Occupational Therapy Exam Prep
2026/2027: 90 Practice Questions with
Answers for NBCOT & University Students
Description:
Master your OT board exams with 90 high-yield practice questions covering pediatrics,
neuro rehab, mental health, and orthopedics. Includes detailed explanations, clinical
reasoning, and updated 2026/2027 content. Perfect for NBCOT prep, university finals, and
licensing success.
Download the 2026/2027 OT Exam Prep Guide — 90 practice questions, expert explanations,
and clinical reasoning to help you pass with confidence. Start studying today!
, OT Exam Prep 2026/2027: 90 Practice Questions & Answers
Section A: Pediatric Occupational Therapy Assessment and Intervention
Question 1
An occupational therapist is preparing to evaluate a toddler who has upper extremity
orthopedic concerns. How will the OT MOST likely obtain the majority of initial assessment
data?
A. Standardized measurement tools that assess visual-motor integration skills
B. Dynamometer and pinch meter readings to quantify grip strength
C. Observation of the child during activities in the child-care center
D. Functional independence measures completed by caregivers
Answer: C
Explanation: Naturalistic observation in the child's natural environment, such as the child-
care center, allows the therapist to collect authentic information about the child's motor
performance skills and participation in activities requiring upper extremity function. This
ecological assessment approach provides primary data relevant to the child's performance
context and yields important information about functional performance. While standardized
assessments (A, B, and D) may be appropriate for older children or as supplementary
measures, observation in the natural environment is most appropriate for initial data
collection with toddlers.
Question 2
During an initial evaluation, the OT suspects that a child has somatodyspraxia. In which area
should the OT focus the evaluation?
A. Ability to print or write legibly
B. Reading competency and comprehension
C. Mathematical calculations and problem-solving
D. New motor task planning and execution
Answer: D
Explanation: Somatodyspraxia is characterized by deficits in learning new motor skills,
planning novel motor actions, and generalizing motor plans to new situations. This condition
,has its foundation in somatosensory discrimination deficits, particularly tactile and
proprioceptive processing, which interfere with body scheme development and awareness.
Inability to print or write (A) is termed dysgraphia, reading dysfunction (B) is dyslexia, and
difficulty with mathematics (C) is dyscalculia—all of which represent different diagnostic
categories.
Question 3
A child avoids playground equipment that requires their feet to be off the ground. What does
this behavior MOST likely indicate?
A. Difficulty modulating proprioceptive input
B. Somatodyspraxia
C. Gravitational insecurity
D. Bilateral integration and sequencing deficit
Answer: C
Explanation: Gravitational insecurity describes an exaggerated fear response to movement
and height, where the child experiences a fear of falling and prefers to keep their feet firmly
on the ground. This is a common sensory processing difficulty. Tactile defensiveness (A)
involves discomfort with various textures and unexpected touch. Somatodyspraxia (B)
involves difficulty with motor planning due to somatosensory discrimination deficits.
Bilateral integration and sequencing deficits (D) relate to poor vestibular-proprioceptive
discrimination affecting coordination and motor execution.
Question 4
When the OT suspects tactile defensiveness as a rationale for a child's challenges, in which
area of participation should the OT focus FIRST?
A. Play behavior and peer interactions
B. Dressing habits and clothing preferences
C. Social skills development
D. Leisure interests and hobbies
Answer: B
Explanation: Children with tactile defensiveness are typically bothered by the tactile aspects
of daily living activities, particularly dressing. They may demonstrate specific clothing
, preferences or aversions, such as avoiding turtlenecks, socks with seams, or shoes, or
conversely, may refuse to remove shoes to minimize tactile input. Play behavior (A), social
skills (C), and leisure interests (D) may be affected secondarily as a result of intolerance to
certain textures or human touch. Assessing dressing habits provides the therapist with crucial
initial information about the child's sensory processing patterns.
Question 5
A child with autism spectrum disorder demonstrates inadequate playground skills, playing
alone and repeating the same play activities daily. Which approach will the OT MOST likely
select to promote her social play skills?
A. Join the group on the playground, facilitating the child's play while including other
children
B. Work with the child on the playground when other students are not present
C. Recommend that the parent enroll the child in extracurricular activities after school
D. Ask the physical education teacher to include the child in small groups during gross motor
activities
Answer: A
Explanation: Direct intervention in the natural environment provides the most effective
opportunity to facilitate social play skills. By joining the playground group, the therapist can
model appropriate social interactions, scaffold the child's participation, and support inclusion
with typically developing peers. This approach addresses both the child's individual needs
and the social context. Working in isolation (B) does not address the social participation goal,
extracurricular activities (C) may not provide adequate support, and delegating to the
physical education teacher (D) does not ensure specialized intervention.
Question 6
A preschooler is having difficulty performing tasks requiring eye-hand coordination as a
result of poor visual tracking skills. What activity should the OT use FIRST to promote visual
tracking skills?
