AOTA Intervention Strategies & Approaches 2 — Questions and Answers
Question 1: During a sensory integration session, a child with gravitational insecurity refuses to leave the floor. The BEST initial response is to:
- Gradually introduce low-height equipment like a platform swing at floor level (Correct answer)
- Encourage the child verbally to try the suspended equipment
- Have the parent demonstrate using the suspended swing
- Document the refusal and move to a tabletop activity
Correct answer: Gradually introduce low-height equipment like a platform swing at floor level
Gravitational insecurity requires a graded approach starting at floor level to build tolerance to movement against gravity without triggering threat responses.
Question 2: Which sensory integration intervention strategy is MOST appropriate for a child with tactile defensiveness who becomes dysregulated during grooming routines?
- Wilbarger Deep Pressure and Proprioceptive Technique (DPPT) (Correct answer)
- Therapeutic listening with modulated music
- Visual schedule for grooming steps
- Social stories about grooming
Correct answer: Wilbarger Deep Pressure and Proprioceptive Technique (DPPT)
The Wilbarger DPPT uses deep pressure and proprioception to reduce tactile defensiveness and is specifically indicated for grooming-related challenges.
Question 3: A therapist is using a net swing to provide vestibular input. To promote calming and organization, which movement pattern should be emphasized?
- Slow, rhythmic, linear movements (Correct answer)
- Fast, rotary spinning movements
- Rapid, unpredictable direction changes
- Intermittent stop-and-start swinging
Correct answer: Slow, rhythmic, linear movements
Slow, rhythmic, linear vestibular input activates the cerebellar-cortical pathways associated with regulation and calming rather than arousal.
Question 4: Which of the following BEST describes the concept of 'sensory diet' in occupational therapy?
- A personalized schedule of sensory activities embedded throughout the day to support regulation (Correct answer)
- A dietary plan that eliminates foods causing sensory aversions
- A clinical program conducted exclusively in the therapy clinic
- A standardized protocol of sensory activities prescribed for all children with SPD
Correct answer: A personalized schedule of sensory activities embedded throughout the day to support regulation
A sensory diet, as described by Wilbarger, is an individualized, activity-based plan providing meaningful sensory input throughout the day to support self-regulation.
Question 5: A school-based OT is consulting with a teacher whose student seeks excessive proprioceptive input by crashing into peers. The MOST appropriate classroom strategy is:
- Incorporate heavy work activities like carrying books or pushing a cart before transitions (Correct answer)
- Restrict physical activity to reduce injury risk
- Refer the student for a behavioral intervention plan only
- Increase seated work to minimize movement opportunities
Correct answer: Incorporate heavy work activities like carrying books or pushing a cart before transitions
Proactively providing heavy work (proprioceptive input) satisfies the sensory need, reducing unsafe sensory-seeking behaviors during transitions.
Question 6: In the Ayres Sensory Integration® (ASI) approach, therapist-child interactions must include which essential element?
- Active child registration and inner drive guiding activity choices (Correct answer)
- Therapist-directed structured tasks with predetermined outcomes
- Parent-led activities replicated from the clinic at home
- Standardized protocols applied consistently across sessions
Correct answer: Active child registration and inner drive guiding activity choices
ASI requires the child's inner drive and active participation to guide session activities, ensuring the child is an active co-creator of the therapeutic experience.
Question 7: A child with poor praxis struggles to sequence novel motor tasks. Which intervention element is MOST directly targeting dyspraxia?
- Providing opportunities to plan and execute novel, adaptive motor challenges (Correct answer)
- Drilling repetitive motor tasks to build automaticity
- Providing verbal step-by-step instructions for each motor action
- Using visual cue cards to guide every movement sequence
Correct answer: Providing opportunities to plan and execute novel, adaptive motor challenges
Praxis develops through the experience of ideating, planning, and executing novel motor challenges — repetition of familiar tasks does not build praxis.
AOTA Intervention Strategies & Approaches 2
During a sensory integration session, a child with gravitational insecurity refuses to leave the floor.
The BEST initial response is to: