Ch. 8-10

Which statement reflects the meaning of activity analysis? a. The process of determining the characteristics of an activity for use with a client. b. The ability to grade and adapt an activity for intervention to meet a client's needs. c. The process of interacting with clients to allow them to succeed. d. The ability of the OT practitioner to communicate with the child and family.

ANS: A Activity analysis is the process of analyzing an activity to determine how and when it should be used with a particular client. It involves the identification of the components or client factors necessary to perform an activity.

Which task represents a formal educational activity? a. Going to preschool. b. Making one's bed. c. Playing school in the backyard. d. Selling lemonade to friends

ANS: A Formal educational activities are structured and may be mandated by public law for specific age groups. These activities are provided in settings such as preschool programs, daycare centers, public schools, and Sunday school classes.

Which stage of adolescent development involves the teen being engrossed with self (e.g., interested in personal appearance), decreased compliance with parents' rules, questioning of adults, and changing moods and behaviors? a. Early adolescence b. Middle adolescence c. Late adolescence d. All stages

ANS: A p. 121, Box 9-3

What influences the onset of menarche? a. Race b. Socioeconomic status c. Heredity d. Both A and C e. All of the above

ANS: E Race, socioeconomic status, heredity, and nutrition influence menarche in girls. Ovulation typically starts 12-18 months after menarche and at the peak period of physical growth.

What does the age at which children develop independent self-care skills depend on? a. Family's cultural expectations b. Opportunities for practice c. The child's motivation to be independent d. Both A and C e. All of the above

ANS: E The specific age at which young children develop independent activities of daily living (ADLs) and instrumental ADL skills varies according to the family's cultural expectations, opportunities for practice, and the child's motivation for independence.

Sixteen-year-old Cindy has decided to go to college to become a veterinarian. She is working in the summer to raise money for tuition. What term most closely describes this? a. Identity achievement b. Identity diffusion c. Identity formation d. Moratorium

ANS: A Identity achievement following identity moratorium is an exploration of possibilities and the healthy resolution of the quest. It is reached in the final years of high school, in college, or in the first years of work. It is characterized by a commitment to interests, values, gender and sexual orientation, political views, career or job, and a moral stance. This relatively stable sense of self enhances self-esteem. Adolescents and young adults who attain identity achievement are autonomous, exhibit mature moral reasoning, and are independent. In resolving their identity issues, they are able to change and adapt in response to personal and social demands without undue anxiety, since they are less self-absorbed, self-conscious, and less vulnerable to pressure from peers.

Who is responsible for discharge planning? a. The registered occupational therapist b. The COTA c. The parent or caregiver d. The client

ANS: A In pediatric OT practice, discharge planning or discontinuation of intervention may be mandated by laws that govern the type of system in which the child receives OT services. Regardless of the system, the discontinuation process is the responsibility of the occupational therapist. The OTA collaborates in the discontinuation process under the supervision of the occupational therapist by reporting on the child's progress and making suggestions regarding future needs.

Which task represents an informal educational activity? a. Playing school in the backyard. b. Making one's bed. c. Selling lemonade to friends. d. Going to preschool.

ANS: A Informal educational activities are less structured and occur in a variety of settings. Examples of activities in which younger children engage include playing school with an older sibling and playing a shopping game with peers.

Which statement best describes legitimate tools of OT practice? a. Instruments or tools that a profession uses to bring about change. b. Tools that remain constant over time. c. Tools commonly found in an OT clinic. d. Instruments commonly used to evaluate clients.

ANS: A Legitimate tools are the instruments or tools that a profession uses to bring about change. Legitimate tools change over time based on the growing knowledge of the profession, technological advances, and the needs and values of both the profession and society. OT practitioners use occupations, purposeful activities, activity analysis, activity synthesis, and therapeutic use of self as tools to help children in their care.

Which type of play is demonstrated when an infant feels his toes and puts them in his mouth? a. Sensorimotor b. Symbolic c. Games with rules d. Constructive

ANS: A Sensorimotor play involves the following: child has good head control (centered and upright); brings hands to mouth constantly; supports on extended arms and props on forearms in prone position; and brings hand to feet and feet to mouth in supine position.

Which set of terms best describes the readiness skills required for setting the table? a. Sequencing, balance, dexterity, and strength. b. Money management, balance, and timing. c. Communication, promptness, and appropriate dress. d. Endurance, communication, money management, and writing.

ANS: A Setting the dinner table requires sequencing, balance, and dexterity while carrying and placing plates and silverware.

Which frame of reference views the child in terms of volition, habits and roles, performance, and environment? a. Model of Human Occupation (MOHO) b. Intentional Relationship Model c. Person—Environment—Occupation d. Biomechanical

ANS: A The OT practitioner uses MOHO to guide clinical reasoning. MOHO views clients in terms of volition, habits and roles (habituation), performance capacity and considers the environment.

Which frame of reference targets the child's range of motion, strength, and endurance for occupations? a. Biomechanical b. Developmental c. Motor control d. Sensory integration

ANS: A The goals of the biomechanical approach are to (a) assess physical limitations on the client's ranges of motion (ROM), muscle strength, and endurance; (b) improve ROM, strength, and endurance; and (c) prevent or reduce contracture and deformities. This approach focuses on the physical limitations that interfere with the client's ability to engage in the occupational performance areas of activities of daily living (ADLs), instrumental ADLs, sleep and rest, play and leisure activities, and work and productive activities.

Which behavior is not observed in 4-month-old infants? a. Exhibiting the rooting reflex. b. Sucking liquid from a bottle. c. Using phasic up/down jaw movements when given solid food. d. Finger feeding.

ANS: A The infant's first suckling pattern predominates for the first 3-4 months of life. Beginning at 4 months, a "true sucking" pattern—an up-and-down tongue movement—develops as head and jaw stability appears. Rooting reflex is present at birth.

For what may the Certified Occupational Therapy Assistant (COTA) be responsible? a. Administering specific assessments to clients selected by the registered occupational therapist. b. Developing the intervention plan. c. Interpreting assessment findings. d. Selecting assessment tools that are used during the evaluation.

ANS: A The roles of the occupational therapist and occupational therapy assistant (OTA) in the occupational therapy (OT) process differ. The occupational therapist is responsible for the selection of assessments used during evaluation, interpretation of results, and development of the intervention plan. The OTA may gather evaluative data under the supervision of the occupational therapist using an approved structured format but is not responsible for the interpretation of assessment results; he or she may contribute to the process by sharing knowledge of the client gained during the assessment process.

To what does the term intervention refer? a. Therapy sessions to facilitate goals. b. Progress reports, billing records, and client profile. c. The evaluation, treatment plan, intervention, and discharge plan. d. The plan of care.

ANS: A Treatment implementation (intervention) involves working within the system through which the child is receiving therapy, working with the family, and working directly with the child. Working with the child involves planning each session, developing and analyzing activities, and then grading and adapting those activities as necessary. This process is geared toward reaching the short-term objectives first and then the long-term goals. Intervention includes the methods used to work toward meeting the goals, the media or activities used during the intervention, and documentation of the child's progress or lack of progress.

What is generally true of the photographs of adolescents in teen magazines, television, and media? a. Adolescents are generally shown as overweight. b. Media do not show a diversity of types. c. Media present a realistic body type. d. Media present an ethnic variety.

ANS: B Adolescents compare their bodies and appearances with "ideal masculine and feminine" images. This social comparison is a significant dimension of body image perception and attitude toward one's body. It is pervasive in the media and manipulated by marketing (e.g., advertisements, teen magazines, TV shows, music videos, and the fashion industry). These images bear little relationship to the ethnic or physical appearance of the diverse population of American teens or their lifestyles. Therefore, it is not surprising that many adolescents struggle with their physical images and are critical of their bodies.

Which group of readiness skills describes what is expected for a child entering elementary school? a. Sitting quietly while listening to a story, coloring and manipulating small objects, running, hopping, and jumping. b. Independence in the bathroom and cafeteria, remaining in the classroom for extended periods, and remaining "on task." c. Social skills and manners; increased skill in creative thinking, problem solving, and expressive writing. d. Independent learning skills and communication of ideas through writing.

ANS: B Children attending elementary school are expected to have greater independence and skill in occupations than younger children. Independence in the bathroom and cafeteria is necessary. In addition to independence in eating, children in elementary school are expected to carry their lunch trays and assist in cleaning the table at the end of a meal. They must remain in their classroom chairs for extended periods. The ability to remain "on task" and attend to work while seated is termed in-seat behavior.

Carrie is 5 years old and unable to dress herself. Her mother must put on her clothes completely, although Carrie is able to select the clothing by nodding to make a choice. What type of performance is this? a. Assisted performance b. Dependent performance c. Functional independence d. Supervised performance

ANS: B Dependent performance occurs when a child is unable to perform an age-appropriate task. A caregiver is required to perform the task for the child (e.g., holding a cup for a child with cerebral palsy).

What type of approach begins by defining goals based upon the valued activities of the client? a. Biomechanical approach b. Occupational Therapy Intervention Process Model (OTIPM) c. Occupational Therapy Practice Framework (OTPF) d. Developmental approach

ANS: B Fisher proposed a model for OT evaluation and intervention using a client-centered, occupation-based, top-down approach called the Occupational Therapy Intervention Process Model (OTIPM).