A. Tossing and catching a water balloon
B. Catching and bursting soap bubbles
2026/2027: 90 Practice Questions with
Answers for NBCOT & University Students
Description:
Master your OT board exams with 90 high-yield practice questions covering pediatrics,
neuro rehab, mental health, and orthopedics. Includes detailed explanations, clinical
reasoning, and updated 2026/2027 content. Perfect for NBCOT prep, university finals, and
licensing success.
Download the 2026/2027 OT Exam Prep Guide — 90 practice questions, expert explanations,
and clinical reasoning to help you pass with confidence. Start studying today!
, OT Exam Prep 2026/2027: 90 Practice Questions & Answers
Section A: Pediatric Occupational Therapy Assessment and Intervention
Question 1
An occupational therapist is preparing to evaluate a toddler who has upper extremity
orthopedic concerns. How will the OT MOST likely obtain the majority of initial assessment
data?
A. Standardized measurement tools that assess visual-motor integration skills
B. Dynamometer and pinch meter readings to quantify grip strength
C. Observation of the child during activities in the child-care center
D. Functional independence measures completed by caregivers
Answer: C
Explanation: Naturalistic observation in the child's natural environment, such as the child-
care center, allows the therapist to collect authentic information about the child's motor
performance skills and participation in activities requiring upper extremity function. This
ecological assessment approach provides primary data relevant to the child's performance
context and yields important information about functional performance. While standardized
assessments (A, B, and D) may be appropriate for older children or as supplementary
measures, observation in the natural environment is most appropriate for initial data
collection with toddlers.
Question 2
During an initial evaluation, the OT suspects that a child has somatodyspraxia. In which area
should the OT focus the evaluation?
A. Ability to print or write legibly
B. Reading competency and comprehension
C. Mathematical calculations and problem-solving
D. New motor task planning and execution
Answer: D
Explanation: Somatodyspraxia is characterized by deficits in learning new motor skills,
planning novel motor actions, and generalizing motor plans to new situations. This condition
,has its foundation in somatosensory discrimination deficits, particularly tactile and
proprioceptive processing, which interfere with body scheme development and awareness.
Inability to print or write (A) is termed dysgraphia, reading dysfunction (B) is dyslexia, and
difficulty with mathematics (C) is dyscalculia—all of which represent different diagnostic
categories.
Question 3
A child avoids playground equipment that requires their feet to be off the ground. What does
this behavior MOST likely indicate?
A. Difficulty modulating proprioceptive input
B. Somatodyspraxia
C. Gravitational insecurity
D. Bilateral integration and sequencing deficit
Answer: C
Explanation: Gravitational insecurity describes an exaggerated fear response to movement
and height, where the child experiences a fear of falling and prefers to keep their feet firmly
on the ground. This is a common sensory processing difficulty. Tactile defensiveness (A)
involves discomfort with various textures and unexpected touch. Somatodyspraxia (B)
involves difficulty with motor planning due to somatosensory discrimination deficits.
Bilateral integration and sequencing deficits (D) relate to poor vestibular-proprioceptive
discrimination affecting coordination and motor execution.
Question 4
When the OT suspects tactile defensiveness as a rationale for a child's challenges, in which
area of participation should the OT focus FIRST?
A. Play behavior and peer interactions
B. Dressing habits and clothing preferences
C. Social skills development
D. Leisure interests and hobbies
Answer: B
Explanation: Children with tactile defensiveness are typically bothered by the tactile aspects
of daily living activities, particularly dressing. They may demonstrate specific clothing
, preferences or aversions, such as avoiding turtlenecks, socks with seams, or shoes, or
conversely, may refuse to remove shoes to minimize tactile input. Play behavior (A), social
skills (C), and leisure interests (D) may be affected secondarily as a result of intolerance to
certain textures or human touch. Assessing dressing habits provides the therapist with crucial
initial information about the child's sensory processing patterns.
Question 5
A child with autism spectrum disorder demonstrates inadequate playground skills, playing
alone and repeating the same play activities daily. Which approach will the OT MOST likely
select to promote her social play skills?
A. Join the group on the playground, facilitating the child's play while including other
children
B. Work with the child on the playground when other students are not present
C. Recommend that the parent enroll the child in extracurricular activities after school
D. Ask the physical education teacher to include the child in small groups during gross motor
activities
Answer: A
Explanation: Direct intervention in the natural environment provides the most effective
opportunity to facilitate social play skills. By joining the playground group, the therapist can
model appropriate social interactions, scaffold the child's participation, and support inclusion
with typically developing peers. This approach addresses both the child's individual needs
and the social context. Working in isolation (B) does not address the social participation goal,
extracurricular activities (C) may not provide adequate support, and delegating to the
physical education teacher (D) does not ensure specialized intervention.
Question 6
A preschooler is having difficulty performing tasks requiring eye-hand coordination as a
result of poor visual tracking skills. What activity should the OT use FIRST to promote visual
tracking skills?
A. Tossing and catching a water balloon
B. Catching and bursting soap bubbles
