NBCOT Practice Questions with Certified Solutions

NBCOT Practice Questions with Certified Solutions Entry into the early intervention system begins with which of the following? A. Screening for developmental delay B. Individualized Family Service Plan C. Screening for family environmental risk factors D. Individualized Education Plan (IEP) A. A family is referred for an early intervention screening at which a developmental therapist or OT screens the child to determine if a full assessment is necessary. (Pediatric Occupational Therapy and Early Intervention by Case-Smith) 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 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 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 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 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 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 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 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 B. 3 years, 2 months, 6 days C. 4 years, 5 months, 6 days D. 3 years, 4 months, 6 days D. The day, month, and year of the child's birth date is subtracted from the date of testing. (Occupational Therapy for Children by Case-Smith) An OT has to calculate the corrected age for a child that was born prematurely. The child had a due date of September 20, 2005 and their birth date was June 12, 2005. The child was born 3 months, 8 days premature and is currently 1 year, 1 month, 25 days old. The therapist determines the corrected age is: A. 10 months, 17 days B. 12 months, 2 days C. 9 months, 8 days D. 7 months, 10 days A. Corrected age is used for children who were born prematurely to "correct" for the number of weeks they were born before the due date. Generally the age is corrected until the child turns 2 years old. Many practitioners consider 36 to 37 weeks and above to be full-term gestation. Children with a gestation period of 36 weeks and above do not receive a corrected age. Subtract the birth date from the due date to yield the exact measurement of prematurity, and to calculate the corrected age, subtract the amount of prematurity from the chronological age. (Occupational Therapy for Children by Case-Smith) A 3-year-old child has been referred for early intervention. In the discussion about intervention with the family, the team should be sure to: A. Use lay terminology to describe the early intervention process B. Explain conditions in detailed technical and medical terms C. Discourage parents asking questions D. Ignore parents' feedback and ideas on intervention A. The team dealing with the case should use lay terminology to describe the early intervention process and repeat information to make sure that the parents understand. They should also welcome parental feedback and incorporate the parents' ideas into a suggested activity. Professionals should encourage parents to ask questions and repeat information when necessary. Because the language used by health care professionals is often technical and medically related, families can easily misunderstand its meaning. OTs and other team members must make a concerted effort to use lay terminology to describe function, rather than neurophysiologic components. (Occupational Therapy for Children by Case-Smith) A 6-year-old is interested in learning to roller skate. However, after the initial few minutes of practice the child does not continue with it and appears to lack the will to follow up what was started. This behavior is typical of Erik Eriksson's psychosocial development stage that deals with: A. Basic trust versus mistrust stage B. Autonomy versus doubt and shame stage C. Self-identity versus role diffusion stage D. Security versus instability B. This stage is characterized by holding on and letting go and is exemplified by the crisis that occurs through the toilet-training process. This stage brings independent movement away from the parents, enabling the child to explore the environment. Parents must provide opportunities for the child to make choices and develop a sense of self-controlled will. (Occupational Therapy for Children by Case-Smith) Which one of the four components of the adaptation process pertains to reception of sensory stimuli from internal and external environments? A. Assimilation B. Accommodation C. Association D. Differentiation A. Assimilation is the reception of sensory stimuli from internal and external environments. Accommodation is the motor response to these stimuli. Association is the organized process of relating current sensory information with the current motor response and then relating this relationship to past responses. Differentiation is the process of identifying the specific elements in a situation that are useful and relevant to another situation to refine the responsive pattern. (Occupational Therapy for Children by Case-Smith) A 4-year-old has been diagnosed with mental retardation. A characteristic that is likely to occur with impaired intellectual ability is: A. Acceptable social skills B. Impairment of occupational performance areas C. Development of bizarre attachment to unusual objects D. Poor eye contact B. A child diagnosed with mental retardation will show significantly impaired intellectual ability, behavioral deficits, and impairmnet of the skills required for independence in occupational performance areas (i.e., age-appropriate play, dressing, and communication). (Occupational Therapy for Children by Case-Smith) A 3-year-old has accidentally ingested lead while playing near ceramic tiles that the family bought to renovate their house. A system that an OT working in pediatric acute care would note to be affected by lead poisoning would be: A. Vocal B. Circulatory C. Digestive D. Cardiac B. In lead poisoning, lead affects the circulatory system by severely limiting the body's ability to synthesize heme, leading to the accumulation of alternate metabolites in the body and, ultimately, anemia. The most significant and irreversible damage occurs in the nervous system. Fluid builds up in the brain, and intracranial pressure can reach life-threatening levels. Cortical atrophy and lead encephalitis can lead to mental retardation, paralysis, blindness, and deafness. (Occupational Therapy for Children by Case-Smith) A child with cerebral palsy shows significant impairment in the function of the lower extremities with mild involvement of the upper extremities. The classification of cerebral palsy for this child would be: A. Hemiplegia B. Tetraplegia C. Choreoathetosis D. Diplegia D. In diplegia, the lower extremities are impaired significantly, with only mild involvement of the upper extremities. Hemiplegia involves the impairment of upper and lower limbs on one side of the body, and tetraplegia or quadriplegia means that all four extremities are affected. Therefore, diplegia is the possible classification of the child's condition. (Occupational Therapy for Children by Case-Smith) A 7-year-old child is diagnosed with attention deficit hyperactivity disorder (ADHD). An etiology for ADHD would be: A. Environmental factors B. Visual and auditory stimulation C. Food allergies and food additives D. Neurochemical imbalances D. Although researchers are still struggling to find conclusive evidence for the etiology of ADHD, studies have demonstrated that ADHD runs in families and three genes have been found to be related to ADHD implicating genetic factors. Imaging in individuals with ADHD has shown decreased activity in the frontal parietal lobes, which inhibit impulsiveness, pointing to neurologic factors. Medications that influence neurotransmitter function are effective in treatment of ADHD, indicating neurochemical imbalances. (Occupational Therapy for Children by Case-Smith) A 5-year-old child has been diagnosed with a pervasive disorder that affects both the neurologic and motor behavioral functions. The diagnosis that MOST closely relates to the child's condition is: A. Respiratory distress syndrome B. Tourette's syndrome C. Asperger's syndrome D. Learning disabilities B. Tourette's syndrome is a pervasive disorder that affects neurologic and motor behavioral function, especially motor tics and vocalizations. Therefore, it is likely that the child has Tourette's syndrome. (Occupational Therapy for Children by Case-Smith) A 5-year-old child with Down syndrome shows significant loss of weight, high fever, and paleness, and is diagnosed with acute lymphoid leukemia. In which of the following phases of leukemia will he be administered chemotherapy to treat small deposits of cells that remain after remission? A. Phase I - Induction therapy B. Phase II - Central nervous system prophylaxis C. Phase III - Intensification and consolidation D. Phase IV - Maintenance or continuation therapy C. Chemotherapy is administered in Phase III - the intensification and consolidation phase- to remove small deposits of cells that remain after remission. (Occupational Therapy for Children by Case-Smith) 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 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 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 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) 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 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 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)