Clinical Skills in Occupational Therapy Assistant Practice
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Course Introduction
This course provides a comprehensive exploration of essential clinical skills required for Occupational Therapy Assistant (OTA) practice. Students will develop foundational competencies in assessment, therapeutic intervention techniques, client communication, documentation, and safety procedures through both theoretical instruction and practical, hands-on experiences. Emphasis is placed on applying evidence-based methods to support clients participation in daily activities across diverse settings. By the end of the course, students will demonstrate proficiency in implementing treatment plans, adapting interventions to individual needs, and collaborating effectively within the interprofessional healthcare team.
Recommended Textbook
Pediatric Skills for Occupational Therapy Assistants 4th Edition by Jean W. Solomon
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2
Chapter 1: Scope of Practice
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Q1) Akita prepares and presents a synopsis of the fieldwork educators' workshop during a staff meeting.What type of scholarship is this?
A) Teaching
B) Discovery
C) Integration
D) Application
Answer: A
Q2) Which of the following is not a category in the Occupational Therapy Practice Framework (OTPF)?
A) Areas of occupation
B) Performance arenas
C) Context and environment
D) Client factors
Answer: B
Q3) In what year will the OT profession turn 100 years old?
A) 2017
B) 2020
C) 2027
D) 2035
Answer: A
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Chapter 2: Family Systems
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Q1) What is an important message to convey to families when first meeting them?
A) You are interested in their child and respect what the family is doing to support and parent their child.
B) Professionals have all of the answers.
C) The road ahead with a child with disabilities will be hard.
D) Therapy is the single most important activity in their child's life.
Answer: A
Q2) Which essential skill for successful intervention with families is most closely shown in the following scenario? The OT practitioner asks the parents what they hope to achieve by coming to therapy.The practitioner seeks to determine how the child spends her day and what problems occur so that an intervention plan can be developed.
A) Acknowledgment
B) Continuity
C) Collaborative goal setting
D) Solution-focused interest
Answer: C
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Chapter 3: Medical Systems
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Q1) OTAs play a vital role in the NICU.
A)True
B)False Answer: False
Q2) Which statement best describes the role of the occupational therapy (OT) practitioner in the medical setting?
A) Encourage the child's performance in strength, endurance, and range of motion as related to medical diagnoses.
B) Engage child in a variety of activities to promote educational performance upon discharge.
C) Facilitate the child's ability to engage in everyday occupations while supporting medical stability for discharge.
D) Provide support to the medical team to assist child in being discharged to home. Answer: C
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Chapter 4: Educational Systems
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Q1) What are special services such as occupational therapy (OT), physical therapy (PT), speech therapy (ST), school health, and social work required for a child to benefit from a special education program called?
A) Related services
B) Resource room services
C) Self-contained services
D) Special education services
Q2) What is the role of the certified occupational therapy assistant (COTA) in the evaluation phase?
A) To choose the evaluation tool to be used.
B) To determine areas to be assessed.
C) To give tests within their competency level.
D) No participation in student evaluations.
Q3) Who are members of an IEP team?
A) Professionals knowledgeable in the area of suspected need
B) Professionals knowledgeable regarding curriculum
C) The parents
D) All of the above
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6
Chapter 5: Community Systems
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Q1) Which of the following is the definition of health in accordance with the World Health Organization (WHO)?
A) Absence of disease and deformity
B) Absence of infirmity
C) State of well-being
D) All of the above
Q2) What is it called when the practitioner is able to remember certain traditions and practices and use them in intervention sessions?
A) Cultural awareness
B) Cultural desire
C) Cultural skill
D) Cultural encounter
Q3) What was one of the most significant shifts from hospital to community care?
A) Community Health Act of 2008
B) Mental Health Center Act of 1963
C) Americans with Disabilities Act
D) No Child Left Behind
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Chapter 6: Principles of Normal Development
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Q1) Which term is not a period of development?
A) Adolescence
B) Early childhood
C) Infancy
D) Puberty
Q2) Which of the following statements is true about the occupational therapy (OT) practitioner's study of typical development?
A) It has no clinical relevance unless the therapist is working with developmentally delayed children.
B) It is best to memorize developmental sequences.
C) It helps practitioners to problem solve developmental sequences while working with children who have special needs.
D) It has limited application while working with special needs children.
Q3) Which of the following is not a rule of motor development?
A) Proximal to distal
B) Lateral to medial
C) Cephalic to caudal
D) Gross to fine
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8
Chapter 7: Development of Performance Skills
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Q1) In which matter do peers influence adolescents more than parents?
A) Academic choices
B) Career
C) Future aspirations
D) Trying out new roles
Q2) Which of the following is true of early maturing adolescent boys?
A) They are rated as less physically attractive.
B) They experience greater peer acceptance.
C) They are less likely to complete college.
D) They try hard to seek attention.
Q3) A child turns to respond to his name being called; he questions rules of the game; and he shows that he is having fun while playing the game.What type of performance skills does this illustrate?
A) motor
B) process
C) social interaction
D) behavioral
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Chapter 8: Development of Occupations
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Q1) Which scale provides a measurement of the child's approach or attitude toward play?
A) Preschool Play Scale
B) Test of Playfulness
C) Takata Play History
D) Reilly's stages
Q2) Which statement does not describe play?
A) Method to release surplus energy
B) Attitude or mood
C) Method to practice survival
D) Extrinsically motivated activity
Q3) What factor(s) influences a child's participation in home management activities?
A) Age
B) Social environment
C) Culture
D) Both A and C
E) All of the above
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10
Chapter 9: Adolescent Development: Becoming an Adult
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Q1) Fifteen-year-old Bill is anxious about future goals and career choices.He is not sure whether to pursue a job or enroll in college.He has many interests, but he does not want to do "what his parents want," although he is not exactly sure what he wants.What term most closely describes this?
A) Identity achievement
B) Identity diffusion
C) Identity formation
D) Moratorium
Q2) What is the occupational therapy (OT) practitioner's role in working with adolescents with disabilities?
A) None, because OT practitioners work only with younger children.
B) They help the adolescent achieve in school.
C) They work on writing and motor skills as they interfere with school only.
D) They facilitate the teen's transition to young adulthood.
Q3) What influences the onset of menarche?
A) Race
B) Socioeconomic status
C) Heredity
D) Both A and C
E) All of the above
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Chapter 10: The Occupational Therapy Process
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Q1) To what does the term intervention refer?
A) Therapy sessions to facilitate goals.
B) Progress reports, billing records, and client profile.
C) The evaluation, treatment plan, intervention, and discharge plan.
D) The plan of care.
Q2) Which of the following statements is not true about short-term objectives?
A) They are all the things the client needs to be able to do to meet long-term goals.
B) They are the statements that describe the terminal functional skills the clients should achieve after intervention.
C) They are interim steps that are used to reach long-term goals.
D) They describe skills that should be mastered in a relatively short time period.
Q3) Which frame of reference views the child in terms of volition, habits and roles, performance, and environment?
A) Model of Human Occupation (MOHO)
B) Intentional Relationship Model
C) Person-Environment-Occupation
D) Biomechanical
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Chapter 11: Anatomy and Physiology for the Pediatric
Practitioner
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Q1) Which tissue covers and protects the body surface, lines body cavities, and consists of densely arranged cells on the outer layer of the body?
A) Nervous
B) Muscle
C) Connective
D) Epithelial
Q2) Which circuit allows transport and exchange between the heart and lungs?
A) Pulmonary
B) Systemic
C) Coronary
D) All of the above
Q3) A physiologist is a biologist who studies A) function.
B) structure.
C) evolution.
D) genetics.
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Chapter 12: Neuroscience for the Pediatric Practitioner
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Q1) Which receptor is responsible for providing continuous information on midrange position sense?
A) Alpha motor neuron
B) Extrafusal muscle fibers
C) Golgi tendon
D) Muscle spindle
Q2) What is the pattern of cortical representation in the motor homunculus for fine motor skills as compared to the area for gross motor skills?
A) Equal amount of cortical representation
B) Greater amount of cortical representation
C) Smaller amount of cortical representation
D) This has not been calculated.
Q3) How does a child with neurological damage (i.e., cerebral palsy) learn to do things with his peers?
