PURPLE BOOK NBCOT FINAL STUDY SHEET
2026 QUESTIONS WITH COMPLETE ANSWERS
GRADED A+
◉ A 5-year-old child presents with difficulty climbing stairs, rising
from a sitting or lying position, and demonstrates progressive
fatigue caused by muscle weakness. The OT might suspect a problem
with:
A. Duchenne's muscular dystrophy
B. Limb-girdle muscular dystrophy
C. Facioscapulohumeral muscular dystrophy
D. A congenital muscular dystrophy. Answer: A. Duchenne's
muscular dystrophy is an X-linked recessive disorder caused by the
deficiency in the production of dystrophin. Dystrophin is a
component of the plasma membrane of the muscle fibers, the
deficiency of which causes the muscle to degenerate and
malfunction. The calf muscles are enlarged because of fibrosis and
proliferation of the adipose tissue, which causes muscle weakness.
Therefore, the child's condition could be diagnosed as Duchenne's
muscular dystrophy. (Occupational Therapy for Children by Case-
Smith)
◉ The behavioral characteristics of autism, a pervasive
developmental disorder (PDD), can be classified into four
,subclusters of disturbances. Of these disturbances, which is MOST
closely related to prognosis?
A. Disturbances in communication
B. Disturbances in behaviors
C. Disturbances in social interactions
D. Disturbances of sensory and perceptual processing Answer: A.
Disturbances in communication can range from mild (slight
articulation impairment) to severe (muteness); thus, the more mild
the communication deficit, the more likely the child will develop
sufficient communication to function as an adult. (Occupational
Therapy for Children by Case-Smith)
◉ A 3-year-old child is diagnosed with cerebral palsy and failure to
thrive, and reportedly has difficulty with drooling, chewing, and
swallowing. The OT should address:
A. Oral motor deficits
B. Motor sensory deficits
C. Self-feeding
D. Vestibular input Answer: A. Oral motor deficits relate to issues
with the oral motor musculature around the mouth. OTs are
qualified to address deficits related to swallowing or dysphagia,
chewing, and drooling. (Occupational Therapy for Children by Case-
Smith)
,◉ A kindergarten teacher observed that a 5-year-old child does not
participate in play with other children and avoids movement
activities on the playground. A screening test you would recommend
for this child to determine if there is a need for a more
comprehensive examination is:
A. Ages & Stages Questionnaires
B. The First STEP
C. Short Sensory Profile
D. Denver Developmental Screening Test-II (Denver-II) Answer: C.
The teacher has already identified the child as being at risk for
developmental or functional deficits. Therefore, it is appropriate to
use a type II assessment, which is the Short Sensory Profile. This
caregiver questionnaire measures the frequency of behaviors
related to sensory processing, modulation, and emotional
responsivity to sensory input in children 3 to 12 years of age. The
Ages & Stages Questionnaires, First STEP, and the Denver-II pertain
to the early screening to identify children at risk for disabilities.
(Occupational Therapy for Children by Case-Smith)
◉ A scenario in which an OT would use the School Function
Assessment examination is:
A. To measure the student's schoolwork task performance in the
classroom and provide information for effective programs and
consultation in the school setting
B. To assess what the child "did do" and what the child "could do" to
help determine the effect of the child's physical disability on
engagement in everyday occupations
, C. For screening children to determine whether they warrant further,
more comprehensive evaluation
D. To measure children's ability to participate in the academic and
social aspects of the school environment Answer: D. The School
Function Assessment is a judgment-based questionnaire designed to
measure a student's performance of functional tasks that support
his or her participation in the academic and social aspects of an
elementary school program (kindergarten through grade 6). Three
scales evaluate the student's level of participation, the type and
amount of task supports needed, and his or her activity performance
on specific school tasks. (Occupational Therapy for Children by Case-
Smith)
◉ An occupational therapy assistant (OTA) works with an OT in an
early intervention program at a local school. The portion of the
evaluation that the OT can assign the OTA to perform is:
A. Selecting evaluation methods and measures
B. Interpreting and analyzing assessment data
C. Administering some of the assessments
D. Documenting some of the goals Answer: C. According to the
Standards of Practice for Occupational Therapy, an OTA would
perform functions such as administering some of the assessments
and documenting some of the results. Selecting evaluation methods
and measures, interpreting and analyzing assessment data, and
writing goals are function of the OT. (Occupational Therapy for
Children by Case-Smith)
2026 QUESTIONS WITH COMPLETE ANSWERS
GRADED A+
◉ A 5-year-old child presents with difficulty climbing stairs, rising
from a sitting or lying position, and demonstrates progressive
fatigue caused by muscle weakness. The OT might suspect a problem
with:
A. Duchenne's muscular dystrophy
B. Limb-girdle muscular dystrophy
C. Facioscapulohumeral muscular dystrophy
D. A congenital muscular dystrophy. Answer: A. Duchenne's
muscular dystrophy is an X-linked recessive disorder caused by the
deficiency in the production of dystrophin. Dystrophin is a
component of the plasma membrane of the muscle fibers, the
deficiency of which causes the muscle to degenerate and
malfunction. The calf muscles are enlarged because of fibrosis and
proliferation of the adipose tissue, which causes muscle weakness.
