OTA 140 Peds Quizzes

What term describes examining the features, characteristics, and qualities of activities? A. Activity analysis B. Occupational analysis C. Role history D. Task analysis

A. Activity analysis Activity and occupational demand refers to the objects and their properties, space demands, social demands, sequence and timing, required actions and skills, and required underlying body functions and body structures. Analysis of activity demands helps the OT practitioner select appropriate activities and media.

When training families and caregivers on feeding techniques, what does the OTA practitioner need to take into consideration? A. All answers are correct B. Family routines and systems C. Medical assessments and precautions D. The child's positioning during mealtime

A. All answers are correct

Which statement shows the responsibility of the certified occupational therapy assistant during the splint fabrication process? A. All are correct. B. Instructing parents, teachers, and others involved in donning and doffing the orthosis C. Teaching the child how to properly don or doff the orthosis D. Writing down the sequence of when to don or doff the orthosis

A. All are correct. The certified OT assistant (COTA) may contribute to the evaluation process and assist in fabricating the orthosis or may fabricate the orthosis, depending on his or her skill level, setting of care, and reimbursement/funding sources. Medicare does not permit OTAs to fabricate orthoses independently.

You are trying to increase the social skills of a group of adolescents. Which adaptations to a sponge-painting activity would best meet this goal? A. Allow them to work in groups of three. B. Limit talking and encourage independent work. C. Provide them with simple directions and a time limit. D. Seat them in desks positioned in a row.

A. Allow them to work in groups of three. Working in groups promotes social skills.

You receive an evaluation report on a child with a developmental disability with feeding concerns. The OTR notes that the child presents with tongue thrust. Which description BEST describes this child's presentation? A. An exaggerated, uncontrolled pushing of food or liquid out of the mouth B. Low tone in the tongue C. An open mouth posture in which the tongue passively hangs out of the oral cavity D. Tongue movement to the sides of the mouth

A. An exaggerated, uncontrolled pushing of food or liquid out of the mouth Tongue thrust is characterized as an exaggerated, uncontrolled pushing of food or liquid out of the mouth. An open mouth posture in which the tongue passively hangs out of the oral cavity is tongue protrusion. Low tone in the tongue is tongue hypotonia. Tongue movement to the sides of the mouth is tongue lateralization.

What is the role of animals in OT practice? A. Animals may help clients reach their goals. B. Animals should not be allowed in the clinic. C. Pet care is considered a social work goal. D. OT practitioners must be trained to care for animals.

A. Animals may help clients reach their goals. Animals allow OT practitioners to address a variety of therapeutic goals. Therapy animals can help children engage with peers, develop self-esteem, and help a child have fun. They can help children work on a variety of goals.

What type of practice includes having a child placing coins in a slot, resting briefly, and repeating the same activity again? A. Blocked B. Distributed C. Transfer of learning D. Variable

A. Blocked An example of blocked practice includes having a child put pegs in a pegboard or placing coins in a slot, resting briefly, and then doing the same activity again.

Which progression most closely reflects typical development? A. Catching a large ball using both hands and body before catching with one hand away from body. B. Skipping before hopping on both feet together. C. Picking up small pieces of cereal with the tips of the fingers before grabbing with the whole hand. D. Sitting before rolling over.

A. Catching a large ball using both hands and body before catching with one hand away from body. Motor development follows three basic rules. Development progresses cephalad to caudal, or head to tail. Development progresses in a proximal to distal direction, which means that children develop control of structures close to their body (such as the shoulder) before they develop those farther away from their body (such as the hand). Development progresses from gross control to fine control, which means that children gain control of large body movements before they can perform more refined movements.

What is thought to be the cause of SI dysfunction? A. Central nervous system (CNS) processing dysfunction B. Genetic abnormality C. Blindness or deafness D. Traumatic brain injury

A. Central nervous system (CNS) processing dysfunction Children who have sensory integrative dysfunction have a cluster of symptoms that are believed to reflect dysfunction in CNS processing of sensory input, rather than a primary sensory deficit such as hearing or visual impairment.

Harry is a 10-year-old boy who is expected to make dinner each evening before his parents get home. This expectation represents which context? A. Cultural B. Personal C. Social D. Temporal

A. Cultural Cultural context includes customs, beliefs/values, standards, and expectations.

What can an OT practitioner do to encourage sleep and rest patterns in children? A. Design a sensory diet. B. Dictate a sleep schedule. C. Nothing can be done; this is not an OT issue. D. Prescribe herbal supplements.

A. Design a sensory diet. Sensory diets may be helpful in regulating a child's sleep-wake cycle.

Which pencil grip is considered the most mature? A. Dynamic tripod B. Static tripod C. Palmar grasp D. Crossed-thumb grasp

A. Dynamic tripod The most mature grasps are the dynamic tripod and lateral tripod grasps.

What would be the first step when working with a 6-year-old child with poor coordination and timing for handwriting? A. Games involving running and moving B. Using fingers to grasp object C. Scooping, using thumb and index finger D. Picking up object, using tip of index finger and thumb

A. Games involving running and moving Coordination and timing deficits may be addressed by beginning with gross movements and progressing to more precise movements. OT practitioners focus coordination intervention by starting with postural control or stability. This may be achieved through intervention or positioning or adaptive equipment. The practitioner provides the child with opportunities to practice coordination by designing activities that require the child to repeat motions and progressively become more accurate. For example, the practitioner may begin by providing a large target area and gradually lessen the target area (to facilitate more precision). Timing may be promoted by including music, rhythmic songs, or counting activities into the intervention sessions.

From where would someone seek AT funding for an 8-year-old to perform successfully in school? A. Individuals with Disabilities Act (IDEA) B. Medicare C. Vocational rehabilitation program D. Birth to three program

A. Individuals with Disabilities Act (IDEA) In 1975, Congress enacted a major piece of legislation, also patterned after civil rights law, this time protecting the rights of children with disabilities. The Education for All Handicapped Children Act, P.L. 94-142, later became known as the Individuals with Disabilities Act, or IDEA. In this legislation, handicapped children were acknowledged as people with "certain inalienable rights."

What are the benefits of keyboarding? A. It improves legibility and reduces spelling errors. B. It requires less memorization and little bilateral coordination. C. It strengthens upper extremity strength and timing. D. It reduces eye strain and improves visual skills.

A. It improves legibility and reduces spelling errors. The keyboard would improve legibility and reduce spelling errors in written assignments. Most school districts have computer keyboarding skills included in their curriculum; OT practitioners should review what is recommended.

Which approach gathers information about the child's goals, priorities, occupational choices and interests, habits and routines, performance, and environment? A. Model of Human Occupation (MOHO) B. Biomechanical approach C. Developmental approach D. Occupational Therapy Practice Framework (OTPF)

A. Model of Human Occupation (MOHO) Kielhofner's Model of Human Occupation (MOHO) gathers information about volitions (e.g., the child's or parents' goals and priorities or occupational choices), habituation or routines (e.g., how the child spends the day), performance (e.g., the child's physical skills and abilities), and environment (e.g., the physical layout of the home).

A child with limited neck extension is working on drinking out of a cup. What type of feeding equipment would be MOST appropriate to introduce to this client? A. Nose cutout cup B. Dysphagia cup C. Spouted sippy cup D. Drinking cup with handles

A. Nose cutout cup

A toddler diagnosed with developmental delays does not finger-feed when presented with food in the clinic. The BEST way to obtain further information about his feeding skills is to: A. Observe him in his home during feeding time B. Interview his parents to determine favorite foods C. Review his chart for food allergies D. Repeat the observation in a quiet area to minimize distractions

A. Observe him in his home during feeding time

The Model of Human Occupation (MOHO) uses what term to define the common and typical way of doing specific occupations? A. Occupational forms B. Performance capacity C. Habituation D. Roles

A. Occupational forms Occupational forms, or tasks, are these conventional sequences of actions that are oriented to a specific purpose and understood by and recognizable to members of a shared culture.

Raysor has difficulty writing. He hesitates when trying to continuously form letters. He does not understand where to begin writing on his paper. He sometimes begins at the bottom of the letter and sometimes at the top, despite frequent repetitions of the letter. What type of problem does Raysor show? A. Poor motor planning B. Poor visual acuity C. Poor midline crossing D. Tactile defensiveness

A. Poor motor planning Children with poor organizational skills may use letters of varying sizes and wrongly mix uppercase (capital) and lowercase (small) letters in words. Some organizational problems are related to poor visual processing, while others are related to poor motor planning or attention. Children with poor handwriting skills may have deficits in motor planning (i.e., figuring out how to move their bodies and then actually doing it) or motor memory (i.e., remembering the motor patterns and being able to repeat them).

What role is the OT practitioner using when he or she provides the family with a schedule for wearing a splint? A. Prescriptive B. Consultative C. Adaptive D. Resourceful

A. Prescriptive When working directly with the child, the OT practitioner functions primarily in the prescriptive and directive role; when working with the family, he or she functions primarily in the consultative role. The prescriptive role involves instructing clients or providing advice for the client to follow.

Which statement describes the principles of sensory integration intervention? A. Provide controlled sensory input to elicit an adaptive response. B. Desensitize the child so she or he can tolerate input. C. Provide fun and exciting activities to promote playfulness. D. Practice motor movements to repeat patterns.

A. Provide controlled sensory input to elicit an adaptive response. The central principle of this intervention approach is the provision of controlled sensory input, through activities presented by the therapist, to elicit adaptive responses from the child, thereby bringing about more efficient brain organization.

What are special services such as occupational therapy (OT), physical therapy (PT), speech therapy (ST), school health, and social work required for a child to benefit from a special education program called? A. Related services B. Resource room services C. Self-contained services D. Special education services

A. Related services According to the Education of the Handicapped Act (EHA), schools are required to provide related services as necessary for the student to benefit from the educational program. These services include transportation, PT, OT, ST, assistive technology services, psychological services, school health services, social work services, and parent counseling and training.

The occupational therapy (OT) practitioner decides to help Molly feed herself by working on strengthening Molly's upper extremity functioning. What type of approach is this? A. Remediation B. Adaptation C. Compensatory D. Strength based

A. Remediation Remediation techniques include upper extremity therapeutic exercises (range of motion and strengthening) and therapeutic activities to increase active participation and independence.

During a sensory integration session, Ryan, a 10-year-old boy, while swinging, suddenly becomes quiet and pale and disengages from interacting with the therapist. What do these behaviors suggest? A. Ryan is showing signs of sensory shutdown behaviors. B. Ryan needs more sensory stimulation. C. Ryan is processing vestibular input accurately. D. Ryan has attention deficit disorder.

A. Ryan is showing signs of sensory shutdown behaviors. While engaging in the activities, introduce changes in the sequence and other components of the activity to detect signs of sensory overload or shutdown behaviors such as purposeless running around, losing track of the end goal of an activity, a glassy-eyed expression, or simply suddenly becoming quiet, retreating to a corner, or even seemingly falling asleep. Introducing the changes can result in sustained interest and maintained vigilance, thereby influencing attention and purposeful interaction with the environment.

Which statement is not a guideline for applying the concept of transfer of learning? A. There is no benefit to practicing the skill in real-life situations. B. Skills need to be presented in a logical progression. C. Foundational skills should be practiced before complex skills. D. Similar skills are more likely to transfer.

A. There is no benefit to practicing the skill in real-life situations. Practicing skills in real-life situations reinforces the child's ability to perform activities more naturally, effectively, and automatically in his or her natural context and promotes transfer of learning to a variety of environments. The best ways to ensure transfer of learning include allowing the child to practice the actual task in natural context; perform a variety of skills with random or variable rest periods.

According to Kielhofner, what is one way to target childhood obesity? A. Through volition—engage children in activities they will sustain over time. B. Change the environment so that children are not allowed sweets or fats. C. Through habits—engage children in 2 hours of physical training each day. D. Through performance—encourage children to work out more intensely each day.

A. Through volition—engage children in activities they will sustain over time. Kielhofner suggested that engaging children in volitionally oriented activities helps them sustain activity over time, which makes a difference in their overall health.

A child's pattern and organization around different occupations is called A. habituation. B. performance capacity. C. volition. D. environmental factors.

A. habituation. Habituation is the internalized readiness to engage in consistent patterns of behavior during certain times of day and days of the week, as determined by one's habits and roles. Habits and roles help children organize their lives and make participation in everyday occupations easier.

Georgette had difficulty holding a spoon, so you build up the handle. What term describes providing her the spoon with a built-up handle for the cooking activity? A. Activity analysis B. Adapting the activity C. Grading the activity D. Occupation

B. Adapting the activity Adapting refers to changing how the activity is performed.

Which statement best reflects the role of the OT practitioner in working in the NICU? A. Assist nursing in medical care of infant and record weights. B. Address positioning for function, range of motion, and age-related motor and sensory development. C. Collaborate with parents on care of infant upon discharge. D. Provide lactation consultation as needed.

B. Address positioning for function, range of motion, and age-related motor and sensory development. OT practitioners may address positioning for function, range of motion, and age-related motor and sensory development. They may make recommendations regarding the environment for high-risk infants, promote positive oral experiences for feeding, and provide ongoing parent education and support related to infant behavior and development. The occupational therapist may address the infant's feeding and swallowing concerns and provide support for breastfeeding. They also work with family members to help them adjust to their new parenting roles.

Why do occupational therapy practitioners use positioning and handling techniques for children with cerebral palsy? A. Facilitate performance of activities of daily living. B. All are correct. C. Maintain postural alignment. D. Facilitate improved movement patterns.

B. All are correct. Positioning and handling methods are especially important for the child with cerebral palsy who is unable to move independently. These methods also help the child work toward the achievement of performance-area goals such as increased independence in dressing, feeding, playing, and doing schoolwork. Practitioners can also select and recommend specific types of positioning equipment, such as chairs, supine or prone standers, and side-lyers, which support the child during functional activities with the best possible postural alignment, control, and stability. Handling techniques such as slow rocking, slow stroking, imposed rotational movement patterns, and bouncing are used to enhance the child's muscle tone, activity level, and ability for independent movement.

What does the age at which children develop independent self-care skills depend on? A. The child's motivation to be independent B. All are correct. C. Family's cultural expectations D. Opportunities for practice

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

Which frame of reference targets the child's range of motion, strength, and endurance for occupations? A. Sensory integration B. Biomechanical C. Motor control D. Developmental

B. Biomechanical 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.

A child who shows difficulty controlling the speed and accuracy of his or her movements and shows inaccurate reach and grasp is showing difficulty with what area of the brain? A. Cerebrum B. Cerebellum C. Brainstem D. Peripheral nervous system

B. Cerebellum When the motor cortex initiates a movement, for example, to pick up a pencil and write one's name in a small box on a form, the cerebellum plays a critical role in the successful execution of this task. It helps some motor units to relax while others contract, making the movement smooth. The cerebellum helps control the speed of the movement and makes adjustments so one can write in the correct space with the correct size print for the space. It monitors the position of the body and therefore plays a huge role in keeping one balanced in the position or postures needed for walking, running, sitting, etc. It also has an important role in learning the complex sequences necessary for completing a motor task, and it is especially critical when the motor task requires speed and dexterity.

Tim, a Certified Occupational Therapy Assistant (COTA), is working to promote Kevin's poor grip strength and postural control. Kevin is unable to stand for extended periods. What aspects is Tim targeting? A. Activity demands B. Client factors C. Context D. Performance patterns

B. Client factors The COTA analyzes activities in terms of client factors to design interventions to meet the client's goals. Client factors refer to values, beliefs, and spirituality; body functions; and body structures. Strength and postural control are considered body functions.

What is the term for the degree of contractility and elasticity in muscle tissue? A. Cocontraction B. Coactivation C. Muscle tone D. Resistance

B. Coactivation The qualities of contractility and elasticity are necessary for the muscle's accurate response to changes in stimuli experienced during movement, an event referred to as coactivation. Muscle tone allows muscles to adapt readily to changing sensory stimuli during functional activities.

Jeannie, the Certified Occupational Therapy Assistant (COTA), is responsible for planning and implementing an after-school exercise program for children in the second and third grades. In which of the following systems is Jeannie working? A. Family B. Community C. Educational D. Medical

B. Community Treatment involves defining the community and working with the community in a variety of ways to support the client and enhance occupational functioning.

What type of role is the OT practitioner using when developing a schedule for wearing a splint that incorporates the natural family routines? A. Prescriptive B. Consultative C. Adaptive D. Resourceful

B. Consultative Consulting with the family on the possibility of achieving the desired goals for the child and for the family builds collaboration and trust, which are key ingredients for intervention success with families.

A therapist planned a Christmas activity but later found out that her clients did not celebrate Christmas. This shows the importance of examining which aspect of environment when planning activities? A. Temporal B. Cultural C. Social D. Physical

B. Cultural Cultural context includes customs, beliefs, activity patterns, behavior standards, and expectations accepted by the society of which the individual is a member. For example, religious beliefs and customs.

What region has the primary function of increasing the surface area for the neuron? A. Axon B. Dendrite C. Cell body D. Golgi

B. Dendrite The three regions of the neuron include the cell body (soma), dendrites, and an axon. The soma contains the nucleus and the organelles and has large attachments that branch repeatedly from it, known as the dendrites. The principle function of the dendrites is to increase the surface area for the neuron to receive most of its synaptic connections.

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. Functional independence B. Dependent performance C. Assisted performance D. Supervised performance

B. Dependent performance 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).

The occupational therapy (OT) practitioner provided Trey with a variety of drawing activities that were fun and promoted hand skill. These activities were slightly challenging for Trey, based on his current level of functioning. What frame of reference was the practitioner using? A. Biomechanical B. Developmental C. Educational D. Sensory

B. Developmental Development occurs through the learning, experiencing, and acquisition of the skills. The rate of development and the progression of skills vary in children but usually follow sequential patterns.

The occupational therapy (OT) practitioner provided Trey with a variety of drawing activities that were fun and promoted hand skill. These activities were slightly challenging for Trey, based on his current level of functioning. What frame of reference was the practitioner using? A. Sensory B. Developmental C. Biomechanical D. Educational

B. Developmental Development occurs through the learning, experiencing, and acquisition of the skills. The rate of development and the progression of skills vary in children but usually follow sequential patterns.

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. Motor control B. Developmental C. Sensory integration D. Biomechanical

B. Developmental 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.

What component is not essential for the acquisition of motor skills? A. Inborn reflexive movement patterns B. Following an exact sequence of motor skills C. Opportunities to practice and repeat movements D. Feedback regarding the effectiveness of our actions

B. Following an exact sequence of motor skills According to the systems approach, feedforward actions require that posture be highly variable and subject to being affected by all the factors motivating the person to choose to catch the balls. No one right way to execute movement exists; rather, movement is strongly influenced by many variables. According to this approach, in contrast to reflex-hierarchical models, motor development follows a step-like progression, starting with primitive reflexes and progressing to voluntary movement control through the higher brain centers. The research of systems theorists has shown that motor activity is most often initiated by the interaction of sensory, perceptual, environmental, and other factors leading to task-focused, goal-directed movement. One other concept from systems model research has important therapeutic implications for the treatment of children with cerebral palsy or other neurologic disorders. Postural control and movement are at their greatest levels of efficiency, flexibility, and adaptability after randomized practice and repetition. Infants attempt to roll, crawl, stand, and walk over several hundred attempts with varied success and failure. Each attempt provides necessary feedback that will feedforward to more skilled motor responses and the eventual mastery of the motor skill.

