically 1 to 2 times per week for 1 year
B. Typically 1 to 2 times per week for 2 year
C. Typically 3 to 4 times per week for 1 year
D. Typically 3 to 4 times per week for 2 year

Treatments typically last between 45 and 60 minutes 1-2 times per week and continue for about 2 years.

An OTR® is working with a child who has sensory integrative dysfunction related to motor planning. According to Ayres Sensory Integration, what type of sensory input would be most supportive in developing this child's motor planning skills?
A. Proprioceptive, visual, and auditory
B. Vestibular, tactile, and olfactory
C. Visual, auditory, and olfactory
D. Tactile, vestibular, and proprioceptive

D. Tactile, vestibular, and proprioceptive

Children with motor planning problems benefit from vestibular and proprioceptive input. They might also have difficulties with tactile perception.

An OTR® is consulting with a general education teacher regarding a student with a significant visual impairment who is being included in kindergarten. The teacher has questions about the best way to teach the child where materials are in the classroom so that he can access them independently. Which strategy would be appropriate?
A. Encourage the child to use depth perception and spatial awareness skills to understand where he or she is in relation to the materials.
B. Encourage the child to use social skills and ask peers to retrieve materials for him.
C. Encourage the child to use tactile and proprioceptive senses to understand where he or she is in relation to the materials.
D. Encourage the child to use imitation skills and to follow peers to understand where he or she is in relation to the materials.

C. Encourage the child to use tactile and proprioceptive senses to understand where he or she is in relation to the materials.

Using these senses will help the child to establish a mental map of the classroom.

An OTR® is working with a client with polyarticular juvenile rheumatoid arthritis (JRA). Which biomechanical technique would be appropriate to include in the client's intervention plan during an exacerbation?
A. A resistive exercise program
B. An AROM program
C. A taping program
D. A pacing program

AROM and PROM exercises, along with splinting, monitoring joint function, preventing deformation, teaching energy conservation techniques, and instruction in the use of adaptive equipment, are all recommended intervention for a child with JRA.

An OTR® is working with an infant on learning how to transition from sitting to kneeling. Which activity would be the most appropriate to achieve this outcome?
A. Place a toy on the kitchen table.
B. Place a toy on the caregiver's lap.
C. Place a toy on a low coffee table on the other side of the room from the child.
D. Place a toy on a surface that cannot be reached in sitting.

D. Place a toy on a surface that cannot be reached in sitting.

Placing the toy on a surface that can only be reached in kneeling or standing (not sitting) would create the next "just-right" challenge.

An OTR® chooses to incorporate the use of a variety of experiences, different media, and novel instructional materials during a handwriting intervention session. Which model of practice is guiding the OTR®'s intervention?
A. Neurodevelopmental
B. Acquisitional
C. Sensorimotor
D. Biomechanical

A sensorimotor approach to handwriting would include the incorporation of a variety of sensory experiences, different media, and novel instructional materials during a handwriting intervention session. It would also include offering the child multiple different writing tools, writing surfaces, and positions for writing.

An OTR® wants to teach a home exercise strengthening program to a child with a mild intellectual disability. How should the OTR® modify the home exercise program so that the client can follow it independently?
A. Reduce the number of exercises from 20 to 15 to encourage independence.
B. Incorporate simplified vocabulary and pictures to encourage independence.
C. Model the home exercise program and allow the child to follow along to encourage independence.
D. Pair the child with a peer who has a similar home exercise program to encourage independence.

A child with a mild intellectual disability might be able to read between the second-grade and seventh-grade levels. Simplified words and pictures may allow the child to follow the home exercise program with greater independence.

An OTR® is working with a pediatric client with delayed visual-perceptual skills. Specifically, the child has difficulty with shape, letter, and color identification and recognition. On the basis of this description, with which visual-perceptual skill is the child having difficulty?
A. Visual discrimination
B. Visual memory
C. Visual closure
D. Figure-ground recognition

Visual discrimination is the brain's ability to process and interpret the features of an object (or other stimuli) related to matching, recognition, and categorization by different attributes.

A school-based OTR® has evaluated a 4-year-old child who has cerebral palsy. Results of the Peabody Developmental Motor Scales Second Edition (PDMS-2) indicate the child is functioning at a 2-year-old developmental level. Which environment is MOST CONDUCIVE for conducting the initial play assessment based on this information?
A. In the classroom with peers and familiar developmental toys
B. In an isolated room with access to age-appropriate computer games
C. At the community playground with sliding, swinging, and climbing opportunities
D. In a therapy room with the OTR® providing the child with a selection of toys

Play is most meaningful when it occurs in context; therefore, the classroom with peers and familiar toys is most appropriate for an initial play assessment. A child's activities cannot be accurately observed unless they occur within the environment where the child plays.

