AOTA Treatment Planning & Protocols 2 — Questions and Answers
Question 1: When designing a sensory diet for a child with sensory modulation disorder, the OT should prioritize activities that are:
- Intense and prolonged to maximize neural input
- Child-directed, predictable, and matched to the child's arousal needs (Correct answer)
- Primarily vestibular to address the most common deficit
- Identical each session to build routine and reduce anxiety
Correct answer: Child-directed, predictable, and matched to the child's arousal needs
A sensory diet should be individualized, child-directed, and calibrated to the child's current arousal level to support self-regulation.
Question 2: A therapist using the Alert Program® as part of sensory integration treatment is primarily targeting:
- Vestibular-proprioceptive integration
- Self-awareness and self-regulation of arousal states (Correct answer)
- Postural control and bilateral coordination
- Tactile discrimination and body scheme
Correct answer: Self-awareness and self-regulation of arousal states
The Alert Program® ('How Does Your Engine Run?') teaches children to identify and self-regulate their arousal/alertness levels.
Question 3: In Ayres Sensory Integration® (ASI), the therapist's role during treatment is best described as:
- Directing the child through a pre-set sequence of therapeutic activities
- Passively observing and recording the child's spontaneous play
- Collaborating with the child to create a 'just-right challenge' within a therapeutic relationship (Correct answer)
- Providing hand-over-hand assistance to ensure correct movement patterns
Correct answer: Collaborating with the child to create a 'just-right challenge' within a therapeutic relationship
ASI requires the therapist to dynamically collaborate with the child, adjusting activities in real-time to present challenges that are neither too easy nor too difficult.
Question 4: A protocol for treating gravitational insecurity would most appropriately begin with:
- Inverted positions on suspended equipment to habituate the vestibular system
- Heavy proprioceptive input to the feet and joints while the child is firmly grounded (Correct answer)
- Rapid linear swinging to increase vestibular tolerance quickly
- Full body spin to stimulate all semicircular canals simultaneously
Correct answer: Heavy proprioceptive input to the feet and joints while the child is firmly grounded
Gravitational insecurity treatment begins with grounded, predictable proprioceptive and linear vestibular input at low intensity to build the child's sense of safety.
Question 5: Which outcome measure is most appropriate for evaluating changes in sensory processing patterns following ASI intervention?
- Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)
- Sensory Processing Measure (SPM) (Correct answer)
- Peabody Developmental Motor Scales (PDMS-2)
- Clinical Observations of Motor and Postural Skills (COMPS)
Correct answer: Sensory Processing Measure (SPM)
The Sensory Processing Measure (SPM) directly assesses sensory processing patterns across environments and is appropriate for tracking intervention outcomes.
Question 6: During treatment planning, a therapist identifies that a child has poor praxis. The most appropriate ASI-based intervention strategy is to:
- Teach the child specific motor sequences through repetitive drill practice
- Provide enhanced sensory opportunities that support ideation, motor planning, and execution (Correct answer)
- Use backward chaining to break down complex tasks into manageable steps
- Focus exclusively on tactile discrimination activities to improve body scheme
Correct answer: Provide enhanced sensory opportunities that support ideation, motor planning, and execution
ASI addresses praxis by enhancing sensory processing (especially somatosensory and proprioceptive) to support the child's ability to ideate, plan, and execute novel movements.
Question 7: A treatment plan for a child with Sensory Over-Responsivity (SOR) should include which type of activities as a primary therapeutic tool?
- High-intensity unexpected sensory experiences to promote desensitization
- Graded, predictable, and controlled sensory experiences within meaningful context (Correct answer)
- Rapid alternation between aversive and neutral stimuli
- Exclusively cognitive strategies for managing sensory discomfort
Correct answer: Graded, predictable, and controlled sensory experiences within meaningful context
For SOR, treatment uses graded, predictable sensory exposures within meaningful activities to support adaptive responses without overwhelming the nervous system.
AOTA Treatment Planning & Protocols 2
When designing a sensory diet for a child with sensory modulation disorder, the OT should prioritize activities that are: