OTA Pediatric OT 5 — Questions and Answers
Question 1: Which primitive reflex, when retained, interferes MOST with a child's ability to cross midline during tabletop tasks?
- Moro reflex
- Asymmetrical tonic neck reflex (ATNR) (Correct answer)
- Symmetrical tonic neck reflex (STNR)
- Galant reflex
Correct answer: Asymmetrical tonic neck reflex (ATNR)
Retained ATNR causes arm extension when the head turns that direction, preventing the child from reaching across midline to the opposite side of the body.
Question 2: An OTA working in a NICU is implementing developmental care for a premature infant. Which intervention is MOST consistent with this approach?
- Stimulate the infant with bright lights and sounds to promote alertness
- Minimize handling, reduce environmental stimuli, and support flexed positioning (Correct answer)
- Begin solid food introduction to accelerate oral motor development
- Encourage maximum awake time to promote cognitive development
Correct answer: Minimize handling, reduce environmental stimuli, and support flexed positioning
NICU developmental care focuses on reducing stress by minimizing stimulation, supporting physiological flexion, and clustering care to promote neurodevelopment.
Question 3: A parent asks an OTA why their child with sensory processing disorder seeks out spinning and crashing into cushions constantly. The OTA BEST explains this as:
- Oppositional behavior that should be ignored
- Vestibular and proprioceptive seeking to regulate the nervous system (Correct answer)
- A sign of hyperactivity that requires medication
- Normal play behavior with no sensory significance
Correct answer: Vestibular and proprioceptive seeking to regulate the nervous system
Sensory seekers engage in intense vestibular (spinning) and proprioceptive (crashing) input because their nervous system requires higher levels of sensory input to achieve regulation.
Question 4: When collaborating with a teacher to modify classroom tasks for a child with fine motor delays, which modification is MOST appropriate for a writing task?
- Excuse the child from all writing assignments
- Allow the child to use a word processor or provide wider-ruled paper with a pencil grip (Correct answer)
- Have a peer write for the child on all tasks
- Reduce academic expectations permanently
Correct answer: Allow the child to use a word processor or provide wider-ruled paper with a pencil grip
Adaptive tools like pencil grips, wider-ruled paper, or word processors support participation and skill development without removing the child from the academic curriculum.
Question 5: A child demonstrates difficulty with figure-ground discrimination. Which daily task would this MOST affect?
- Tying shoelaces
- Finding items in a cluttered backpack or on a busy worksheet (Correct answer)
- Maintaining seated balance in a chair
- Understanding verbal directions from a teacher
Correct answer: Finding items in a cluttered backpack or on a busy worksheet
Figure-ground discrimination is the ability to distinguish a foreground object from a complex background; deficits make it hard to locate items among distractors on worksheets or in cluttered spaces.
Question 6: According to IDEA, which term describes the written plan outlining special education services for a school-age child (ages 3–21)?
- Individualized Family Service Plan (IFSP)
- Individualized Education Program (IEP) (Correct answer)
- 504 Accommodation Plan
- Transition Planning Document (TPD)
Correct answer: Individualized Education Program (IEP)
The IEP is the legally mandated document under IDEA Part B that outlines goals, services, and accommodations for eligible school-age children with disabilities.
Question 7: An OTA is treating a 10-year-old with juvenile idiopathic arthritis (JIA). Which joint protection strategy is MOST important to teach?
- Encourage the child to push through pain to maintain strength
- Use large joints instead of small joints and avoid sustained grip positions (Correct answer)
- Immobilize all affected joints with rigid splints continuously
- Discontinue all physical activity to prevent joint damage
Correct answer: Use large joints instead of small joints and avoid sustained grip positions
Joint protection in JIA involves distributing forces across larger joints (e.g., using a whole hand rather than fingers) and avoiding prolonged static gripping to reduce inflammation and pain.
OTA Pediatric OT 5
Which primitive reflex, when retained, interferes MOST with a child's ability to cross midline during tabletop tasks?