This week focuses on: Pediatric Conditions and Interventions, Pediatric Development, Pediatric Reflexes, and IEP.
This week focuses on: Pediatric Conditions and Interventions, Pediatric Development, Pediatric Reflexes, and IEP.
To streamline studying, we have highlighted our most recommended material. If you are limited on time, please review this material first.
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Module 2 Quiz
If you do not receive above 80% or better on this exam. it is highly recommended that you sign up for a personal tutoring session immediately before taking the actual NBCOT® exam. A personal tutor can significantly help you better understand any problem areas.
A 3-year-old is referred to you with a developmental delay. Since her cognitive skills are significantly delayed, what type of play will you incorporate into your therapy?
Symbolic play is the ability of children to use objects, actions or ideas to represent other objects, actions, or ideas as play. It is an important element in Piaget’s theory. Symbolic play is a vehicle for the child to understand the world around him as well as an indicator of the child’s cognitive development. Piaget determined that play is described in three stages: functional play (sensorimotor) such as an infant grasping a rattle; symbolic play (experience) which includes constructive concepts and pretend play activities; and games with rules which build social skills.
Symbolic play is the ability of children to use objects, actions or ideas to represent other objects, actions, or ideas as play. It is an important element in Piaget’s theory. Symbolic play is a vehicle for the child to understand the world around him as well as an indicator of the child’s cognitive development. Piaget determined that play is described in three stages: functional play (sensorimotor) such as an infant grasping a rattle; symbolic play (experience) which includes constructive concepts and pretend play activities; and games with rules which build social skills.
An OT is using facilitation techniques incorporating tapping, movement, and compression, while working with a patient who has a diagnosis of athetoid cerebral palsy. What quality of muscle tone would this patient typically present with?
C. Fluctuating.
Athetoid cerebral palsy, also called dyskinetic cerebral palsy, affects 10 to 25 percent of all people with this condition. This type of cerebral palsy is the result of brain damage to the basal ganglia, located in the midbrain region. It is characterized by abnormal regulation of tone, abnormal postural control, and coordination deficits. Abnormal movement patterns may increase with stress, excitement, or purposeful activity. Muscle tone is usually normal or can be decreased during sleep.
As a form of athetonia, athetoid cerebral palsy is characterized by involuntary slow and writhing movements, which usually affects the hands, feet, arms and legs. In some cases, this type of cerebral palsy can also affect the facial muscles, causing grimacing or drooling. While spastic cerebral palsy is characterized by increased muscle tone and tension, this type of cerebral palsy causes mixed muscle tone, where some muscles are too tense, while others are too relaxed. Sometimes this involuntary muscle activity affects the whole body at once. The symptoms of athetoid cerebral palsy tend to diminish completely during sleep, though they often heighten during times of waking stress.
C. Fluctuating.
Athetoid cerebral palsy, also called dyskinetic cerebral palsy, affects 10 to 25 percent of all people with this condition. This type of cerebral palsy is the result of brain damage to the basal ganglia, located in the midbrain region. It is characterized by abnormal regulation of tone, abnormal postural control, and coordination deficits. Abnormal movement patterns may increase with stress, excitement, or purposeful activity. Muscle tone is usually normal or can be decreased during sleep.
As a form of athetonia, athetoid cerebral palsy is characterized by involuntary slow and writhing movements, which usually affects the hands, feet, arms and legs. In some cases, this type of cerebral palsy can also affect the facial muscles, causing grimacing or drooling. While spastic cerebral palsy is characterized by increased muscle tone and tension, this type of cerebral palsy causes mixed muscle tone, where some muscles are too tense, while others are too relaxed. Sometimes this involuntary muscle activity affects the whole body at once. The symptoms of athetoid cerebral palsy tend to diminish completely during sleep, though they often heighten during times of waking stress.
The current focus of OT intervention is on developing grasp and release techniques with an 8-year-old boy who recently had a right upper extremity prosthesis fitted. The goal is to facilitate self-feeding so that he can regain his independence in this ADL. What is the BEST position for the prosthesis to be placed, in the initial stages of his prosthetic training?
C. Position the child’s elbow at 90 degrees of flexion and the shoulder at 0 degrees of internal rotation. To facilitate effective grasp and release, the easiest position to start with is to have the child’s elbow at 90 degrees of flexion and his shoulder at 0 degrees of internal rotation.
C. Position the child’s elbow at 90 degrees of flexion and the shoulder at 0 degrees of internal rotation. To facilitate effective grasp and release, the easiest position to start with is to have the child’s elbow at 90 degrees of flexion and his shoulder at 0 degrees of internal rotation.
What goal would be addressed when an OT recommends that a child, who has difficulty completing work at school, use an inclined surface to write on at both school and at home?
B. It would address inadequate wrist extension during writing. When writing on an inclined surface a student will have to extend their wrist.
B. It would address inadequate wrist extension during writing. When writing on an inclined surface a student will have to extend their wrist.
What treatment techniques would you expect to utilize with a 7-year- old girl who has a diagnosis of ASD?
B. Swinging for vestibular input.
Treatment techniques that are used to treat children with autism include sensory integrative techniques, such as swinging or animal walks to provide specific types of sensory input, and visual structure to help compensate for deficits in other sensory areas, such as visual schedules and timers. Exposure to flashing lights or loud noises would likely exacerbate the girl’s sensory dysfunction in visual or auditory processing, rather than help to provide appropriate input. These techniques are also likely to cause the girl discomfort and distress.
B. Swinging for vestibular input.
Treatment techniques that are used to treat children with autism include sensory integrative techniques, such as swinging or animal walks to provide specific types of sensory input, and visual structure to help compensate for deficits in other sensory areas, such as visual schedules and timers. Exposure to flashing lights or loud noises would likely exacerbate the girl’s sensory dysfunction in visual or auditory processing, rather than help to provide appropriate input. These techniques are also likely to cause the girl discomfort and distress.
An OT is working with a four-year-old girl for the first time in the OT clinic. As soon as the girl’s mother leaves the room, the girl begins sobbing profusely. What should the OT do next?
B. The OT should redirect the child to another activity.
It will be important to find another activity that will distract and motivate the child. ie. To keep the session client centered and look for activities that interest the child.
B. The OT should redirect the child to another activity.
It will be important to find another activity that will distract and motivate the child. ie. To keep the session client centered and look for activities that interest the child.
An OT observes a 5th grade student in the classroom and then conducts the Sensory Profile assessment. The OT determines that the student does not pay attention to table-top activities due to hyperactivity. What suggestions can the OT provide?
D. Ways to balance free time and structure so the student can direct his own actions.
A treatment strategy for a child with inattention and hyperactivity should include an environment that provides a balance between structure and freedom so the child can direct his own actions.
ADD is the term commonly used to describe symptoms of inattention, distractibility, and poor working memory. With ADHD, the added feature is hyperactivity. Strategies to help students who easily become distracted include physical placement of the student in the classroom, increased movement, and breaking long stretches of work into shorter chunks.
Chunk classwork into small manageable steps. Give the student a certain task to complete and then allow the student to choose a preferred activity, preferably one that includes movement.
Giving them a ‘brain break” can be very beneficial. According to research, brain breaks are simple physical and mental exercises that are designed to restore attention. The theory is that learning through movement increases oxygen into the bloodstream, which leads to improved concentration. Many studies have proven that brain breaks have a positive effect on students’ academic performance.
https://www.educationandbehavior.com/strategies-for-studentren-with-adhd/
https://www.teachhub.com/5-teaching-strategies-getting-students-focus
D. Ways to balance free time and structure so the student can direct his own actions.
A treatment strategy for a child with inattention and hyperactivity should include an environment that provides a balance between structure and freedom so the child can direct his own actions.
ADD is the term commonly used to describe symptoms of inattention, distractibility, and poor working memory. With ADHD, the added feature is hyperactivity. Strategies to help students who easily become distracted include physical placement of the student in the classroom, increased movement, and breaking long stretches of work into shorter chunks.
Chunk classwork into small manageable steps. Give the student a certain task to complete and then allow the student to choose a preferred activity, preferably one that includes movement.
Giving them a ‘brain break” can be very beneficial. According to research, brain breaks are simple physical and mental exercises that are designed to restore attention. The theory is that learning through movement increases oxygen into the bloodstream, which leads to improved concentration. Many studies have proven that brain breaks have a positive effect on students’ academic performance.
https://www.educationandbehavior.com/strategies-for-studentren-with-adhd/
https://www.teachhub.com/5-teaching-strategies-getting-students-focus
What pencil grasp is this child in the photo, demonstrating?
C. Palmar Supinate Pencil Grasp.
Palmar Supinate – The crayon or marker is held in the palm (“palmar”) with the thumb on top in a slight forearm-up (“supinated”) position. This is considered a “primitive” grasp and typically accompanies the “scribbling” stage. Scribbling movements are typically initiated by the shoulder and elbow, which involve larger muscle groups and a relatively low level of precision.
C. Palmar Supinate Pencil Grasp.
Palmar Supinate – The crayon or marker is held in the palm (“palmar”) with the thumb on top in a slight forearm-up (“supinated”) position. This is considered a “primitive” grasp and typically accompanies the “scribbling” stage. Scribbling movements are typically initiated by the shoulder and elbow, which involve larger muscle groups and a relatively low level of precision.
A 6 year old child with Autism Spectrum Disorder (ASD) is able to write several letters with correct letter formation and sizing using a static tripod grasp. What grasp pattern will the OT work on next with this child?
D. Dynamic tripod grasp.
After a child has mastered the static tripod grasp, the OT can work on dynamic tripod grasp.
D. Dynamic tripod grasp.
After a child has mastered the static tripod grasp, the OT can work on dynamic tripod grasp.
What further assessment is needed when an OT observes a 4-year-old girl get startled after a toy princess that she is playing with starts to vibrate?
B. The OT should further assess tactile defensiveness.
Children who have tactile defensiveness are sensitive to touch sensations and can be easily overwhelmed by, and fearful of, ordinary daily experiences and activities. Sensory defensiveness can prevent a child from play and interactions critical to learning and socialization.
Often, children with tactile defensiveness (hypersensitivity to touch/tactile input) will avoid touching, become fearful of, or will be bothered by the following:
– textured materials/items
– “messy” things
– vibrating toys, etc.
– a hug
– a kiss
– certain clothing textures
– rough or bumpy bed sheets
– seams on socks
– tags on shirts
– light touch
– hands or face being dirty
– shoes and/or sandals
– wind blowing on bare skin
– bare feet touching grass or sand
B. The OT should further assess tactile defensiveness.
Children who have tactile defensiveness are sensitive to touch sensations and can be easily overwhelmed by, and fearful of, ordinary daily experiences and activities. Sensory defensiveness can prevent a child from play and interactions critical to learning and socialization.
Often, children with tactile defensiveness (hypersensitivity to touch/tactile input) will avoid touching, become fearful of, or will be bothered by the following:
– textured materials/items
– “messy” things
– vibrating toys, etc.
– a hug
– a kiss
– certain clothing textures
– rough or bumpy bed sheets
– seams on socks
– tags on shirts
– light touch
– hands or face being dirty
– shoes and/or sandals
– wind blowing on bare skin
– bare feet touching grass or sand
For a child with oral hypersensitivity, what would be an appropriate type of toothbrush?
D. The most appropriate type would be a soft sponge-tipped toothette.
Encouraging a child to use a soft sponge-tipped toothette is typically indicated in the child with oral hypersensitivity. We have sensory receptors in our mouths that allow us to recognize information about temperature, texture and taste. Children with healthy oral sensory systems can tolerate eating foods that have mixed textures like cereal and milk, spaghetti and mince or vegetable soup. They manage tooth brushing and visits to the dentist with minimal complaints. Some children struggle with processing and responding to the oral sensory information they encounter in everyday life. They may be over responsive or have increased sensitivity to oral input, causing them to be resistant to oral sensory experiences like trying new foods or brushing their teeth. A soft sponge-tipped toothette, is typically indicated in the child with oral hypersensitivity/defensiveness as the bristles of a regular toothbrush cause discomfort to those with sensory challenges.
http://www.jeanekolbe-ot.co.za/tipsandtricks/2016/9/26/oral-sensory-processing
D. The most appropriate type would be a soft sponge-tipped toothette.
Encouraging a child to use a soft sponge-tipped toothette is typically indicated in the child with oral hypersensitivity. We have sensory receptors in our mouths that allow us to recognize information about temperature, texture and taste. Children with healthy oral sensory systems can tolerate eating foods that have mixed textures like cereal and milk, spaghetti and mince or vegetable soup. They manage tooth brushing and visits to the dentist with minimal complaints. Some children struggle with processing and responding to the oral sensory information they encounter in everyday life. They may be over responsive or have increased sensitivity to oral input, causing them to be resistant to oral sensory experiences like trying new foods or brushing their teeth. A soft sponge-tipped toothette, is typically indicated in the child with oral hypersensitivity/defensiveness as the bristles of a regular toothbrush cause discomfort to those with sensory challenges.
http://www.jeanekolbe-ot.co.za/tipsandtricks/2016/9/26/oral-sensory-processing
What in-hand manipulation activity would be best to use in order to work on complex rotation?
D. Turn pencil over to erase
Complex rotation is a movement involving rotation of an object that requires isolated, independent movements of the fingers and thumb. The movement is further described as manipulating the object with finger pads to turn it between 180-360 degrees An example of this movement would be to turn over a pencil to use the eraser.
