NBCOT COTA Exam And Answers.
General Environmental Considerations Definition and Maior Concepts -
\and Maior Concepts 1. The environment "the aggregate of phenomena that surrounds
individual and influences (her) development existence" (Mosey, 1996, p. 171).
environment which lives, and exposure to various settings, influences his or her
development and adaptation. The environment facilitate because for adaptation
problem-solving strategies to developed. Conversely, environment can hinder develop-
and adaptation impoverished hostile. 5. A person's abilities, limitations, problems,
activities, occupations be fully under- stood without considerations his/her current and
expected environment. 6. Physical/nonhuman environment. Everything nonhuman (i.e.,
buildings, objects, tools, devices, animals, trees). Sensory environment. Visual: lighting,
colors, posters all over Auditory: loudness of loudspeakers, class- room noise. c.
Tactile: seating textures. d. Olfactory: pleasant offensive odors. Gustatory: pleasant
offensive 8. Social-cultural/human environment. a. Social roles: organized pattern
behavior that characteristic enerauem defined position social system" (Mosey, 1996, p.
64); for example, student, parent, worker. Social network: "the of voluntary relationships
that make individual's social environment" (Mosey, 1996, 184). aspects: "the social
structures, values norms, and expectations that accepted shared of people" d.
Psychological aspects: environmental character- istics that affect mood and stress level
(e.g., a calming, cheerful envi chaotic, uncomfortable, depressing setting). 9. The AOTA
description environment beyond the physical and social environment to include concept
In the AOTA Practice Framework, context "refere law expected occupant environment
Practice ramework expanded variety interrelated conditions are within and surrounding
the interrelated less tangible physical and sto 15
Definition and Maior Concepts -
\social environments nonetheless exer influence performance" (AOTA 2008, Contexts
include cultural, personal, tempor virtual. (1) "cultural context includes customs activity
patterns, behavior standards, and tations accepted by the society of whi client is a
member" (AOTA "personal context demos individual such age, socioeconomic status,
educational that not health condition" 2008, p. "temporal context includes stages time
year, time of day and duration activity, history" (AOTA 2008, The virtual context refers
the "enviro in which communication by mea airways or computers absence of cal
contact" (AOTA 2008, 645); exan e-mail, video-conferencing, web-based networking.
Legislation Related to the Environment -
\Environment 1. Americans with Disabilities Act (ADA): civil law aimed at allowing full
participation in society people with disabilities. Several sections mandate accessible
environie for persons with disabilities. b. Included are policies dealing with public sevic
employment, public accommodations. 2. Omnibus Budget Reconciliation Act dates that
restraints cannot be used without justification, agreement, and documentation 3.
Individuals with Disabilities Education Act (IDEA mandates that children disabilities
geine education in least restrictive and most environment. a. Inclusive models are be
,used to enable chil to be taught a regular classIOom. b. Education must prepare iving
and emplovment environme child for indepgnd The role of practitioners environmental
ase ment and modification has increased with mentation of the OBRA, and IDEA. (See
4 more specific information on OR IDEA.)
me Role of Occupational Therapy (OT) Practitioners -
\2. OT practitioners advocate for and design environ- ments that use principles of
universal design meet physical, sensory, sociocultural, psychological needs individual.
Table 15-1. OT practitioners can help identify settings and approaches implement the
OBRA, and IDEA. porson's environment-living, vocational, a-whether takes place
hospital, nursing school, practitioners familiar with
me Role of Occupational Therapy (OT) Practitioners -
\practitioners can advocate for ADA, OBRA, IDEA compliance to enable individuals
function independently-and with least restriction-as possible, their environment.
