OTA 200 Final Exam

Why is caregiver education an important consideration for any pediatric OTA? Select the BEST answer Correct answer- Families/Caregivers must understand what they can do and why they should do it to ensure home carryover and client gains What is an infant's first method of mobility? Correct answer- Rolling On which of the performance contexts can the pediatric occupational therapy practitioner have the greatest impact? Correct answer- Environmental Context What long term goals would a COTA who works in an outpatient pediatric clinic work on with an 8 year old child with cerebral palsy? Correct answer- Dressing, buttoning one inch buttons, and related modifications and adaptations What long term goals would a COTA work on in a school setting with an ambulatory six year old child who has a one year developmental delay throughout all developmental areas gross motor, personal social, sensory motor, activities of daily living and fine motor skills. Correct answer- Attention span for circle time activities, toilet hygiene for wiping, taking off and putting on a light weight jacket, and handwriting for school tasks What goals would a COTA working in an acute hospital setting work on with a 16 year old who has asthma and is being chronically readmitted? Correct answer- Use of psycho educational model to instruct client in triggers for asthma, strategies for incorporating the use of an inhaler when needed; ensuring that an inhaler is available at all times; and energy conservation techniques related to dressing such as sitting down to put pants, socks, and shoes on in a straight back chair that has back support What goals would a COTA work on in a home bound setting with a child with a three year old who has Down's Syndrome and has not met their developmental milestones? This child is being treated at home for they are medically fragile. Correct answer- Protective extension to the front and self-feeding starting with finger foods and decreased tongue thrust. A new student age 10 with HIV has been added to a COTA's fine motor group in a school setting. The group involves cutting with scissors and the use of a plastic knife for cold meal preparation? The COTA knows that they need to do the following? Correct answer- Proceed to implement treatment per standard policies, procedures, and precautions The COTA's role in the evaluation phase is: Correct answer- To give assessments tools within their competency level The OTR's role in the evaluation phase is: Correct answer- To determine the areas to be assessed, choose the evaluation tool to be used, and to interpret the test results To provide for trunk stability in a patient with cerebral palsy what would you use? Correct answer- A wheelchair with lateral side supports and a lap tray. What do you do with a child with spasticity? Correct answer- Rhythmic movements combined with gentle shaking One of the concerns seen most frequently in cerebral palsy is: Correct answer- - Absent or impaired righting and equilibrium responses. - Wide ranges of movement patterns Occupational therapy practitioners use positioning and handling techniques for children with cerebral palsy to: Correct answer- - Maintain postural alignment - Facilitate improved movement patterns - Facilitate performance of ADL's Useful techniques to help special children tolerate hair care do not include which one of the following: Correct answer- Using quick, fast, & light touch movements A child with severely limited strength, coordination and problem solving would probably not benefit from which one of the following dressing methods? Correct answer- A button hook for buttons To promote safe mobility the COTA does not use which one of the following methods with a child? Correct answer- Using momentum such as running to help the child go up and down steps Which activity would typically present the mostchallenge to a 5 year old child who has moderate spastic diplegia? Correct answer- Clinging with their lower extremities to playground equipment Which activity would typically present the most challenge to a 5 year old child who has moderate upper extremity spastic hemiplegia and mild lower extremity hemiplegia? Correct answer- Rolling a ball across a tabletop to another child & balancing up and down on a teeter tauter One of the most commonly used assessment tool for obtaining an in-depth knowledge of a child's sensory responses is the: Correct answer- Child Sensory Profile The Theory of Sensory Integration believes that Correct answer- The concept of neuroplasticity is an essential component of SI. While there are many sensory systems in the human body, SI intervention targets Correct answer- Tactile, vestibular, and proprioceptive An example of a childhood activity that requires good vestibular functioning is Correct answer- Playing hopscotch An example of a 7-year-old child with the Sensory Modulation DIsorder of Over- Responsivity would be Correct answer- A child who cries when asks to do finger painting An example of something a parent might say that would indicate a possible SPD is Correct answer- John screams every time I say "it is time to brush your teeth". In the context of SPD's, the phrase "clinical observations" refers to Correct answer- Observation of a child's performance on specific sensory related tasks. Recommending a sensory diet means Correct answer- Making sure the child gets recommended sensory input throughout the day. Which choice below is not a major safety concern when using suspended equipment during intervention? Correct answer- Triggering an autonomic nervous