AOTA Q Flashcards
An OTR® is part of a team that is planning to implement a schoolwide positive behavioral intervention and supports (PBIS). Which statement reflects the application of schoolwide PBIS programming?
Written expectations that state what behaviors the school considers inappropriate
Consistent application of procedures for correcting misbehaviors at school
Development of a detailed support plan to meet the needs of all students
General strategies that teachers can modify to teach appropriate behaviors
Solution: The correct answer is B.
Consistent application of procedures to correct misbehaviors is a key feature of schoolwide PBIS programming. For the program to be effective, the majority of the school staff must agree to implement the intervention and receive training and support on an ongoing, consistent basis.
A: Expectations need to be clearly defined and written in positive statements so students know how to behave rather than what behaviors are considered inappropriate.
C: In schoolwide PBIS, support plans are intended to be written only for students with chronic, challenging behaviors.
D: A key feature of schoolwide PBIS programming is very specific strategies that all teachers can apply consistently.
An OTR® is evaluating a child with oppositional defiant disorder with aggressive behaviors. The parents report that the child enjoys doing a very limited repertoire of activities. The OTR decides to use the Model of Human Occupation (MOHO) to guide assessment and intervention. Which MOHO-based assessment is BEST to use with this child to develop a list of meaningful occupations that can be used for intervention?
Pediatric Interest Profiles
Short Child Occupational Profile
Pediatric Volitional Questionnaire
Coping Inventory
Solution: The correct answer is A.
The Pediatric Interest Profiles assessment is a self-report that surveys children’s play and leisure interests. This assessment asks the child to indicate his or her level of participation in and feelings of enjoyment associated with the activity.
B: The Short Child Occupational Profile can be used for this client, but it is more often used to develop an occupational profile of the child rather than to identify a list of activities in which the child is interested in engaging.
C: The Pediatric Volitional Questionnaire is an observational assessment that captures a child’s behaviors in a variety of environments. Although it may be used to derive a list of occupations in which the child is interested, the list will be dependent on the context in which the observation was made.
D: The Coping Inventory is not a MOHO-based assessment.
An OTR® receives a referral for a 7th grader diagnosed with oppositional defiant disorder. Which condition that often occurs concurrently with oppositional defiant disorder should the OTR® look for?
Depression
Conduct disorder
Attention deficit hyperactivity disorder
Schizophrenia
Solution: The correct answer is C.
Attention deficit hyperactivity disorder (ADHD) often occurs with oppositional defiant disorder (ODD), so practitioners conducting an assessment with a client with ODD should always look for signs of ADHD.
A, D: Depression and schizophrenia are not associated with oppositional defiant disorder.
B: Conduct disorder is more severe than oppositional defiant disorder (ODD). Some children start out with an ODD diagnosis, and when the child’s conduct worsens, the diagnosis is switched to conduct disorder and the ODD diagnosis is dropped.
An OTR® is working with a child with autism who gets easily frustrated with challenging tasks. The child’s current goal is to learn how to hit a ball with a bat. The OTR decides to use shaping as an intervention strategy. Which technique BEST describes shaping as a teaching strategy?
The OTR teaches successive approximations of the task, such as picking up the bat, swinging the bat, and tapping a ball with the bat.
The OTR teaches the child each prerequisite step of the activity in a systematic fashion and asks the child to combine each step, for example, holding the bat and then swinging the bat.
The OTR helps the child hold the bat and swing the bat and then allows the child to hit the ball independently.
The OTR systematically demonstrates to the child how to swing the bat, instructs the child to swing the bat, and implements a time delay before a ball is pitched to learn the new skill.
Solution: The correct answer is A.
Successively approximating or learning intermediate behaviors that are prerequisite components of the final behavior is part of the shaping technique.
B: This approach is an example of forward chaining.
C: This approach is an example of backward chaining.
D: This approach is an example of time-delay procedure.
An OTR® is working in a lower socioeconomic status school district that offers developmental screenings to all 3-year-olds whose parents can prove residency. As part of the process, the OTR® screens for Duchenne’s muscular dystrophy (DMD). Which activity would alert the OTR® to the need to refer the child to a specialist?
