Occupational Therapist Test Pediatric OT 4 — Questions and Answers
Question 1: Which reflex, if present beyond 6 months of age, is considered pathological and can interfere with voluntary reaching and rolling?
- Palmar grasp reflex
- Asymmetrical tonic neck reflex (ATNR) (Correct answer)
- Rooting reflex
- Moro reflex
Correct answer: Asymmetrical tonic neck reflex (ATNR)
The ATNR should integrate by 4–6 months; persistence beyond 6 months can hinder midline crossing, bilateral hand use, and rolling.
Question 2: A parent reports their 18-month-old has stopped saying words they previously used and no longer makes eye contact. As an OT, your MOST important immediate action is to:
- Begin sensory integration therapy immediately
- Recommend referral to the child's physician and early intervention services (Correct answer)
- Advise the parent to wait until age 2 before seeking evaluation
- Suggest speech therapy only
Correct answer: Recommend referral to the child's physician and early intervention services
Regression of language and loss of social skills are red flags for autism spectrum disorder requiring urgent medical and early intervention referral.
Question 3: When working with a premature infant in the NICU, which approach guides OT intervention to support neurodevelopmental care?
- Sensory integration therapy
- Neurodevelopmental Treatment (NDT)
- Neonatal Individualized Developmental Care and Assessment Program (NIDCAP) (Correct answer)
- Constraint-Induced Movement Therapy (CIMT)
Correct answer: Neonatal Individualized Developmental Care and Assessment Program (NIDCAP)
NIDCAP is a relationship-based developmental care approach specifically designed for premature infants in the NICU, guiding individualized sensory and motor supports.
Question 4: A 9-year-old with juvenile idiopathic arthritis has pain and joint stiffness in the morning. Which OT recommendation BEST addresses morning self-care participation?
- Schedule demanding self-care tasks for early morning to maximize energy
- Recommend a warm bath or shower before dressing to reduce joint stiffness (Correct answer)
- Avoid all upper extremity activities until afternoon
- Discontinue fine motor activities entirely during flares
Correct answer: Recommend a warm bath or shower before dressing to reduce joint stiffness
Warm water helps reduce joint stiffness in inflammatory arthritis, making self-care tasks easier and less painful during the morning peak stiffness period.
Question 5: An OT uses the Test of Visual Perceptual Skills (TVPS) with a child. What does this assessment specifically measure?
- Visual-motor integration requiring pencil and paper tasks
- Motor-free visual perception across seven subtypes (Correct answer)
- Ocular motor control and tracking ability
- Visual acuity and refractive error
Correct answer: Motor-free visual perception across seven subtypes
The TVPS measures motor-free visual perceptual skills including discrimination, memory, spatial relationships, form constancy, sequential memory, figure-ground, and closure.
Question 6: Which feeding intervention approach uses systematic desensitization through structured food exploration without pressure to eat?
- Applied behavior analysis (ABA) feeding protocol
- Sequential-Oral-Sensory (SOS) Approach to Feeding (Correct answer)
- Beckman Oral Motor Protocol
- Modified barium swallow study
Correct answer: Sequential-Oral-Sensory (SOS) Approach to Feeding
The SOS Approach uses a hierarchy of food interaction steps from tolerating food near the child to tasting and eating, without pressure, to reduce food aversion.
Question 7: A 6-year-old with spastic diplegia due to cerebral palsy walks with scissor gait. Which gross motor goal is MOST appropriate for OT within the school context?
- Normalize muscle tone in lower extremities
- Improve seated postural stability for classroom participation (Correct answer)
- Achieve independent ambulation without assistive devices
- Increase ankle range of motion through passive stretching
Correct answer: Improve seated postural stability for classroom participation
Within the school OT role, addressing seated postural stability directly supports the child's ability to participate in classroom learning activities.
Occupational Therapist Test Pediatric OT 4
Which reflex, if present beyond 6 months of age, is considered pathological and can interfere with voluntary reaching and rolling?