PURPLE BOOK NBCOT FULL PAPER 2026
QUESTIONS WITH ANSWERS GRADED A+
◉ In the assessment phase of early intervention, an OT assesses the
daily living skills of an infant. In the context of early intervention, the
areas that are being assessed are:
A. Feeding and sleeping patterns
B. Play and leisure patterns
C. Motor development patterns
D. Sensory development patterns Answer: A. Daily living skills in
infants refer to self-sustaining skills, such as feeding and sleeping.
Sleep patterns can be evaluated from the parent's description of a
typical day. Daily living skills also refer to bathing and dressing, but
this is as it involves the parents. (Pediatric Occupational Therapy
and Early Intervention by Case-Smith)
◉ An assessment team in early intervention has completed an
evaluation of a toddler. In compiling the Individualized Family
Service Plan, the goals should be determined by the:
A. Service coordinator for the case
B. Therapists from each discipline
C. Reimbursing agency
D. Parents Answer: D. Although therapists suggest goals based on
the evaluation process, ultimately a child's parents decide which
,goals will be included and which goals are a priority. Goals that
relate specifically to the family's concerns about the care of their
child are included in the plan. If therapists have other goals, these
can be added with parental consent. (Pediatric Occupational
Therapy and Early Intervention by Case-Smith)
◉ In early intervention there are different types of risk factors. A
child with Down syndrome is an example of:
A. Biological risk
B. Environmental risk
C. Established risk
D. Recurring risk Answer: C. Children with known chromosomal,
structural, or metabolic defects are classified as having established
risk. (Pediatric Occupational Therapy and Early Intervention by
Case-Smith)
◉ The parent of a child that is being treated in therapy describes
how the child covers their ears when riding in the car with the
windows down. The parent does not understand why the child
persists in this behavior. The OT explains that this behavior could be
the result of:
A. Sensory defensiveness
B. Gravitational insecurity
C. Underresponsiveness
,D. Aversion to movement Answer: A. A child experiencing sensory
defensiveness has a tendency to respond negatively to sensation that
is considered by most people to be noninvasive or nonirritating. This
frequently includes hyperresponsiveness to light or unexpected
touches, high-frequency noises, certain visual stimulation, or certain
smells and tastes. (Sensory Integration: Theory and Practice by
Bundy)
◉ An OT is using the Peabody Developmental Motor Scales to
evaluate a child. The therapist is assessing the child's:
A. Performance of tasks that support school participation
B. Visual perception skills in community settings
C. Gross and fine motor skills
D. Performance in everyday tasks Answer: C. The Peabody assesses a
child's abilities with gross and fine motor skills. (Occupational
Therapy for Children by Case-Smith)
◉ A patient diagnosed with insulin dependent diabetes mellitus is
referred to occupational therapy for splinting. A primary area that
must be assessed before prescribing a splint is:
A. Edema
B. Sensation
C. Pain
D. Fine motor manipulation Answer: B. Persons with long-standing
diabetes frequently have increased incidences of other conditions,
, such as peripheral neuropathies. Therefore, a sensory evaluation is
necessary to determine if sensation is diminished. A person with
diminished sensation secondary to peripheral neuropathy may not
be able to perceive or gauge pressure when wearing a splint. This
can lead to skin breakdown. (Introduction to Splinting: A Clinical
Reasoning & Problem Solving Process by Coppard and Lohman)
◉ An OT is asked to administer a test to a child and compare the
assessment results or scores to the sample population of children
that have similar characteristics as this child. The BEST type of
evaluation to administer would be:
A. Criterion-referenced test
B. Norm-referenced test
C. Skilled observation
D. Checklist Answer: B. A norm-referenced test is developed by
giving the test in question to a large number of children, usually
several hundred or more. This group is the more normative group
and norms or averages are derived from this sample. When a norm-
referenced test is administered, the performance of the child being
tested is compared to the normative sample. (Occupational Therapy
for Children by Case-Smith)
◉ During an evaluation, the OT must determine a child's exact
chronological age. The child was born on March 6, 2003 and the
testing date is July 12, 2006. The child's chronological age is:
A. 4 years, 6 months, 5 days
QUESTIONS WITH ANSWERS GRADED A+
◉ In the assessment phase of early intervention, an OT assesses the
daily living skills of an infant. In the context of early intervention, the
areas that are being assessed are:
A. Feeding and sleeping patterns
B. Play and leisure patterns
C. Motor development patterns
D. Sensory development patterns Answer: A. Daily living skills in
infants refer to self-sustaining skills, such as feeding and sleeping.
