Intro final sample questions & units 1-14

What are occupations?

These are the activities and tasks that one does throughout their day that are uniquely meaningful and important to them. According to the American Occupational Therapy Association, occupations can help give life meaning and purpose.

OTPF

The OTPF is a key document that helps occupational therapy practitioners understand the scope of occupational therapy practice and the areas in which we provide services to our clients

Domain of OTPF

The domain of occupational therapy refers to the knowledge base and areas of expertise occupations (THE WHAT). It includes contexts, performance patterns, performance skills, and client factors. We use the occupational therapy domain to help identify client strengths and weaknesses, barriers to change, and opportunities for change

Process of OTPF

The process is the structured, step-by-step approach used by therapists (THE HOW) to deliver services, which includes evaluation, intervention, and outcome measurement

Cornerstones of OT include

core values and beliefs rooted in occupation, knowledge of and expertise in the therapeutic use of occupation, professional behaviors and dispositions, and therapeutic use of self

What is the therapeutic use of self

Using your personality, insights, perceptions (gifts), and judgements as part of the therapeutic process.

what FOR uses backward and forward chaining the most

Behavioral Frame of Reference commonly uses forward chaining and backward chaining; this is not the only frame of reference that uses the concept. However, what you will see it mostly associated with are these techniques, which are grounded in behavioral principles of learning.

What is forward chaining

Teaching a skill by starting with the first step and moving forward (client completes the first step, therapist completes the rest). Forward chaining - tying shoes, showing them, they copy and carry out, repeating the steps over and over until they are completed.

what is backward chaining

Teaching by starting with the last step and moving backward (the therapist completes all but the last step, and the client completes the final step). Backward chaining - tying shoes, we do the task except for the last part, and then they complete it and then repeat with completing less of the tasks.

Forward Chaining Example: Task: Making a sandwich

Step 1: Maria gathers the ingredients.

Step 2: Maria spreads the butter on the bread.

Step 3: Maria adds the filling (e.g., ham, cheese).

Step 4: Maria puts the top slice of bread on.

Step 5: Maria cuts the sandwich.

Intervention: The therapist teaches Maria each step sequentially, starting with gathering the ingredients. Once Maria masters the first step, the therapist adds the next step, and so on, until Maria can complete the entire task independently.

Backward Chaining Example:

Task: Making a sandwich

Intervention: The therapist completes all steps except the last one (cutting the sandwich). Maria starts by cutting the sandwich. Once she masters this step, the therapist gradually works backward, allowing Maria to complete more steps until she can perform the entire task independently.

Benefits and Challenges of backward/forward chaining:

Time Constraints

Challenge: Chaining techniques can be time-consuming, requiring multiple sessions to master each step.

Strategy: Prioritize the most critical steps and focus on those first. Use efficient teaching methods and monitor progress regularly to adjust the pace as needed.

Benefits and Challenges of backward/forward chaining: clients cognitive and physical abilities

Challenge: Clients with cognitive impairments or physical limitations may find chaining techniques particularly challenging.

Strategy: Adapt the steps to match the client's abilities. Use assistive devices, visual supports, and simplified instructions to accommodate their needs.

Transactional perspective

Focuses on present interactions and context, emphasizing situational doing in the moment

Life experience perspective

Highlights how past and ongoing experiences shape meaning, identity, and personal narratives across time

A client recently sustained a spinal cord injury resulting in paraplegia. The client expresses feelings of frustration and decreased well-being because they are unable to return to their favorite community coffee shop, which has only stairs at the entrance. Which factor MOST significantly contributes to the client's reduced sense of well-being?

A. The client's impaired motor function limits mobility

B. The client's personal history of enjoying social routines at the coffee shop

C. The lack of environmental accessibility prevents engagement in a valued occupation

D. The client's emotional response to adjusting to life changes after injury

C. The lack of environmental accessibility preventing engagement in a valued occupation

A 35-year-old woman recently returned to work after maternity leave. She is a full-time professional, a mother to a 6-month-old baby, and a caregiver for her aging mother who lives in the same household. She reports feeling overwhelmed and unable to find time for herself. She is constantly shifting between work tasks, childcare, and caregiving responsibilities, leaving little time for leisure or rest. As a result, she is experiencing stress and fatigue, which is impacting her overall well-being.