At 2.5 years old a child develops simple rotation. The turning or rolling of an object held at finger pads approximately 90 degrees or less (unscrewing a small bottle cap).
At 6-7 years old a child develops complex rotation. The rotation of an object between 180 and 360 degrees (turning a pencil over to erase).
https://ot.eku.edu/sites/ot.eku.edu/files/files/In%20Hand%20Manipulation.pdf
D. Turn pencil over to erase
Complex rotation is a movement involving rotation of an object that requires isolated, independent movements of the fingers and thumb. The movement is further described as manipulating the object with finger pads to turn it between 180-360 degrees An example of this movement would be to turn over a pencil to use the eraser.
At 2.5 years old a child develops simple rotation. The turning or rolling of an object held at finger pads approximately 90 degrees or less (unscrewing a small bottle cap).
At 6-7 years old a child develops complex rotation. The rotation of an object between 180 and 360 degrees (turning a pencil over to erase).
https://ot.eku.edu/sites/ot.eku.edu/files/files/In%20Hand%20Manipulation.pdf
An OT is assigned to work with a 6-year-old student to help him with handwriting adaptations. Currently, the student demonstrates a prone grasp and slight upper extremity weakness. Using the remedial approach, which work surface and position would be most useful in supporting this student?
A. Standing upright and writing on a chalkboard. The remedial approach uses compensation to allow the student to utilize existing skills to complete a task. Since the student has a prone grasp, writing vertically on a chalkboard will provide a better hand position for the student while writing. The vertical reach and resistance of the chalkboard will help to strengthen the student’s upper extremity as he writes.
A. Standing upright and writing on a chalkboard. The remedial approach uses compensation to allow the student to utilize existing skills to complete a task. Since the student has a prone grasp, writing vertically on a chalkboard will provide a better hand position for the student while writing. The vertical reach and resistance of the chalkboard will help to strengthen the student’s upper extremity as he writes.
A 4th grade teacher has 3 students diagnosed with ADHD in her classroom. The teacher decides to incorporate movement breaks into her lessons. What type of intervention is this strategy an example of?
A. Tier 1 intervention. Tier 1 intervention includes changes in the classroom that benefit all students, including those considered to be “at risk”. Tier 1 intervention is the first step of the Response to Intervention, or RTI, process. RTI Tier 1 interventions are the “first line of defense” for supporting students. Response to Intervention (RTI) was designed to help prevent students from needing special education assistance. Tier 1 instruction is delivered to the whole class.
https://www.understood.org/en/school-learning/special-services/rti/at-a-glance-3-tiers-of-rti-support
https://studyskills.com/spedadhd/rti-tier-1-interventions-4/
A. Tier 1 intervention. Tier 1 intervention includes changes in the classroom that benefit all students, including those considered to be “at risk”. Tier 1 intervention is the first step of the Response to Intervention, or RTI, process. RTI Tier 1 interventions are the “first line of defense” for supporting students. Response to Intervention (RTI) was designed to help prevent students from needing special education assistance. Tier 1 instruction is delivered to the whole class.
https://www.understood.org/en/school-learning/special-services/rti/at-a-glance-3-tiers-of-rti-support
https://studyskills.com/spedadhd/rti-tier-1-interventions-4/
An OT observes a 7-month-old infant in sitting, becoming off-balance and reacting with extension and abduction of their limbs toward the side in which they are falling. What reflex is this infant demonstrating?
D. Sideward parachute (protective extension sideward).
Sideward parachute (protective extension sideward): Prevent fall; increase support (arm extension) on side opposite force- stop from falling to side.Tip infant off-balance to side. Arm extension and abduction to the side. 7 mos→ Persists
D. Sideward parachute (protective extension sideward).
Sideward parachute (protective extension sideward): Prevent fall; increase support (arm extension) on side opposite force- stop from falling to side.Tip infant off-balance to side. Arm extension and abduction to the side. 7 mos→ Persists
An OT is working with a 7-year-old boy who has Down Syndrome. One of the therapy goals is to improve the boy’s fine motor skills , specifically his in-hand manipulation. What activity would achieve this goal?
B. Place 3 coins in the child’s hand and ask him to post the coins into a piggy bank, one coin at a time.
In-Hand Manipulation refers to the ability to move and position objects within one hand without the assistance of the other hand.
B. Place 3 coins in the child’s hand and ask him to post the coins into a piggy bank, one coin at a time.
In-Hand Manipulation refers to the ability to move and position objects within one hand without the assistance of the other hand.
A 5-year-old girl is asked to color-in a picture of a garden which includes a tree, a sun, a flower, and a bunny. As she begins coloring in the picture, she tells the OT that she cannot see the bunny in the picture. What can the OT potentially interpret from this?
C. The girl may have difficulty with visual perception. Visual perception is the ability to see and interpret (analyze and give meaning to) the visual information that surrounds us. The process of “taking in” one’s environment is referred to as perception. Figure-ground perception is a visual perceptual skill which gives one the ability to focus on one specific piece of information in a busy background.
A. Visual acuity refers to the sharpness and clarity of the girl’s vision which does not appear to be affected in this scenario.
D. Difficulty in fine motor skills is incorrect because she can clearly grab the the markers and color the paper.
C. The girl may have difficulty with visual perception. Visual perception is the ability to see and interpret (analyze and give meaning to) the visual information that surrounds us. The process of “taking in” one’s environment is referred to as perception. Figure-ground perception is a visual perceptual skill which gives one the ability to focus on one specific piece of information in a busy background.
A. Visual acuity refers to the sharpness and clarity of the girl’s vision which does not appear to be affected in this scenario.
D. Difficulty in fine motor skills is incorrect because she can clearly grab the the markers and color the paper.
At which stage of cognitive development is this child functioning?
C. Sensorimotor.
Piaget’s Theory of Cognitive Development is a description of cognitive development as four distinct stages in children:
1. sensorimotor
2. preoperational
3. concrete
4. formal
The first stage, sensorimotor, begins at birth and lasts until 18 months-2 years of age. The term “sensorimotor” was used by Piaget, because he believed that infants were dependent on their senses and their physical abilities to understand their world. Because they can see, hear, taste, and smell from birth, they combine these senses with their emerging physical abilities to interact with objects by grasping, shaking, banging, and tasting them. During their early experiences, infants are only aware of what is immediately in front of them. Because they don’t understand how things react, they are constantly learning about the world through trial and error by shaking or throwing things and putting things in their mouths. As they become more mobile, infants’ ability to develop cognitively increases.
A. Preoperational. One of Piaget’s stages of cognitive development. It involves the development of language, memory, and imagination. 2 to 7 years old.
B. Trust vs. mistrust is the first stage in Erik Erikson’s theory of psychosocial development. This stage begins at birth continues to approximately 18 months of age. During this stage, the infant is uncertain about the world in which they live and looks towards their primary caregiver for stability and consistency of care.
D. Unoccupied play. This is one of the stages of play developed by Mildred Parten Newhall. In unoccupied play, the child learns about and discovers how their body moves, no toys are involved.
C. Sensorimotor.
Piaget’s Theory of Cognitive Development is a description of cognitive development as four distinct stages in children:
1. sensorimotor
2. preoperational
3. concrete
4. formal
The first stage, sensorimotor, begins at birth and lasts until 18 months-2 years of age. The term “sensorimotor” was used by Piaget, because he believed that infants were dependent on their senses and their physical abilities to understand their world. Because they can see, hear, taste, and smell from birth, they combine these senses with their emerging physical abilities to interact with objects by grasping, shaking, banging, and tasting them. During their early experiences, infants are only aware of what is immediately in front of them. Because they don’t understand how things react, they are constantly learning about the world through trial and error by shaking or throwing things and putting things in their mouths. As they become more mobile, infants’ ability to develop cognitively increases.
A. Preoperational. One of Piaget’s stages of cognitive development. It involves the development of language, memory, and imagination. 2 to 7 years old.
B. Trust vs. mistrust is the first stage in Erik Erikson’s theory of psychosocial development. This stage begins at birth continues to approximately 18 months of age. During this stage, the infant is uncertain about the world in which they live and looks towards their primary caregiver for stability and consistency of care.
D. Unoccupied play. This is one of the stages of play developed by Mildred Parten Newhall. In unoccupied play, the child learns about and discovers how their body moves, no toys are involved.
An OT is selecting a standardized assessment to evaluate a 7-year-old student who recently sustained a TBI while playing football and he now presents with an intention tremor, difficulty concentrating on his work, a poor delay of gratification and letter reversals in his written work. The OT has decided to use the Motor-Free Visual Perception Test (MVPT-3) to assess this student’s visual perceptual skills. What is the MOST likely clinical reasoning behind selecting the MVPT-3 over the Developmental Test of Visual Perception (DTVP-3)?
C. The MVPT-3 assesses visual perception independent of motor ability.
The MVPT-3 assesses an individual’s visual perceptual ability without any motor involvement needed to make a response. It is especially useful with those who may have learning, motor, or cognitive disabilities. As the student has an intention tremor and the focus of the assessment is on evaluating his visual perceptual skills, this is the most appropriate test to use in this scenario. It is important to first establish the student’s visual perceptual skills before testing his visual motor integration.
A. The DTVP-3 can be used to assess children from 4-0 to 12-11.
B. The MVPT-4 is the most recent revision of the only non-motor visual perceptual assessment that can be used throughout the lifespan. Data for this version was collected from 2012–2014.
D. Typically the MVPT-3 takes 25 mins and the DTVP-3 takes 30 minutes to administer.
The Motor-Free Visual Perception Test (MVPT-3) is a widely used, standardized test of visual perception. Unlike other typical visual perception measures, this measure is meant to assess visual perception independent of motor ability. It was originally developed for use with children, however it has been used extensively with adults. The MVPT can be used to determine differences in visual perception across several different diagnostic groups and is often used by occupational therapists to screen those with stroke or head injury. The MVPT-3 was published by Colarusso and Hammill in 2003 and is intended for individuals between the ages of 4-95 and takes approximately 25 minutes to administer.
The Developmental Test of Visual Perception (DTVP-3): The DTVP-3 is the most recent revision of Marianne Frostig’s popular Developmental Test of Visual Perception. Published in 2013. New normative data were collected in 2010 and 2011. Used with children age range: 4-0 through 12-11. Testing Time: 30 minutes.
The results of the five DTVP-3 subtests are combined to form three composites: Motor-reduced Visual Perception, Visual-Motor Integration, and General Visual Perception (combination of motor-reduced and motor-enhanced subtests).
https://www.proedinc.com/Products/13700/dtvp3-developmental-test-of-visual-perception–third-edition.aspx
https://www.proedinc.com/Products/14216/motorfree-visual-perception-testfourth-edition-.aspx
C. The MVPT-3 assesses visual perception independent of motor ability.
The MVPT-3 assesses an individual’s visual perceptual ability without any motor involvement needed to make a response. It is especially useful with those who may have learning, motor, or cognitive disabilities. As the student has an intention tremor and the focus of the assessment is on evaluating his visual perceptual skills, this is the most appropriate test to use in this scenario. It is important to first establish the student’s visual perceptual skills before testing his visual motor integration.
A. The DTVP-3 can be used to assess children from 4-0 to 12-11.
B. The MVPT-4 is the most recent revision of the only non-motor visual perceptual assessment that can be used throughout the lifespan. Data for this version was collected from 2012–2014.
D. Typically the MVPT-3 takes 25 mins and the DTVP-3 takes 30 minutes to administer.
The Motor-Free Visual Perception Test (MVPT-3) is a widely used, standardized test of visual perception. Unlike other typical visual perception measures, this measure is meant to assess visual perception independent of motor ability. It was originally developed for use with children, however it has been used extensively with adults. The MVPT can be used to determine differences in visual perception across several different diagnostic groups and is often used by occupational therapists to screen those with stroke or head injury. The MVPT-3 was published by Colarusso and Hammill in 2003 and is intended for individuals between the ages of 4-95 and takes approximately 25 minutes to administer.
The Developmental Test of Visual Perception (DTVP-3): The DTVP-3 is the most recent revision of Marianne Frostig’s popular Developmental Test of Visual Perception. Published in 2013. New normative data were collected in 2010 and 2011. Used with children age range: 4-0 through 12-11. Testing Time: 30 minutes.
The results of the five DTVP-3 subtests are combined to form three composites: Motor-reduced Visual Perception, Visual-Motor Integration, and General Visual Perception (combination of motor-reduced and motor-enhanced subtests).
https://www.proedinc.com/Products/13700/dtvp3-developmental-test-of-visual-perception–third-edition.aspx
https://www.proedinc.com/Products/14216/motorfree-visual-perception-testfourth-edition-.aspx
Sean is a 2nd grade student with a diagnosis of glaucoma with visual impairment. He does not qualify for special education services, but he could benefit from occupational therapy services to provide adaptations to assist him with reading, keyboarding, and managing his lunch tray. Sean could receive occupational therapy services through which federal law?
B. The Rehabilitation Act of 1973.
Section 504 of this act includes provisions for providing accommodations for students with disabilities in public schools, including occupational therapy services, as long as the student has a medically diagnosed condition.
B. The Rehabilitation Act of 1973.
Section 504 of this act includes provisions for providing accommodations for students with disabilities in public schools, including occupational therapy services, as long as the student has a medically diagnosed condition.
A student in the 3rd grade has difficulty with his visual processing skills and to address this, several strategies were recommended in his IEP. However, after 4 months of implementing these strategies, they no longer seem to be helping the student. What is the NEXT stage of the OT intervention process, in this scenario?
B. Discuss new interventions with the special education teacher to be implemented in the classroom. If the student’s progress has plateaued, then it is important to discuss new interventions with the special education teacher to be implemented in the classroom to yield more progress towards the student’s goals.
B. Discuss new interventions with the special education teacher to be implemented in the classroom. If the student’s progress has plateaued, then it is important to discuss new interventions with the special education teacher to be implemented in the classroom to yield more progress towards the student’s goals.
An OTR® is working with a 6-year old child who has a sensory processing disorder. A key therapeutic strategy is to use play activities that would foster an optimal arousal level without overloading the child with sensory input. In order to monitor the child’s level of arousal during therapy, what responses should the OTR® be aware of, which would indicate that the child has reached his sensory threshold. Choose the best 3 answers.
A. The child splays his legs out toward the ground when the therapist pulls him on a scooter board and picks up speed.
B. The child hugs the rope ladder tightly as he climbs and stops after advancing 1 rung above the floor.
E. The child becomes nauseous and pale.
These behaviors, demonstrated during the activities, are indicative of a child who has reached his sensory threshold. A threshold refers to a certain level at which a child responds to sensory information. For some children, they may be hyper-responsive and therefore take on a low sensory load to effectively respond to their environment. For others, they may be hypo-responsive and can take on a higher sensory load of information before they react.
All the other activities produce an adaptive play response that is optimal and appropriate for the child.
Ayers, Jean A. (20056). Disorders involving the vestibular system and tactile defensiveness checklist, Sensory Integration and the Child (25th Anniversary Edition, pp 7,77, and 113). Torrance, CA: Western Psychological Services.
http://www.infantva.org/documents/copa-conf2008-sensory-koontz.pdf
A. The child splays his legs out toward the ground when the therapist pulls him on a scooter board and picks up speed.
B. The child hugs the rope ladder tightly as he climbs and stops after advancing 1 rung above the floor.
E. The child becomes nauseous and pale.
These behaviors, demonstrated during the activities, are indicative of a child who has reached his sensory threshold. A threshold refers to a certain level at which a child responds to sensory information. For some children, they may be hyper-responsive and therefore take on a low sensory load to effectively respond to their environment. For others, they may be hypo-responsive and can take on a higher sensory load of information before they react.
All the other activities produce an adaptive play response that is optimal and appropriate for the child.
Ayers, Jean A. (20056). Disorders involving the vestibular system and tactile defensiveness checklist, Sensory Integration and the Child (25th Anniversary Edition, pp 7,77, and 113). Torrance, CA: Western Psychological Services.
http://www.infantva.org/documents/copa-conf2008-sensory-koontz.pdf
By what age is it stated that an IEP must include documentation pertaining to the student’s transition from public school to post-secondary education/employment?
C. By age 16. IDEA 2004 mandates that the IEP must include documentation addressing transition planning by the age of 16 at the latest. Individual states are allowed to set the age at which transition planning begins earlier, but not later than age 16.
C. By age 16. IDEA 2004 mandates that the IEP must include documentation addressing transition planning by the age of 16 at the latest. Individual states are allowed to set the age at which transition planning begins earlier, but not later than age 16.
A 14-year-old girl with a medical diagnosis of scoliosis wears a Milwaukee brace to school. Due to her mobility limitations, she is experiencing discomfort sitting in the school desks and has difficulty taking notes due to her limited neck mobility. Adaptations for the student have been requested but the OT finds out that the girl does not qualify for an IEP. How is the OT able to provide services to this student?
D. The OT can provide services to the girl through a 504 plan. Section 504 of the Rehabilitation Act of 1973 allows schools to provide adaptations to students in public schools who have a medical diagnosis that limits their functional abilities in school. An IEP does not have to be in place for services to be provided in this manner.
D. The OT can provide services to the girl through a 504 plan. Section 504 of the Rehabilitation Act of 1973 allows schools to provide adaptations to students in public schools who have a medical diagnosis that limits their functional abilities in school. An IEP does not have to be in place for services to be provided in this manner.
Can an OTA attend an IEP meeting without the presence of the OT, and make changes to the IEP?
C. Yes, the OTA may make changes during the IEP meeting if before the IEP meeting, the OT and OTA discussed and agreed upon potential changes in goals or amount or type of service.
It is entirely appropriate for an OTA to attend an IEP meeting and present information concerning student progress and IEP goals to be addressed by occupational therapy, based on previous collaboration between the supervising OT and the OTA. If, at the IEP meeting, the IEP team requests additions or changes to the goals being addressed by occupational therapy, the supervising OT would need to review those recommendations and agree to any changes; the OTA cannot make that decision alone, without additional collaboration between the OT and OTA. If, before the IEP meeting, the OT and OTA discussed and agreed upon potential changes in goals or amount or type of service, the OTA may make the changes during the IEP meeting.
https://www.aota.org/About-Occupational-Therapy/Professionals/CY/Articles/School-consumer.aspx
C. Yes, the OTA may make changes during the IEP meeting if before the IEP meeting, the OT and OTA discussed and agreed upon potential changes in goals or amount or type of service.
It is entirely appropriate for an OTA to attend an IEP meeting and present information concerning student progress and IEP goals to be addressed by occupational therapy, based on previous collaboration between the supervising OT and the OTA. If, at the IEP meeting, the IEP team requests additions or changes to the goals being addressed by occupational therapy, the supervising OT would need to review those recommendations and agree to any changes; the OTA cannot make that decision alone, without additional collaboration between the OT and OTA. If, before the IEP meeting, the OT and OTA discussed and agreed upon potential changes in goals or amount or type of service, the OTA may make the changes during the IEP meeting.
https://www.aota.org/About-Occupational-Therapy/Professionals/CY/Articles/School-consumer.aspx
An elementary school student who is not identified as having special needs is demonstrating delays in both their speech and gross motor development. The student’s teacher approaches the school OT and asks if she can do something to help this student. How should the OT respond?
A. The OT should refer the teacher to the special education director. Occupational therapy in public schools cannot be provided unless a child qualifies for special education services under IDEA 2004 or for an accommodation plan under Section 504 of the Rehabilitation Act of 1973. Since the student does not have either of these services in place, the special education director will need to observe the student and determine if an evaluation for special education services is warranted. If the student’s performance in school is significantly impacted by his speech and gross motor delays, the special education director will request permission for the evaluation from the student’s parents and will notify those members of the special education team who may need to evaluate the student.
A. The OT should refer the teacher to the special education director. Occupational therapy in public schools cannot be provided unless a child qualifies for special education services under IDEA 2004 or for an accommodation plan under Section 504 of the Rehabilitation Act of 1973. Since the student does not have either of these services in place, the special education director will need to observe the student and determine if an evaluation for special education services is warranted. If the student’s performance in school is significantly impacted by his speech and gross motor delays, the special education director will request permission for the evaluation from the student’s parents and will notify those members of the special education team who may need to evaluate the student.
Matthew is a 19-year-old male with a dual diagnosis of cerebral palsy and cognitive impairment. He has been attending high school (after the age of 18) for prevocational training and is now ready to begin transitional employment. To assist Matthew with his transitional employment, what type of activities should be incorporated into his OT intervention plan?
B. Actual work tasks at Matthew’s place of employment. Transitional employment involves on-site job training for a period of 3 to 6 months. The OT practitioner would help Matthew by training him to perform actual work tasks at his place of employment. Matthew’s job would be pre-arranged by the school and would last 3 to 6 months, after which time the OT would work with Matthew’s IEP team to determine what type of ongoing employment Matthew can complete.
B. Actual work tasks at Matthew’s place of employment. Transitional employment involves on-site job training for a period of 3 to 6 months. The OT practitioner would help Matthew by training him to perform actual work tasks at his place of employment. Matthew’s job would be pre-arranged by the school and would last 3 to 6 months, after which time the OT would work with Matthew’s IEP team to determine what type of ongoing employment Matthew can complete.
The parents of an 8 year old boy who has been diagnosed with ASD have agreed to incorporate a goal of improving their son’s handwriting and visual motor skills into his IEP. However, the parents inform the OT in the middle of the school year that they would like to change the boy’s goal to be able to swing independently. How should the OT respond to this request?
D. Work on swinging if it relates to an activity of improving visual motor skills. Work on swinging if it relates to an activity of improving visual motor skills. The parents are not able to change the goals in the middle of the school year. However, the OT can work on swinging if she combines visual motor skills with it.
D. Work on swinging if it relates to an activity of improving visual motor skills. Work on swinging if it relates to an activity of improving visual motor skills. The parents are not able to change the goals in the middle of the school year. However, the OT can work on swinging if she combines visual motor skills with it.
You observe a 7-month-old baby who is sitting and playing on the floor being knocked off balance by the family dog. The baby immediately reacts by extending and abducting his arm to the side (opposite to the side hit by the dog). What reflex is this infant demonstrating?
D. Sideways parachute (UE protective extension to the side). This reflex helps prevent falling by increasing support through the UE on the side opposite the force. The reflex stops the infant from falling to the side. To elicit, tip the infant off-balance to the side. Arm extension and abduction to the side will be observed. The reflex emerges at 7 months and persists.
D. Sideways parachute (UE protective extension to the side). This reflex helps prevent falling by increasing support through the UE on the side opposite the force. The reflex stops the infant from falling to the side. To elicit, tip the infant off-balance to the side. Arm extension and abduction to the side will be observed. The reflex emerges at 7 months and persists.
A school‐based OTR® working with a middle school student who has been diagnosed with ASD, is developing an intervention plan for him as part of his IEP. The student presents with the following difficulties: poor social skills, difficulty attending to tasks, and tactile defensive behavior especially when in close proximity to other students. What type of structuring would be the MOST BENEFICIAL for this student to help him cope with being in a classroom with other children?
C. The student would benefit from sitting in a quiet corner of the room.
A distraction free and structured/predictable environment is most conducive to learning for students who can become easily distracted and overwhelmed by too much input.
The student may be distracted and disturbed by the free movement of others in the classroom, i.e. other students may bump into him, his chair or table when they move about the classroom. The student may be unable to understand this contact is accidental. Personal space is important. If it is practical, establish a work area in the classroom that is uncluttered, free from distractions and not subject to ‘traffic flow’ by other students.
Structuring the classroom:
• Make sure the student has a clear and easy path to the teacher for help.
• Position the student in a quiet corner of the room where there is little chance of him being distracted by light, reflections, the door opening and closing etc.
• The student might perform better when facing a wall or window providing the view is not too distracting.
A, B and D. These are not an option as schools are required to have an IEP in place for students with special needs It is very important not to exclude or separate the student from the rest of the class, but to establish a work area that takes the student’s special needs into account.
https://www.autismhelp.info/for-professionals-teachers-employers/teaching-students-with-autism
C. The student would benefit from sitting in a quiet corner of the room.
A distraction free and structured/predictable environment is most conducive to learning for students who can become easily distracted and overwhelmed by too much input.
The student may be distracted and disturbed by the free movement of others in the classroom, i.e. other students may bump into him, his chair or table when they move about the classroom. The student may be unable to understand this contact is accidental. Personal space is important. If it is practical, establish a work area in the classroom that is uncluttered, free from distractions and not subject to ‘traffic flow’ by other students.
Structuring the classroom:
• Make sure the student has a clear and easy path to the teacher for help.
• Position the student in a quiet corner of the room where there is little chance of him being distracted by light, reflections, the door opening and closing etc.
• The student might perform better when facing a wall or window providing the view is not too distracting.
A, B and D. These are not an option as schools are required to have an IEP in place for students with special needs It is very important not to exclude or separate the student from the rest of the class, but to establish a work area that takes the student’s special needs into account.
https://www.autismhelp.info/for-professionals-teachers-employers/teaching-students-with-autism
Katie, a 15-month-old child who acquired a hypoxic brain injury as a result of complications during childbirth, has been referred to an early intervention program. Katie presents with cortical blindness in the right visual field of both her eyes. What observations would the OTR® MOST likely see during a treatment session which is focused on improving Katie’s gross motor skills?
C. Difficulty climbing over a pile of large foam blocks preferring to climb around them.
Due to difficulty with visual processing as a result of cortical blindness, the child will demonstrate difficulty with gross motor movements because of fear of movement requiring the need to seek the ground. Therefore, the child may demonstrate poor bilateral integration for reciprocal movements necessary to climb over uneven and unsteady surfaces.
A. Although gross-motor delays are expected, muscle fatigue with constant use of upper extremity support is unlikely due to the trunk control she has gained for unsupported sitting balance by this age.
B. It is likely that the child will be able to sustain her attention.
D. It is likely that the child will demonstrate some dependence and use of her other senses to compensate for her visual difficulties. She would therefore not be aversive to tactile stimulation.
https://nei.nih.gov/faqs/cortical-visual-impairment-cvi
Reed, Kathlyn. (2001) Quick Reference to Occupational Therapy. Gaithersburg, MD: Aspen Publishers, pp 241-248.
C. Difficulty climbing over a pile of large foam blocks preferring to climb around them.
Due to difficulty with visual processing as a result of cortical blindness, the child will demonstrate difficulty with gross motor movements because of fear of movement requiring the need to seek the ground. Therefore, the child may demonstrate poor bilateral integration for reciprocal movements necessary to climb over uneven and unsteady surfaces.
A. Although gross-motor delays are expected, muscle fatigue with constant use of upper extremity support is unlikely due to the trunk control she has gained for unsupported sitting balance by this age.
B. It is likely that the child will be able to sustain her attention.
D. It is likely that the child will demonstrate some dependence and use of her other senses to compensate for her visual difficulties. She would therefore not be aversive to tactile stimulation.
https://nei.nih.gov/faqs/cortical-visual-impairment-cvi
Reed, Kathlyn. (2001) Quick Reference to Occupational Therapy. Gaithersburg, MD: Aspen Publishers, pp 241-248.
Emma is a 9-month-old girl who according to her pediatrician, is developing normally. What characteristics would you expect to see as Emma plays on the ground?
A. Exploratory play.
A 9-month-old typically demonstrates equilibrium reactions while sitting, as well as the ability to sit without support while rotating the upper body, reciprocal creeping, and the ability to engage in exploratory play. The Moro reflex disappears in normally developing infants by the age of 6 months. Walking without support does not typically develop before the age of 10 months. Symbolic/Fantasy play is role playing or make-believe play, such as pretending to be a baby, firefighter, superhero, or monster, and make believe actions, such as driving a car by moving a pretend steering wheel, or using a block of wood as a cell phone.
A. Exploratory play.
A 9-month-old typically demonstrates equilibrium reactions while sitting, as well as the ability to sit without support while rotating the upper body, reciprocal creeping, and the ability to engage in exploratory play. The Moro reflex disappears in normally developing infants by the age of 6 months. Walking without support does not typically develop before the age of 10 months. Symbolic/Fantasy play is role playing or make-believe play, such as pretending to be a baby, firefighter, superhero, or monster, and make believe actions, such as driving a car by moving a pretend steering wheel, or using a block of wood as a cell phone.
An Early Intervention (EI) OTR® has been working with a 2 1/2 year old child named Kristin. The OTR® has set up a meeting with the parents to discuss and plan the coordination of the child’s transition to Early Childhood Special Education (ECSE) for the next 6 months. The parents have displayed feelings of doubt and concern about being prepared for the transition. What strategies would be MOST EFFECTIVE to ensure Kristin’s smooth transition into the preschool setting?
Choose the best 3 answer choices:
B, E, and F. All of these answer choices support the client-centered approach. Interventions involving both the child and family in preparation for what is expected in the receiving environment to ensure a smooth transitioning process, is also client-centered. “Strategies may include altering or modifying activities, remediating deficits, reducing environmental barriers, and preventing challenges by anticipating needs in the receiving environment. Although barriers exist to participation, practitioners can reduce such barriers through collaboration and accessing resources related to best practice in transition planning”.
Answer a) promotes parent-infant bonding in the NICU.
Answer c) is administered from ages 4 to 8 years 11 months.
Answer d) is addressed as at 16 years of age or younger in preparation for post-secondary transition.
Shah, N., Washko, J. and Stoffel, A. (2018, October 5). Strategies for Supporting Transition from Early Intervention to Early Childhood Special Education, OT Practice Pulse. Retrieved from
B, E, and F. All of these answer choices support the client-centered approach. Interventions involving both the child and family in preparation for what is expected in the receiving environment to ensure a smooth transitioning process, is also client-centered. “Strategies may include altering or modifying activities, remediating deficits, reducing environmental barriers, and preventing challenges by anticipating needs in the receiving environment. Although barriers exist to participation, practitioners can reduce such barriers through collaboration and accessing resources related to best practice in transition planning”.
Answer a) promotes parent-infant bonding in the NICU.
Answer c) is administered from ages 4 to 8 years 11 months.
Answer d) is addressed as at 16 years of age or younger in preparation for post-secondary transition.
Shah, N., Washko, J. and Stoffel, A. (2018, October 5). Strategies for Supporting Transition from Early Intervention to Early Childhood Special Education, OT Practice Pulse. Retrieved from
A 3-year-old boy is beginning school-based occupational therapy after transferring out of the local birth-to-three program. He has a diagnosis of Trisomy 21. What medical complications is this child likely to present with, based on his diagnoses?
D. Heart defect and atlantoaxial instability.
Down syndrome is also known as Trisomy 21.
People with Down syndrome can have a variety of complications, some of which become more prominent as they get older. These complications can include:
• Heart defects. About half the children with Down syndrome are born with some type of congenital heart defect. These heart problems can be life-threatening and may require surgery in early infancy.
• Gastrointestinal (GI) defects. GI abnormalities occur in some children with Down syndrome and may include abnormalities of the intestines, esophagus, trachea and anus. The risk of developing digestive problems, such as GI blockage, heartburn (gastroesophageal reflux) or celiac disease, may be increased.
• Immune disorders. Because of abnormalities in their immune systems, people with Down syndrome are at increased risk of developing autoimmune disorders, some forms of cancer, and infectious diseases, such as pneumonia.
• Sleep apnea. Because of soft tissue and skeletal changes that lead to the obstruction of their airways, children and adults with Down syndrome are at greater risk of obstructive sleep apnea.
• Obesity. People with Down syndrome have a greater tendency to be obese compared with the general population.
• Spinal problems. Some people with Down syndrome may have a misalignment of the top two vertebrae in the neck (atlantoaxial instability). This condition puts them at risk of serious injury to the spinal cord from overextension of the neck.
• Leukemia. Young children with Down syndrome have an increased risk of leukemia.
• Dementia. People with Down syndrome have a greatly increased risk of dementia — signs and symptoms may begin around age 50. Having Down syndrome also increases the risk of developing Alzheimer’s disease.
• Other problems. Down syndrome may also be associated with other health conditions, including endocrine problems, dental problems, seizures, ear infections, and hearing and vision problems.
A, B and C – are associated with complications of prematurity.
https://www.mayoclinic.org/diseases-conditions/down-syndrome/symptoms-causes/syc-20355977
https://www.marchofdimes.org/complications/premature-babies.aspx
D. Heart defect and atlantoaxial instability.
Down syndrome is also known as Trisomy 21.
People with Down syndrome can have a variety of complications, some of which become more prominent as they get older. These complications can include:
• Heart defects. About half the children with Down syndrome are born with some type of congenital heart defect. These heart problems can be life-threatening and may require surgery in early infancy.
• Gastrointestinal (GI) defects. GI abnormalities occur in some children with Down syndrome and may include abnormalities of the intestines, esophagus, trachea and anus. The risk of developing digestive problems, such as GI blockage, heartburn (gastroesophageal reflux) or celiac disease, may be increased.
• Immune disorders. Because of abnormalities in their immune systems, people with Down syndrome are at increased risk of developing autoimmune disorders, some forms of cancer, and infectious diseases, such as pneumonia.
• Sleep apnea. Because of soft tissue and skeletal changes that lead to the obstruction of their airways, children and adults with Down syndrome are at greater risk of obstructive sleep apnea.
• Obesity. People with Down syndrome have a greater tendency to be obese compared with the general population.
• Spinal problems. Some people with Down syndrome may have a misalignment of the top two vertebrae in the neck (atlantoaxial instability). This condition puts them at risk of serious injury to the spinal cord from overextension of the neck.
• Leukemia. Young children with Down syndrome have an increased risk of leukemia.
• Dementia. People with Down syndrome have a greatly increased risk of dementia — signs and symptoms may begin around age 50. Having Down syndrome also increases the risk of developing Alzheimer’s disease.
• Other problems. Down syndrome may also be associated with other health conditions, including endocrine problems, dental problems, seizures, ear infections, and hearing and vision problems.
A, B and C – are associated with complications of prematurity.
https://www.mayoclinic.org/diseases-conditions/down-syndrome/symptoms-causes/syc-20355977
https://www.marchofdimes.org/complications/premature-babies.aspx
At what age can a child be expected to verbalize that they need to use the bathroom?
B. 2-3 years.
Children between the ages of 2 and 3 become aware that they need to use the bathroom and can verbalize it, but do not always make it to the bathroom in time. The following developmental stages occur between the ages of 19 months and 4 years:
19-24 months: Urinates regularly
2-3 years old: Achieves regular toileting with occasional accidents; verbalizes when need to go to bathroom
3-4 years old: Goes to bathroom independently; may need help with wiping/fasteners/difficult clothing
B. 2-3 years.
Children between the ages of 2 and 3 become aware that they need to use the bathroom and can verbalize it, but do not always make it to the bathroom in time. The following developmental stages occur between the ages of 19 months and 4 years:
19-24 months: Urinates regularly
2-3 years old: Achieves regular toileting with occasional accidents; verbalizes when need to go to bathroom
3-4 years old: Goes to bathroom independently; may need help with wiping/fasteners/difficult clothing
While an OT is evaluating a 9-month-old infant’s oral-motor skills, she observes that the infant is starting to chew bananas. What does this observation indicate?
D. An OT determines that the child’s oral-motor skills are age appropriate.
Oral Motor skills and feeding at 3-7 months
By 4 months of age, most infants have gained fair head control and are able to remain in an upright position with support, and parents are beginning to introduce puréed foods. By this time, the anatomical structure of their jaws and tongues have dropped forward to support munching patterns. They also may open their mouth when a spoon is presented and are able to manage thin purees with minimal difficulties.
Oral Motor skills and feeding at 7-9 months
Between 7 and 9 months of age, infants are now moving into unsupported sitting, quadruped and crawling. This development supports jaw stability, breath support and fine motor development for self-feeding skills. Infants at this age now begin to be able to successfully manage “lumpy” purees, bite and munch softer foods, and the development of rotary chewing begins.
https://www.theottoolbox.com/2018/08/development-of-oral-motor-skills.html
D. An OT determines that the child’s oral-motor skills are age appropriate.
Oral Motor skills and feeding at 3-7 months
By 4 months of age, most infants have gained fair head control and are able to remain in an upright position with support, and parents are beginning to introduce puréed foods. By this time, the anatomical structure of their jaws and tongues have dropped forward to support munching patterns. They also may open their mouth when a spoon is presented and are able to manage thin purees with minimal difficulties.
Oral Motor skills and feeding at 7-9 months
Between 7 and 9 months of age, infants are now moving into unsupported sitting, quadruped and crawling. This development supports jaw stability, breath support and fine motor development for self-feeding skills. Infants at this age now begin to be able to successfully manage “lumpy” purees, bite and munch softer foods, and the development of rotary chewing begins.
https://www.theottoolbox.com/2018/08/development-of-oral-motor-skills.html
At what age can you expect a typically developing child to stab food with a fork?
A. 24-36 months.
Every child progresses differently with self-feeding, which is why there is such an age range regarding utensil use development. The consensus is that by 36 months, a child can use a fork to pierce soft foods and bring it to their mouth.
A. 24-36 months.
Every child progresses differently with self-feeding, which is why there is such an age range regarding utensil use development. The consensus is that by 36 months, a child can use a fork to pierce soft foods and bring it to their mouth.
During an early intervention session, a baby is observed sitting on the floor without any external support. The baby is leaning forwards and propping herself on her hands. What is the next stage of sitting, this child can be expected to achieve?
B. Sitting with arms at sides, for support.
Progression of developing sitting: sitting forwards, propping self on arms (forwards), sitting with a more upright posture and supporting self with arms at sides, and finally sitting without any support and hands are free for play.
B. Sitting with arms at sides, for support.
Progression of developing sitting: sitting forwards, propping self on arms (forwards), sitting with a more upright posture and supporting self with arms at sides, and finally sitting without any support and hands are free for play.
A 21-month-old child who is developmentally delayed has achieved the following milestones: using his fingers to eat Cheerios and peas, dipping his spoon into his food, and drinking from a cup. In order to plan the next stage of the child’s intervention, what developmental age should the OT use as a guideline to grade the child’s self-feeding skills?
D. 15 to 18 months.
With developmental milestones, remember that there is a range of “average” and many milestones do overlap. In this scenario, the baby is functioning at an age level of 12-14 months. Typically, at this age, a toddler is able to dip their spoon in food, bring the spoon to their mouth, and drink from a cup.
Self-feeding development:
5-7 months: Take cereal/baby food from spoon
6-8 months: Attempt to hold bottle, may not retrieve if falls, needs monitoring for safety
6-9 months: Holds, tries to eat (self-feed) crackers (6 ½- 7 mos), but sucks more than bites; eats soft foods that dissolve, grab spoon and bangs or sucks on end of it (9mos), imitates stirring with spoon (9 ½ mos)
9-13 months: Finger feeds self soft table foods (macaroni, peas, dry cereal), objects if fed by adult
12-14 months: Dip spoon in food, bring to mouth, spills food before reaches mouth, cup drinking with firm jaw
15-18 months: Scoop food and bring to mouth, Straw use begins at 18 mos
24-30 months: Interest in fork, stab food (canned fruit). Proficient spoon use and eats cereal w/milk or rice with gravy with utensil.
D. 15 to 18 months.
With developmental milestones, remember that there is a range of “average” and many milestones do overlap. In this scenario, the baby is functioning at an age level of 12-14 months. Typically, at this age, a toddler is able to dip their spoon in food, bring the spoon to their mouth, and drink from a cup.
Self-feeding development:
5-7 months: Take cereal/baby food from spoon
6-8 months: Attempt to hold bottle, may not retrieve if falls, needs monitoring for safety
6-9 months: Holds, tries to eat (self-feed) crackers (6 ½- 7 mos), but sucks more than bites; eats soft foods that dissolve, grab spoon and bangs or sucks on end of it (9mos), imitates stirring with spoon (9 ½ mos)
9-13 months: Finger feeds self soft table foods (macaroni, peas, dry cereal), objects if fed by adult
12-14 months: Dip spoon in food, bring to mouth, spills food before reaches mouth, cup drinking with firm jaw
15-18 months: Scoop food and bring to mouth, Straw use begins at 18 mos
24-30 months: Interest in fork, stab food (canned fruit). Proficient spoon use and eats cereal w/milk or rice with gravy with utensil.
While assessing the motor skills of an 11-month-old boy, an OT and OTA observe him walking while holding onto furniture for support and crawling on the floor to retrieve toys. What does this behavior most likely indicate?
A. That this is typical development.
This child is crawling, cruising, and almost walking which is typical for his age. Cruising with one hand for support,
walking with his hands held, and standing independently for a short time- with legs wide, arms up/out are all milestones an 11 month old infant can be expected to achieve. Crawling is usually achieved before 11 month.
A. That this is typical development.
This child is crawling, cruising, and almost walking which is typical for his age. Cruising with one hand for support,
walking with his hands held, and standing independently for a short time- with legs wide, arms up/out are all milestones an 11 month old infant can be expected to achieve. Crawling is usually achieved before 11 month.
A 5-year-old girl is being treated in the hand therapy clinic following a distal ulnar fracture of her left arm. She is being fitted for a dorsal long forearm splint with Velcro straps. Her parents are concerned that she may try to remove the splint as she is a very curious child and tends to take everything apart, including her Velcro shoes. How should the certified hand therapist adapt the splint to prevent the child from removing it from her forearm?
B. Replace the Velcro straps with shoelaces and shoelace locks. Shoelaces for attachment rather than Velcro straps are often more challenging for removal. “Bow Biters,” little plastic critters that tie on the lace and then clamp down on the bow after it is tied, can also be used to secure the lace, therefore making removal more difficult. This would prevent her from removing the splint. The cartoon design is fun and appealing and she is more likely to keep the splint on, to show the design to her peers and loved ones.
patient.html”>https://www.mitchmedical.us/extremity-splinting/splinting-the-pediatric-patient.html
B. Replace the Velcro straps with shoelaces and shoelace locks. Shoelaces for attachment rather than Velcro straps are often more challenging for removal. “Bow Biters,” little plastic critters that tie on the lace and then clamp down on the bow after it is tied, can also be used to secure the lace, therefore making removal more difficult. This would prevent her from removing the splint. The cartoon design is fun and appealing and she is more likely to keep the splint on, to show the design to her peers and loved ones.
patient.html”>https://www.mitchmedical.us/extremity-splinting/splinting-the-pediatric-patient.html
An OT has been working with a child who has been diagnosed with an Autism spectrum disorder, on further developing his hand function. Once the student is able to efficiently grasp objects of different sizes, what would the next goal of OT intervention be?
B. Place objects in different directions so the student has to move his arm while maintaining his grasp.
Once the student has developed the ability to grasp objects of different sizes, it is important to have him use his newly developed skill for functional tasks.
B. Place objects in different directions so the student has to move his arm while maintaining his grasp.
Once the student has developed the ability to grasp objects of different sizes, it is important to have him use his newly developed skill for functional tasks.
During an OT session, a withdrawn 4-year-old girl who has been diagnosed with a developmental delay spontaneously reaches out for a crayon and starts to brush her hair with it. What type of behavior is this child demonstrating?
B. The child is demonstrating goal-directed behavior. The girl is initiating the task by being spontaneous, and despite using a crayon, she has a goal to comb her hair. Piaget believed that as babies begin to grow and learn about their environment through their senses, they begin to engage in intentional, goal-directed behaviors. In other words, they begin to think about what they want to accomplish, how to accomplish it, and then they do it. Purposeful activities are defined as goal-directed behaviors and guided by client centered goals
B. The child is demonstrating goal-directed behavior. The girl is initiating the task by being spontaneous, and despite using a crayon, she has a goal to comb her hair. Piaget believed that as babies begin to grow and learn about their environment through their senses, they begin to engage in intentional, goal-directed behaviors. In other words, they begin to think about what they want to accomplish, how to accomplish it, and then they do it. Purposeful activities are defined as goal-directed behaviors and guided by client centered goals
An 8-year-old girl with Spina Bifida Myelomeningocele ( spinal level L1) has been referred for occupational therapy services to help her gain independence in her BADLs. After an initial evaluation, what ADL task would the OT most likely identify as needing the most remediation?
C. The OT would identify a need to develop the girl’s dressing skills.
Myelomeningocele Spina Bifida (SBM) is the most severe form of spina bifida. The physical impairments in SBM include motor and sensory deficits of the lower limbs leading to difficulties with stance and locomotion, as well as urinary and bowel dysfunction. Upper limb function, as well as lower limb function, is impaired in two thirds of children with SBM. Upper limb motor deficits in SBM include motor weakness and impaired hand and finger dexterity, motor speed, motor planning, and bimanual coordination. This affects development of eye-hand co-ordination which may interfere with activities of daily living (ADLs), such as buttoning a shirt or opening a lunchbox. Difficulties with spatial relations, body image, and development of hand dominance may also be evident. A variety of cognitive impairments in perception and cognitive development have also been documented.
Other common symptoms are:
– Weakness or paralysis in the lower limbs
– Urinary and bowel incontinence
– Type 2 Arnold-Chiari malformation- an abnormal brain development involving the cerebellum.
https://clinicalgate.com/spina-bifida-a-congenital-spinal-cord-injury/
https://www.medicalnewstoday.com/articles/220424.php
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075008/
C. The OT would identify a need to develop the girl’s dressing skills.
Myelomeningocele Spina Bifida (SBM) is the most severe form of spina bifida. The physical impairments in SBM include motor and sensory deficits of the lower limbs leading to difficulties with stance and locomotion, as well as urinary and bowel dysfunction. Upper limb function, as well as lower limb function, is impaired in two thirds of children with SBM. Upper limb motor deficits in SBM include motor weakness and impaired hand and finger dexterity, motor speed, motor planning, and bimanual coordination. This affects development of eye-hand co-ordination which may interfere with activities of daily living (ADLs), such as buttoning a shirt or opening a lunchbox. Difficulties with spatial relations, body image, and development of hand dominance may also be evident. A variety of cognitive impairments in perception and cognitive development have also been documented.
Other common symptoms are:
– Weakness or paralysis in the lower limbs
– Urinary and bowel incontinence
– Type 2 Arnold-Chiari malformation- an abnormal brain development involving the cerebellum.
https://clinicalgate.com/spina-bifida-a-congenital-spinal-cord-injury/
https://www.medicalnewstoday.com/articles/220424.php
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075008/
An OT is working with a 5-year-old child with a Caudal Lumbar Spina Bifida Meningocele in an outpatient setting. What is the MOST appropriate intervention for this child, based on this information?
B. Playing a game of hopscotch.
Spina Bifida Meningocele- spinal fluid and meninges protrude through an abnormal vertebral opening; the malformation contains no neural elements and may or may not be covered by a layer of skin. Some individuals with meningocele may have few or no symptoms while others may experience such symptoms as complete paralysis with bladder and bowel dysfunction. Children with Spina Bifida Meningocele at this level (caudal lumbar) are more likely to experience difficulty with gross motor skills and may have difficulty with instability, therefore, playing a game of hopscotch will offer an opportunity to practice balance skills.
B. Playing a game of hopscotch.
Spina Bifida Meningocele- spinal fluid and meninges protrude through an abnormal vertebral opening; the malformation contains no neural elements and may or may not be covered by a layer of skin. Some individuals with meningocele may have few or no symptoms while others may experience such symptoms as complete paralysis with bladder and bowel dysfunction. Children with Spina Bifida Meningocele at this level (caudal lumbar) are more likely to experience difficulty with gross motor skills and may have difficulty with instability, therefore, playing a game of hopscotch will offer an opportunity to practice balance skills.
A 4-year-old boy who has a global developmental delay is being seen by an OT for regular intervention. In order to focus on improving this boy’s pincer grasp, which activity should the OT recommend for the boy to participate in at home?
C. Have him pick up small beans one at a time and place them in a bowl.
This is a good intervention to promote pincer grasp. Simply placing his hands in a pile of rice or beans is usually used for sensory or dexterity-related development. Neither throwing a ball into a hoop or building towers out of legos requires the boy to use a pincer grasp.
C. Have him pick up small beans one at a time and place them in a bowl.
This is a good intervention to promote pincer grasp. Simply placing his hands in a pile of rice or beans is usually used for sensory or dexterity-related development. Neither throwing a ball into a hoop or building towers out of legos requires the boy to use a pincer grasp.
A 5-year-old patient appears to have difficulty placing discs into a grid when playing the game “Connect 4.” What grasp pattern is required for this task?
C. Pad-to-pad prehension.
Placing discs into a grid when playing “Connect 4” requires pad-to-pad prehension.
Prehension- a functional grasp that enables the hand to hold or manipulate objects. There are 2 types: power & precision. Power grip is used for holding objects forcefully while being moved by more proximal joint muscles. Example: holding a hammer or doorknob. Precision grip – also known as prehensile precision, is used when object manipulation requires finer movement. Example: holding a coin, to look at one side.
Pad-to-pad prehension – MCP & PIP finger joints are flexed, thumb abducted and opposed, distal joints of both are extended.
C. Pad-to-pad prehension.
Placing discs into a grid when playing “Connect 4” requires pad-to-pad prehension.
Prehension- a functional grasp that enables the hand to hold or manipulate objects. There are 2 types: power & precision. Power grip is used for holding objects forcefully while being moved by more proximal joint muscles. Example: holding a hammer or doorknob. Precision grip – also known as prehensile precision, is used when object manipulation requires finer movement. Example: holding a coin, to look at one side.
Pad-to-pad prehension – MCP & PIP finger joints are flexed, thumb abducted and opposed, distal joints of both are extended.
In order to improve handwriting skills, a slant board is provided to a 2nd grade student to use when writing. What is the benefit of using this slanted/angled surface?
C. Wrist extension for pencil grasp. Using a slanted board has many benefits, one of which is, it forces the wrist and hand into tenodesis (wrist extension and finger flexion). Writing with an extended wrist automatically places the hand into a functional position and allows the hand to pull the radial digits into opposition. Maintaining radial digit opposition to the thumb is necessary for promoting an efficient grasp on the pencil. By improving the student’s pencil grasp, he can develop the skill of handwriting
Other benefits:
C. Wrist extension for pencil grasp. Using a slanted board has many benefits, one of which is, it forces the wrist and hand into tenodesis (wrist extension and finger flexion). Writing with an extended wrist automatically places the hand into a functional position and allows the hand to pull the radial digits into opposition. Maintaining radial digit opposition to the thumb is necessary for promoting an efficient grasp on the pencil. By improving the student’s pencil grasp, he can develop the skill of handwriting
Other benefits:
A 6-year-old girl can identify a circle, a triangle, and a rectangle on separate flashcards. When her teacher asks her to identify similar shapes in a busy picture, the girl has difficulty locating the shapes. This is an example of which visual perceptual deficit?
D. Figure Ground.
Refer to “Handwriting” in Study Materials Module 2. Figure ground refers to a child’s ability to distinguish an object against its background. The best choice is Figure ground because the student is not able to recognize the shapes within a picture.
A. Visual discrimination is the skill a child uses to see subtle differences between objects or pictures. This visual perceptual skill can be described as “paying attention to detail”.
B. The ability to recall or remember the visual details of what you have seen is referred to as visual memory.
C. Spatial orientation refers to the ability to identify the position or direction of objects in space.
D. Figure Ground.
Refer to “Handwriting” in Study Materials Module 2. Figure ground refers to a child’s ability to distinguish an object against its background. The best choice is Figure ground because the student is not able to recognize the shapes within a picture.
A. Visual discrimination is the skill a child uses to see subtle differences between objects or pictures. This visual perceptual skill can be described as “paying attention to detail”.
B. The ability to recall or remember the visual details of what you have seen is referred to as visual memory.
C. Spatial orientation refers to the ability to identify the position or direction of objects in space.
A child who presents with generalized hypotonia is having difficulty dressing himself for school in the mornings. The biggest obstacle, which is impacting on his ability to be independent in this ADL, is his poorly developed balance in both sitting and standing. As a result, dressing has become a very tedious and frustrating task for him. What compensatory technique would be the MOST helpful to recommend, so that this child has the opportunity to dress himself independently and efficiently?
B. The most helpful compensatory technique would be to introduce side-lying.
By using side-lying, the boy’s body will be fully supported by the floor/bed. He will therefore be able to use his hands freely to dress himself.
B. The most helpful compensatory technique would be to introduce side-lying.
By using side-lying, the boy’s body will be fully supported by the floor/bed. He will therefore be able to use his hands freely to dress himself.
An OT is working in the school system and one of the students in her caseload has developmental delay. The OT asks the student to hold a thick crayon and the student holds the crayon in a static tripod grasp. What would be best intervention to incorporate next in the treatment session?
Upgrade the child to using a thinner pencil. The student is using a static tripod grasp, therefore the next step is to work on using a dynamic tripod grasp.
Upgrade the child to using a thinner pencil. The student is using a static tripod grasp, therefore the next step is to work on using a dynamic tripod grasp.
When an activity is structured to incorporate rolling a child who presents with SI difficulties in a yoga mat, what are the treatment goals of this specific intervention?
A. To provide proprioceptive and vestibular input.
Tactile Defensiveness is a sensory processing issue, where the child’s neurological system is “hypersensitive” to light touch sensation. Light touch tends to be alerting and arousing whereas deep tactile pressure is a firm, consistent touch which tends to be calming and organizing. The theory behind inhibition is that because multiple sensations and multiple pathways interact with each other in the CNS, by providing one kind of input, it may reduce/inhibit the sensation of the other.
The vestibular and proprioceptive systems are interrelated and have some common functions. The proprioceptive system plays an important regulatory role in sensory processing as proprioceptive input can assist in controlling responses to sensory stimuli. Rolling in a yoga mat provides the child with both proprioceptive and vestibular input. Being encased in the mat, gives constant deep pressure (proprioception) and the act of rolling stimulates the vestibular system.
A. To provide proprioceptive and vestibular input.
Tactile Defensiveness is a sensory processing issue, where the child’s neurological system is “hypersensitive” to light touch sensation. Light touch tends to be alerting and arousing whereas deep tactile pressure is a firm, consistent touch which tends to be calming and organizing. The theory behind inhibition is that because multiple sensations and multiple pathways interact with each other in the CNS, by providing one kind of input, it may reduce/inhibit the sensation of the other.
The vestibular and proprioceptive systems are interrelated and have some common functions. The proprioceptive system plays an important regulatory role in sensory processing as proprioceptive input can assist in controlling responses to sensory stimuli. Rolling in a yoga mat provides the child with both proprioceptive and vestibular input. Being encased in the mat, gives constant deep pressure (proprioception) and the act of rolling stimulates the vestibular system.
By what age can a child use all of the utensils pictured independently?
D. 6.
By age 6 a typically developing child will have acquired all of the skills needed to use the utensils pictured, including the ability to cut food with a knife.
D. 6.
By age 6 a typically developing child will have acquired all of the skills needed to use the utensils pictured, including the ability to cut food with a knife.
A 7-month-old infant uses all of his fingers to pull a small toy towards himself, without using his thumb. What type of grasp is this infant using?
D. Raking grasp. This grasp develops at about age 7 months. An infant will use the fingers to “rake” objects toward himself. This grasp is often seen when infants first attempt to feed themselves finger foods.
D. Raking grasp. This grasp develops at about age 7 months. An infant will use the fingers to “rake” objects toward himself. This grasp is often seen when infants first attempt to feed themselves finger foods.
At which stage of cognitive development is this child functioning?
D. Sensorimotor.
Piaget’s Theory of Cognitive Development is a description of cognitive development as four distinct stages in children:
1. sensorimotor
2. preoperational
3. concrete
4. formal
The first stage, sensorimotor, begins at birth and lasts until 18 months-2 years of age. This stage involves the use of motor activity without the use of symbols. Knowledge is limited in this stage, because it is based on physical interactions and experiences. Infants cannot predict reaction, and therefore must constantly experiment and learn through trial and error. Such exploration might include shaking a rattle or putting objects in the mouth. As they become more mobile, infants’ ability to develop cognitively increases.
A. Preoperational. One of Piaget’s stages of cognitive development. It involves the development of language, memory, and imagination. 2 to 7 years old.
B. Trust vs. mistrust is the first stage in Erik Erikson’s theory of psychosocial development. This stage begins at birth continues to approximately 18 months of age. During this stage, the infant is uncertain about the world in which they live and looks towards their primary caregiver for stability and consistency of care.
C. Unoccupied play. This is one of the stages of play developed by Mildred Parten Newhall. In unoccupied play, the child learns about and discovers how their body moves, no toys are involved.
D. Sensorimotor.
Piaget’s Theory of Cognitive Development is a description of cognitive development as four distinct stages in children:
1. sensorimotor
2. preoperational
3. concrete
4. formal
The first stage, sensorimotor, begins at birth and lasts until 18 months-2 years of age. This stage involves the use of motor activity without the use of symbols. Knowledge is limited in this stage, because it is based on physical interactions and experiences. Infants cannot predict reaction, and therefore must constantly experiment and learn through trial and error. Such exploration might include shaking a rattle or putting objects in the mouth. As they become more mobile, infants’ ability to develop cognitively increases.
A. Preoperational. One of Piaget’s stages of cognitive development. It involves the development of language, memory, and imagination. 2 to 7 years old.
B. Trust vs. mistrust is the first stage in Erik Erikson’s theory of psychosocial development. This stage begins at birth continues to approximately 18 months of age. During this stage, the infant is uncertain about the world in which they live and looks towards their primary caregiver for stability and consistency of care.
C. Unoccupied play. This is one of the stages of play developed by Mildred Parten Newhall. In unoccupied play, the child learns about and discovers how their body moves, no toys are involved.
An OT is working with a 17-month-old boy who presents with a global developmental delay. Developmentally, in terms of using utensils during mealtimes, the boy is able to hold a spoon in his one hand and spontaneously bang the spoon on his highchair. What activity should be introduced NEXT to help this boy progress to the next developmental stage?
A. Dipping the spoon in apple sauce.
Typically a child progresses from banging a spoon, to dipping a spoon into food, to scooping food with spoon, to piercing food with fork, to using a knife with some assistance, to eventually using a knife and fork with skill.
Developmental norms:
10-12 Months: Holds spoon to play, bang, mouth, drop
13-15 Months: Dips spoon in food. Brings spoon to mouth, turns spoon over but obtains some food
By 36 months: Can use a fork to pierce soft foods and bring to mouth
By 6 Years: Can cut with a fork and knife (entire process of holding utensils, controlling and cutting food, and bringing to mouth)
As the OT is working on utensil use, finger feeding would not address the treatment goal.
https://mamaot.com/when-can-kids-feed-themselves-mealtime-milestones/
A. Dipping the spoon in apple sauce.
Typically a child progresses from banging a spoon, to dipping a spoon into food, to scooping food with spoon, to piercing food with fork, to using a knife with some assistance, to eventually using a knife and fork with skill.
Developmental norms:
10-12 Months: Holds spoon to play, bang, mouth, drop
13-15 Months: Dips spoon in food. Brings spoon to mouth, turns spoon over but obtains some food
By 36 months: Can use a fork to pierce soft foods and bring to mouth
By 6 Years: Can cut with a fork and knife (entire process of holding utensils, controlling and cutting food, and bringing to mouth)
As the OT is working on utensil use, finger feeding would not address the treatment goal.
https://mamaot.com/when-can-kids-feed-themselves-mealtime-milestones/
Before recommending sensory seating such as a wobble cushion, for a child in the context of the classroom, what should be considered FIRST?
A. Is the student fidgeting because their feet can’t touch the floor.It is always important to start by FIRST establishing why the student needs sensory seating. Sensory cushions, regardless of shape, are all designed to be filled with air. This creates a moving surface for the child to sit on. Before suggesting a wobble cushion, it is important to check that the child is not fidgeting because their feet can’t touch the floor. If the child’s chair is too high for them, they will find sitting still in their chair very difficult. The cushion will make them even higher and even more unstable. Also, children with poor core stability and balance might find the cushions very difficult to sit on. This is because the cushion is unstable and therefore harder to stay seated on compared to a harder surface. Sensory seating (chair or movement cushion) helps children get the extra movement they are ‘seeking’ whilst sitting in a classroom. The ultimate aim of sensory chairs and fidget cushions is to help children with their attention and ability to focus. It is thought that children who move about are doing this to help keep themselves regulated and/or alert. Some children might move in order to help themselves to focus while others may move because it helps keep their body and/or thinking more organized. The idea is that the motion of the sensory movement decreases other distracting or unsafe movements that the child may be doing to help keep themselves alert and focused. It allows these children to move about in a more appropriate way. Wobble cushions are typically recommended for children with ADHD or ASD. Within the sensory processing disorder model, these children would be called movement/vestibular seekers.
A. Is the student fidgeting because their feet can’t touch the floor.It is always important to start by FIRST establishing why the student needs sensory seating. Sensory cushions, regardless of shape, are all designed to be filled with air. This creates a moving surface for the child to sit on. Before suggesting a wobble cushion, it is important to check that the child is not fidgeting because their feet can’t touch the floor. If the child’s chair is too high for them, they will find sitting still in their chair very difficult. The cushion will make them even higher and even more unstable. Also, children with poor core stability and balance might find the cushions very difficult to sit on. This is because the cushion is unstable and therefore harder to stay seated on compared to a harder surface. Sensory seating (chair or movement cushion) helps children get the extra movement they are ‘seeking’ whilst sitting in a classroom. The ultimate aim of sensory chairs and fidget cushions is to help children with their attention and ability to focus. It is thought that children who move about are doing this to help keep themselves regulated and/or alert. Some children might move in order to help themselves to focus while others may move because it helps keep their body and/or thinking more organized. The idea is that the motion of the sensory movement decreases other distracting or unsafe movements that the child may be doing to help keep themselves alert and focused. It allows these children to move about in a more appropriate way. Wobble cushions are typically recommended for children with ADHD or ASD. Within the sensory processing disorder model, these children would be called movement/vestibular seekers.
A 14-month-old boy has recently mastered scooping food with a spoon and bringing it to his mouth. What is next developmental step you can expect this boy to demonstrate?
C. The next developmental step would be to drink using a straw.
Typical developmental sequence:
6-9 months: grabbing spoon and banging it
9-13 months: finger feeding self soft table foods
15-18 months: scooping food and bringing it to mouth
18 months: straw use
C. The next developmental step would be to drink using a straw.
Typical developmental sequence:
6-9 months: grabbing spoon and banging it
9-13 months: finger feeding self soft table foods
15-18 months: scooping food and bringing it to mouth
18 months: straw use
A 4-year-old girl wanders around a sensory integration clinic and then spontaneously picks up a bubble maker. The girl pushes the power button, and as the bubble maker gently vibrates in her hands and bubbles start to come out, she immediately drops it onto the floor and runs away crying. What is the girl’s reaction MOST likely indicative of?
D. Tactile defensiveness. Children who are tactile defensive are sensitive to touch sensations and can be easily overwhelmed by ordinary daily experiences and activities, such as touching a vibrating toy.
D. Tactile defensiveness. Children who are tactile defensive are sensitive to touch sensations and can be easily overwhelmed by ordinary daily experiences and activities, such as touching a vibrating toy.
A 4-year-old boy has been diagnosed with attention deficit disorder with hyperactivity and has been referred to OT. What type of behavior should the OT expect to see?
C. Inattention, hyperactivity, and impulsivity.
Inattention: the student may wander off task, lack persistence, and may have difficulty sustaining focus. /em>
Hyperactivity: the student may move around the room constantly
Impulsivity: the student may act out in the moment and may excessively interrupt others or make important decisions without considering the long-term consequences.
C. Inattention, hyperactivity, and impulsivity.
Inattention: the student may wander off task, lack persistence, and may have difficulty sustaining focus. /em>
Hyperactivity: the student may move around the room constantly
Impulsivity: the student may act out in the moment and may excessively interrupt others or make important decisions without considering the long-term consequences.
An OTR® works with a COTA® in a school-based setting. The OTR® wishes to train the COTA® in the administration of certain portions of the standardized tests used to evaluate new students. Which test is the most appropriate for the COTA® to assist in administering?
The COTA® would be allowed to administer portions of tests that are standardized and have specific, objective instructions. The Peabody Developmental Motor Scales, Bruininks-Oseretsky Test of Motor Proficiency, Motor-Free Visual Perception Test, and Miller Assessment for Preschoolers meet this requirement. The Sensory Profile is a questionnaire-style test that parents complete and the Transdisciplinary Play-Based Assessment is a non-standardized assessment that utilizes team observations, so these two tests do not meet the criteria. The Allen Cognitive Level Screening Tool does have specific instructions, but is more complicated to administer because scores need to be validated by observed performance.
The COTA® would be allowed to administer portions of tests that are standardized and have specific, objective instructions. The Peabody Developmental Motor Scales, Bruininks-Oseretsky Test of Motor Proficiency, Motor-Free Visual Perception Test, and Miller Assessment for Preschoolers meet this requirement. The Sensory Profile is a questionnaire-style test that parents complete and the Transdisciplinary Play-Based Assessment is a non-standardized assessment that utilizes team observations, so these two tests do not meet the criteria. The Allen Cognitive Level Screening Tool does have specific instructions, but is more complicated to administer because scores need to be validated by observed performance.
An OT is assigned to work with a 6-year-old student to help him with handwriting adaptations. Currently, the student has pronate grasp and slight upper extremity weakness. Using the remedial approach, which work surface and position would be most useful in supporting this student?
Standing upright and writing on a chalkboard. The remedial approach uses compensation to allow the student to utilize existing skills to complete a task. Since the student has a prone grasp, writing vertically on a chalkboard will provide a better hand position for the student while writing. The vertical reach and resistance of the chalkboard will help to strengthen the student’s upper extremity as he writes.
Standing upright and writing on a chalkboard. The remedial approach uses compensation to allow the student to utilize existing skills to complete a task. Since the student has a prone grasp, writing vertically on a chalkboard will provide a better hand position for the student while writing. The vertical reach and resistance of the chalkboard will help to strengthen the student’s upper extremity as he writes.