A positive Gower’s sign
Abdominal distention
Excessive bruising
A positive Trendelenburg’s sign
Solution: The correct answer is A.
A positive Gower’s sign may be indicative of DMD. A positive Gower’s sign is noted when a child is asked to get up from sitting on the floor and walks the hands up the legs and then moves into a standing position.
B: Abdominal distention may be a sign of cystic fibrosis in infants.
C: Excessive bruising may be a sign of hemophilia.
D: A positive Trendelenburg’s sign may be related to hip dysplasia.
An OTR® is working on exploring the home environment with an infant in early intervention. The child is approximately 3 months behind in gross motor skills. Given this delay, at what age would the OTR expect the child to crawl?
<6 months
9 months
12 months
15 months
Solution: The correct answer is C.
Infants typically begin to crawl (move around on all fours, with belly off the ground) by age 9 months. Given this child’s delay, crawling may emerge around 12 months.
A, B, D: By age 3 months, most infants have mastered head control. Around age 6 months, an infant begins to roll. Around age 15 months, many children are able to walk.
An OTR® is working on dressing in early intervention with a 2-year-old who has a developmental delay. The child is able to take off socks and put legs through pant holes when pants are held up. What is the next area of dressing the OTR should address?
Lace shoes.
Put on mittens.
Remove coat.
Put on socks.
Solution: The correct answer is C.
At age 2, a child should be able to doff a coat after fasteners have been unfastened; the child should also be able to remove shoes if not tied; begin to help with pulling down pants; and locate armholes in shirt.
A, B, D: A typically developing 2-year-old would not be expected to complete these skills independently.
An OTR® is working at an after-school program connected to a homeless shelter for women and children. The OTR is engaged in a conversation with a woman who says that her 10-year-old child has recently lost quite a bit of weight, is excessively thirsty, and frequently needs to urinate. To which type of specialist should the child be referred?
Pediatrician
Endocrinologist
Neurologist
Nephrologist
Solution: The correct answer is A.
Weight loss, polyuria, and dehydration are common signs of Type 1 diabetes. Onset is usually around age 10. The appropriate referral would be to a pediatrician, who would likely suggest further consultation with a clinician specializing in diabetes diagnosis and management, if appropriate.
B, C, D: Occupational therapists can make recommendations or referrals to other professionals as needed; however, a pediatrician would be the most appropriate referral for a child in this situation.
Which assessment tool would an OTR® administer to gain an understanding of how a child’s sensory processing abilities are affecting the child’s participation in daily life activities at home?
Sensory Integration and Praxis Test (SIPT)
Sensory integration clinical observations
Sensory Profile
BruininksOseretsky Test of Motor Performance (BOT2)
Solution: The correct answer is C.
Interviews and caregiver questionnaires such as the Sensory Profile can be used to gain an understanding of how sensory problems influence a child’s participation in daily activities.
A, B: The SIPT and sensory integration clinical observations would provide the therapist with information related to the underlying neurological functions that affect sensory integration. However, these two assessment tools would not provide information about how the child’s ability to integrate sensory information that affects daily life activities.
D: The BOT2 would provide the OTR® with information about the child’s motor planning, but not about daily life activities.
An OTR® is working with a child who has scoliosis with a curve of 70°. The child would like to engage in sports activities. On the basis of this medical condition, which factor would most likely limit the child’s ability to participate in sports?
The need to wear a therapeutic brace
Weak abdominal muscles
Cardiopulmonary function
Ability to manage pain
Solution: The correct answer is C.
Children with a scoliosis curve between 65 and 80 may have reduced cardiopulmonary function.
A: The need to wear a brace would likely not have an impact on the child’s ability to participate in sports.
B: Although weak abdominal muscles may be present, cardiopulmonary issues become the primary concern with children who have significant curvatures because they impact life functions.
D: Scoliosis is usually not painful.