A) Repetition of task
B) Passive movement
C) Active repetition
D) A and C
E) All of the above
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Chapter 13: Pediatric Health Conditions
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Q1) Karen, the Certified Occupational Therapy Assistant (COTA), is concerned that Tom fell off the balance beam while in OT.He complained of pain, and Karen noticed some swelling and tenderness on his ankle.What is the most likely diagnosis for this injury?
A) Contusion
B) Crush injury
C) Dislocation
D) Sprain
Q2) Why is it important for a COTA to understand the problems commonly associated with a specific diagnosis?
A) To know what to expect when seeing the child for the first time.
B) To prepare for the initial evaluation.
C) To be a more valuable member of the treatment team.
D) All of the above.
Q3) What must the OT practitioner never do when a child is having a seizure?
A) Turn the child's head to the side in case she or he vomits.
B) Put a finger in the child's mouth.
C) Remove dangerous objects around her or him.
D) Put something soft under her or his head.
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Chapter 14: Childhood and Adolescent Psychosocial and
Mental Health Disorders
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Q1) Mary needs extra time for her writing assignments and she needs a tutor in math to help her sequence properly.The occupational therapy (OT) practitioner works with her on writing and sequencing once a week and provides suggestions to the child, teacher, and parent.What type of learning disorder does this depict?
A) Mild
B) Moderate
C) None
D) Severe
Q2) Susan, a 12-year-old girl, refuses to go to her new school.She is irritable and angry, and she complains of headaches every morning.Susan perspires and feels restless each morning.She is unable to sleep because she worries about the next day at school.What do these symptoms represent?
A) Normal reactions to new situations
B) Phobic anxiety disorder
C) Separation anxiety
D) Generalized anxiety disorder
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Chapter 15: Childhood and Adolescent Obesity
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Q1) Which strategy is not recommended for managing and preventing obesity in children and adolescents?
A) Set many short-term, achievable goals at a time.
B) Address issues of health rather than weight.
C) Encourage the child to have regular sleeping hours.
D) Do not completely deny child occasional sweets or soda.
Q2) What is the category for a body mass index (BMI) value that falls in the 96th percentile?
A) Healthy weight
B) Overweight
C) Obese
D) Morbidly obese
Q3) What is the recommended physical activity level for children?
A) Vigorous activity for 1 hour daily.
B) Moderate activity for 30 minutes daily.
C) Quiet activity all day long.
D) Outdoor play for at least 20 minutes daily.
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Chapter 16: Intellectual Disabilities
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Q1) Danny is 14 years old.He requires extensive help for all ADLs.He is able to communicate his wants and needs by answering yes/no questions.Which intellectual disability category applies to Danny?
A) Mild
B) Moderate
C) Severe
D) Profound
Q2) What term describes causes of intellectual disability present before a child is born?
A) Acquired
B) Perinatal
C) Postnatal
D) Prenatal
Q3) Which IQ scores are considered to be within normal limits?
A) 0-100
B) 50-70
C) 80-90
D) 85-115
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18
Chapter 17: Cerebral Palsy
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Q1) Why do occupational therapy practitioners use positioning and handling techniques for children with cerebral palsy?
A) Maintain postural alignment.
B) Facilitate improved movement patterns.
C) Facilitate performance of activities of daily living.
D) Both A and C.
E) All of the above.
Q2) Frank is unable to extend his hand quickly enough to prevent him from falling.With what reaction is he having difficulty?
A) Equilibrium
B) Protective
C) Righting
D) Static balance
Q3) What is one of the problems seen most frequently in children with cerebral palsy?
A) Early integration of the primitive reflexes
B) Absent or impaired righting and equilibrium responses
C) Wide ranges of movement patterns
D) Excessive muscle strength
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19
Chapter 18: Positioning and Handling: A
Neurodevelopmental Approach
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Q1) What is the first event that must happen for a child to move?
A) Flexion
B) Extension
C) Rotation
D) Weight shift
Q2) The COTA positions her palm on the child's abdomen and back in an effort to help the child move from upright sitting to quadruped.What is the term used for what the practitioner is doing?
