Question 1

Charisse is a 16-year-old high school student with quadriplegic cerebral palsy and cognitive delay. She uses an electric wheelchair, but cannot navigate her classrooms without crashing into furniture. What adaptations do you recommend to Charisse's teacher?

Accepted Answer

The adaptations you recommend to Charisse's teacher include arranging Charisse's classrooms to allow wide spaces between pieces of furniture, placing Charisse's desk near the door of the classroom, and getting permission from custodial staff to mark Charisse's pathways in her classes with high-contrast tape. All of these adaptations will help compensate for Charisse's difficulty avoiding obstacles in her classrooms.

Question 2

Martin is a 20-year-old high school student with multiple developmental disabilities. His mother complains that she is having difficulty managing Martin at home due to his size. When Martin's dad is home, he is able to lift Martin into the bathtub and bed. But Martin's dad is a truck driver and is gone for weeks at a time. What do you recommend to Martin's mother?

Accepted Answer

You recommend to Martin's mother to contact the aging and disabilities resource center and request a home evaluation. The resource center can help Martin's mother obtain and pay for an electronic lift if that is what she needs to transfer Martin. They can also recommend and help obtain funding for other adaptations that might benefit Martin and his family.

Question 3

Sam is a 12-year-old student with muscular dystrophy. He is still ambulatory and uses a wheeled walker to get around the school. He complains to you that he cannot open the heavy bathroom door and hates to ask for help. What do you recommend to your OT department to help Sam be independent in accessing the bathroom?

Accepted Answer

You recommend to your OT department to write a proposal to install an electronic door opener on one of the boy's bathroom doors. This is the least restrictive option for Sam, as it allows him to open the door to the bathroom he normally uses based on his assigned grade and classes. This option does not infringe on the privacy of Sam's classmates and does not make Sam feel singled out by having to use an alternate bathroom.

Question 4

Darla is a 2-year-old student with spina bifida. She cannot sit on the floor with her playmates at her daycare to play with toys. What accommodation do you recommend for Darla?

Accepted Answer

You recommend that Darla be positioned in side lying or in a floor sitter to play with toys. Her spina bifida is severe enough that her upper body postural control is compromised on something without support, such as a bench. She will require the upper body support that is provided in either a side-lying position or floor sitter.

Question 5

The third-grade class has several children with disabilities, including two children with ADHD, one child with a cognitive disability, and one child with a hearing impairment. What does your special education director purchase for the classroom teacher to use with this group of students?

Accepted Answer

The special education director purchases a classroom amplification system for the classroom teacher to use with this group of students. Classroom amplification systems provide extra auditory input to students who have difficulty with auditory processing. Besides being beneficial for the student with a hearing impairment, the amplification system will assist the students with ADHD in attending to the teacher and the student with a cognitive disability in processing instructions.

Question 6

Your 7-year-old student, Gabriel, cannot draw a recognizable picture. He holds pencils with a perfect tripod grasp. How could you help him draw a simple picture of his house?

Accepted Answer

You could help Gabriel draw a simple picture of his house by giving him step-by-step visual samples to imitate. Giving Gabriel a picture to trace will not help develop his ability to visualize a picture, and giving him a visual sample to copy is most likely beyond his skill level. Step-by-step visual samples will help Gabriel learn how to start and add details to a simple picture.

Question 7

Jacob is a 13-year-old student with autism. He has tactile defensiveness and handles everything with his fingertips, including pencils, pens, and art tools. He is having difficulty holding a paint brush during watercolor painting in art class. What adaptation do you provide to make painting easier for Jacob?

Accepted Answer

You provide Jacob with a large, soft foam grip on the paintbrush. Since Jacob has tactile defensiveness, the large foam grip enlarges the gripping surface for Jacob and cushions his fingers to decrease discomfort during the task.

Question 8

A middle school student with cognitive disability cannot write his name. What would be an appropriate adaptation?

Accepted Answer

An appropriate adaptation for a middle school student with a cognitive disability who cannot write his name would be a self-inking name stamp. The student is old enough that he may not acquire the ability to write his name, and a name stamp would allow him to learn to sign papers, forms, and other documents.

Question 9

Your student, Dani, begins to cry when you ask her to write a paragraph. She says it's too hard and you are a mean OT teacher. How could you grade this activity, so it is not so overwhelming for Dani?

Accepted Answer

To grade this activity so that it is not so overwhelming for Dani, you would reduce the number of sentences she is required to write. Dani should be expected to write sentences if she is capable of doing so, but may respond better to the activity if she is not required to write as many sentences as initially assigned.

Question 10

You are seeing two, 4-year-old kindergarten students together and would like them to participate in the same cutting project. You know that one student is able to cut on a straight line independently, while the other has difficulty. How do you grade this activity to challenge both students?

Accepted Answer

To grade this activity to challenge both students, give them the same activity. But allow one to complete the entire cutting task and allow the other student to cut on the straight lines only. This will allow the students to complete the same activity, but at their own skill levels.