Kayla, a 7-year-old first grader, is having trouble in school because her teacher says she does not try to write well. The Certified Occupational Therapy Assistant (COTA) observed that Kayla had trouble with letter identification, especially when the letters were smaller than those on her desk. What type of visual perceptual skill does this describe? A. Figure ground B. Form constancy C. Visual closure D. Visual memory

B. Form constancy Form constancy: The ability to realize and recognize that forms, letters, and numbers are the same or are constant whether they are moved, turned, or changed to a different size. This means that a square is always a square no matter what size or color.

What would be the first step when working with a 6-year-old child with poor coordination and timing for handwriting? A. Picking up object, using tip of index finger and thumb B. Games involving running and moving C. Using fingers to grasp object D. Scooping, using thumb and index finger

B. Games involving running and moving Coordination and timing deficits may be addressed by beginning with gross movements and progressing to more precise movements. OT practitioners focus coordination intervention by starting with postural control or stability. This may be achieved through intervention or positioning or adaptive equipment. The practitioner provides the child with opportunities to practice coordination by designing activities that require the child to repeat motions and progressively become more accurate. For example, the practitioner may begin by providing a large target area and gradually lessen the target area (to facilitate more precision). Timing may be promoted by including music, rhythmic songs, or counting activities into the intervention sessions.

What is not considered a core value to a program to prevent childhood obesity? A. Social participation B. Including only obese children C. Health education D. Moderate to high physical activity

B. Including only obese children To promote follow-through, many programs involve team models and educating teachers and parents. Other programmatic goals include promoting sports and extracurricular activities, encouraging hobbies, and involving families and friends in a more active lifestyle. Importantly, programs emphasize setting realistic goals as key to successful outcomes. The outcomes are not measured solely by the amount of weight loss, but generally include child, adolescent, family or school satisfaction, increased knowledge of nutrition and exercise, improvement in healthy eating habits, increased levels of physical activity, and increased participation in social activities. Figure 15-6 provides examples of low-cost, noncompetitive activities that children and their families may enjoy as part of an intervention plan.

What is the term for things that a child is happy to do, finds happiness in doing, and usually is able to do successfully? A. Values B. Interests C. Occupational forms D. Occupational objects

B. Interests Interests are things that a child finds enjoyable and satisfying to do. Usually children are interested in activities in which they are most likely to be successful and engage without possibility of failure, pain, or difficulty.

Which of the following does not describe the development progression of movement? A. Gross to fine B. Lateral to medial C. Cephalic to caudal D. Proximal to distal

B. Lateral to medial See Box 6-3. Motor development does not progress from lateral to medial (rather it is proximal to distal). When viewing the body in anatomical position proximal would include medial and distal would be lateral movement.

Raysor has difficulty writing. He hesitates when trying to continuously form letters. He does not understand where to begin writing on his paper. He sometimes begins at the bottom of the letter and sometimes at the top, despite frequent repetitions of the letter. What type of problem does Raysor show? A. Poor midline crossing B. Poor motor planning C. Poor visual acuity D. Tactile defensiveness

B. Poor motor planning Children with poor organizational skills may use letters of varying sizes and wrongly mix uppercase (capital) and lowercase (small) letters in words. Some organizational problems are related to poor visual processing, while others are related to poor motor planning or attention. Children with poor handwriting skills may have deficits in motor planning (i.e., figuring out how to move their bodies and then actually doing it) or motor memory (i.e., remembering the motor patterns and being able to repeat them).

When a child identifies a set of related actions and attitudes that define a familiar status, this is what within the conceptual area of habituation? A. Social groups B. Roles C. Habits D. Personal causation

B. Roles When a child identifies as a son or daughter, brother or sister, student, soccer player, band member, or worker, he or she is internalizing a role.

Suck-swallow-breathe synchrony is not necessary for which of the following? A. Eating without gasping B. Smiling and frowning C. Sleeping without drooling D. Talking and singing

B. Smiling and frowning Suck-swallow-breathe synchrony typically emerges as the first self-regulatory activity during the prenatal period. Infants work on further developing the suck-swallow-breathe synchrony, often finding pleasure in drinking from a bottle and/or breast-feeding.

Stewart is a 9-year-old boy who is having difficulty in school. Stewart shows an aversion to being touched and is uncomfortable with movement. He has poor penmanship, is unable to keep up with his friends on the playground, and shows poor self-esteem. Stewart has low muscle tone, a positive asymmetric tonic neck reflex in standing positions, difficulty tracking objects, and associative reactions. He has poor shoulder cocontraction and endurance. He wants to play soccer at recess with the other kids. A student observes the session in preparation for working with him the following week. The student decides to instruct Stewart on the techniques of playing soccer. She provides Stewart with verbal and demonstrative instructions on the skills needed for soccer. They go outside and play a game of soccer. According to OT theory, what is true of this session? A. The student has not fully analyzed the occupations of the child. B. Stewart can benefit from more than just a sensory integrative approach. C. This is a typical sensory integrative session. D. Practicing a skill is not a principle used by occupational therapists.

B. Stewart can benefit from more than just a sensory integrative approach. The practitioner may use other approaches (motor control/motor learning) if they deem necessary.

Which concept is least central to motor control theory? A. Promote problem solving B. Teach components C. Meaningful activities D. Natural contexts

B. Teach components Meaningful activities are the foundation of OT practice and have been found to increase a child's motor performance. OT practitioners carefully design meaningful interventions to maximize the child's involvement, volition, and engagement. Children will repeat activities that they find meaningful. OT practitioners use meaningful activities that closely mimic occupations of childhood as both the goal of intervention and the means to achieve the goals. Engaging a child in meaningful activity in a natural context is the most effective strategy, because it allows the child to adapt, problem solve, and respond appropriately and accordingly within the natural context. OT practitioners providing intervention to a child within their natural context are urged to allow the child to make mistakes, problem solve, and self-correct to create motor solutions.

Which statement most closely represents the role of the Certified Occupational Therapy Assistant (COTA) in sensory integration (SI) intervention? A. The COTA may not treat children with SI dysfunction. B. The COTA may use an SI approach under supervision. C. The COTA may not use SI intervention techniques. D. The COTA may only perform formal SI evaluations.

B. The COTA may use an SI approach under supervision. When an appropriately SI-trained and experienced pediatric occupational therapist is available only on a limited basis (or not at all), the COTA can contribute effectively to promoting sensory processing with practical intervention strategies.

When working with a child, what must the OT practitioner realize regarding therapeutic relationships? A. The child is the most important relationship to consider. B. The practitioner must develop relationships with all those who are involved in the child's health care. C. It is most important to establish trust with the mother. D. It is most important to stay objective and distant from the caregivers.