Side note:
1. Treatment initated when lateral curvature is more than 10d
2. less than 20d=mild
3. more than 40d=may result in permanent deformity
An OTR® is working in a preschool with a child who has a developmental delay in toileting. The child is beginning to show interest in toileting and can stay dry for more than 2 hours at a time. What is the next “just-right” challenge for this child?
Moving the bowels regularly
Wiping independently after having a bowel movement
Managing clothing during toileting
Telling someone when he or she has to go to the bathroom
Solution: The correct answer is D.
At age 2, children typically begin to show interest in toileting, can stay dry for 2 or more hours, and can flush the toilet independently and urinate regularly. The next developmental challenges include telling someone that they have to use the bathroom, waking up dry after sleeping, wiping self after urinating, and washing hands independently.
A: A child typically has regular bowel movements by age 18 months.
B, C: Wiping independently after a bowel movement and managing clothing independently typically happens after age 3 and usually before age 5.
An OTR® is completing a motor evaluation with an 8-year-old child with spina bifida resulting in a lesion at L5. What type of motor functions can the child be expected to demonstrate?
Full use of the upper extremities but poor or absent trunk control; use of assistive technology for mobility
Ability to activate the long muscles of the back during functional movement; ambulation for short distances with hip, knee, and ankle orthoses
Good trunk control and ability to flex the hips and abduct and extend the knees; ambulation with knee, ankle, and foot orthoses; use of a wheelchair for energy conservation likely
Ability to flex the hips and extend the knees; ambulation with ankle and foot orthoses; use of a wheelchair unlikely
Solution: The correct answer is D.
A child with spina bifida and an L5 lesion can be expected to flex the hips, extend the knees, and ambulate with ankle and foot orthoses.
A: Full use of the upper extremities but poor or absent trunk control necessitating assistive technology for mobility is consistent with a lesion at C8–T1.
B: Ability to activate the long muscles of the back and ambulate short distances with hip, knee, and ankle orthoses is consistent with a lesion at the T4–T6 level.
C: Good trunk control and ability to flex the hips, abduct and extend the knees, and ambulate with knee, ankle, and foot orthoses is consistent with a lesion at L2–L3; the child would likely use a wheelchair for energy conservation.
An OTR® is working with a pediatric client with delayed visual–perceptual skills. Specifically, the child has difficulty with shape, letter, and color identification and recognition. On the basis of this description, with which visual–perceptual skill is the child having difficulty?
Visual discrimination
Visual memory
Visual closure
Figureground recognition
Solution: The correct answer is A.
Visual discrimination is the brain’s ability to process and interpret the features of an object (or other stimuli) related to matching, recognition, and categorization by different attributes.
B, C, D: Visual memory, visual closure, and visual figure ground are other important visualperceptual skills, but they do not allow the individual to visually discriminate among key features of objects.
An OTR® is working in a pediatric developmental follow-up clinic and learns that a new client has a diagnosis of congenital club hand. When the child and the parent enter the room, the OTR® attempts to gain more information about the client’s diagnosis through observation. For what should the OTR® be looking?
Partial or full absence of the capitates and hamate and muscle hypertrophy
Dislocation of the humerus and signs of nerve damage
Bony malformations and underdeveloped musculature
Partial or full absence of the radius and bowing of the ulnar shaft
Solution: The correct answer is D.
Congenital club hand is associated with partial or full absence of the radius and bowing of the ulnar shaft. In addition, the upper extremity nerve and musculature are either absent or underdeveloped.
A, B, C: These options include a partial presentation of congenital club hand (e.g., nerve damage or underdeveloped musculature), but they also include information about presentations that are not aligned with this condition.
An OTR® is working with a child on toilet training. The child is 2½ years old and has an intellectual disability. Which of the following strategies is appropriate to include during intervention?
Encourage the child to wash his hands after using the bathroom
Encourage the child to try buttoning and unbuttoning pants
Encourage the use of a toileting schedule
Encourage the use of a potty chair
Solution: The correct answer is C.
Children are typically physiologically able to get on a regular toileting schedule at age 2½.
A, B: These skills are usually mastered after age 2½; a child with an intellectual disability may need more time to master them.
D: Introducing a potty chair may not help the child generalize the skill to a regular toilet.
