CTRS CTRS Special Populations & Clinical Considerations 1 — Questions and Answers
Question 1: For a client with a traumatic brain injury (TBI), TR interventions should primarily address:
- Only physical mobility deficits
- Cognitive, behavioral, emotional, and social consequences of injury alongside physical recovery (Correct answer)
- Vocational training exclusively
- Family counseling only
Correct answer: Cognitive, behavioral, emotional, and social consequences of injury alongside physical recovery
TBI produces multidimensional impairments across cognitive, behavioral, emotional, and physical domains that TR must address through carefully graded activity selection.
Question 2: When working with clients who have schizophrenia, a CTRS should be aware that negative symptoms include:
- Hallucinations and delusions
- Flat affect, social withdrawal, anhedonia, and avolition that affect leisure motivation and participation (Correct answer)
- Increased energy and racing thoughts
- Compulsive repetitive behaviors
Correct answer: Flat affect, social withdrawal, anhedonia, and avolition that affect leisure motivation and participation
Negative symptoms of schizophrenia—such as anhedonia (inability to feel pleasure) and avolition (lack of motivation)—directly challenge leisure engagement and require targeted TR strategies.
Question 3: Sensory integration techniques in TR are most commonly used with which population?
- Adults with cardiac conditions
- Children and adults with autism spectrum disorder or sensory processing disorders (Correct answer)
- Clients in cardiac rehabilitation
- Geriatric clients with hip fractures only
Correct answer: Children and adults with autism spectrum disorder or sensory processing disorders
Sensory integration approaches address sensory processing differences common in autism and related conditions, helping clients regulate arousal and engage in leisure activities.
Question 4: In geriatric TR practice, 'reminiscence therapy' is evidence-based for improving:
- Cardiovascular endurance
- Cognitive engagement, sense of identity, mood, and social connection in older adults (Correct answer)
- Balance and fall prevention only
- Medication adherence
Correct answer: Cognitive engagement, sense of identity, mood, and social connection in older adults
Structured reminiscence activities activate long-term memory, reinforce personal identity, reduce depression, and promote social interaction in older adult populations.
Question 5: A TR specialist working in a pediatric oncology unit should prioritize which type of intervention?
- High-intensity competitive sports
- Normalization experiences, play, creative expression, and coping skill development appropriate to developmental stage (Correct answer)
- Adult leisure education curricula
- Strict bed rest with no stimulation
Correct answer: Normalization experiences, play, creative expression, and coping skill development appropriate to developmental stage
Pediatric oncology TR uses age-appropriate play and creative activities to normalize the hospital experience, build coping skills, and support developmental progression during treatment.
Question 6: For clients with spinal cord injury (SCI) at the C6 level, TR programming should consider that the client typically retains:
- Full hand function and ambulation
- Wrist extension but not finger function, requiring adapted equipment for many leisure activities (Correct answer)
- No upper extremity function
- Full trunk stability and lower extremity control
Correct answer: Wrist extension but not finger function, requiring adapted equipment for many leisure activities
C6 SCI preserves wrist extension (radial wrist extensors) but eliminates intrinsic hand and finger function, requiring tenodesis or adaptive equipment for TR activities.
CTRS CTRS Special Populations & Clinical Considerations 1
For a client with a traumatic brain injury (TBI), TR interventions should primarily address: