AOTA Treatment Planning & Protocols 3 — Questions and Answers
Question 1: When writing measurable goals for sensory integration intervention, which goal is most appropriately written?
- Child will improve sensory processing skills by the end of the treatment period.
- Child will tolerate various textures during mealtime without behavioral outbursts on 4/5 opportunities as measured in 3 months. (Correct answer)
- Child will demonstrate better self-regulation and sensory tolerance over time.
- Child will benefit from sensory diet activities to improve participation at school.
Correct answer: Child will tolerate various textures during mealtime without behavioral outbursts on 4/5 opportunities as measured in 3 months.
Well-written goals must be specific, measurable, achievable, relevant, and time-bound (SMART), including observable behavior, criteria, and timeline.
Question 2: A child's treatment plan notes 'tactile defensiveness.' Which activity would be LEAST appropriate to include in an early treatment session?
- Deep pressure massage applied by the child using a vibrating massage tool
- Light unpredictable touch applied by a peer during a group game (Correct answer)
- Heavy work activities such as carrying books or pushing a cart
- Child-initiated play in a bin of rice or dried beans
Correct answer: Light unpredictable touch applied by a peer during a group game
Light, unpredictable touch from others is most likely to trigger defensive reactions and should be avoided early in treatment for tactile defensiveness.
Question 3: According to fidelity measures for ASI intervention (e.g., the ASI Fidelity Measure), which of the following is a core structural element of ASI?
- Use of standardized sensory processing questionnaires during every session
- Provision of adequate space and variety of suspended and moveable equipment (Correct answer)
- Implementation of a scripted sequence of activities each session
- Mandatory caregiver participation in all direct treatment sessions
Correct answer: Provision of adequate space and variety of suspended and moveable equipment
ASI fidelity requires a well-equipped space with suspended equipment and a variety of sensory materials to allow for individualized, dynamic intervention.
Question 4: A therapist is planning intervention for a 7-year-old with bilateral integration and sequencing difficulties. Which activity is most aligned with ASI treatment principles?
- Practicing a specific two-handed craft project using step-by-step verbal instructions
- Navigating an obstacle course that requires crossing midline and timing motor sequences (Correct answer)
- Completing worksheets targeting left-right discrimination
- Drilling jump rope sequences with adult-guided hand and foot placement
Correct answer: Navigating an obstacle course that requires crossing midline and timing motor sequences
ASI uses meaningful, child-directed obstacle courses and motor challenges that naturally require bilateral coordination, sequencing, and adaptive responses.
Question 5: Which of the following best describes the role of proprioception in a sensory integration treatment protocol?
- Proprioception is primarily used to address visual-perceptual deficits
- Proprioception provides organizing, calming input that supports modulation and body scheme (Correct answer)
- Proprioception input is contraindicated for children with hypotonia
- Proprioception activities should only follow vestibular input, never precede it
Correct answer: Proprioception provides organizing, calming input that supports modulation and body scheme
Proprioceptive input (heavy work, joint compression, resistance) is organizing and calming, supporting arousal modulation and body scheme development.
Question 6: When treating a child with Sensory Under-Responsivity (SUR), a therapist should structure sessions to:
- Reduce sensory input to avoid overwhelming the child's nervous system
- Provide high-intensity, varied multisensory input to achieve a threshold for response (Correct answer)
- Focus exclusively on auditory and visual stimulation
- Use primarily calming strategies such as weighted blankets and dim lighting
Correct answer: Provide high-intensity, varied multisensory input to achieve a threshold for response
Children with SUR require higher-intensity, varied, and novel sensory input to reach their sensory threshold and generate an adaptive response.
Question 7: A parent asks how long their child will need ASI therapy. The therapist's best response is based on:
- A standard protocol of 20 sessions for all sensory processing disorders
- The severity of the deficit, rate of progress, and achievement of functional goals (Correct answer)
- Insurance authorization length, which determines appropriate treatment duration
- Age of the child, with younger children always requiring shorter treatment courses
Correct answer: The severity of the deficit, rate of progress, and achievement of functional goals
Treatment duration in ASI is individualized, determined by clinical progress, severity of deficit, functional goal attainment, and ongoing reassessment.
AOTA Treatment Planning & Protocols 3
When writing measurable goals for sensory integration intervention, which goal is most appropriately written?