Sixteen-year-old Harry has little interest in exploring his career or academic options. He only wants to hang out with his friends. What term most closely describes this? a. Identity achievement b. Identity diffusion c. Identity formation d. Moratorium

ANS: B Identity diffusion, common in early adolescence, is the least defined sense of personal identity. In this identity state, an adolescent avoids or ignores the task of exploring his or her identity and has little interest in exploring options. These adolescents have yet to make a commitment to choices, interests, or values. The question "who am I" is not a significant issue. They tend to avoid or have difficulties meeting the day-to-day demands of life, such as completing schoolwork or participating in sports or extracurricular activities.

Which OT theorist provided the profession a format to obtain play information during an interview? a. Reilly b. Takata c. Bundy d. Knox

ANS: B Occupational therapist Nancy Takata developed Play History, a format that helps OT practitioners obtain information about a child's play. The interview format helps describe a child's play skills.

What type of social play is demonstrated when a child plays next to another child in the sandbox without interacting? a. Solitary b. Parallel c. Competitive d. Group play

ANS: B Parham identified the social aspects of play as progressing from solitary to parallel to group play.

Which scale provides a measurement of the child's approach or attitude toward play? a. Preschool Play Scale b. Test of Playfulness c. Takata Play History d. Reilly's stages

ANS: B Professor and occupational therapist Anita Bundy designed the Test of Playfulness to objectively measure playfulness. Bundy found that a child's attitude about and approach to activities (i.e., playfulness) provide valuable information to occupational therapy (OT) practitioners

Which of the following statements is not true about short-term objectives? a. They are all the things the client needs to be able to do to meet long-term goals. b. They are the statements that describe the terminal functional skills the clients should achieve after intervention. c. They are interim steps that are used to reach long-term goals. d. They describe skills that should be mastered in a relatively short time period.

ANS: B Short-term goals are the steps the client needs to achieve in order to meet the long-term goals. They are statements that describe the skills that should be mastered in a relatively short period.

Which statement refers to self-efficacy? a. View of one's body. b. View of one's physical performance. c. View of one's strengths and weaknesses. d. View of how others see one.

ANS: B Successful participation in these popular age-related groups can transfer beyond the context of therapy by building self-efficacy and autonomy. Identifying and developing performance skills enhance self-efficacy and self-esteem, which, in turn, promotes a positive sense of self.

Which frame of reference is described when the practitioner identifies the level of motor skill a child is achieving and works to help the child accomplish the next step in the sequence? a. Biomechanical b. Developmental c. Motor control d. Sensory integration

ANS: B The developmental frame of reference is used to facilitate the child's ability to perform age-appropriate tasks in the areas of self-care, play/leisure, education, and social participation. The developmental frame of reference targets intervention at the level at which the child is currently functioning and requires that the practitioner provide a slightly advanced challenge. Practitioners using the developmental frame of reference need a clear understanding of the logical progression of skills.

Which statement refers to therapeutic use of self? a. The practitioner's ability to work with a variety of clients. b. The practitioner's ability to be aware of his/her own feelings and use this awareness to skillfully communicate with both the client and the client's family. c. The practitioner's ability to interact with the client. d. The practitioner's ability to develop an appropriate intervention plan for the client.

ANS: B Therapeutic use of self is the ability of the OT practitioner to communicate with the child and the child's family or caregivers while being aware of his or her own personal feelings. OT practitioners use their individual characteristics to relate to families, interact with children, and help children perform occupations. As such, OT practitioners who are aware of their own strengths and weaknesses have insight into how one's use of self influences intervention, so they may help children and their families more effectively.

For adolescents, which phase of psychosocial development is the most intense period of development, during which peers replace parents as the primary influence and conformity with peer groups is desirable? a. Early adolescence b. Middle adolescence c. Late adolescence d. Early adulthood

ANS: B There is a continuation of movement toward psychological and social independence from parents. There is also an increased involvement in peer group culture, displayed in adopting peer value systems, codes of behavior, and styles of dress and appearance and demonstrating individualism and separation from family in an overt way.

At what age is toileting training for daytime bladder control typically completed? a. 18-24 months b. 24 months c. 30-36 months d. 48 months

ANS: C Daytime bowel and bladder control is usually attained between 2 and 3 years of age, although the child may still need assistance with difficult clothing or fasteners.