Which of the following best describes this woman's current situation?

A) Occupational imbalance

B) Occupational alienation

C) Occupational deprivation

D) Occupational justice

A) Occupational imbalance

Explanation:

The woman is experiencing an occupational imbalance, which occurs when there is a mismatch between time spent on different occupations. In this case, her responsibilities are skewed heavily towards work, caregiving, and parenting, leaving little time for restorative activities like leisure or self-care. This imbalance leads to stress, fatigue, and a decrease in overall well-being.

Occupational alienation

This term refers to a sense of disconnection or estrangement from one's occupations, often due to a lack of meaningful engagement. While the woman may feel overwhelmed, she is still engaging in important roles (work, caregiving, etc.), so she is not alienated from her occupations.

Occupational deprivation

This happens when someone is unable to engage in meaningful occupations due to external barriers (e.g., poverty, environmental constraints). While she is struggling with balancing her roles, she is not deprived of the occupations themselves.

Occupational justice

Occupational justice refers to the fair and equitable distribution of opportunities for meaningful occupation for not just a client but also groups and communities. It's not directly relevant here since the issue is more about an imbalance in time spent on various occupations rather than systemic barriers to access.

occupational marginalization

Inability of people to make choices for participation in parts of occupations or have autonomy.

occupational imbalance

Groups or populations that do not share in equal opportunities to pursue occupations.

An occupational therapist is creating a professional development plan to support their transition into a leadership role. Which of the following components is most essential to include in the plan to align with AOTA's Standards for Continuing Competence?

A. A list of preferred continuing education courses

B. A timeline for completing licensure renewal

C. A self-assessment of current skills and areas for growth

D. A record of previous employment and job titles

Correct Answer: C - a self-assessment of current skills and areas for growth

AOTA emphasizes self-assessment as a foundational step in continuing competence. It helps identify gaps and guides meaningful professional development.

what situation often relates to Fidelity

if the situation involves avoiding conflist it often relates to fidelity

if the situation centers on pleasing others, what kind of trap is it?

an Autonomy trap

subtle conflicts can exist, but what comes first?

clients rights and safety always come first

A client with early dementia refuses to participate in therapy despite encouragement. The caregiver insists the OT "make the client do it" because it is "for their own good." What is the BEST action for the OT?

A. Respect the client's refusal and discontinue the session

B. Persuade the client by emphasizing caregiver's wishes

C. Ignore the client's refusal to meet the caregiver's expectations

D. Document refusal and force minimal participation to justify billing

A. Respect the client's refusal and discontinue the session

An OT is treating a client with post-stroke hemiplegia. The OT knows of a new evidence-based intervention that could improve outcomes, but it requires more preparation time. What is the MOST ethical action?

A. Use the intervention only if the client requests it

B. Implement the intervention because it is in the client's best interest

C. Avoid the intervention to save time and maintain a lighter caseload

D. Wait until the clinic director approves the new method

B. Implement the intervention because it is in the client's best interest

An OT overhears a coworker making negative comments about another OT's competence in front of clients. What is the BEST ethical action?

A. Ignore the comments to maintain peace

B. Report the concern privately to the coworker and/or supervisor

C. Confront the coworker publicly during the incident

D. Share the comments with other staff to gain support

B. Report the concern privately to the coworker and/or supervisor

An OT working in home health notices that a client has no grab bars despite being at high fall risk. What should the OT do FIRST?

A. Not address grab bars since it is not related to a therapy goal

B. Recommend home modifications and provide resources to obtain them

C. Wait until the client's family requests equipment

D. Advise the client to use furniture for support instead

B. Recommend home modifications and provide resources to obtain them

A client presents with difficulty maintaining grasp strength following a distal radius fracture. The OT analyzes muscle function, range of motion, and pain patterns to identify the source of occupational performance limitations.

Which type of reasoning is the therapist primarily using?