Therefore, the child's condition could be diagnosed as Duchenne's
muscular dystrophy. (Occupational Therapy for Children by Case-
Smith)
◉ The behavioral characteristics of autism, a pervasive
developmental disorder (PDD), can be classified into four
,subclusters of disturbances. Of these disturbances, which is MOST
closely related to prognosis?
A. Disturbances in communication
B. Disturbances in behaviors
C. Disturbances in social interactions
D. Disturbances of sensory and perceptual processing Answer: A.
Disturbances in communication can range from mild (slight
articulation impairment) to severe (muteness); thus, the more mild
the communication deficit, the more likely the child will develop
sufficient communication to function as an adult. (Occupational
Therapy for Children by Case-Smith)
◉ A 3-year-old child is diagnosed with cerebral palsy and failure to
thrive, and reportedly has difficulty with drooling, chewing, and
swallowing. The OT should address:
A. Oral motor deficits
B. Motor sensory deficits
C. Self-feeding
D. Vestibular input Answer: A. Oral motor deficits relate to issues
with the oral motor musculature around the mouth. OTs are
qualified to address deficits related to swallowing or dysphagia,
chewing, and drooling. (Occupational Therapy for Children by Case-
Smith)
,◉ A kindergarten teacher observed that a 5-year-old child does not
participate in play with other children and avoids movement
activities on the playground. A screening test you would recommend
for this child to determine if there is a need for a more
comprehensive examination is:
A. Ages & Stages Questionnaires
B. The First STEP
C. Short Sensory Profile
D. Denver Developmental Screening Test-II (Denver-II) Answer: C.
The teacher has already identified the child as being at risk for
developmental or functional deficits. Therefore, it is appropriate to
use a type II assessment, which is the Short Sensory Profile. This
caregiver questionnaire measures the frequency of behaviors
related to sensory processing, modulation, and emotional
responsivity to sensory input in children 3 to 12 years of age. The
Ages & Stages Questionnaires, First STEP, and the Denver-II pertain
to the early screening to identify children at risk for disabilities.
(Occupational Therapy for Children by Case-Smith)
◉ A scenario in which an OT would use the School Function
Assessment examination is:
A. To measure the student's schoolwork task performance in the
classroom and provide information for effective programs and
consultation in the school setting
B. To assess what the child "did do" and what the child "could do" to
help determine the effect of the child's physical disability on
engagement in everyday occupations
, C. For screening children to determine whether they warrant further,
more comprehensive evaluation
D. To measure children's ability to participate in the academic and
social aspects of the school environment Answer: D. The School
Function Assessment is a judgment-based questionnaire designed to
measure a student's performance of functional tasks that support
his or her participation in the academic and social aspects of an
elementary school program (kindergarten through grade 6). Three
scales evaluate the student's level of participation, the type and
amount of task supports needed, and his or her activity performance
on specific school tasks. (Occupational Therapy for Children by Case-
Smith)
◉ An occupational therapy assistant (OTA) works with an OT in an
early intervention program at a local school. The portion of the
evaluation that the OT can assign the OTA to perform is:
A. Selecting evaluation methods and measures
B. Interpreting and analyzing assessment data
C. Administering some of the assessments
D. Documenting some of the goals Answer: C. According to the
Standards of Practice for Occupational Therapy, an OTA would
perform functions such as administering some of the assessments
and documenting some of the results. Selecting evaluation methods
and measures, interpreting and analyzing assessment data, and
writing goals are function of the OT. (Occupational Therapy for
Children by Case-Smith)
