OTA Pediatric OT 3 — Questions and Answers
Question 1: A 3-year-old is unable to build a tower of more than 4 blocks. According to typical developmental milestones, how many blocks should a child this age stack?
- 4–5 blocks
- 6–8 blocks
- 9–10 blocks (Correct answer)
- 2–3 blocks
Correct answer: 9–10 blocks
By age 3, children typically build towers of 9–10 blocks; building fewer than this may indicate a fine motor or cognitive developmental delay.
Question 2: An OTA working with a child with cerebral palsy notices the child's head consistently tilts to one side. This is MOST likely due to:
- Poor visual acuity requiring glasses
- Asymmetrical tonic neck reflex (ATNR) retention (Correct answer)
- Voluntary compensation for a hearing impairment
- Normal postural preference in early childhood
Correct answer: Asymmetrical tonic neck reflex (ATNR) retention
Persistent ATNR beyond 6 months causes head turning and limb extension patterns that can lead to asymmetrical head positioning in children with cerebral palsy.
Question 3: When positioning a child with hypotonia for tabletop activities, which seating consideration is MOST important?
- Allow the child to slouch to promote comfort and relaxation
- Ensure hips, knees, and ankles are at 90° with feet supported (Correct answer)
- Use a standard chair without modifications to encourage active sitting
- Position the child in a reclined position to reduce postural demands
Correct answer: Ensure hips, knees, and ankles are at 90° with feet supported
The 90-90-90 position (hips, knees, ankles at 90°) with feet supported provides optimal postural stability for children with hypotonia during tabletop tasks.
Question 4: Which play stage involves a child playing alongside peers without interacting, characteristic of ages 2–3?
- Cooperative play
- Parallel play (Correct answer)
- Associative play
- Onlooker play
Correct answer: Parallel play
Parallel play, typical of ages 2–3, involves children playing near each other with similar materials but without direct interaction or shared goals.
Question 5: A parent reports their 18-month-old is not yet pointing to objects to show interest. This is a red flag for:
- Hearing impairment only
- Autism spectrum disorder and warrants further evaluation (Correct answer)
- Normal development since pointing emerges at age 2
- Fine motor delay requiring only hand strengthening
Correct answer: Autism spectrum disorder and warrants further evaluation
Protodeclarative pointing (to share interest) should emerge by 12 months; absence at 18 months is a significant early red flag for ASD requiring evaluation.
Question 6: An OTA uses a weighted vest with a child who has sensory modulation disorder. How long should the vest typically be worn per session according to sensory integration guidelines?
- All day to provide continuous input
- 20–30 minutes with breaks, not to exceed 2 hours total daily (Correct answer)
- 5 minutes only, once per week
- Only during high-stimulation activities for unlimited duration
Correct answer: 20–30 minutes with breaks, not to exceed 2 hours total daily
Weighted vests are typically used for 20–30 minute intervals with breaks, as the nervous system habituates to sustained deep pressure, reducing effectiveness over time.
Question 7: Which of the following is the PRIMARY goal of constraint-induced movement therapy (CIMT) in pediatric OT?
- Strengthen the unaffected limb through intensive use
- Promote use of the affected upper extremity by restraining the unaffected hand (Correct answer)
- Reduce pain in the affected extremity
- Improve bilateral coordination by using both hands equally
Correct answer: Promote use of the affected upper extremity by restraining the unaffected hand
CIMT restrains the unaffected limb to force use of the affected extremity, promoting neuroplastic reorganization and improved function in children with hemiplegia.
OTA Pediatric OT 3
A 3-year-old is unable to build a tower of more than 4 blocks.
According to typical developmental milestones, how many blocks should a child this age stack?