OTR OTR Pediatric & Developmental Occupational Therapy 1 — Questions and Answers
Question 1: A 4-year-old child is unable to copy a circle or cross. According to developmental norms, which statement BEST describes this finding?
- Normal — these skills emerge at age 5
- Delayed — circle copying typically emerges by age 3 and cross by age 4 (Correct answer)
- Advanced delay — these are kindergarten-level skills
- Not clinically significant until age 6
Correct answer: Delayed — circle copying typically emerges by age 3 and cross by age 4
Copying a circle typically develops around age 3 and a cross around age 4, so a 4-year-old unable to do either demonstrates delayed fine motor development.
Question 2: Which sensory processing framework, developed by Winnie Dunn, describes four quadrant patterns based on neurological threshold and behavioral response?
- Sensory Integration Theory (Ayres)
- Sensory Processing Model (Dunn) (Correct answer)
- DIR/Floortime Model
- Alert Program
Correct answer: Sensory Processing Model (Dunn)
Dunn's Sensory Processing Model categorizes sensory processing into four quadrants: Low Registration, Sensation Seeking, Sensory Sensitivity, and Sensation Avoiding, based on threshold and self-regulation.
Question 3: An OTR is working with a 7-year-old with autism spectrum disorder who has tactile defensiveness. Which therapeutic approach is MOST evidence-based for this presentation?
- Forced exposure to aversive textures
- Wilbarger Deep Pressure and Proprioceptive Technique (DPPT) / brushing protocol (Correct answer)
- Restricting all tactile input
- Cognitive behavioral therapy alone
Correct answer: Wilbarger Deep Pressure and Proprioceptive Technique (DPPT) / brushing protocol
The Wilbarger DPPT (brushing protocol) uses deep pressure and joint compression to reduce tactile defensiveness and is widely used within a sensory integration framework.
Question 4: During handwriting evaluation, an OTR notices a child consistently inverts letters, reverses b/d, and uses an inconsistent grip. This most likely indicates the need to assess:
- Visual acuity only
- Visual-motor integration and lateral dominance establishment (Correct answer)
- Cognitive ability via standardized IQ testing
- Auditory processing
Correct answer: Visual-motor integration and lateral dominance establishment
Letter reversals and inconsistent grip may indicate delayed visual-motor integration or incomplete lateral dominance, both of which are assessed by the OTR in handwriting evaluations.
Question 5: Which feeding milestone should be established before introducing pureed solids to an infant?
- Pincer grasp
- Sitting with minimal support and head control (Correct answer)
- Bilateral hand coordination
- Chewing with rotary jaw movement
Correct answer: Sitting with minimal support and head control
Head and trunk control sufficient to sit with minimal support is a prerequisite for safe introduction of pureed solids because it supports airway protection during swallowing.
Question 6: A school-based OTR is determining eligibility for services under IDEA. The MOST important criterion for providing OT as a related service is:
- The child has a medical diagnosis
- OT is necessary for the child to benefit from special education (Correct answer)
- The parents request OT services
- The child scores below average on a standardized fine motor test
Correct answer: OT is necessary for the child to benefit from special education
Under IDEA, OT is provided as a related service only when it is necessary for the student to access and benefit from their special education program, not based on diagnosis or test scores alone.
OTR OTR Pediatric & Developmental Occupational Therapy 1
A 4-year-old child is unable to copy a circle or cross.
According to developmental norms, which statement BEST describes this finding?