A 4th grade teacher has 3 students diagnosed with ADHD in her classroom. She incorporates movement breaks into her class schedule during her lessons. This strategy is an example of what type of intervention?
A. Tier 1 intervention. Tier 1 intervention includes changes in the classroom that benefit all students, including those considered to be “at risk”. Tier 1 intervention is the first step of the Response to Intervention, or RTI, process. RTI Tier 1 interventions are the “first line of defense” for supporting students. Response to Intervention (RTI) was designed to help prevent students from needing special education assistance. Tier 1 instruction is delivered to the whole class.
https://www.understood.org/en/school-learning/special-services/rti/at-a-glance-3-tiers-of-rti-support
https://studyskills.com/spedadhd/rti-tier-1-interventions-4/
A. Tier 1 intervention. Tier 1 intervention includes changes in the classroom that benefit all students, including those considered to be “at risk”. Tier 1 intervention is the first step of the Response to Intervention, or RTI, process. RTI Tier 1 interventions are the “first line of defense” for supporting students. Response to Intervention (RTI) was designed to help prevent students from needing special education assistance. Tier 1 instruction is delivered to the whole class.
https://www.understood.org/en/school-learning/special-services/rti/at-a-glance-3-tiers-of-rti-support
https://studyskills.com/spedadhd/rti-tier-1-interventions-4/
Charley is a 24-month-old toddler with hemiplegic cerebral palsy affecting his right side. The OTR® places a mitt on Charley’s left hand while he is playing in order to encourage him to use his right hand. This is an example of what type of intervention?
B. Constraint-induced therapy. Also called forced-use therapy, this intervention constrains the normal limb to force the child to use the affected limb.
B. Constraint-induced therapy. Also called forced-use therapy, this intervention constrains the normal limb to force the child to use the affected limb.
Sara is a 6-year-old girl who displays sensory-seeking behavior, including running everywhere, climbing on the furniture, and jumping off tables and countertops. Sara’s behavior is an example of _______?
D. Sensory Modulation Disorder. A child with a Sensory Modulation Disorder has difficulty modulating (regulating) sensory input. Sensory modulation is the ability to respond appropriately to sensory information and remain at an appropriate level of alertness for daily activities. It includes the subtypes: 1. Sensory Over-Responsivity, 2. Sensory-Under Responsivity, and 3. Sensory Craving/ Seeking. In this scenario, Sara is demonstrating sensory-seeking behavior. The nervous system of the sensory-craver needs intense input in order for the sensation to be registered. Sensory-cravers seek out intense sensations constantly but are often disorganized due to high levels of random sensory input. They are constantly touching, crashing, and moving, and they have no awareness of personal space. The child may also: Demonstrate decreased safety due to impulsiveness and excessive risk taking behaviors.
Appears to be in constant motion but may be clumsy and awkward, frequently falling and bruising (but may not notice injury until pointed out).
https://childrenstherapy.org/what-is-sensory-modulation-disorder/
D. Sensory Modulation Disorder. A child with a Sensory Modulation Disorder has difficulty modulating (regulating) sensory input. Sensory modulation is the ability to respond appropriately to sensory information and remain at an appropriate level of alertness for daily activities. It includes the subtypes: 1. Sensory Over-Responsivity, 2. Sensory-Under Responsivity, and 3. Sensory Craving/ Seeking. In this scenario, Sara is demonstrating sensory-seeking behavior. The nervous system of the sensory-craver needs intense input in order for the sensation to be registered. Sensory-cravers seek out intense sensations constantly but are often disorganized due to high levels of random sensory input. They are constantly touching, crashing, and moving, and they have no awareness of personal space. The child may also: Demonstrate decreased safety due to impulsiveness and excessive risk taking behaviors.
Appears to be in constant motion but may be clumsy and awkward, frequently falling and bruising (but may not notice injury until pointed out).
https://childrenstherapy.org/what-is-sensory-modulation-disorder/
Miley is a student in the 4-year-old kindergarten class at the elementary school. Miley’s mother complains to the OTR® that Miley cannot tie her shoes. How should the OTR® respond?
A. The OTR® should tell Miley’s mother not to worry as Miley is too young to start learning how to tie her shoes. Children typically develop the skills necessary to learn shoe-tying between the ages of 5 and 6 years.
A. The OTR® should tell Miley’s mother not to worry as Miley is too young to start learning how to tie her shoes. Children typically develop the skills necessary to learn shoe-tying between the ages of 5 and 6 years.
A parent reports that their child, who is 6 years old, was recently diagnosed with sensory processing disorders. The parent has mentioned that the child is relatively eager to learn and engage with other children, but discovered that the child has difficulty performing basic functional skills at home such as holding the toothbrush during oral care and spills food when eating cereal. The OT and OTA collaborate to collect data on the child’s functional capacities in school related to the parent’s concern. What is the best way to collect this information?
Select the 3 best choices.
Answers: b, c, and f best correspond to fine motor problems including problems with hand and finger grasp, hand-eye coordination and hand strength. Although it is possible, behavioral problems may be related to sensory processing disorders (a, d, and e), the fine motor problems are related to the parent’s concerns and could play a part in establishing priorities and goals should the child be eligible for IEP.
https://childdevelopment.com.au/areas-of-concern/fine-motor-skills/fine-motor-skills/
Fine Motor Skills – Kid Sense Child Development
What are fine motor skills? Fine motor skills involve the use of the smaller muscle of the hands, such as when doing up buttons, opening lunch boxes or using pencils or scissors. Fine motor skill efficiency significantly influences the quality of the task outcome as well as the speed of task performance. Efficient fine motor skills […]
childdevelopment.com.au
Answers: b, c, and f best correspond to fine motor problems including problems with hand and finger grasp, hand-eye coordination and hand strength. Although it is possible, behavioral problems may be related to sensory processing disorders (a, d, and e), the fine motor problems are related to the parent’s concerns and could play a part in establishing priorities and goals should the child be eligible for IEP.
https://childdevelopment.com.au/areas-of-concern/fine-motor-skills/fine-motor-skills/
Fine Motor Skills – Kid Sense Child Development
What are fine motor skills? Fine motor skills involve the use of the smaller muscle of the hands, such as when doing up buttons, opening lunch boxes or using pencils or scissors. Fine motor skill efficiency significantly influences the quality of the task outcome as well as the speed of task performance. Efficient fine motor skills […]
childdevelopment.com.au
A school-based OTR® has a student lie in prone-prop position to practice handwriting. What problem is the OTR® addressing by positioning the student this way for handwriting?
D. Poor core stability. When a student cannot sit upright in a chair to work on handwriting, a more stable position may help the student free up the writing hand. Prone on elbows is one position that helps stabilize the core.
A. If this position was used to address poor upper extremity strength, the student would not be able to “free” one hand to use for writing. With poor upper limb strength, the student would have to remain in a static posture, supporting their weight on both their forearms.
B. Limited attention to task is best addressed with structuring the environment and task. Examples: special seating e.g. ball seat, using a quiet space, allowing intermittent break periods, provide child with a fidget.
C. Impaired visual tracking can on be addressed by using visual exercises.
D. Poor core stability. When a student cannot sit upright in a chair to work on handwriting, a more stable position may help the student free up the writing hand. Prone on elbows is one position that helps stabilize the core.
A. If this position was used to address poor upper extremity strength, the student would not be able to “free” one hand to use for writing. With poor upper limb strength, the student would have to remain in a static posture, supporting their weight on both their forearms.
B. Limited attention to task is best addressed with structuring the environment and task. Examples: special seating e.g. ball seat, using a quiet space, allowing intermittent break periods, provide child with a fidget.
C. Impaired visual tracking can on be addressed by using visual exercises.
Sean is a second grade student with a diagnosis of glaucoma with visual impairment. He does not qualify for special education services, but he could benefit from occupational therapy services to provide adaptations to assist him with reading, keyboarding, and managing his lunch tray. Sean could receive occupational therapy services through which federal law?
B. The Rehabilitation Act of 1973. Section 504 of this act includes provisions for providing accommodations for students with disabilities in public schools, including occupational therapy services, as long as the student has a medically diagnosed condition.
B. The Rehabilitation Act of 1973. Section 504 of this act includes provisions for providing accommodations for students with disabilities in public schools, including occupational therapy services, as long as the student has a medically diagnosed condition.
At what age can a child be expected to begin assisting in pulling down his pants?
C. 2 years. By the age of two, a child should begin to help pull his pants down, and will pull down elastic-waist pants by age two and a half.
C. 2 years. By the age of two, a child should begin to help pull his pants down, and will pull down elastic-waist pants by age two and a half.
Madison is an active child who loves to run, jump and climb in the playground. At what age can she be expected to zip up her jacket independently?
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B. 4 years.
At 4 years old a child can buckle shoes or a belt, fasten large buttons without assistance, pull up zipper on jacket, put on shoes and socks (not yet able to tie shoes), zip a jacket zipper, puts on socks correctly, and identify the front and back of a garment.
At least 3 references concur that age 4 is the age when a child can be expected to manipulate a zipper.
https://www.abcpediatrictherapy.com/age-child-dressing-skills/
https://www.baltimoretherapyspot.com/developmental-milestones-for-children-2-5-years-old/
https://www.unitypoint.org
B. 4 years.
At 4 years old a child can buckle shoes or a belt, fasten large buttons without assistance, pull up zipper on jacket, put on shoes and socks (not yet able to tie shoes), zip a jacket zipper, puts on socks correctly, and identify the front and back of a garment.
At least 3 references concur that age 4 is the age when a child can be expected to manipulate a zipper.
https://www.abcpediatrictherapy.com/age-child-dressing-skills/
https://www.baltimoretherapyspot.com/developmental-milestones-for-children-2-5-years-old/
https://www.unitypoint.org
At what age can a child typically be expected to get dressed independently?
C. 5-6.
At 5 years old a child can tie and untie knots as well as dress unsupervised.
Developmental milestones related to self-dressing skills. These are meant to be general guidelines for when these skills tend to typically emerge.
• By 4 1/2 years of age:
Unbuttons front-opening clothing
Buttons front-opening clothing (e.g., button-down shirt)
Puts on weather-appropriate clothing without prompting (e.g., puts on coat if cold outside)
Tightens shoelaces by pulling up or out
• By 5 years of age:
Places jacket or coat on designated hook or place
Undresses daily at designated times without reminders
Tying shoe laces is a complex skill that requires the integration of both sides of the body (bilateral coordination), integration of what is seen and hand movement (visual motor integration), planning, sequencing and manual dexterity. Developmentally, kids are ready from about 5 years of age to start learning to tie shoelaces, although some may not master it for a while.
• By 5 1/2 years of age:
Dresses independently when asked
Tucks in shirt
http://mamaot.com/when-do-kids-learn-to-dress-themselves-developmental-progression-of-self-dressing-skills/
https://www.yourkidsot.com/blog/best-tips-for-tying-shoe-laces
C. 5-6.
At 5 years old a child can tie and untie knots as well as dress unsupervised.
Developmental milestones related to self-dressing skills. These are meant to be general guidelines for when these skills tend to typically emerge.
• By 4 1/2 years of age:
Unbuttons front-opening clothing
Buttons front-opening clothing (e.g., button-down shirt)
Puts on weather-appropriate clothing without prompting (e.g., puts on coat if cold outside)
Tightens shoelaces by pulling up or out
• By 5 years of age:
Places jacket or coat on designated hook or place
Undresses daily at designated times without reminders
Tying shoe laces is a complex skill that requires the integration of both sides of the body (bilateral coordination), integration of what is seen and hand movement (visual motor integration), planning, sequencing and manual dexterity. Developmentally, kids are ready from about 5 years of age to start learning to tie shoelaces, although some may not master it for a while.
• By 5 1/2 years of age:
Dresses independently when asked
Tucks in shirt
http://mamaot.com/when-do-kids-learn-to-dress-themselves-developmental-progression-of-self-dressing-skills/
https://www.yourkidsot.com/blog/best-tips-for-tying-shoe-laces
An OT is working with a 4-year-old child with Down syndrome. The OT plans to administer a comprehensive standardized assessment that measures the extent to which this student can integrate their visual and motor abilities. What would be the most appropriate assessment?
A. Beery Developmental Test of Visual-Motor Integration (VMI). The Beery VMI helps assess the extent to which individuals can integrate their visual and motor abilities. The Short Format and Full Format tests present drawings of geometric forms arranged in order of increasing difficulty that the individual is asked to copy. Optional Supplemental Tests for More Detailed Evaluation
Two supplemental tests-the VMI Visual Perception Test and the VMI Motor Coordination Test- can each be administered in 5 minutes or less. They are generally given if full- or short-form VMI results indicate a need for further testing. The supplemental tests use the same VMI stimulus forms, so it easy to compare results from all 3 tests, using a profile form provided in the Test Booklet.
B. Bayley Scales of Infant & Toddler Development Motor Scale: Assesses the mental, psychomotor and behavior of infants and toddlers ages from 1 month to 42 months.
C. Beery Developmental Test of Visual-Motor Integration-Visual Perception- this is a standardized supplement to the Beery VMI and if needed, is administered after the Beery VMI. This is a timed test, where during a three- minute period the task is to identify the exact match for as many of the stimuli figures as possible. To make this as pure a visual-perceptual task as possible, the only motor requirement of the individual is to point to his/her responses.