Explanations of Incorrect Answers

B, C, D: Play is most meaningful when it occurs in context; therefore, observing the child's play in an isolated room, at a community playground that may not be familiar, or in a therapy room does not provide a familiar context for the child. A child's activities cannot be accurately observed unless they occur within the environment where the child plays.

An OTR® is working as part of the school district's response-to-intervention initiative to deliver a handwriting curriculum with the kindergarten teacher. The OTR® is working with a small group of students to remediate their pencil grips. Which grip would require remediation?
A. The pencil rests on the distal phalanx of the radial side of the little finger, and the pads of all five fingers control the movement; the thumb is opposed to the ring finger and the wrist is flexed.
B. The pencil rests against the radial side of the middle finger, and the pads of the fingers control the movement; the thumb is not opposed to the index finger and rests on the distal interphalangeal joint.
C. The pencil rests against the radial side of the ring finger, and the pads of the fingers control the movement; the thumb is not opposed to the index finger and rests on the distal interphalangeal joint.
D. The pencil rests against the distal phalanx of the radial side of the ring finger, and the pads of the fingers control the movement; the thumb is opposed to the index finger.

A. The pencil rests on the distal phalanx of the radial side of the little finger, and the pads of all five fingers control the movement; the thumb is opposed to the ring finger and the wrist is flexed.

This grip is not functional and should be remediated.

An OTR® is reviewing the chart of a client with Down syndrome. The chart indicates that the client has a history of patent ductus arteriosus (PDA). What are the risks associated with this condition?
A. This condition can lead to increased blood pressure and rapid heart rate.
B. This condition can lead to difficulties with feeding and shortness of breath.
C. This condition can lead to heart failure and inadequate oxygenation of the brain.
D. This condition can lead to vertigo and dehydration.

PDA is a heart defect that is common in premature children and people with Down syndrome. A defect of the ductus arteriosus results in a lack of constriction, which may result in heart failure and inadequate oxygenation of the brain.

An OTR® is working with a 4-year-old who was recently diagnosed with Duchenne's muscular dystrophy (DMD). The client's parents are concerned and want to understand how this condition will progress and affect the child's participation in daily life. Which statement describes the progression of DMD?
A. The condition progresses slowly, and children often experience difficulty with muscles around their pelvis and shoulder girdle.
B. The condition progresses so that the facial muscles have decreased mobility; children eventually have a masklike appearance.
C. The condition usually has an onset before adolescence, and it progresses until children cannot raise their arms above their heads.
D. The condition progresses quickly, and children often need to use a wheelchair by age 9.

D. The condition progresses quickly, and children often need to use a wheelchair by age 9.

Explanations of Incorrect Answers

A: This answer describes limb girdle muscular dystrophy, not DMD.

B, C: These answers describe facioscapulohumeral muscular dystrophy, not DMD.

A 2-year-old client was referred to an outpatient burn clinic for management of developing scar tightness in the left hand and wrist. The client's mother is the primary caregiver and has expressed severe guilt about the child's being burned in a kitchen fire 6 months ago. The mother is feeling very overwhelmed with the postburn management program and has been having difficulty looking at the client's hand during therapy. What should be the INITIAL program for the mother to carry out at home?
A. Compression glove worn 24 hours per day with 20 minutes of deep scar massage every 2 hours during waking hours
B. Compression glove worn 24 hours per day with silicone gel pads inserted at all the web spaces and regular play time with play dough and toy building blocks
C. Coban™ self-adherent wrap on each individual finger during the day, deep scar massage 3 times per day, and antideformity hand splint at night
D. Coban™ self-adherent wrapping of each individual finger and elasticated tubular bandage 24 hours per day, regular PROM of left fingers and wrist

B. Compression glove worn 24 hours per day with silicone gel pads inserted at all the web spaces and regular play time with play dough and toy building blocks

It is important that the mother accept the child after the accident, and having therapeutic playtime can help with mother-child bonding. To not further overwhelm the mother, the initial scar management program should be simple and yet efficient. The use of silicone gel pad inserts at the web spaces can soften the scar and maintain the web spaces.

A 3-year-old child has increased upper-extremity flexor tone secondary to mild cerebral palsy. The OTR® observes that the child's thumb adducts into the palm during prewriting activities such as coloring a picture. This movement interferes with the child's ability to complete prehensile tasks. Which intervention would be MOST BENEFICIAL to use for initially facilitating grasp and release patterns for fine motor task accomplishment?
A. Provide a soft thumb abductor splint for the child to wear during prewriting tasks.
B. Fabricate a long opponens splint for facilitating tenodesis during fine motor activities.
C. Engage the child in upper-extremity weight-bearing intermittently during a prewriting task.
D. Apply facilitation techniques to the wrist and finger extensors just prior to having the child practice specific grasp patterns.

