NBCOT (COTA) Exam Prep And
Answers.
Development of Sensorimotor Integration -
\Prenatal Period
Neonatal Period
First 6mo
6-12mo
13-24mo
2-3yrs
3-7yrs
Prenatal Period -
\Responds first to tactile stimuli
Reflex Development
Innate tactile, proprioceptive, and vestibular input reactions
Neonatal Period -
\Tactile, 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 -
\Vestibular, 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 -
\Vestibular, 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 -
\Tactile 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 -
\This 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 -
\Child 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 -
\As 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 -
\Hemispheric specialization for specific tasks varies with different individuals
Bilateral Integration -
\As 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 -
\Dependent 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 -
\Developed in the area of feeding, provides the foundation for early oral communication
and later language development.
Rooting Reflex -
\Onset 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 -
\Onset 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
Relevance: Allows ingestion of nourishment
Traction Reflex -
\Onset Age: 28wk gestation
Integration Age: 2-5mo
Stimulus: Grasp infant's forearms and pull-to-sit
Response: Complete flexion of upper extremeties
Relevance: Enhances momentary reflexive grasp
Moro Reflex -
\Onset Age: 28wk gestation
Integration: 4-6mo
Stimulus: Rapidly drop infant's head backward
Response: arm extension/ abduction, hand opening then arm flexion and adduction
Relevance: Facilitates ability to depart from dominant flexor posture (protective
response)
Plantar Grasp Reflex -
\Onset Age: 28wk
Integration Age: 9mo
Stimulus: Apply pressure with thumb on the infant's on the infant's ball of the foot.
Response: Toe Flexion
Relevance: Increases tactile input to the sole of the foot
Galant Reflex -
\Onset Age: 32wk gestation
Integration Age: 2mo
Stimulus: Hold infant in prone suspension, gently scratch or tap alongside side the spine
with finger, from shoulders to buttocks.
Answers.
Development of Sensorimotor Integration -
\Prenatal Period
Neonatal Period
First 6mo
6-12mo
13-24mo
2-3yrs
3-7yrs
Prenatal Period -
\Responds first to tactile stimuli
Reflex Development
Innate tactile, proprioceptive, and vestibular input reactions
Neonatal Period -
\Tactile, 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 -
\Vestibular, 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 -
\Vestibular, 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 -
\Tactile 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 -
\This 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 -
\Child 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 -
\As 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 -
\Hemispheric specialization for specific tasks varies with different individuals
Bilateral Integration -
\As 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 -
\Dependent 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 -
\Developed in the area of feeding, provides the foundation for early oral communication
and later language development.
Rooting Reflex -
\Onset 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 -
\Onset 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
Relevance: Allows ingestion of nourishment
Traction Reflex -
\Onset Age: 28wk gestation
Integration Age: 2-5mo
Stimulus: Grasp infant's forearms and pull-to-sit
Response: Complete flexion of upper extremeties
Relevance: Enhances momentary reflexive grasp
Moro Reflex -
\Onset Age: 28wk gestation
Integration: 4-6mo
Stimulus: Rapidly drop infant's head backward
Response: arm extension/ abduction, hand opening then arm flexion and adduction
Relevance: Facilitates ability to depart from dominant flexor posture (protective
response)
Plantar Grasp Reflex -
\Onset Age: 28wk
Integration Age: 9mo
Stimulus: Apply pressure with thumb on the infant's on the infant's ball of the foot.
Response: Toe Flexion
Relevance: Increases tactile input to the sole of the foot
Galant Reflex -
\Onset Age: 32wk gestation
Integration Age: 2mo
Stimulus: Hold infant in prone suspension, gently scratch or tap alongside side the spine
with finger, from shoulders to buttocks.