B. The practitioner must develop relationships with all those who are involved in the child's health care. When working with children, it is necessary to establish a therapeutic relationship with the child, the caretaker(s), and appropriate individuals within the community system(s) involved in the child's health care. This requires the therapist to be acutely aware of the many different relationships that must be nurtured and maintained to promote the most successful outcomes for the child. Not only must the child be empowered but the significant figures in the child's live must be empowered as well. This requires the therapist to strive to maintain multiple therapeutic relationships and this may require different approaches and strategies with the different individuals involved in the child's care.

A child is engaged in a play group at his local place of worship. When using MOHO as a guide to practice, this sort of activity is an environmental factor. This is an example of: A. occupational form. B. social group. C. spaces. D. objects.

B. social group. The MOHO concepts that help us think of the environmental factors that directly influence participation are spaces, objects, social groups, and occupational tasks. Social groups are collections of people who come together for a variety of formal and informal purposes. Social groups include play groups, classrooms, worship communities, internet social networking groups, families, and a neighborhood.

During a treatment session, a therapist provides the guidelines for choice and performance of tasks by allowing a child to choose from a set of alternative activities that addresses the same area of concern. This type of therapeutic strategy is: A. coaching. B. structure. C. encouragement. D. giving feedback.

B. structure. Using the strategy of "structure" to modify the social environment and occupational task helps create a therapeutic environment in which the child is most likely to be successful.

What age range most closely represents an infant who is able to roll from prone to supine, get into a quadruped position, has complete head control and transfers objects from hand to hand while in supine, reaches with one hand, uses radial palmar grasp, and reaches to be picked up? A. 1 to 2 months B. 9 to 12 months C. 6 to 8 months D. 13 to 18 months

C. 6 to 8 months At 6 months an infant has complete head control, possesses equilibrium reactions, begins assuming quadruped position, rolls from prone to supine position, and bounces while standing. At 6 months an infant transfers objects from hand to hand while in supine position, shifts weight and reaches with one hand while in prone position, and reaches with one hand and supports self with other while seated. The 6-month infant reaches to be picked up, uses radial palmar grasp, begins to use thumb while grasping, shows visual interest in small objects, rakes small objects, and begins to hold objects in one hand. From 7 to 9 months the infant shifts weight and reaches while in quadruped position, creeps, develops extension, flexion, and rotation movements, and increases the number of activities that can be accomplished while seated. The 7 to 9-month infant reaches with supination, uses index finger to poke objects, uses inferior scissors grasp to pick up small objects, uses radial digital grasp to pick up cube, and displays voluntary releases abilities.

In which period (other than fetal growth) is physical growth most rapid? A. Puberty B. Preschool C. Birth to 6 months D. Middle childhood

C. Birth to 6 months During the first year, infants triple their body weight and their height increases by 10 to 12 inches. Their body shape changes, and by 4 months the sizes of their heads and bodies are more proportionate. By 12 months, average infants weigh 21 to 22 lb. and are 29 to 30 inches tall.

Tracy is a 5-year-old girl who is unable to get on a tricycle. She tries, but even after directions and demonstrations, ends up backward or sideward on the seat and is unable to understand how she should be positioned. Which term most closely describes Tracy's difficulties? A. Sensory modulation B. Constructional praxis C. Developmental dyspraxia D. Cognition

C. Developmental dyspraxia Developmental dyspraxia: Children with this disorder represent some degree of motor planning difficulty, which is part of the diagnosis of severe developmental delay and is consistent with their development across the board. (a) The first and most fundamental process is the ability to register and organize tactile, proprioceptive, vestibular, and visual input in order to assemble accurate internal cognitive maps of the body and the environment with which the body typically interacts. (b) The second process, which is based on these constructions, requires the ability to conceptualize internal images of purposeful actions, termed ideation in the neuropsychological and rehabilitation literature. (c) The third process is the planning of sequences of movements within the demands of the task and environmental context, including the ability to program anticipatory actions within the next few seconds.

Which statement best describes the role of the occupational therapy (OT) practitioner in the medical setting? A. Encourage the child's performance in strength, endurance, and range of motion as related to medical diagnoses. B. Engage child in a variety of activities to promote educational performance upon discharge. C. Facilitate the child's ability to engage in everyday occupations while supporting medical stability for discharge. D. Provide support to the medical team to assist child in being discharged to home.

C. Facilitate the child's ability to engage in everyday occupations while supporting medical stability for discharge. The role of the OT practitioner in the medical setting is to facilitate the infant's, child's, or adolescent's ability to engage in everyday occupations while supporting medical stability for discharge. The OT practitioner facilitates community reentry by providing outpatient services and recommending community resources.

Which sitting position is most helpful for writing? A. Feet on floor, desk resting on lap B. Feet off floor, desk under armpits C. Feet on floor, desk slightly above elbow D. Feet off floor, desk slightly above elbow

C. Feet on floor, desk slightly above elbow The best sitting position for a child is sitting with the hips and knees at 90 degrees, feet flat on the floor, and the ankles at 90 degrees. The desk should be at a height of two inches above the flexed elbow.

The COTA working with 6-year-old Dylan plays a game of crumpling sheets of paper into balls and throwing them. What is the goal of this activity? A. Basketball mastery B. Finger individuation C. Hand strengthening D. Range of motion

C. Hand strengthening Crumpling sheets of paper helps develop hand strength.

What is the role of the OT practitioner during a hippotherapy session? A. Teach the child to ride properly. B. Improve the child's communication skills. C. Help the child successfully ride the horse. D. Improve the child's posture and balance.

C. Help the child successfully ride the horse. Hippotherapy, a special form of equine-assisted therapy, uses the dynamic three-dimensional movement of the horse to achieve specific therapeutic goals. In the United States, hippotherapy is always provided by an OT practitioner, physical therapist (PT), or speech-language pathologist. The OT practitioner helps the child successfully ride to work on therapeutic goals.

Kelly is a 4-year-old child with developmental delays. What process skill are you observing when you see her walk up to some other children and ask if she can join them playing "house"? A. Disagrees B. Reaches C. Initiates D. Walks

C. Initiates Initiates is a process skill; Reaches and Walks are motor skills; Disagrees is a social interaction skills.

Which statement is not true concerning using mental practice to develop motor skills? A.Mental practice combined with physical practice works best. B. Mental practice can help the person prepare to perform a task. C. Mental practice replaces physical practice. D.Mental practice should be relatively short, not prolonged.

C. Mental practice replaces physical practice. Mental practice helps to facilitate acquisition of new skills as well as the relearning of old skills. Mental practice helps the person prepare to perform a task. Mental practice combined with physical practice works best. For mental practice to be effective, the individual should have some basic imagery ability. Mental practice should be relatively short, not prolonged.