A. Provide a soft thumb abductor splint for the child to wear during prewriting tasks.

Soft splints may enhance thumb control when mild increases in tone are present. In a small study with 4 young children, this splint was found to be effective at improving grasp and supination.

An OTR® is working on exploring the home environment with an infant in early intervention. The child is approximately 3 months behind in gross motor skills. Given this delay, at what age would the OTR® expect the child to crawl?
A. <6 months
B. 9 months
C. 12 months
D. 15 months

Infants typically begin to crawl by age 9 months. Given this child's delay, crawling may emerge around 12 months.

An OTR® is working in the neonatal intensive care unit with an infant who was born at 26 weeks gestation. The infant's birth history is positive for placental abruption. Given this information, what might the OTR® observe for?
A. Signs and symptoms of Marfan's syndrome
B. Signs and symptoms of congenital cerebral palsy
C. Signs and symptoms of fragile X
D. Signs and symptoms of erythrocytosis

Congenital cerebral palsy is often a result of prematurity. Infants born between 26 and 32 weeks gestation are at high risk for cerebral palsy because of the likelihood of experiencing a cerebrovascular accident at or around the time of birth, placental abruption, fetomaternal hemorrhage, placental infarction, and maternal exposure to teratogens.

An OTR® is working in the school system with a child who has a behavioral disability. The OTR® wants to improve the child's classroom environment to promote more opportunities for success. Which rational intervention (RI) approach would the OTR® use?
A. Facilitation
B. Monitoring
C. Gentle correction
D. Reprimand

According to RI, facilitation is characterized by observing the child and responding to the child's needs by improving the child's environmental supports.

An OTR® is conducting a handwriting evaluation with an 8-year-old client. During the evaluation, the OTR® notices that the child's eyes are not in alignment when copying from far point to near point. What type of problems might the child experience as a result of eye misalignment?
A. Being able to manipulate a pencil from writing point to eraser
B. Being able to answer a question posed by the teacher when the child had not volunteered
C. Being able to copy assignments from the chalkboard into an assignment notebook
D. Being able to organize papers into a folder

Misalignment of the eyes, along with shaking eyes, excessively large or small pupils, and pupils that are not black but appear to have an opaque film over them are all red flags related to visual problems. Misalignment of the eyes may complicate the child's ability to copy assignments from the chalkboard into an assignment notebook.

An OTR® is working with a child who has a diagnosis of cerebral palsy. The child's tone fluctuates from low to normal with little spasticity. What would the OTR® expect to see when the child reached for a toy that was positioned on the table next to the child?
A. A limb that appeared flaccid
B. A limb that appeared ataxic
C. A limb that appeared choreoathetoid
D. A limb that appeared athetoid

D. A limb that appeared athetoid

Athetosis is characterized by tone that fluctuates from low to normal with little spasticity.

An OTR® is working on sequencing a bedtime routine with a child with autism. Which activities would be supportive of this outcome?
A. Providing the child with pictures of the different tasks involved in the routine so that the child may perform them in order.
B. Encouraging the child to complete the last task in a series of tasks so that the child is more inclined to want to complete the routine.
C. Allowing the child to select which activities to eliminate from the routine.
D. Introducing the child to adaptive equipment (e.g., an electric toothbrush) so that the routine takes less time.

A. Providing the child with pictures of the different tasks involved in the routine so that the child may perform them in order.

Clients with autism benefit from the use of visual supports, such as pictures. Using pictures may help this child recall steps so that the child can perform them in the correct order.

An OTR® is working at an after-school program connected to a women's homeless shelter. The OTR® is engaged in a conversation with the mother of a 10-year-old boy; she says that the child has recently loss quite a bit of weight and is excessively thirsty. To which specialist should the child be referred?
A. Pediatrician
B. Endocrinologist
C. Neurologist
D. Audiologist

These factors, along with polyuria and dehydration, are common signs of Type 1 diabetes. Onset is usually around age 10. The appropriate referral would be to an endocrinologist.

An OTR® is working with a child on shoe tying. At around what age can the OTR® expect a typically developing child to master this skill?
A. Age 4
B. Age 5
C. Age 6
D. Age 7

The OTR® can expect a typically developing child to master shoe tying at age 6.