D. Beery Developmental Test of Visual-Motor Integration-Motor Coordination- this is a standardized supplement to the Beery VMI and if needed is administered after the Beery VMI. This is a timed test, where during a 5-minute period the task is to simply trace the stimulus form with a pencil without going outside the double-lined path.
https://sites.google.com/site/darceyot/evaluations
https://www.therapro.com/Browse-Category/Visual-Perception-and-Visual-Skills/6th-Ed-Starter-Kit.html
A. Beery Developmental Test of Visual-Motor Integration (VMI). The Beery VMI helps assess the extent to which individuals can integrate their visual and motor abilities. The Short Format and Full Format tests present drawings of geometric forms arranged in order of increasing difficulty that the individual is asked to copy. Optional Supplemental Tests for More Detailed Evaluation
Two supplemental tests-the VMI Visual Perception Test and the VMI Motor Coordination Test- can each be administered in 5 minutes or less. They are generally given if full- or short-form VMI results indicate a need for further testing. The supplemental tests use the same VMI stimulus forms, so it easy to compare results from all 3 tests, using a profile form provided in the Test Booklet.
B. Bayley Scales of Infant & Toddler Development Motor Scale: Assesses the mental, psychomotor and behavior of infants and toddlers ages from 1 month to 42 months.
C. Beery Developmental Test of Visual-Motor Integration-Visual Perception- this is a standardized supplement to the Beery VMI and if needed, is administered after the Beery VMI. This is a timed test, where during a three- minute period the task is to identify the exact match for as many of the stimuli figures as possible. To make this as pure a visual-perceptual task as possible, the only motor requirement of the individual is to point to his/her responses.
D. Beery Developmental Test of Visual-Motor Integration-Motor Coordination- this is a standardized supplement to the Beery VMI and if needed is administered after the Beery VMI. This is a timed test, where during a 5-minute period the task is to simply trace the stimulus form with a pencil without going outside the double-lined path.
https://sites.google.com/site/darceyot/evaluations
https://www.therapro.com/Browse-Category/Visual-Perception-and-Visual-Skills/6th-Ed-Starter-Kit.html
A 7-month-old baby is observed picking up a cheerio, using a specific type of grasp which is characterized by him using finger flexion and no thumb opposition to scrape the the cheerio into his palm. What is this grasp called?
D. Raking grasp
Between 5-7 months of age a child will develop a raking grasp. The child consciously uses their fingers to grasp an object. They do not have finger isolation so they use all of their fingers as a whole unit to pull an object into their hand. This movement is termed “raking” and it is how most infants obtain objects of any size, small or large.
D. Raking grasp
Between 5-7 months of age a child will develop a raking grasp. The child consciously uses their fingers to grasp an object. They do not have finger isolation so they use all of their fingers as a whole unit to pull an object into their hand. This movement is termed “raking” and it is how most infants obtain objects of any size, small or large.
An OT is referred to work with a 5-year-old with cerebral palsy. Upon observation, the child appears to present with uncoordinated, clumsy movements. What type of cerebral palsy does this child most likely have?
Ataxic CP is derived from the word “ataxia,” meaning lack of coordination and order.
Hypotonia is diminished muscle tone. The infant or child with hypotonic cerebral palsy appears floppy — like a rag doll.
People with dyskinetic forms of cerebral palsy have variable movement that is involuntary (outside of their control).
Spastic cerebral palsy is the most common type of cerebral palsy. The muscles of people with spastic cerebral palsy feel stiff and their movements may look stiff and jerky. Spasticity is a form of hypertonia, or increased muscle tone
Ataxic CP is derived from the word “ataxia,” meaning lack of coordination and order.
Hypotonia is diminished muscle tone. The infant or child with hypotonic cerebral palsy appears floppy — like a rag doll.
People with dyskinetic forms of cerebral palsy have variable movement that is involuntary (outside of their control).
Spastic cerebral palsy is the most common type of cerebral palsy. The muscles of people with spastic cerebral palsy feel stiff and their movements may look stiff and jerky. Spasticity is a form of hypertonia, or increased muscle tone
A 5-year-old child is playing the game “Connect 4″ which requires him to pick up and post 1” diameter discs into slots. The child appears to have difficulty maintaining his grasp on the discs while placing them into the grid. What type of grasp is required for this task?
C. Pad-to-pad prehension. Placing discs into a grid when playing “Connect 4” requires pad-to-pad prehension.
Precision grips can be categorized as pad-to-pad prehension, tip-to-tip prehension, and pad-to-side prehension. Each tends to be a dynamic function with relatively little static holding.
Pad-to-Pad Prehension- involves opposition of the pad of the thumb to the pad of the finger.
Tip-to-Tip Prehension- the interphalangeal joints of the finger and thumb have the range and available muscle force to create nearly full joint flexion.
Pad-to-Side Prehension- also known as key grip (or lateral pinch) because a key is held between the pad of the thumb and side of the index finger. Pad-to-side prehension differs from the other forms of precision handling only in that the thumb is more
adducted and less rotated.
https://shodhganga.inflibnet.ac.in/bitstream/10603/23416/10/10_introduction.pdf
C. Pad-to-pad prehension. Placing discs into a grid when playing “Connect 4” requires pad-to-pad prehension.
Precision grips can be categorized as pad-to-pad prehension, tip-to-tip prehension, and pad-to-side prehension. Each tends to be a dynamic function with relatively little static holding.
Pad-to-Pad Prehension- involves opposition of the pad of the thumb to the pad of the finger.
Tip-to-Tip Prehension- the interphalangeal joints of the finger and thumb have the range and available muscle force to create nearly full joint flexion.
Pad-to-Side Prehension- also known as key grip (or lateral pinch) because a key is held between the pad of the thumb and side of the index finger. Pad-to-side prehension differs from the other forms of precision handling only in that the thumb is more
adducted and less rotated.
https://shodhganga.inflibnet.ac.in/bitstream/10603/23416/10/10_introduction.pdf
Which of the motor milestones listed occurs around 11 months of age?
D. Walks with hands held. By 11 months of age, an infant typically develops the ability to cruise around furniture and walk with hands held.
D. Walks with hands held. By 11 months of age, an infant typically develops the ability to cruise around furniture and walk with hands held.
In order to improve handwriting skills, an OT provides a slant board to a 2nd grade student. What benefit will be achieved by using this slanted surface?
Wrist Extension. Using a slanted board has many benefits, one of which is, it forces the wrist and hand into tenodesis (wrist extension and finger flexion). Writing with an extended wrist automatically places the hand into a functional position and allows the hand to pull the radial digits into opposition. Maintaining radial digit opposition to the thumb is necessary for promoting an efficient grasp on the pencil. By improving the student’s pencil grasp, he can develop the skill of handwriting
Other benefits:
Wrist Extension. Using a slanted board has many benefits, one of which is, it forces the wrist and hand into tenodesis (wrist extension and finger flexion). Writing with an extended wrist automatically places the hand into a functional position and allows the hand to pull the radial digits into opposition. Maintaining radial digit opposition to the thumb is necessary for promoting an efficient grasp on the pencil. By improving the student’s pencil grasp, he can develop the skill of handwriting
Other benefits:
An OT places a 6-month-old infant in supine position on the floor while his head is turned to one side. The OT observes the infant’s entire body turning in the direction of his head. What reflex is this infant demonstrating?
A. Neck righting (NOB). Between the age of 4 months and 5 years, a child will exhibit the neck-righting reflex. It is triggered by the stretching of the neck muscles when there is rotation of the head or movement of the cervical/neck spine.
A. Neck righting (NOB). Between the age of 4 months and 5 years, a child will exhibit the neck-righting reflex. It is triggered by the stretching of the neck muscles when there is rotation of the head or movement of the cervical/neck spine.
During a feeding intervention with a 8-year-old child with cerebral palsy, the OT recognizes several problems while the child sits in a chair. What is the first area of concern to address?
When working with this child it is important to first address postural stability so they are in an ergonomically aligned position to eat food properly.
When working with this child it is important to first address postural stability so they are in an ergonomically aligned position to eat food properly.
At what age can a child be expected to begin spontaneously scribbling on paper?
D. 12-18 months. At approximately 12 to 18 months, a child typically begins to spontaneously scribble on paper.
There’s a difference between marking a page with a crayon and scribbling. Peabody Developmental Motor Scales, 2nd edn – Guide to Item Administration (PDMS-2)- states that a child begins to scribble at around 14 months.
At 12 months- Scribbles after demo.
At 14-15 months- Spontaneous scribble.
A. 6-9 months, a baby masters transferring an object between hands, starts to isolate their index fingers and uses an immature pincer grasp.
B. 10-12 months, a baby develops a mature pincer grasp. The child may begin to mark a piece of paper with a crayon.
C. 18-24 months- The next pre-writing skill after scribbling, is imitating horizontal and vertical lines at 24 months.
https://theinspiredtreehouse.com/developmental-milestones-ages-1-2/#_a5y_p=2700308
D. 12-18 months. At approximately 12 to 18 months, a child typically begins to spontaneously scribble on paper.
There’s a difference between marking a page with a crayon and scribbling. Peabody Developmental Motor Scales, 2nd edn – Guide to Item Administration (PDMS-2)- states that a child begins to scribble at around 14 months.
At 12 months- Scribbles after demo.
At 14-15 months- Spontaneous scribble.
A. 6-9 months, a baby masters transferring an object between hands, starts to isolate their index fingers and uses an immature pincer grasp.
B. 10-12 months, a baby develops a mature pincer grasp. The child may begin to mark a piece of paper with a crayon.
C. 18-24 months- The next pre-writing skill after scribbling, is imitating horizontal and vertical lines at 24 months.
https://theinspiredtreehouse.com/developmental-milestones-ages-1-2/#_a5y_p=2700308
A child with Down syndrome has an inferior pincer grasp and can hold a tiny object between the pads of his finger and the thumb. What is the next fine motor grasp pattern to develop?
C. Fine pincer grasp.
Typical progression of the pincer grasp, is moving from using the pads of the fingers to the tips of the fingers. to pick up small objects.
C. Fine pincer grasp.
Typical progression of the pincer grasp, is moving from using the pads of the fingers to the tips of the fingers. to pick up small objects.
What are the benefits of using a ball seat for a child with ADHD in the classroom?
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B. To stay focused and maintain alignment.
The ball seat has several benefits. It can correct a child’s posture and help meet his or her movement needs. Children with ADHD have an increased need for movement and they often seek out this movement in unacceptable ways in the classroom. Ball seats allow children to wiggle and shift position without disturbing their classmates. The seats also help correct poor posture, which facilitates proper position while working and attention to task.
B. To stay focused and maintain alignment.
The ball seat has several benefits. It can correct a child’s posture and help meet his or her movement needs. Children with ADHD have an increased need for movement and they often seek out this movement in unacceptable ways in the classroom. Ball seats allow children to wiggle and shift position without disturbing their classmates. The seats also help correct poor posture, which facilitates proper position while working and attention to task.
A mother of a 3-year-old girl is concerned that her daughter can neither walk up stairs nor run. The mother would like to know at what age a typical child can perform these skills. How should the OT respond?
Between 18-24 months a child can walk up stairs and run.
Before a child is able to walk up stairs and run, they first have to master walking on a flat surface. This milestone is typically achieved by 12 months. Muscle strength, weight shifting, balance, and co-ordination are some of the key elements needed for walking up stairs and running. These only become well developed once a child is standing up against gravity and starting to move.
When it comes to milestones, it is important to remember that a stipulated age is merely a general guideline. There is a range of ages, for meeting developmental milestones. For example, the usual age range for a child to start walking is from 10 – 15 months.
Between 18-24 months a child can walk up stairs and run.
Before a child is able to walk up stairs and run, they first have to master walking on a flat surface. This milestone is typically achieved by 12 months. Muscle strength, weight shifting, balance, and co-ordination are some of the key elements needed for walking up stairs and running. These only become well developed once a child is standing up against gravity and starting to move.
When it comes to milestones, it is important to remember that a stipulated age is merely a general guideline. There is a range of ages, for meeting developmental milestones. For example, the usual age range for a child to start walking is from 10 – 15 months.
An OT screens a child in the classroom who is seen acting aggressively, arguing repeatedly with the teacher, and losing his temper. What diagnosis does this student most likely have?
A. Oppositional defiant disorder.
Children with oppositional defiant disorder break rules and act aggressively, argue repeatedly with adults, lose their temper, feel great anger or resentment, ignore adult rules and requests, and display negative behaviors.
A. Oppositional defiant disorder.
Children with oppositional defiant disorder break rules and act aggressively, argue repeatedly with adults, lose their temper, feel great anger or resentment, ignore adult rules and requests, and display negative behaviors.
A 5-year-old child is asked to trace a squiggly line with his finger, and then trace the same line with a pencil. What visual skill does this activity work on?
C. Visual tracking. This is typically defined as the ability to efficiently move the eyes from left to right (or right to left, up and down, and circular motions) OR focusing on an object as it moves across a person’s visual field.
A. Visual scanning is the ability to use vision to search in a systematic manner, such as top to bottom and left to right. A child needs to use visual scanning to avoid obstacles when navigating their environment. Smooth visual scanning is required for reading.
B. Visual memory focuses on one’s ability to recall visual information that has been seen. Visual memory is a critical factor in reading and writing. When a child is writing a word, he must recall the formation of parts of the letter from memory
D. Visual acuity is a measure of the ability of the eye to distinguish shapes and the details of objects at a given distance.