The Role of the Team -
\1. practitioners part of an interdiscipli- nary team that determines the needs abilities of
an individual with disability specific environ- ment. Basis team construction. a. The
facility which the individual disability presently resides and/or participates. The
individual's needs and her abilities/func tional Geographical location. Funding ity (ie.,
third-party payers and/or offices individuals with disabilities). Support caregivers. The
should always include the consumer and caregivers. 4. Professional team members
may belong to Rehabilitation Engineers Society of North America (RESNA) and/or
Registry Rehabilitation Technology Suppliers (NRRTS). Both professional organizations
help develop standards measuring tools to ensure proper design, prescription, and
delivery of rehabilitation technology. available the individual with a disabil-
The Role of the Team -
\5. professional team members. Assistive technology professional (ATP): analzE
consumer needs, help select appropriate assistive technology identified and proid.
training in use the b. Computer design provision of efficient technology. c. trainer: for
driving adaptations. subsequent section driver rehabilitation. Nurse: ensure medical
care medication regimes prescribed the doctor. e. Occupational and occupational
assistant: refer section. Physical therapist: mobility difficulties individual encounter the
environment. Physician: and assess services and purchases. Psychologist: assist
adjustment indicated. i. Rehabilitation counselor: assess and advise vocational issues. j.
Speech language pathologist: to assess mend augmentative communication aids.
Rehabilitation design equipment assist with modifications adaptive equipme 1. Seating
mobility specialist (SMS): seating, positioning, mobility needs and appropriate
recommendations. Social worker: to obtaining funding. evaluae n. Teacher: children the
school system, help any modifications within classroom setting
The Role of the Team -
,\payer their respective case man- to approve and/or provide funding for the lividual's
needed environmental modifica. dors: provide items requested therapists and required
the individual to function Environmental
individual function Purposes Environmental Evaluation Intervention -
\Lientify and prioritize needs, goals, desires, blem areas individual with disability within
his/her environments. huablish the regarding everyday functional activities within his/her
environment. functional use devices being considered lor particular individual facilitate
mastery the environment.
Purposes of Environmental Evaluation and Intervention -
\Environmental Identify device's availability, safety, cs. Determine device's frequency 6.
Determine funding financial resources for equip- ment and/or modifications. a.
questionable ethics inter- of the with show him/ her device order top-of-the-line
equipment that is covered his/her insurance, he/she does financial resources self-pay.
Determine environmental constraints. For example, individual be living in flight walk-up
apartment device locked up lobby, opening of vandalism theft. 8. individual with a
disability and device allow reevaluation. Ensure device will for possible modifica tions,
upon reassessment of individual change in found. and everyday Chapter 15
Overall Environmental Evaluation Evaluation of Performance Skills Client Factors*** -
\role the occupational contributes to the evaluation process collaboration with the
supervisor. Supervision required. (2) level supervision required mined by experience
established service competence. h. Service competency be established. OTA cannot
independently or inter- evaluation results. Performance are essential when conducting
environmental evalua- for they are allow person function in his/her environment. LUpon
establishment service competency, OIA following areas: Sensory (eg, assess
Getermine there impairment discrimi- nation inluence safety the manipula- devices).
driving Visual perceptual processing skills of Test, standardized to assess visual motor
for poten- tial difficulties computer Musculoskeletal skills range of motion, strength,
endurance, assess (1) (4) (5)
Evaluation Performance and Client Factors -
\physically devices optimal capability). d. Neuromuscular (eg. coordination, assess
person's mically and environmental manipula- tion). skills (eg., following directions and
judg- ment, assess is of limitations and able to follow recall operation assistive
technology wheelchairs) use of f. Psychosocial (e.g., support, assess if individual ask
assis- tance, needed the right person). utilize rhyth-
Contextual Evaluation -
\manipula- to The contributes evaluation process with OT supervision. targeted
evaluation include: a. Physical considerations. (1) Arrangement furniture. Accessibility
items needed activi- ties safe (3) Housing/workplace Neighborhood characteristics.
Contextual Evaluation -
, \Environment: Intervention the individual with disability (3) Opportunities for socialization
(4) Sociocultural norms, values, and expectations Social roles: expectations for
performance Availability and of transportation. Overall accessibility. Sociocultural
considerations. independent function. (5) Community resources available. individual's
network relation ships between individual disability
Home Evaluation General Considerations*** -
\General Considerations OTAS perform home assessments and make adap- tations,
modifications, and recommendations to anticipated dwelling to increase safe,
independent functioning with OT supervision 2. an individual with disability discharged
to home from facility, evaluation should be discharge The person's current status
(abilities and and risks in home determine need for home modifications adapta-
Overall Characteristics of the Home -
\good private one-family, family, apartnment, walk-up, elevator access. 2. Protection
from weather/environmental changes. Presence and of driveway. 4. Level which person
lives. Entrance dwelling wheelchair raimp. level entrance, 6. Number of entrances that
are accessible the vidual, Some buildings allow residents to delivery because has ramp.