Which group of readiness skills describes what is expected in middle childhood and adolescence? a. Sitting quietly while listening to a story, coloring and manipulating small objects, running, hopping, and jumping. b. Independence in the bathroom and cafeteria, remaining in the classroom for extended periods, and remaining "on task." c. Social skills and manners; increased skill in creative thinking, problem solving, and expressive writing. d. Independent learning skills and communication of ideas through writing.

ANS: C Educational readiness skills for middle childhood and adolescence build on the competencies gained during the preceding periods. Appropriate social skills and manners are expected, and increased skill in creative thinking, problem solving, and the development of ideas is required. Children learn expressive writing during this period and must be ready to perform cognitively and motorically. During middle childhood, children and adolescents also begin to seek independence. They question authority figures but must learn to work with them effectively in educational settings.

Which statement best describes purposeful activity? a. A person involved in purposeful activities is more concerned with the process required to complete the activities. b. Purposeful activities are prescribed based on analysis of their inherent characteristics. c. Purposeful activity requires active participation from the client. d. Purposeful activities are deemed by the OT practitioner to be critically important to skill development.

ANS: C Purposeful activities are defined as goal-directed behaviors or tasks that constitute occupations. An activity is purposeful if the individual is a voluntary, active participant and the activity is directed toward a goal that the individual considers meaningful. OT practitioners use purposeful activities to evaluate, facilitate, restore, or maintain individuals' abilities to function in their daily occupations.

Which fact is not true concerning American teenagers? a. Eighteen percent of adolescents are overweight. b. Depression is a significant health concern. c. Seventy-five percent of teens report using marijuana. d. Alcohol is the most widely used drug by adolescents.

ANS: C See Quick Facts: American Teenagers P.115 Box 9-1

Which statement best represents a top-down approach toward intervention? a. Haley will bring both hands together during play. b. Haley will pick up a Cheerio with a neat pincer grasp. c. Haley will play with a variety of toys using two hands. d. Haley will stack four cubes using both hands.

ANS: C Since OT practitioners are interested in helping children engage in their occupations, evaluations and interventions focusing on occupations are recommended. The focus of this evaluation and intervention plan is on the child's occupations. Later in the process, the OT practitioner determines the client factors or components that are interfering with performance. However, goals for intervention can be developed on the basis of overall performance. OT practitioners are encouraged to address the concerns of parents, caregivers, and teachers when designing an intervention that focuses on occupational performance.

Which statement reflects social participation in adolescents? a. Adolescents avoid cliques and enjoy solitary activities. b. Adolescents value parents and authority figures more than peers. c. Sense of belonging, acceptance, and friends play a significant role in development. d. Teen friendships involve superficial sharing and are not meaningful.

ANS: C Social integration, a sense of belonging, acceptance, and friendships, all play a significant role in an adolescent's emotional adjustment. By engaging in a spectrum of social activities, adolescents explore and develop social roles and relationships.

Which age range most closely represents adolescence? a. 3-5 years b. 6-12 years c. 12-18 years d. 18-22 years

ANS: C The term adolescence defines the psychosocial development that occurs during puberty. However, there is little agreement about the ages at which adolescence begins and ends. This chapter uses the most commonly agreed-upon period of adolescence, 10-19 years.

Gerry is a 14-year-old boy who regularly breaks rules and has pierced his nose, but he holds a steady job after school. Which statement reflects this behavior? a. Antisocial behavior b. Atypical behavior c. Destructive behavior d. Typical, contradictory behavior

ANS: D Adjusting to these physical changes and developing a healthy body image contribute to a positive self-concept. This is a process of self-evaluation related to other abilities and competencies in physical activities (e.g., competitive sports). It also involves experimenting with changing one's physical appearance to express individuality. This can be simple and temporary, such as dying or cutting one's hair, or a more permanent statement such as body piercing and tattoos.

What is the occupational therapy (OT) practitioner's role in working with adolescents with disabilities? a. None, because OT practitioners work only with younger children. b. They help the adolescent achieve in school. c. They work on writing and motor skills as they interfere with school only. d. They facilitate the teen's transition to young adulthood.

ANS: D Adolescents with disabilities do not always have opportunities to make choices about their appearance and to experiment with change as part of their adolescence experience. Exploring self and body image is more difficult for them, since these adolescents may depend on others for their self care, may not have their own money, and often lack independence in community mobility. Maintaining their child-like status, rather than adjusting to the emotional and psychological changes and demands of adolescence, may be more comfortable for their parents. Within the framework of therapy, OT practitioners can facilitate experimentation and also support parents in their attempts to encourage typical adolescent activities (such as the transition to adulthood).

What can be expected of a 4-year-old? a. Ability to put on clothing; generally knowing the right and wrong side. b. Ability to tie his or her shoes. c. Ability to zip pants and buckle belts. d. Both A and C. e. All of the above.

ANS: D By 4 years old, children recognize correct and incorrect sides; as fine motor skills progress, they can also use buckles, zippers, and laces.

Which type of play is demonstrated when an adolescent makes a model airplane? a. Sensorimotor b. Symbolic c. Games with rules d. Constructive

ANS: D In doing so, they divided play into the categories of functional (sensorimotor), constructive (manipulative), dramatic ("pretend"), and formal (rule governed). Sensorimotor play involves gross motor movements and sensation (running, jumping, rolling). Constructive play involves making things and putting things together (e.g. model airplane, craft projects, building with blocks). Pretend play involves using one's imagination (e.g., dress up, make believe play) and formal play is games with rules (play board games).

Which of the following statements is true about long-term goals? a. They do not need to be behavioral. b. They need to be measurable but not behavioral. c. They are the building blocks for OT intervention. d. They are the expected outcomes of OT intervention.

ANS: D Long-term goals are statements that describe the occupational goals the client should achieve after intervention. These goals should be measurable, observable, clear, and written in behavioral terms. Goals need to be very specific and address the problems that have been identified.

Which sequence describes the progression of play according to Reilly? a. Competency, achievement, exploratory b. Achievement, competency, exploratory c. Exploratory, achievement, competency d. Exploratory, competency, achievement

ANS: D Mary Reilly, a noted occupational therapist and researcher, described play as a progression through three stages: (a) exploratory behaviors, (b) competency, and (c) achievement.

Fifteen-year-old Bill is anxious about future goals and career choices. He is not sure whether to pursue a job or enroll in college. He has many interests, but he does not want to do "what his parents want," although he is not exactly sure what he wants. What term most closely describes this? a. Identity achievement b. Identity diffusion c. Identity formation d. Moratorium

ANS: D Moratorium in early and middle adolescence is emotionally healthy. It can continue into late adolescence, particularly for college students. Adolescents in this state openly explore alternatives, strive for autonomy, try out different interests, and pursue a sense of individuality. Adolescents experiencing a prolonged state of identity moratorium are likely to be undecided about the major course of study and their goals for the future and to still be actively exploring options. When the uncertainty of the moratorium state continues for too long, it is associated with anxiety, self-consciousness, impulsiveness, and depression.

Which statement does not describe play? a. Method to release surplus energy b. Attitude or mood c. Method to practice survival d. Extrinsically motivated activity

ANS: D Play has been viewed as (a) a method to release surplus energy, (b) a link in the evolutionary change from animal to human being (recapitulation theory), (c) a method to practice survival skills, and (d) an attitude or mood

Which strategy is not suggested when working with adolescents with cognitive impairments? a. Give specific feedback with concrete examples. b. Be consistent and use repetition. c. Select activities that match the teen's abilities. d. Present multiple instructions at a time.

ANS: D See Box 9-3

Which statement(s) best reflects the cognitive development of adolescents? a. Thinking becomes abstract, creative, and complex. b. Adolescents have difficulty with problem solving. c. Adolescents learn the consequences of their actions. d. Both A and C are correct. e. All of the above are correct.

ANS: D Their ability to think becomes more creative, complex, and efficient (speed and adeptness). It is more thorough, organized, and systematic than it was in late childhood. Adolescents' ability to problem-solve and reason becomes increasingly sophisticated, and they develop the capacity to think abstractly (i.e., they do not require concrete examples). Initially, they are less likely to apply this more sophisticated thinking to new situations

Which readiness skill(s) do children entering preschool programs need? a. Toileting b. Self-feeding c. Cooperative play d. Both A and C e. All of the above

ANS: E Children entering preschool programs need certain readiness skills, which include independence in toileting with a minimum of assistance for handling fasteners, independence in self-feeding, and cooperative play behavior. Children attending a preschool program are also expected to understand rules and schedules. They need to exhibit the beginning of behavioral and emotional maturity (i.e., controlling tempers and mood swings).

What factor(s) influences a child's participation in home management activities? a. Age b. Social environment c. Culture d. Both A and C e. All of the above

ANS: E Home management activities are tasks that are necessary to obtain and maintain one's personal and household possessions. The context significantly influences a child's or adolescent's participation in home management tasks. Children's ages and their physical, social, and cultural environments determine their roles in this domain. Children and adolescents may have chores that they are expected to complete on a regular schedule. Examples of chores include making the bed, setting the dinner table, and cutting the grass. Some children and adolescents have the incentive of a monetary allowance to complete the assigned chores, whereas others do not have a monetary incentive but are still expected to assist in the maintenance of their households