OTA Pediatric OT 4 — Questions and Answers
Question 1: A school-based OTA is asked to address handwriting with a 2nd grader. Which handwriting program is evidence-based and commonly used by OTAs?
- Handwriting Without Tears (HWT) (Correct answer)
- The Orton-Gillingham Method
- Applied Behavioral Analysis (ABA)
- Social Thinking Curriculum
Correct answer: Handwriting Without Tears (HWT)
Handwriting Without Tears is a widely used, evidence-based handwriting curriculum developed by OT Jan Olsen that addresses letter formation and legibility.
Question 2: An OTA notices a child consistently reverses letters 'b' and 'd' when writing. At what age does letter reversal typically become a concern?
- Age 5
- Age 6
- Age 7–8 (Correct answer)
- Age 10
Correct answer: Age 7–8
Letter reversals are developmentally normal until ages 7–8; persistence beyond this age may indicate a learning disability or visual-perceptual difficulties warranting evaluation.
Question 3: Which frame of reference guides sensory integration therapy in pediatric OT practice?
- Biomechanical frame of reference
- Ayres Sensory Integration (ASI) frame of reference (Correct answer)
- Model of Human Occupation (MOHO)
- Cognitive-behavioral frame of reference
Correct answer: Ayres Sensory Integration (ASI) frame of reference
The Ayres Sensory Integration frame of reference, developed by A. Jean Ayres, provides the theoretical foundation for sensory integration assessment and intervention.
Question 4: A 6-year-old with developmental coordination disorder (DCD) struggles with buttoning shirts. Which approach is MOST appropriate initially?
- Teach the child to avoid clothing with buttons permanently
- Provide adaptive equipment like button hooks and practice with large buttons first (Correct answer)
- Refer immediately to physical therapy instead
- Have the parent complete buttoning for the child indefinitely
Correct answer: Provide adaptive equipment like button hooks and practice with large buttons first
Starting with large buttons and adaptive tools like button hooks provides initial success while building toward independent fastener management.
Question 5: An OTA observes a child with Down syndrome during a feeding session. Which oral motor characteristic is MOST common in this population?
- Hypersensitive gag reflex with refusal of all textures
- Low muscle tone affecting tongue control and jaw stability (Correct answer)
- Premature loss of primary teeth affecting chewing
- Hyperactive bite reflex persisting into school age
Correct answer: Low muscle tone affecting tongue control and jaw stability
Hypotonia is the hallmark feature of Down syndrome and commonly affects oral motor structures, resulting in poor tongue control, jaw instability, and open-mouth posture.
Question 6: During visual-motor integration assessment, a child scores significantly below average. Which standardized tool was MOST likely used?
- Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) (Correct answer)
- Sensory Profile 2
- Pediatric Evaluation of Disability Inventory (PEDI)
- Denver Developmental Screening Test
Correct answer: Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI)
The Beery VMI is the gold standard standardized assessment for visual-motor integration skills in children, measuring the ability to integrate visual and motor abilities.
Question 7: A child with spina bifida (myelomeningocele at L3–L4) receives school-based OT. Which area is MOST important for the OTA to address?
- Ambulation and gait training
- Upper extremity function for self-care and academic tasks (Correct answer)
- Auditory processing for classroom learning
- Speech and language development
Correct answer: Upper extremity function for self-care and academic tasks
Children with spina bifida often have intact upper extremity function but need OT support for self-care tasks like dressing, catheterization, and wheelchair-based school participation.
OTA Pediatric OT 4
A school-based OTA is asked to address handwriting with a 2nd grader.
Which handwriting program is evidence-based and commonly used by OTAs?