Sleep patterns can be evaluated from the parent's description of a
typical day. Daily living skills also refer to bathing and dressing, but
this is as it involves the parents. (Pediatric Occupational Therapy
and Early Intervention by Case-Smith)
◉ An assessment team in early intervention has completed an
evaluation of a toddler. In compiling the Individualized Family
Service Plan, the goals should be determined by the:
A. Service coordinator for the case
B. Therapists from each discipline
C. Reimbursing agency
D. Parents Answer: D. Although therapists suggest goals based on
the evaluation process, ultimately a child's parents decide which
,goals will be included and which goals are a priority. Goals that
relate specifically to the family's concerns about the care of their
child are included in the plan. If therapists have other goals, these
can be added with parental consent. (Pediatric Occupational
Therapy and Early Intervention by Case-Smith)
◉ In early intervention there are different types of risk factors. A
child with Down syndrome is an example of:
A. Biological risk
B. Environmental risk
C. Established risk
D. Recurring risk Answer: C. Children with known chromosomal,
structural, or metabolic defects are classified as having established
risk. (Pediatric Occupational Therapy and Early Intervention by
Case-Smith)
◉ The parent of a child that is being treated in therapy describes
how the child covers their ears when riding in the car with the
windows down. The parent does not understand why the child
persists in this behavior. The OT explains that this behavior could be
the result of:
A. Sensory defensiveness
B. Gravitational insecurity
C. Underresponsiveness
,D. Aversion to movement Answer: A. A child experiencing sensory
defensiveness has a tendency to respond negatively to sensation that
is considered by most people to be noninvasive or nonirritating. This
frequently includes hyperresponsiveness to light or unexpected
touches, high-frequency noises, certain visual stimulation, or certain
smells and tastes. (Sensory Integration: Theory and Practice by
Bundy)
◉ An OT is using the Peabody Developmental Motor Scales to
evaluate a child. The therapist is assessing the child's:
A. Performance of tasks that support school participation
B. Visual perception skills in community settings
C. Gross and fine motor skills
D. Performance in everyday tasks Answer: C. The Peabody assesses a
child's abilities with gross and fine motor skills. (Occupational
Therapy for Children by Case-Smith)
◉ A patient diagnosed with insulin dependent diabetes mellitus is
referred to occupational therapy for splinting. A primary area that
must be assessed before prescribing a splint is:
A. Edema
B. Sensation
C. Pain
D. Fine motor manipulation Answer: B. Persons with long-standing
diabetes frequently have increased incidences of other conditions,
, such as peripheral neuropathies. Therefore, a sensory evaluation is
necessary to determine if sensation is diminished. A person with
diminished sensation secondary to peripheral neuropathy may not
be able to perceive or gauge pressure when wearing a splint. This
can lead to skin breakdown. (Introduction to Splinting: A Clinical
Reasoning & Problem Solving Process by Coppard and Lohman)
◉ An OT is asked to administer a test to a child and compare the
assessment results or scores to the sample population of children
that have similar characteristics as this child. The BEST type of
evaluation to administer would be:
A. Criterion-referenced test
B. Norm-referenced test
C. Skilled observation
D. Checklist Answer: B. A norm-referenced test is developed by
giving the test in question to a large number of children, usually
several hundred or more. This group is the more normative group
and norms or averages are derived from this sample. When a norm-
referenced test is administered, the performance of the child being
tested is compared to the normative sample. (Occupational Therapy
for Children by Case-Smith)
◉ During an evaluation, the OT must determine a child's exact
chronological age. The child was born on March 6, 2003 and the
testing date is July 12, 2006. The child's chronological age is:
A. 4 years, 6 months, 5 days