7. Steps: the number present outside dwelling, inside dwelling, laundry room, the
mailbox, Railings: location and number railings outside and facing entrance door;
presence railings for interior a. Interior should inches ease grasp. railings should those
who walk: 34-38 inches, depending on height. Railings should inches in diameter
nonskid surfaces.
home tions. Overall Characteristics of the Home of -
\Door sills: identify where they present, entrance to dwelling bedroom doors, bathroom
doors, kitchen doorway. 10. Elevators: doorway, type operation. IL. Hallways: width
hallway entrance. 12. Doorways: width entrance measure door frame; frame frame
Doorways: of opening for entrance d and throughout dwelling that opened. a. Space
accommodate door swing must be minimum inches needed for using walkers. minimum
inches needed using wheelchairs. 14. Type(s) door handles: handles functional knobs.
15. Identification objects obstrucin doorways pathways. of pets: can obstacles safety
concerns vision, problems, who require assistive devias 17. Carpeting: wall wall th
height of 18. Electrical cords: placed flow traic good condition or frayed, overloaded
underng carpeting. Presence of firm chair the dwelling height. 20. Light accessibility
from varios (standing chair). inches Telephones: number phones, location Lype (e.g.,
cordless, cell, push button rotaryl gency numbers telephone. Presence working smoke
detectors. 23. Presence heaters wood-buming 24. Presence emergency call system
gency exit
Bedroom Considerations -
\size of bed, height floor to mattress, ape mattress wheeled frame or not, posi- ae bed
(against the wall freestanding). the from which the individual with sability enters/exits.
3Ahiliy change location, if needed. LAessibility dothes and dresser drawers. Suficient
available for bedside commode, Considerations anded
General Environmental Considerations Definition and Maior Concepts -
\and Maior Concepts 1. The environment "the aggregate of phenomena that surrounds
individual and influences (her) development existence" (Mosey, 1996, p. 171).
environment which lives, and exposure to various settings, influences his or her
development and adaptation. The environment facilitate because for adaptation
problem-solving strategies to developed. Conversely, environment can hinder develop-
and adaptation impoverished hostile. 5. A person's abilities, limitations, problems,
activities, occupations be fully under- stood without considerations his/her current and
expected environment. 6. Physical/nonhuman environment. Everything nonhuman (i.e.,
buildings, objects, tools, devices, animals, trees). Sensory environment. Visual: lighting,
colors, posters all over Auditory: loudness of loudspeakers, class- room noise. c.
Tactile: seating textures. d. Olfactory: pleasant offensive odors. Gustatory: pleasant
offensive 8. Social-cultural/human environment. a. Social roles: organized pattern
behavior that characteristic enerauem defined position social system" (Mosey, 1996, p.
64); for example, student, parent, worker. Social network: "the of voluntary relationships
that make individual's social environment" (Mosey, 1996, 184). aspects: "the social
structures, values norms, and expectations that accepted shared of people" d.
Psychological aspects: environmental character- istics that affect mood and stress level
(e.g., a calming, cheerful envi chaotic, uncomfortable, depressing setting). 9. The AOTA
description environment beyond the physical and social environment to include concept
In the AOTA Practice Framework, context "refere law expected occupant environment
Practice ramework expanded variety interrelated conditions are within and surrounding
the interrelated less tangible physical and sto 15
Definition and Maior Concepts -
\social environments nonetheless exer influence performance" (AOTA 2008, Contexts
include cultural, personal, tempor virtual. (1) "cultural context includes customs activity
patterns, behavior standards, and tations accepted by the society of whi client is a
member" (AOTA "personal context demos individual such age, socioeconomic status,
educational that not health condition" 2008, p. "temporal context includes stages time
year, time of day and duration activity, history" (AOTA 2008, The virtual context refers
the "enviro in which communication by mea airways or computers absence of cal
contact" (AOTA 2008, 645); exan e-mail, video-conferencing, web-based networking.