Which frame of reference views the child in terms of volition, habits and roles, performance, and environment? A. Biomechanical B. Person—Environment—Occupation C. Model of Human Occupation (MOHO) D. Intentional Relationship Model

C. Model of Human Occupation (MOHO) 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 statement reflects the dynamic and ever-changing nature of the brain? A. Physiology B. Cell migration C. Neuroplasticity D. Proliferation

C. Neuroplasticity Neuroplasticity is a term used to describe the dynamic and ever-changing nature of the brain. The brain is use dependent, meaning that the way you use it is reflected in its structural and functional architecture.

Which observation indicates a child has poorly developed hand arches? A. Strong grip strength B. High muscle tone C. No creases seen in the palm D. Hand can form a bowl

C. No creases seen in the palm Children with poorly developed hand arches have flat, underdeveloped, weak hands. The lack of hand arching interferes with the strength and coordination. When the arches are well developed, the hand is able to form a bowl in the palm, and distinct creases are seen in the palm. Children with poorly developed arches may compensate by holding the pencil tightly against the palm, showing no web space.

According to MOHO, which subsystem should be objectively measured and is typically measured using other frames of reference? A. Environment B. Volition C. Performance capacity D. Habituation

C. Performance capacity Performance capacity is the third and final MOHO concept addressing client personal factors. Performance capacity is a child's ability to do things as supported by the status of his/her physical and mental components as well as his/her subjective experience of living within his/her body. Occupational therapy (OT) practitioners use other theories to measure, classify, and describe the status of physical and mental components of a child. Therefore, MOHO acknowledges the importance of a child's physical and mental components but relies on OT practitioner's utilization of other frames of reference (biomechanical, sensory integration) to evaluate and explain those components.

Which activity is most suitable for a group of 15- to 17-year-old girls? A. Blowing bubbles B. Playing with Barbie dolls C. Scrapbooking D. A 20-piece puzzle

C. Scrapbooking Scrapbooking is age appropriate for adolescent girls. The other activities are best for younger ages.

The COTA, Marvin, is working with 3-year-old Harvey on his prewriting skills. Which skill would be the easiest for Harvey to accomplish? A. Copy a square. B. Imitate a straight line. C. Spontaneously scribble. D. Draw a face.

C. Spontaneously scribble. 12 months: Stirring spoon. 14 months: Scribbling—1 scribble 1 inch long. 23 to 24 months: Imitating vertical line 2 inches long. 27 to 28 months: Imitating horizontal line 2 inches long. 33 to 34 months: Copying circle—end points within half inch of each other. 39 to 40 months: Copying cross—intersecting lines within 20 degrees of perpendicular. 41 to 42 months: Tracing line—deviates 2 times.

The COTA, Marvin, is working with 3-year-old Harvey on his prewriting skills. Which skill would be the easiest for Harvey to accomplish? A. Imitate a straight line. B. Draw a face. C. Spontaneously scribble. D. Copy a square.

C. Spontaneously scribble. 12 months: Stirring spoon. 14 months: Scribbling—1 scribble 1 inch long. 23 to 24 months: Imitating vertical line 2 inches long. 27 to 28 months: Imitating horizontal line 2 inches long. 33 to 34 months: Copying circle—end points within half inch of each other. 39 to 40 months: Copying cross—intersecting lines within 20 degrees of perpendicular. 41 to 42 months: Tracing line—deviates 2 times.

Glen is a 5-year-old boy who is unable to pick up cereal and small toys. The certified occupational therapy assistant (COTA) engages Glen in a game to pull objects out of Play-Doh and poke his finger in the Play-Doh to make holes. On what skills do these activities work? A. Balance and range of motion B. Endurance and trunk strength C. Strength and in-hand manipulation D. Timing and sequencing

C. Strength and in-hand manipulation Children and youth with motor deficits may experience decreased strength, which negatively impacts the ability to engage and perform occupations. For example, an OT practitioner using distributed practice to develop a child's fine motor skills for handwriting and play designs an interesting session using a "Fall" theme. The session begins with the child tearing small pieces of paper (working on neat pincer grasp), then gluing the pieces on paper (in hand manipulation) and ending with coloring around the picture (tripod grasp).

Daniel continually drops various objects from his highchair and is fascinated by watching the objects fall. What stage of Piaget's sensorimotor period does this illustrate? A. Primary Circular Reactions B. Secondary Circular Reactions C. Tertiary Circular Reactions D. Invention of New Means through Mental Combinations

C. Tertiary Circular Reactions During the stage called tertiary circular reactions, he or she repeatedly attempts a task and modifies the behavior to achieve the desired consequences. The repetition helps the infant understand the concept of cause-effect relationships.

On what does the success of home-based intervention with children with disabilities most depend? A. The degree to which the intervention is supported by research B. The skill of the practitioner in implementing therapy activities with children C. The extent to which the family is involved in its design and implementation D. The conceptual framework guiding the intervention

C. The extent to which the family is involved in its design and implementation Families have the most significant environmental influence on a young child's life and development. OT practitioners enter children's lives for relatively brief periods. Family members are the "constants" in most children's lives.

What must be true for OT services to be provided in the public-school system? A. The services must be functional, and outcome based. B. The services must be medically necessary. C. The services must be related to the child's educational needs. D. There are no requirements or restrictions.

C. The services must be related to the child's educational needs. IDEA mandates that related services support access to and progress in the general education curriculum or natural environment.

Which strategy to help with dressing is not appropriate for a child with sensory processing issues? A. Allow the child to pick his clothing. B. Cut out tags completely. C. Use detergent with a strong fragrance. D. Wash new clothing before the child wears it.

C. Use detergent with a strong fragrance. Wash new clothes in familiar detergent before having the child wear them. Use detergent with mild or no fragrance.

A therapist engages in a give-and-take interaction with a child, his parents, and consultants from other disciplines working with the child to gain an agreement about something that the child should do. The goal of this type of therapeutic strategy is to: A. validate. B. identify. C. negotiate. D. advise.

C. negotiate. Negotiate: Engage in give-and-take with the child, his or her parents, and other professionals to achieve a common perspective or agreement about something that the child will or should do in the future.

What must the OT practitioner consider when fabricating an orthosis? A. Gross motor development B. Development of grasp patterns C. Hand use D. None are correct E. All are correct

D. All are correct It is critical to appreciate the normal developmental progress of the child's hand to appreciate which activity level suits each child. Orthotic intervention must try to accommodate this development. When fabricating orthoses for children with congenital hand differences, the OT practitioner looks at the child's development and current functioning, determines the purpose of the orthosis, and considers the context in which the child will use the orthosis.

