8 month old child w/ myelomeningocele at L1 with normal
cognitive function. Which activity would OTA most likely focus
on?
A. Doffing sleeves of overhead shirts with assistance.
B. Increasing trunk balance when placed in sitting.
C. Transferring objects from one hand to the other.
D. Transitioning from sitting to supine and from supine to
sitting. Correct Answers B. Increasing trunk balance when
placed in sitting.
Rationale: This is normal for 8 month old. Gross motor skills
development in childs with myelomeningocele parallel those of
a typical child. The difference is that upright mobility at the 12
to 18 month level concentrates on use of assistive devices.
&
-Doffing sleeves overhead is a skill consistent at the 10 to 12
month level.
-Transferring objects from one hand to another is found at the 6
to 8 month level
-Transition from sitting to supine comes after working on trunk
balance after being placed in sitting, from 9 to 11 months.
9 y/o girl hospitalized w/ cystic fibrosis. Hospital does not have
play area and has no other children. Which age-appropriate
activity should OTA suggest for hospital volunteers to do with
child?
,A. Dressing paper dolls.
B. Coloring in coloring books.
C. Playing card games.
D. Cutting and pasting pictures on cards. Correct Answers C.
Playing card games.
Rationale: Children aged 7-12 are developmentally able to
participate in games with rules, competition, and social
interaction. The other activities reflect creative play that is
developed between ages 4 and 7. In addition, they are solitary
activities and do not afford opportunities for competitive fun and
socialization. Hospitalization can be lonely and frightening, so
having volunteers play with the child can be psychologically
beneficial, as well as developmentally appropriate.
A 5 year-old demonstrates age-appropriate cognitive and fine
motor skills. Which activity would the child be able to complete
at this developmental level?
A. Cutting long thin strips with scissors.
B. Holding and snipping with scissors.
C. Cutting simple figure shapes with scissors.
D. Opening and closing scissors in a controlled fashion. Correct
Answers C. Cutting simple figure shapes with scissors.
Rationale: According to established developmental milestones,
cutting simple figure shapes is a 4- to 6-year-old cognitive and
fine motor skill. Cutting strips is a 3- to 4-year-old skill. Holding
and snipping with scissors and opening and closing scissors in a
controlled fashion are 2- to 3-year-old skills.
,A child w/ a tactile defensive sensory modulation disorder
attends a private early intervention clinic. The OTA collaborates
with the child's parents to develop strategies and guidelines to
help the child handle the symptoms of this disorder at home.
Which is the best recommendation for the OTA to make to the
parents?
A. Avoid the use of swings and other moving equipment during
play activities.
B. Encourage the use of swings and other moving equipment
during play activities.
C. Soften the child's clothing by repeated laundering and remove
clothing tags.
D. Provide a variety of textures in the clothing the child wears.
Correct Answers C. Soften the child's clothing by repeated
laundering and remove clothing tags.
Rationale: Children w/ tactile defensive sensory modulation
disorder find stiff clothing, textured clothing, and clothing tags
aversive. The use or avoidance of swings and other moving play
equipment is indicated for vestibular processing disorder.
A child w/ spinal muscle atrophy can no longer reach beyond 90
degrees of shoulder abduction and 90 degrees of shoulder
flexion. The parents state that the child can no longer
independently don or doff a T-shirt. Which is the best approach
for the OTA to recommend the child use to don a T-shirt?
A. Place the T-shirt directly on the child's lap, have the child
don the arms first, then don the head of the T-shirt.
, B. Have the child wear front-opening shirts instead of T-shirts to
eliminate the need to don shirts over the head.
C. Have the child support the elbows on a table at chest height to
don the T-shirt over the arms, then don over the head.
D. Have the child lean to the right and don the right arm, repeat
with the left arm, and then don the head of the T-shirt. Correct
Answers C. Have the child support the elbows on a table at
chest height to don the T-shirt over the arms, then don over the
head.
Rationale: Spinal muscle atrophy is a progressive disorder and
the OTA needs to prepare the child/family for progressive skill
loss. The best technique, as shoulder ROM decreases, is to use a
table for support to don the arms then use elbow and neck
flexion to don the T-shirt over the head. Wearing front-opening
shirts instead of T-shirts is an effective compensatory technique
to eliminate the need to don shirts over the head. However, the
exam item specifically asked for an approach to help the child
don a T-shirt. When the child can no longer don a T-shirt using
adaptive strategies, the use of front-opening shirts can
effectively maintain the child's independence in dressing.
A client has right-sided weakness and decreased motor control.
The OTA uses the proprioceptive neuromuscular faciitation
(PNF) approach to help the client increase use of the right upper
extremity and hand. Which of the following actions should the
OTA have the client do during an intervention session to apply
PNF principles?
A. Reach overhead with the right hand to retrieve a dish out of a
higher cabinet and set it down on the countertop in front.