A) Handling
B) Intervention
C) Positioning
D) Weight bearing
Q3) Anitra is a 2-year-old with low muscle tone, flat emotions, and frequent lethargy.The COTA who treats her has difficulty gaining Anitra's attention when trying to engage her in movement activities.What handling technique can facilitate increased tone, alertness, and activity level?
A)Slowly rocking with her positioned sideways in an adult-sized rocking chair.
B) Wrapping her with a light flannel blanket.
C) Tickling her feet.
D) Positioning her on the lap and bouncing her up and down.
Page 20
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Chapter 19: Activities of Daily Living and Sleeprest
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Q1) What is the practitioner doing by moving the objects higher so that the child has to reach above his head to get them?
A) Remediating
B) Adapting
C) Compensating
D) Grading
Q2) What term is used to describe a parent calming his or her child or two siblings working to clean their room?
A) Family-centered care
B) Co-occupation
C) Multidisciplinary
D) Behavior modification
Q3) The activities of obtaining and using supplies and washing, drying, combing, and trimming one's hair fall in what category?
A) Grooming
B) Personal device care
C) Personal hygiene or grooming
D) Toileting hygiene
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21
Chapter 20: Instrumental Activities of Daily Living
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Q1) Which of the following is not considered an instrumental activity of daily living (IADL)?
A) Care of pets
B) Community mobility
C) Eating and feeding
D) Shopping
Q2) Terry is a 14-year-old girl who can never find her papers and does not know where to put her school supplies.She loses assignments in her backpack.With what executive function is she experiencing difficulty?
A) Emotional control
B) Organization of materials
C) Self-monitoring
D) Working memory
Q3) When working on IADLs with children who have cognitive limitations, the OT practitioner will not do which of the following?
A) Divide tasks into smaller components.
B) Provide visuals to communicate each step.
C) Provide positive reinforcements.
D) Provide thorough written directions outlining all steps.
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22
Chapter 21: Play and Playfulness
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Q1) Which rule is the most important to ensure safety in a therapy session?
A) Cover electrical outlets.
B) Cut all hanging cords.
C) Inspect toys and equipment regularly.
D) Watch children at all times.
Q2) Mike and Scott are wrestling in the water.Mike flips Scott, who goes under water.Scott gets up laughing and pushes Mike.In which type of play are they engaged?
A) Symbolic
B) Games with rules
C) Sensorimotor
D) Rough and tumble
E) Both B and C
Q3) The OT practitioner played a dress-up game in therapy to work on the child's goal to put on a shirt independently.What does this session illustrate?
A) Play as the goal
B) Play as the tool
C) Backward chaining
D) Playfulness as the goal
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23
Chapter 22: Functional Task at School: Handwriting
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Q1) Which pencil grip is considered the most mature?
A) Crossed-thumb grasp
B) Dynamic tripod
C) Palmar grasp
D) Static tripod
Q2) The COTA, Marvin, is working with 3-year-old Harvey on his prewriting skills.Which skill would be the easiest for Harvey to accomplish?
A) Copy a square.
B) Imitate a straight line.
C) Spontaneously scribble.
D) Draw a face.
Q3) What type of learner benefits from role playing and feeling the letters?
A) Auditory
B) Visual
C) Kinesthetic or tactile
D) Perceptual
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Chapter 23: Therapeutic Media: Activity With Purpose
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Q1) According to the OTPF, which factor is considered an occupational performance context?
A) Activity demands
B) Habits
C) Motor
D) Personal
Q2) Tim, a Certified Occupational Therapy Assistant (COTA), is working to promote Kevin's poor grip strength and postural control.Kevin is unable to stand for extended periods.What aspects is Tim targeting?
A) Activity demands
B) Client factors
C) Context
D) Performance patterns
Q3) You are trying to increase the social skills of a group of adolescents.Which adaptations to a sponge-painting activity would best meet this goal?
A) Allow them to work in groups of three.
B) Limit talking and encourage independent work.
C) Provide them with simple directions and a time limit.
D) Seat them in desks positioned in a row.
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Chapter 24: Motor Control and Motor Learning
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Q1) What term is used to describe the intrinsic processes that go hand in hand with children experiencing and participating in meaningful activities that lead to long-lasting changes in motor performance?