What type of damage is characterized by hyperactive deep tendon reflexes, spastic paralysis or weakness as in cerebral palsy, hydrocephalus, or shaken baby syndrome? A. Motor system B. Peripheral nervous system C. Autonomic nervous system D. Central nervous system

D. Central nervous system Central nervous system damage results in upper motor neuron pathology which is characterized by hyperactive deep tendon reflexes and spastic paralysis or weakness. Pediatric examples include cerebral palsy, developmental dyspraxia, hydrocephalus, shaken baby syndrome and other reasons for traumatic brain injuries, and spina bifida.

Shameka is working with a close friend's grandmother. During a recent visit, her friend asks how her grandmother is doing in OT. Shameka encourages her friend to visit her grandmother to find out how she is doing. Which principle of ethics does this scenario illustrate? A. Nonmaleficence B. Justice C. Veracity D. Confidentiality

D. Confidentiality Confidentiality refers to the right to privacy of consumers.

What can an occupational therapy (OT) practitioner do to engage the family in establishing health habits? A. Make the family members feel guilty about their poor health habits. B. Make complex suggestions that require major life changes. C. Keep things private and encourage the family not to seek support from others. D. Engage the whole family in simple habit changes.

D. Engage the whole family in simple habit changes. Since family context significantly affects eating and exercise patterns, it is important to establish healthy eating and exercise habits early, before parental control over diet diminishes during adolescence. Adolescents are more likely to purchase foods outside the home. These foods are often foods of convenience, high in sugars and fats, and of questionable nutritional value. If paired with an increase in sedentary activity level (e.g., homework, fewer physical extracurricular activities) the change in diet can lead to weight gain in adolescents. Adolescence brings challenges associated with weight, diet, and exercise. It is the peak time for dysfunctional eating patterns and psychopathology. At the same time, peer and the media are influential forces in relation to behaviors and attitudes concerning weight, body image, and choices about exercise and use of discretionary time.

Alison quickly repositions her body to catch a ball. Of what is this an example? A. Adaptation B. Blocked practice C. Feedback D. Feedforward

D. Feedforward Feedforward is that intangible abstract representation of sensation that gives us the awareness of what the movement pattern will feel like before we begin to move. Feedforward refers to the adjustments in anticipation of the movement required. For example, a child may position himself to catch a ball by predicting where he thinks the ball will go.

What is the practitioner doing by moving the objects higher so that the child has to reach above his head to get them? A. Remediating B. Adapting C. Compensating D. Grading

D. Grading Grading the location of bath supplies on shelves by altering the shelf height or the placement of supplies on the shelves will provide the child with reaching opportunities prior to entering the bath tub or shower area.

Recent changes in service delivery have changed OT practitioners' roles. Which of the following is not part of the OT practitioner's duties? A. Assessing family interests, priorities, and concerns B. Observing daily routines of children and their families C. Sharing information with families about intervention strategies D. Helping families develop a household budget to meet all their needs

D. Helping families develop a household budget to meet all their needs Recent changes in service delivery and implementation have resulted in an expansion of OT practitioners' roles. Their duties now also include the following: * Assessing family interests, priorities, and concerns * Observing and gathering information about the daily routines of children and families in their homes and in the classrooms * Gathering and sharing information with families about development and intervention strategies * Implementing therapy in collaboration with parents, caregivers, and general educators

Which of the following statements is true about the occupational therapy (OT) practitioner's study of typical development? A. It is best to memorize developmental sequences. B. It has no clinical relevance unless the therapist is working with developmentally delayed children. C. It has limited application while working with special needs children. D. It helps practitioners to problem solve developmental sequences while working with children who have special needs.

D. It helps practitioners to problem solve developmental sequences while working with children who have special needs. The OT practitioner must understand development and the process of typical development. The sequence of acquisition in relation to occupational performance skills and areas is the foundation for OT assessment of and intervention with children who have special needs. The sequence of skill acquisition is predictable in the typically developing child. The OT practitioner's knowledge of normal development guides the order of expectations and choice of activities for children who are not developing typically. The practitioner relies on knowledge of typical development to assist the child in developing useful, functional skills.

Which of the following statements is true about typical development? A. It is a biomechanical process. B. It is unpredictable and spontaneous. C. The rate remains the same for all children. D. It occurs naturally.

D. It occurs naturally. The sequence of skill acquisition is predictable in the typically developing child. Although normal development is predictable and sequential, the rate of skill acquisition varies among children.

A therapist begins intervention with a child who does not like any of the activities that the therapists selects for him to do. Each treatment session, the child walks to a corner, crosses his arms, and will not do anything that the therapist has planned. The therapist asks the child's mother what he likes to do. On finding out the child likes elephants, the therapist incorporates them into the activities in the treatment session. The therapist allows the child to select from two activities, both of which the child has been mildly successful in completing. Which step in the volitional process is the therapist trying to impact through this change of approach to intervention? A. Experience B. Anticipation C. Interpretation D. Making choices

D. Making choices Children are more likely to choose a certain activity if they think it is fun; if they think it is meaningful; and if they believe they can successfully engage in and complete the activity.

What should the Certified Occupational Therapy Assistant (COTA) consider when selecting assistive switches? A. Use whatever switch is available. B. Make access challenging for the individual. C. Move the switch around as much as possible to find the best spot. D. Match switch characteristics to the user's specific needs.

D. Match switch characteristics to the user's specific needs. Like so many aspects of rehabilitation, AT assessment is a team endeavor. Although COTAs do not conduct evaluations, it is critical to understand the process of evaluation so that the clinical information that is shared with the occupational therapist is valuable in adjusting AT goals and intervention procedures for individual users. Numerous approaches to decision making for assistive technology exist. The one discussed here is adapted from a model rooted in the field of human factor.

What term is used to describe the intrinsic processes that go hand in hand with children experiencing and participating in meaningful activities that lead to long-lasting changes in motor performance? A. Bilateral motor control B. In-hand manipulation C. Implement usage D. Motor learning

D. Motor learning Motor learning refers to the intrinsic processes that go hand in hand with children experiencing and participating in meaningful activities that lead to long-lasting changes in motor performance.

Which statement best describes making the activity of carving a pumpkin more challenging for a group of teenagers? A. Allow them to work in pairs. B. Allow them to light the candles. C. Have them use an extremely dull knife. D. Provide samples of intricate stencils for them to trace and cut.

D. Provide samples of intricate stencils for them to trace and cut. Grading activities involves making things more or less difficult for clients. Requiring more details increases the activity demands.

Which of the following is not considered a performance skill that may affect handwriting performance? A. Muscle tone B. Sensory processing C. Endurance D. School desk

D. School desk The performance skills that may affect handwriting performance include muscle tone, strength, endurance, posture, integrity of structures, visual perception, and sensory processing. In addition to evaluating the underlying factors that may affect handwriting. A child's school desk is part of the physical context.