An OTR® is evaluating a 12-month-old child for home-based early intervention services. During the evaluation, the child's mother reports that the child has recently been diagnosed with anemia. The OTR® observes that the interior of the house is in need of repair and notes peeling paint and wallpaper. Which action is most appropriate for the OTR® to take?
A. Alert the child's mother to attend quickly to bleeding episodes because the child's blood may not clot normally.
B. Encourage the child's mother to provide the child with more vitamin D-rich foods and monitor how much milk the child drinks on a daily basis.
C. Alert the child's mother that anemia may be indicative of lead poisoning and to consult a physician as soon as possible.
D. Alert the child's mother that anemia may be indicative of chronic pulmonary disease and to consult a physician as soon as possible.

Anemia may be an indicator of lead poisoning.

Explanations of Incorrect Answers

A: Hemophilia is associated with clotting difficulties.

B: Anemia may also be related to a deficiency of iron-rich foods.

D: Anemia and chronic pulmonary disease are not generally related.

An OTR® is working with a child who dislikes having hair washed, playing in sand, and shaking hands. What type of sensory dysfunction might this child have?
A. Somatodyspraxis
B. Tactile defensiveness
C. Gravitational insecurity
D. Hyporesponsivity

B. Tactile defensiveness

Tactile defensiveness is characterized by difficulty making sense of or interpreting tactile input. The child in this scenario might feel that the tactile input outlined in this option is noxious.

An OTR® is working in an outpatient clinic with a child with ADHD. The client reports having difficulty keeping the bedroom neat and tidy without the mother's assistance. On the basis of this condition, which activity demand related to cleaning one's room would be problematic for the client?
A. The mother's expectation that food not be eaten in bedrooms
B. Drawers that are not designated for specific types of clothing
C. A small wastepaper basket
D. Lack of space under the client's bed

B. Drawers that are not designated for specific types of clothing

According to AOTA (2008, pp. 634), "Activity demands include the specific objects and their properties used in the activity, the physical space requirements of the activity, the social demands, sequence and timing, the required actions or skills needed to perform the activity, and the required body functions and structures used during the performance of the activity." The lack of designated drawers for different types of clothing may prevent the client from keeping the room neat and tidy.

An OTR® receives a referral for a child who has difficulty with balance and coordination. The OTR® wants to determine whether the child has difficulty with visual-receptive functions. Which assessment method would be appropriate to use for this purpose?
A. Administration of the Developmental Test of Visual Motor Integration
B. Observation of how the child's eyes work together
C. Interview with the teacher to determine whether the child has difficulty with spelling
D. Administration of the Bruininks-Oseretsky Test of Motor Proficiency

Observing how a child's eyes work together would provide insight into visual-receptive functions.

An OTR® is working with a child who has a sensory processing disorder. The therapist would like to assess the child's motor planning using a standardized assessment tool. Which tool would be appropriate for the therapist to use?
A. Sensory Integration and Praxis Test (SIPT)
B. Sensory integration clinical observations
C. Sensory Profile
D. Bruininks-Oseretsky Test of Motor Performance (BOT-2)

The BOT-2 can be used to assess aspects of fine and gross motor functioning that may be difficult as a result of dyspraxia.

An OTR® is working with a 4-year-old on increasing independence with toileting at school. The child's parents indicate that toileting is also a problem at home. Which strategy would help the child to carry over what has been learned at school to home?
A. Provide the parents with information about when other children with autism have mastered toileting.
B. Provide the parents with the names and phone numbers of other parents of children with autism who have already mastered toileting.
C. Provide the parents with an exact copy of the child's toileting picture checklist that is used at school.
D. Provide the parents with a description of how the school's bathroom is set up.

Children with autism benefit from visual supports, such as checklists and communication boards. Providing the parents with an exact copy of the child's toileting picture checklist enables the parents to follow the same routine at home.

An OTR® wants to design an intervention activity that will provide a child with proprioceptive input. Which intervention activity would provide this type of input?
A. Encouraging the child to play in a bin of rice or beans
B. Encouraging the child to swing on a platform swing while "climbing" a rope with the hands
C. Encouraging the child to finger paint at an easel
D. Encouraging the child to walk on a balance beam

Proprioceptive input is gained through the child's muscles and joints. "Climbing" a rope would provide this type of input.

An OTR® conducts a screening with a second-grade student who was referred to occupational therapy for handwriting legibility. In which way would the OTR® assess legibility during the screening?
A. Calculate the number of letters or words written per minute.
B. Ask the student to generate a short composition and determine whether it matches grade expectations.
C. Observe the child's posture and note the child's grasp on the writing utensil.
D. Document the total number of readable words divided by the total number of words written.