Legislation Related to the Environment -
\Environment 1. Americans with Disabilities Act (ADA): civil law aimed at allowing full
participation in society people with disabilities. Several sections mandate accessible
environie for persons with disabilities. b. Included are policies dealing with public sevic
employment, public accommodations. 2. Omnibus Budget Reconciliation Act dates that
restraints cannot be used without justification, agreement, and documentation 3.
Individuals with Disabilities Education Act (IDEA mandates that children disabilities
geine education in least restrictive and most environment. a. Inclusive models are be
,used to enable chil to be taught a regular classIOom. b. Education must prepare iving
and emplovment environme child for indepgnd The role of practitioners environmental
ase ment and modification has increased with mentation of the OBRA, and IDEA. (See
4 more specific information on OR IDEA.)
me Role of Occupational Therapy (OT) Practitioners -
\2. OT practitioners advocate for and design environ- ments that use principles of
universal design meet physical, sensory, sociocultural, psychological needs individual.
Table 15-1. OT practitioners can help identify settings and approaches implement the
OBRA, and IDEA. porson's environment-living, vocational, a-whether takes place
hospital, nursing school, practitioners familiar with
me Role of Occupational Therapy (OT) Practitioners -
\practitioners can advocate for ADA, OBRA, IDEA compliance to enable individuals
function independently-and with least restriction-as possible, their environment.
The Role of the Team -
\1. practitioners part of an interdiscipli- nary team that determines the needs abilities of
an individual with disability specific environ- ment. Basis team construction. a. The
facility which the individual disability presently resides and/or participates. The
individual's needs and her abilities/func tional Geographical location. Funding ity (ie.,
third-party payers and/or offices individuals with disabilities). Support caregivers. The
should always include the consumer and caregivers. 4. Professional team members
may belong to Rehabilitation Engineers Society of North America (RESNA) and/or
Registry Rehabilitation Technology Suppliers (NRRTS). Both professional organizations
help develop standards measuring tools to ensure proper design, prescription, and
delivery of rehabilitation technology. available the individual with a disabil-
The Role of the Team -
\5. professional team members. Assistive technology professional (ATP): analzE
consumer needs, help select appropriate assistive technology identified and proid.
training in use the b. Computer design provision of efficient technology. c. trainer: for
driving adaptations. subsequent section driver rehabilitation. Nurse: ensure medical
care medication regimes prescribed the doctor. e. Occupational and occupational
assistant: refer section. Physical therapist: mobility difficulties individual encounter the
environment. Physician: and assess services and purchases. Psychologist: assist
adjustment indicated. i. Rehabilitation counselor: assess and advise vocational issues. j.
Speech language pathologist: to assess mend augmentative communication aids.
Rehabilitation design equipment assist with modifications adaptive equipme 1. Seating
mobility specialist (SMS): seating, positioning, mobility needs and appropriate
recommendations. Social worker: to obtaining funding. evaluae n. Teacher: children the
school system, help any modifications within classroom setting
The Role of the Team -
,\payer their respective case man- to approve and/or provide funding for the lividual's
needed environmental modifica. dors: provide items requested therapists and required
the individual to function Environmental
individual function Purposes Environmental Evaluation Intervention -
\Lientify and prioritize needs, goals, desires, blem areas individual with disability within
his/her environments. huablish the regarding everyday functional activities within his/her
environment. functional use devices being considered lor particular individual facilitate
mastery the environment.
Purposes of Environmental Evaluation and Intervention -
\Environmental Identify device's availability, safety, cs. Determine device's frequency 6.
Determine funding financial resources for equip- ment and/or modifications. a.
questionable ethics inter- of the with show him/ her device order top-of-the-line
equipment that is covered his/her insurance, he/she does financial resources self-pay.