A) Bilateral motor control
B) In-hand manipulation
C) Implement usage
D) Motor learning
Q2) Karen provides her client, Bill, with 1-minute rests between 5-minute of repetitive skill practice.What kind of practice is this?
A) Continual
B) Distributed
C) Blocked
D) Variable
Q3) What type of practice includes having a child placing coins in a slot, resting briefly, and repeating the same activity again?
A) Blocked
B) Distributed
C) Transfer of learning
D) Variable
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Page 26
Chapter 25: Sensory Processingintegration and Occupation
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Q1) COTAs can become certified in the administration and interpretation of the Sensory Integration and Praxis Tests (SIPT).
A)True
B)False
Q2) During a sensory integration session, Ryan, a 10-year-old boy, suddenly becomes quiet, forgets the object to the swinging game he is playing, and stops playing.What do these behaviors suggest?
A) Ryan is processing vestibular input accurately.
B) Ryan has attention deficit disorder.
C) Ryan is showing signs of sensory shutdown behaviors.
D) Ryan needs more sensory stimulation.
Q3) Which statement most closely represents the role of the Certified Occupational Therapy Assistant (COTA) in sensory integration (SI) intervention?
A) The COTA may not use SI intervention techniques.
B) The COTA may use an SI approach under supervision.
C) The COTA may only perform formal SI evaluations.
D) The COTA may not treat children with SI dysfunction.
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Chapter 26: Applying the Model of Human Occupation to Pediatric Practice
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Q1) The Model of Human Occupation (MOHO) uses what term to define the common and typical way of doing specific occupations?
A) Habituation
B) Occupational forms
C) Performance capacity
D) Roles
Q2) A child does not like the way it feels when he slides.He has done similar activities in the past and did not like them.He now avoids any activity that requires sliding or movement that is similar.The step on the volitional process that is being affected is the child's
A) interpretation.
B) experience.
C) anticipation.
D) making choices.
Q3) The subjective experience a child has in being in her own body is called
A) lived body.
B) personal causation.
C) volitional process.
D) occupational task.
28
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Chapter 27: Assistive Technology
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Q1) Which statement is true concerning assistive technology (AT)?
A) AT refers to aids and devices that help rehabilitate an individual.
B) AT helps a person to be more functional.
C) AT is always commercially manufactured.
D) AT helps persons with only certain diagnoses.
Q2) Which of the following is an example of a low-technology device?
A) Pencil grip
B) Environmental control unit (ECU)
C) Powered wheelchair
D) Laptop computer
Q3) The child observes all the letters pass by on the computer screen and presses a button when the letter he wants passes by.What type of selection is this?
A) Direct selection
B) Encoding
C) Scanning
D) Physical selection
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29
Chapter 28: Orthoses, Orthotic Fabrication, and Elastic
Therapeutic Taping for the Pediatric Population
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Q1) Which statement is not a goal of orthotic fabrication?
A) Alleviate pain
B) Enhance function
C) Prevent deformity
D) Shorten soft tissue structures
Q2) What type of protocol is provided with orthosis?
A) Occupational
B) Cleaning
C) Repair and maintenance
D) Wearing
Q3) Which statement is not a function of Kinesio tape?
A) Supports muscle
B) Improves ROM
C) Stabilizes fractures
D) Reduces pain and inflammation
Q4) Which factor is not considered when fabricating an orthosis for a child?
A) Swelling
B) Compliance
C) Sensory factors
D) Time before lunch
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Chapter 29: Animal-Assisted Activities and Therapy
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Q1) Which statement most reflects pet-assisted therapy?
A) Play with animals on a farm.
B) Feed the fish in the classroom.
C) Brush the trained facilitator's dog with the affected side.
D) Feed your own dog treats.
Q2) What is the role of the OT practitioner during a hippotherapy session?
A) Help the child successfully ride the horse.
B) Improve the child's communication skills.
C) Improve the child's posture and balance.
D) Teach the child to ride properly.
Q3) George enjoys lifting the bowl of water and feeding his dog every day.The certified occupational therapy assistant (COTA) incorporates this activity into George's morning sessions to improve George's upper extremity strength.How is she using this activity?
A) Diversion
B) Hippotherapy
C) Modality
D) Occupation
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