Stewart is a 9-year-old boy who is having difficulty in school. Stewart shows an aversion to being touched and is uncomfortable with movement. He has poor penmanship, is unable to keep up with his friends on the playground, and shows poor self-esteem. Stewart has low muscle tone, a positive asymmetric tonic neck reflex in standing positions, difficulty tracking objects, and associative reactions. He has poor shoulder cocontraction and endurance. He wants to play soccer at recess with the other kids. The occupational therapy (OT) practitioner who is treating Stewart begins the session by playing swinging games in the net and inner tube swings. Together, they design an obstacle course, and Stewart hits balls with his head and runs around the course. Stewart jumps on a miniature trampoline and tries to make baskets. Stewart ends the session by participating in a finger-painting activity. What type of treatment approach does this describe? A. Sensory modulation B. Motor control C. Sensory diet D. Sensory integration

D. Sensory integration The central principle of this intervention approach is the provision of controlled sensory input, through activities presented by the therapist, to elicit adaptive responses from the child, thereby bringing about more efficient brain organization (Fig. 25-7). This latter result becomes observable in the increased organization of behavior, movement, and affective expression that is seen in the child. These diverse and multilevel responses are elicited within a rich environment that provides multiple, variable types of sensory experiences with the guidance of a skilled occupational therapist (Fig. 25-10).

Henry, a 9-year-old boy, complains of how his new school clothes feel, hates noises in the car, and is easily irritated at school by all the movement of his classmates. Henry becomes car sick easily. He is a very picky eater, stating that he does not like the smell and taste of many foods. Which type of deficit do these findings represent? A. Developmental dyspraxia B. Bilateral integration dysfunction C. Postural-ocular dysfunction D. Sensory modulation disorder

D. Sensory modulation disorder Sensory modulation and discrimination disorders can be found in one or more sensory systems in any affected individual, namely vestibular, somatosensory, visual, auditory, and olfactory/gustatory. Henry is showing discrimination and sensory defensive behaviors (e.g., tactile, auditory, vestibular).

Which strategy is not recommended for managing and preventing obesity in children and adolescents? A. Address issues of health rather than weight. B. Do not completely deny child occasional sweets or soda. C. Encourage the child to have regular sleeping hours. D. Set at least 6 short-term, achievable goals at a time.

D. Set at least 6 short-term, achievable goals at a time. Box 15-5 Managing and Preventing Obesity Set goals that are obtainable, simple, and easy to measure. Set one short achievable goal at a time. Make goals very concrete so the child sees progress. For example, provide child with a pedometer to measure distance walked. Have simple short-term goals such as walk to best friend's house or walk to the nearest store. Develop goals with child or adolescent. Have child set own reward system. Keep goals positive. For example, walk to the end of the street every other day rather than do not watch TV on Tuesdays. Involve friends and family in goals. Minimize the number of breads, sweets, and soda and replace with healthy choices such as fruit, vegetables, and water at home. Do not completely deny child occasional sweets or soda. Otherwise, he or she may crave them and eat more when they are available to him or her. Address issues of health rather than weight. Focus on the child's volition (interests, motivation, and desires) to engage in a variety of activities. Build on existing physical and healthy routines and habits. Consistently repeat new behaviors until they become part of the child's everyday behaviors. Encourage child to get regular sleeping hours. Involve child in chores that require physical effort (e.g., sweeping, taking out garbage, raking, running errands). Sample goals: Mark will eat a vegetable at each meal. Diane will play outside with her family or friends for 1 hour each day. Jose and his family will drink water instead of soda during the weekend. Rochelle will try Frisbee and tee ball (two new activities) at least three times. Sajay will help his parent prepare a low-fat, low-carbohydrate meal (once a week).

What is sensory processing? A. A fear of height, movement, or textures so that the child is unable to make an adaptive response B. Discriminating between different textures within the environment C. Planning, designing, and executing movements D. The process of receiving, detecting, and making sense of input from the environment

D. The process of receiving, detecting, and making sense of input from the environment The term sensory processing refers to the means by which the brain receives, detects, and integrates incoming sensory information for use in producing adaptive responses to one's environment.

Brigit is an 8-year-old girl who presses hard on the paper and frequently smears her letters and rips the paper. What do you expect to observe with her grasp pattern? A. Dynamic tripod grasp B. Grasp by the eraser C. Loose grasp D. Tight grasp

D. Tight grasp Tight grasps may limit the variety of movements and make smooth, fluid motions difficult. Writers using tight grasps often press hard on the paper, which results in the formation of dark, sometimes smeared, letters.

What is the role of the OTA in the IEP team? A. To analyze and interpret test results independently of the occupational therapist B. To determine level of service along with the teacher and principal C. To negotiate changes in the child's goals with the parent D. To report findings and recommendations under direction of the occupational therapist

D. To report findings and recommendations under direction of the occupational therapist The occupational therapist is responsible for completing the evaluation (with input from the OTA), interpreting the information, and presenting the report to the IEP team.

What is the term for when the child moves something from the palm of the hand to the tips of the fingers? A. Flexion B. Rotation C. Shift D. Translation

D. Translation Translation: Working items to or from the palm of the hand to or from the tips of the fingers without dropping the items (e.g., moving coins from the palm of the hand to the tips of the thumb and index finger to place coins into the slot of a vending machine).

Stewart is a 9-year-old boy who is having difficulty in school. Stewart shows an aversion to being touched and is uncomfortable with movement. He has poor penmanship, is unable to keep up with his friends on the playground, and shows poor self-esteem. Stewart has low muscle tone, a positive asymmetric tonic neck reflex in standing positions, difficulty tracking objects, and associative reactions. He has poor shoulder cocontraction and endurance. He wants to play soccer at recess with the other kids. Which activity would best work on Stewart's poor shoulder cocontraction and endurance? A. Playing "Simon Says" B. Spinning in a net C. Walking on a balance beam D. Wheelbarrow walking

D. Wheelbarrow walking Observation of the endurance level as well as frustration tolerance, problem solving, and creativity is critical to guiding the intervention session. The OT practitioner adjusts the bar as necessary, raising or lowering it for challenges accordingly. Wheelbarrow walking involves cocontraction and endurance. The other activities may not challenge the child as needed.

Which technique is not used to promote swallowing in children? A. Position the child in a semi-reclined position. B. Provide a calm setting. C. Use vibration and quick stroking about lip. D. Work quickly with the child.

D. Work quickly with the child. Work slowly with the child. Some children may have a delayed swallow.

A child does not like the way he feels when he slides. He has done similar activities in the past and did not like them. He now avoids any activity that requires sliding or movement that is similar. The step on the volitional process that is being affected is the child's: A. interpretation. B. experience. C. making choices. D. anticipation.

D. anticipation. How the volitional process is influenced by a child's interests, values, and personal causation.