Question 11

Your student, Melody, is a sixth-grader with autism. She is doing well in therapy, and you have recommended dismissing her from regular treatment to your OT department. Melody's teacher has expressed concerns about her transition to middle school the next school year. What does your OT department recommend at Melody's IEP review?

Accepted Answer

Your OT department recommends decreasing Melody's OT frequency to consultation once per month, with an increase in frequency to once per week for the month of September in the next school year. She can be monitored through once per month consultation and then can be seen again at a higher frequency during the first month of the next school year to insure she has a smooth transition to middle school. Melody cannot be dismissed from OT and then resume it again the next school year without a new evaluation being completed.

Question 12

Your OT department would like your students with movement needs to receive sensory movement breaks during the school day. Your schedule does not allow you to supervise these movement breaks. How could you insure that your students receive the movement breaks that they need?

Accepted Answer

To insure that your students receive movement breaks during the school day, you could train the school's paraprofessionals to provide the movement breaks. The paraprofessionals, also called teacher's aides, are often assigned to assist special education students during the school day anyway. Time could be allotted for movement breaks within this assigned time. The paraprofessionals would need to receive training from you to learn how to provide the movement breaks correctly and safely.

Question 13

Carson is 2-year-old birth to three client. He has tactile defensiveness, and your OT department has ordered the Wilbarger brushing protocol as a part of his treatment plan. How do you administer this protocol at the proper frequency to address Carson's tactile defensiveness?

Accepted Answer

The Wilbarger brushing protocol must be administered every two hours during the day. So to complete this protocol at the proper frequency, you must train Carson's parents and daycare providers on how to administer it.

Question 14

Faith is a new first-grade student who is beginning OT treatment for fine motor skills. Her mother asks you what activities Faith can do at home to reinforce the skills that OT will address. How do you respond to Faith's mother?

Accepted Answer

You respond to Faith's mother by giving her a list of suggested fine motor activities that Faith can participate in at home during daily routines and play time. These activities should reinforce Faith's fine motor skills, but should be simple and common enough to fit into the family's daily schedule.

Question 15

You issue a slant board and pencil grip to your first-grade student to use in his classroom. When you check on his status, you notice that he is not using either device. You ask his teacher about the devices, and she tells you that she forgot about them. How do you emphasize the importance of these devices to your student's teacher?

Accepted Answer

To emphasize the importance of these devices, you could show the teacher how the devices are used and how they improve your student's ability to complete written work. The teacher will be more likely to remember to have your student use the devices if she understands their purposes and knows that they are effective.

Question 16

What activity could you select for your new rheumatoid arthritis patient who has a short-term objective to increase upper body strength?

Accepted Answer

If your rheumatoid arthritis patient is new to your clinic, you need to start strengthening exercises slowly to avoid putting too much stress on the patient's joints. Active range of motion exercises using ½-pound wrist weights would allow strengthening to start gradually. You can increase the weight based on the patient's tolerance.

Question 17

Mabel is your 87-year-old nursing rehabilitation patient with a diagnosis of chronic obstructive pulmonary disease (COPD). She lives alone and has a private home health aide, who visits daily to help her with bathing, meal preparation, and housekeeping. What activities will you focus on during Mabel's therapy sessions?

Accepted Answer

You would focus on hygiene, dressing, toileting, and using a microwave to heat food during Mabel's therapy sessions. Mabel's home health aide helps her with bathing, fixing meals, and cleaning her home. The home health aide does not live with Mabel, so Mabel would be expected to complete basic tasks. She may also be expected to heat food for meals when the home health aide is not there.

Question 18

Howard is your 42-year-old hand therapy patient with a diagnosis of carpal tunnel syndrome. He works as a salesman for a pharmaceuticals company and has a territory that covers half of your state. What activity must you spend time adapting for Howard to prevent his carpal tunnel syndrome from exacerbating?

Accepted Answer

You must adapt driving for Howard to prevent his condition from exacerbating. Talking on the phone and typing on the computer are easily adapted through the use of hands-free technology. You will be able to recommend these adaptations to Howard without having to spend a lot of time addressing them during therapy. Instead, you will need to spend time adapting driving for Howard, as this may mean modifications to Howard's steering wheel, hand controls, and keys.

Question 19

What activities do you select for your new hospital inpatient with respiratory Methicillin Resistant Staphylococcus Aureus (MRSA)?

Accepted Answer

You would select upper-body strengthening using exercise bands and exercise putty in the patient's room. Respiratory MRSA is contagious. If the patient has respiratory MRSA, he/she will be isolated from other patients. You will have to provide treatment in his/her room.

Question 20

Alice is a 52-year-old outpatient with multiple sclerosis. She tells you she misses cooking and would like to do more of it. How do you respond to Alice's comment?

Accepted Answer

You tell her that you will work on adapting cooking tasks in therapy, so she can cook more at home. If Alice has multiple sclerosis, she may gain some strength and endurance in therapy. But it will most likely not return to her previous levels. However, if you work with her on adapting cooking tasks, she will be able to resume cooking at home in spite of the limitations the multiple sclerosis has caused.

Quiz 2: Implementing Interventions