Determine environmental constraints. For example, individual be living in flight walk-up
apartment device locked up lobby, opening of vandalism theft. 8. individual with a
disability and device allow reevaluation. Ensure device will for possible modifica tions,
upon reassessment of individual change in found. and everyday Chapter 15
Overall Environmental Evaluation Evaluation of Performance Skills Client Factors*** -
\role the occupational contributes to the evaluation process collaboration with the
supervisor. Supervision required. (2) level supervision required mined by experience
established service competence. h. Service competency be established. OTA cannot
independently or inter- evaluation results. Performance are essential when conducting
environmental evalua- for they are allow person function in his/her environment. LUpon
establishment service competency, OIA following areas: Sensory (eg, assess
Getermine there impairment discrimi- nation inluence safety the manipula- devices).
driving Visual perceptual processing skills of Test, standardized to assess visual motor
for poten- tial difficulties computer Musculoskeletal skills range of motion, strength,
endurance, assess (1) (4) (5)
Evaluation Performance and Client Factors -
\physically devices optimal capability). d. Neuromuscular (eg. coordination, assess
person's mically and environmental manipula- tion). skills (eg., following directions and
judg- ment, assess is of limitations and able to follow recall operation assistive
technology wheelchairs) use of f. Psychosocial (e.g., support, assess if individual ask
assis- tance, needed the right person). utilize rhyth-
Contextual Evaluation -
\manipula- to The contributes evaluation process with OT supervision. targeted
evaluation include: a. Physical considerations. (1) Arrangement furniture. Accessibility
items needed activi- ties safe (3) Housing/workplace Neighborhood characteristics.
Contextual Evaluation -
, \Environment: Intervention the individual with disability (3) Opportunities for socialization
(4) Sociocultural norms, values, and expectations Social roles: expectations for
performance Availability and of transportation. Overall accessibility. Sociocultural
considerations. independent function. (5) Community resources available. individual's
network relation ships between individual disability
Home Evaluation General Considerations*** -
\General Considerations OTAS perform home assessments and make adap- tations,
modifications, and recommendations to anticipated dwelling to increase safe,
independent functioning with OT supervision 2. an individual with disability discharged
to home from facility, evaluation should be discharge The person's current status
(abilities and and risks in home determine need for home modifications adapta-
Overall Characteristics of the Home -
\good private one-family, family, apartnment, walk-up, elevator access. 2. Protection
from weather/environmental changes. Presence and of driveway. 4. Level which person
lives. Entrance dwelling wheelchair raimp. level entrance, 6. Number of entrances that
are accessible the vidual, Some buildings allow residents to delivery because has ramp.
7. Steps: the number present outside dwelling, inside dwelling, laundry room, the
mailbox, Railings: location and number railings outside and facing entrance door;
presence railings for interior a. Interior should inches ease grasp. railings should those
who walk: 34-38 inches, depending on height. Railings should inches in diameter
nonskid surfaces.
home tions. Overall Characteristics of the Home of -
\Door sills: identify where they present, entrance to dwelling bedroom doors, bathroom
doors, kitchen doorway. 10. Elevators: doorway, type operation. IL. Hallways: width
hallway entrance. 12. Doorways: width entrance measure door frame; frame frame
Doorways: of opening for entrance d and throughout dwelling that opened. a. Space
accommodate door swing must be minimum inches needed for using walkers. minimum
inches needed using wheelchairs. 14. Type(s) door handles: handles functional knobs.
15. Identification objects obstrucin doorways pathways. of pets: can obstacles safety
concerns vision, problems, who require assistive devias 17. Carpeting: wall wall th
height of 18. Electrical cords: placed flow traic good condition or frayed, overloaded
underng carpeting. Presence of firm chair the dwelling height. 20. Light accessibility
from varios (standing chair). inches Telephones: number phones, location Lype (e.g.,
cordless, cell, push button rotaryl gency numbers telephone. Presence working smoke
detectors. 23. Presence heaters wood-buming 24. Presence emergency call system
gency exit
Bedroom Considerations -
\size of bed, height floor to mattress, ape mattress wheeled frame or not, posi- ae bed
(against the wall freestanding). the from which the individual with sability enters/exits.
3Ahiliy change location, if needed. LAessibility dothes and dresser drawers. Suficient
available for bedside commode, Considerations anded