system reaction. Important questions to ask family or caregivers to provide information regarding the student's sensory processing include Correct answer- - Does you child seek sensory input and prefer rough and tumble play? - Does your child dislike tags in clothing, seams on socks, and/or pants that do not cover their ankles? - Is your child often constipated? What is a sensory rich activity of daily living? Correct answer- Brushing your teeth Rooting Reflex Correct answer- a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple Tonic Labyrinthine Reflex (TLR) Correct answer- - 0 - 6 months - Prone position = Maximal flexor tone ( UE + LE held in flexion) - Supine position = Maximal Extensor tone ( UE + LE held in extension) If persists, it will interfere with : - Ability to initiate rolling - Ability to prop on elbows with extended hips when prone - Ability to flex trunk and hips to come to a sitting position from supine - Often causes full body extension, which interferes with balance in sitting or standing. Forward Parachute Reflex Correct answer- 6 to 9 months -- persists stimulus: suddenly tip infant forward toward supporting surface while vertically suspended response: sudden extension of UE, hand opening, and neck extension relevance: allows accurate placement of UE in anticipation of supporting surface to prevent a fall Backward Parachute Reflex Correct answer- 9 to 10 months -- persists stimulus: quickly but firmly tip infant off-balance backward response: backward arm extension or arm extension to one side relevance: protects body to prevent a fall; unilaterally facilitates spinal rotation Sideward Parachute Reflex Correct answer- 7 months -- persists stimulus: quickly but firmly tip infant off-balance to the side while in the sitting position response: arm extension and ABduction to the side relevance: protects body to prevent a fall; supports body for unilateral use of opposite arm Moro Reflex Correct answer- Infant reflex where a baby will startle in response to a loud sound or sudden movement. ATNR Reflex Correct answer- Landau reflex Correct answer- STNR (symmetrical tonic neck reflex) Correct answer- Babinski reflex Correct answer- Tongue Lateralization Correct answer- movement of the tongue to the sides of the mouth to propel food between the teeth for chewing Tongue lateralization with a downward thrust pattern Correct answer- Tongue depression Correct answer- Cerebral Palsy Correct answer- - Result of a lesion in the cerebral cortex of the central nervous system (CNS) that is nonprogressive • CNS damage occurs prenatally, perinatally, or within the first 2 years of life • Not hereditary, progressive, or contagious Dyskinetic Cerebral Palsy Correct answer- Cerebral palsy that involves continuous involuntary movements associated with hyperbilirubinemia and amage to basal nuclei ganglion; manifestations include drooling and uncontrollable movements of the face and extremeties Athetosis Correct answer- Fluctuation of muscle tone from low to normal, with little or no spasticity and poor co-activation Choreoathetosis Correct answer- Constant fluctuations from high to low and jerky movements Dystonia Correct answer- Sustained twisted postures triggered by movement Ataxic Cerebral Palsy Correct answer- • Small shifts in muscle tone • Typically, all extremities involved • Clumsy, with decreased balance and coordination • Decreased equilibrium reactions and lack of proximal stability Mixed Cerebral Palsy Correct answer- • Combinations of high and low tone • Hypertonic movement in extremities (increased flexor tone in the arms and increased extensor tone in the legs) • Hypotonic flexor muscles in neck and trunk Oral Hypersensitivity Correct answer- - Over responsive gag reflex - Preference to maintain tongue at midline; poor lateral tongue movement - Tight lips, cheeks, tongue - Abnormal resting pattern of facial muscles, tongue, jaw Oral Hyposensitivity Correct answer- - Overstuffs mouth - Does not chew food thoroughly - Tongue movements are sloppy and poorly coordinated Beckman Oral Motor Correct answer- Facial massage prior to attempting to get child ready for touch and determine how to grade pace for child's comfort level. Sensory Integration Correct answer- Sensor Modulation Disorder Correct answer- Sensory over-responsivity (SOR) Sensory under-responsivity Sensory seeking/craving Sensory Discrimination Disorder (SDD) Correct answer- Have difficulties and have problems determining the characteristics of sensory stimuli. Examples; (Do I see a "P" or a "Q"? Do I hear "cat" or "cap"? Do I feel a quarter or a dime in my pocket? Am I falling to the side or backwards?). Sensory-Based Motor Disorder (SBMD) Correct answer- -includes underlying sensory discrimination disorder as well as possible sensory modulation disorder -dyspraxia -sensory-based postural disorders Dyspraxia Correct answer- Difficulty planning and carrying out new motor actions. May have difficulty in forming a goal or idea, planning a sequence of actions or performing new motor tasks. - These individuals are clumsy, awkward, and accident-prone. What behaviors might you see that provides a hint on the presence of SPD's? Correct answer- And n the home, classroom, and community. Diadokokinesis Correct answer- Rapid, repetitive bilateral forearm rotations ■ Do it with each arm individually, then do both arms together ■ Check for smoothness, fluidity, and number of rotations ■ Watch for excessive humeral abd/adduction ■ 5yo can do 2-4 bilateral smooth rotations in 10 seconds ■ 7-8yo can do 10 in 10 seconds indicating full maturity