NBCOT (COTA) Exam Prep
Development of Sensorimotor Integration - answerPrenatal Period
Neonatal Period
First 6mo
6-12mo
13-24mo
2-3yrs
3-7yrs
Prenatal Period - answerResponds first to tactile stimuli
Reflex Development
Innate tactile, proprioceptive, and vestibular input reactions
Neonatal Period - answerTactile, proprioceptive, and vestibular inputs are critical from birth
onward for the eventual development of body scheme.
Vestibular system, although fully developed at birth, continues to be refined and impacts on the
infant's arousal. Helps the infant to feel more organized and content.
Visual system develops as infant responds to human faces and items of high contrast places
approximately 10in from the face.
Auditory system is immature at birth and develops as the infant orients to voices and other
sounds.
First 6mo - answerVestibular, proprioceptive, and visual systems become more integrated and lay
the foundation for postural control, which facilitates a steady visual field.
Tactile and proprioceptive systems continue to be refined, laying the foundation for development
of somatosensory skills.
Visual and tactile systems become more integrated as the child reaches out and grasps objects,
,laying the foundation for eye-hand coordination.
Infant movement patterns progress from reflexive to voluntary and goal directed.
6-12mo - answerVestibular, visual, and somatosensory responses increase in quantity and quality
as the infant becomes more mobile.
Tactile and proprioceptive perception becomes more refined, allowing for development of fine
motor and motor planning skills.
Tactile and proprioceptive responses also lead to midline skills and eventual crossing of midline.
Auditory, tactle, and proprioceptive perception is heightened allowing for development of sounds
for the purpose of communication.
Tactile, proprioceptive, gustatory, and olfactory perception are integrated, allowing for primitive
self-feeding.
13-24mo - answerTactile perception becomes more precise allowing for discrimination and
localization to further refinement of fine motor skills.
Further integration of all systems promotes the complexity of motor planning as the toddler's
repertoire of movement patterns expands.
Symbolic gesturing and vocalization promotes ideation, indicating the toddler's ability to
conceptualize.
Motor planning abilities contribute to self-concept as the toddler begins to master the
environment.
2-3yrs - answerThis is a period of refinement as the vestibular, proprioceptive, and visual systems
further develop, leading to improved balance and postural control.
Further development of tactile discrimination and localization lead to improved fine motor skills.
Motor planning and praxis ideation also progresses during this period for more skillful
occupational performance.
3-7yrs - answerChild is driven to challenge sensorimotor competencies through roughhouse play,
playground activities, games, sports, music, dancing , arts and crafts, household chores, and
school tasks. These occupations provide opportunities to promote psychosocial development and
, self-esteem.
Crossing Midline - answerAs the child becomes more mobile, movement against gravity and
weightshift increase, leading to eventual crossing of the midline, often in attempt to reach for a
toy, while weightbearing on the opposing upper extremity for balance. Begins at 9-12mo.
Laterality - answerHemispheric specialization for specific tasks varies with different individuals
Bilateral Integration - answerAs the child experiments with movement, the nervous system is
stimulated, and the resulting sensations help the child to coordinate the two sides of the body.
Begins at 9-12mo.
Visual-Motor Integration - answerDependent upon the lower level skills of visual attention, visual
memory, visual discrimination, kinesthesia, position in space, figure ground, form constancy, and
spatial relations.
Oral-Motor Control - answerDeveloped in the area of feeding, provides the foundation for early
oral communication and later language development.
Rooting Reflex - answerOnset Age: 28wk gestation
Integration Age: 3mo
Stimulus: Stroke corner of the mouth, upper lip, and lower lip.
Response: Movement of the tongue, mouth, and/or head toward stimulus.
Relevance: Allows searching for and locating feeding source.
Suck-Swallow Reflex - answerOnset Age: 28wk gestation
Integration Age: 2-5mo
Stimulus: Place examiner's index finger inside infant's mouth with head in midline.