The OTR® would use the word legibility formula, which would allow the OTR® to calculate the number of written words relative to the number of legible words. The OTR® would likely also address the other legibility factors, such as alignment, spacing, sizing, and slant.

An OTR® is working with an 18-month-old child with bilateral transverse upper-arm deficiency who was recently fitted with myoelectric prosthetics. Which self-care tasks would be appropriate to work on in therapy?
A. Donning and doffing prosthetics independently
B. Using ties or hook-and-loop fastener to fasten shoes bimanually
C. Raising upper extremities to assist with upper-body dressing
D. Indicating to a caregiver when more juice is desired

On the basis of the child's condition and age, raising the upper extremities to assist with upper-body dressing is appropriate.

Which treatment activity would support a pediatric client's ability to increase visual attention to complete homework tasks?
A. Providing directional cues paired with verbal cues
B. Reorganizing a worksheet so that the answer spaces are clearly defined
C. Using a game like Bingo
D. Color-coding folders and notebooks for different subjects

Reorganizing a worksheet with clearly defined answer spaces would help the child to attend to relevant information on the worksheet.

An OTR® is working with a child with ADHD who is transitioning from elementary school to middle school and discussing the child's concerns with the educational team. Given the child's condition, with which occupation might the child need support?
A. Meeting a new friend
B. Initiating a routine
C. Listening to instructions or conversations
D. Forming a bond with more than one teacher

Children with ADHD typically have difficulty paying attention to details and may miss important information that is conveyed verbally, such as with instructions or conversations.

An OTR® has completed a screening of fine motor skills with all of the students enrolled in a kindergarten class. The results indicate that five students in the class are functioning in the lower 25th percentile. What INITIAL action should the OTR® take in response to these findings?
A. Compare the screening results of these students to standardized achievement test scores.
B. Discuss the students' results and potential follow-up options with the classroom teacher.
C. Document that scores for each of the students are within normal limits.
D. Recommend scheduling a comprehensive occupational therapy evaluation for each of the students screened.

B. Discuss the students' results and potential follow-up options with the classroom teacher.

Additional information that is relevant to the child's development and performance in school will help to establish the accuracy of the screening findings.

A student in the third grade with a learning disability has attended school-based occupational therapy for several years to improve visual-perceptual skills for completing curriculum-based school work. The latest update report to the parents indicates the student is not making progress toward the stated Individualized Education Program (IEP) goals. This report is similar to the previous two reports. What action should the OTR® take NEXT to address the lack of progress?
A. Continue occupational therapy intervention knowing that developmental progress due to maturity is still possible.
B. Discuss alternative classroom modifications and adaptations with the student's teacher.
C. Request the special education team schedule an interim meeting to modify the student's IEP.
D. Send a letter to the student's parents informing them that occupational therapy is no longer beneficial to their child.

B. Discuss alternative classroom modifications and adaptations with the student's teacher.

The student's response to occupational therapy intervention and teacher data is important in implementing an effective intervention plan. The intervention plan appears to need modification on the basis of the student's response.

Sets with similar terms

Chapter 7 Health Promotion During Early Childhood

20 terms

Chapter 32 - the toddler and family (evolve)

48 terms

Toddlers EAQ

12 terms

Toddler

77 terms

Sets found in the same folder

Neurological Impairments: TBI, SCI and CVA

105 terms

Occupational Rehabilitation and Return-to-Work Pro…

131 terms

practice

46 terms

Neurodegenerative Diseases

108 terms

Other sets by this creator

NASM Essentials of Corrective Exercise Training

615 terms

Response to Intervention (RTI)

3 terms

Wheelchair Seating and Mobility

145 terms

Other Quizlet sets

ACCT 2010 (Practice Review Points - Review Quiz Mi…

18 terms

Ch 8 - Central Nervous System Fills in & multiple…

43 terms

Macro midterm

67 terms

Pediatric Assessment and Intervention

Terms in this set (191)

Sets with similar terms

Chapter 7 Health Promotion During Early Childhood

Chapter 32 - the toddler and family (evolve)

Toddlers EAQ

Toddler

Sets found in the same folder

Neurological Impairments: TBI, SCI and CVA

Occupational Rehabilitation and Return-to-Work Pro…

practice

Neurodegenerative Diseases

Other sets by this creator

NASM Essentials of Corrective Exercise Training

Response to Intervention (RTI)

Other OT Topics- activity analysis, assistive tech…

Wheelchair Seating and Mobility

Other Quizlet sets

ACCT 2010 (Practice Review Points - Review Quiz Mi…

Ch 8 - Central Nervous System Fills in & multiple…

Macro midterm

Related questions

Features

Help

About

Language