Response: Strong, rhythmical sucking
Development of Sensorimotor Integration - answerPrenatal Period
Neonatal Period
First 6mo
6-12mo
13-24mo
2-3yrs
3-7yrs
Prenatal Period - answerResponds first to tactile stimuli
Reflex Development
Innate tactile, proprioceptive, and vestibular input reactions
Neonatal Period - answerTactile, proprioceptive, and vestibular inputs are critical from birth
onward for the eventual development of body scheme.
Vestibular system, although fully developed at birth, continues to be refined and impacts on the
infant's arousal. Helps the infant to feel more organized and content.
Visual system develops as infant responds to human faces and items of high contrast places
approximately 10in from the face.
Auditory system is immature at birth and develops as the infant orients to voices and other
sounds.
First 6mo - answerVestibular, proprioceptive, and visual systems become more integrated and lay
the foundation for postural control, which facilitates a steady visual field.
Tactile and proprioceptive systems continue to be refined, laying the foundation for development
of somatosensory skills.
Visual and tactile systems become more integrated as the child reaches out and grasps objects,
,laying the foundation for eye-hand coordination.
Infant movement patterns progress from reflexive to voluntary and goal directed.
6-12mo - answerVestibular, visual, and somatosensory responses increase in quantity and quality
as the infant becomes more mobile.
Tactile and proprioceptive perception becomes more refined, allowing for development of fine
motor and motor planning skills.
Tactile and proprioceptive responses also lead to midline skills and eventual crossing of midline.
Auditory, tactle, and proprioceptive perception is heightened allowing for development of sounds
for the purpose of communication.
Tactile, proprioceptive, gustatory, and olfactory perception are integrated, allowing for primitive
self-feeding.
13-24mo - answerTactile perception becomes more precise allowing for discrimination and
localization to further refinement of fine motor skills.
Further integration of all systems promotes the complexity of motor planning as the toddler's
repertoire of movement patterns expands.
Symbolic gesturing and vocalization promotes ideation, indicating the toddler's ability to
conceptualize.
Motor planning abilities contribute to self-concept as the toddler begins to master the
environment.
2-3yrs - answerThis is a period of refinement as the vestibular, proprioceptive, and visual systems
further develop, leading to improved balance and postural control.
Further development of tactile discrimination and localization lead to improved fine motor skills.
Motor planning and praxis ideation also progresses during this period for more skillful
occupational performance.
3-7yrs - answerChild is driven to challenge sensorimotor competencies through roughhouse play,
playground activities, games, sports, music, dancing , arts and crafts, household chores, and
school tasks. These occupations provide opportunities to promote psychosocial development and
, self-esteem.
Crossing Midline - answerAs the child becomes more mobile, movement against gravity and
weightshift increase, leading to eventual crossing of the midline, often in attempt to reach for a
toy, while weightbearing on the opposing upper extremity for balance. Begins at 9-12mo.
Laterality - answerHemispheric specialization for specific tasks varies with different individuals
Bilateral Integration - answerAs the child experiments with movement, the nervous system is
stimulated, and the resulting sensations help the child to coordinate the two sides of the body.
Begins at 9-12mo.
Visual-Motor Integration - answerDependent upon the lower level skills of visual attention, visual
memory, visual discrimination, kinesthesia, position in space, figure ground, form constancy, and
spatial relations.
Oral-Motor Control - answerDeveloped in the area of feeding, provides the foundation for early
oral communication and later language development.
Rooting Reflex - answerOnset Age: 28wk gestation
Integration Age: 3mo
Stimulus: Stroke corner of the mouth, upper lip, and lower lip.
Response: Movement of the tongue, mouth, and/or head toward stimulus.
Relevance: Allows searching for and locating feeding source.
Suck-Swallow Reflex - answerOnset Age: 28wk gestation
Integration Age: 2-5mo
Stimulus: Place examiner's index finger inside infant's mouth with head in midline.
Response: Strong, rhythmical sucking