A. Narrative reasoning

B. Diagnostic reasoning

C. Interactive reasoning

D. Pragmatic reasoning

Answer: B — Diagnostic reasoning focuses on identifying underlying performance deficits through clinical assessment.

An OT working in an inpatient rehab facility chooses to implement task-specific training for ADL performance based on current evidence for stroke rehabilitation.

This decision reflects which type of professional reasoning?

A. Conditional reasoning

B. Procedural reasoning

C. Ethical reasoning

D. Interactive reasoning

Answer: B — Procedural reasoning involves choosing interventions based on evidence and protocols.

what exactly are models? Why do they matter?

Models provide structure for our clinical reasoning and connect theory to real-world practice. They help us see the whole person, their context, and their meaningful occupations

A ____ __ ______ enables a therapist to conceptualize a person holistically within a specific theory.

model of practice

________, ______, and ______ __ ________ are three levels of theory organization in occupational therapy.

Philosophy, models, and frames of reference

A ______ __ ________ enables a specific approach to intervention

frame of reference

When an OT department selects a practice model to guide service delivery, it helps reflect the _________ __ ___________ _________.

philosophy of occupational therapy

A major assumption of the Ecology of Human Occupation Model is....

that the environmental context is important in predicting occupational performance

What is the first occupation-based model to include the concept of client-centeredness?

PEO

What model identifies activity, task, and occupation as the three levels of occupation

PEO

What model is an occupation-based model founded on biopsychosocial framework that focuses on health as defined by the ICF and WHO, utilizing a top-down approach

The PEOP

In what model, is personal causation understood to be a level of self-awareness in ability?

MOHO

What model has been developed in response to occupational therapy's move to a paradigm that focuses on the value of occupation?

MOHO

Assumptions of the FOR: social participation

Guides interventions aimed at engagement in meaningful occupations through social roles and relationships across the lifespan.

Blends attachment theory, social learning theory, and developmental psychology

Client-centered, environment-focused, relationship-building (peer connections)

Key terminology of the FOR: social participation

Social participation: (occupational performance) interactions with peers, family, society, and community.

Social engagement: emotional regulation, relational development, and communication

Developmental appropriateness

Populations of the FOR: social participation

Older Adults facing isolation, Adults with mental health conditions, Children with developmental delay, and those with social-emotional challenges.

Interventions for the FOR: social participation

Interventions focus on group-based activities, social skills training, environmental modifications, and modeling of behaviors.

1. An OT is working with a client who sustained a distal radius fracture and has limited wrist extension. Which intervention BEST aligns with the biomechanical frame of reference?

A. Teach compensatory strategies for dressing

B. Provide a wrist cock-up splint to maintain a neutral position (The biomechanical frame focuses on restoring range of motion, strength, and endurance. A wrist cock-up splint supports joint alignment and prevents contractures.)

C. Facilitate weight-bearing through the affected wrist during standing

D. Use sensory stimulation to improve wrist proprioception

B. Provide a wrist cock-up splint to maintain a neutral position (The biomechanical frame focuses on restoring range of motion, strength, and endurance. A wrist cock-up splint supports joint alignment and prevents contractures.)

2. Which principle underlies the biomechanical frame of reference?

A. Motor patterns can be retrained through sensory input

B. Functional performance improves when physical limitations are compensated for

C. Movement occurs through muscle strength, joint integrity, and endurance (Biomechanical principles emphasize musculoskeletal capacity as the basis for movement.)

D. Task analysis is used to grade activities for cognitive engagement

C. Movement occurs through muscle strength, joint integrity, and endurance (Biomechanical principles emphasize musculoskeletal capacity as the basis for movement.)

3. A client with a spinal cord injury at T10 wants to return to work as a teacher. Which intervention BEST reflects the rehabilitation frame of reference?

A. Strengthening hip flexors to improve gait

B. Training in wheelchair mobility and classroom accessibility (Rehabilitation focuses on compensatory strategies and adaptive equipment to maximize independence despite residual deficits.)

C. Facilitating normal movement patterns through handling techniques

D. Using sensory input to promote postural control

B. Training in wheelchair mobility and classroom accessibility (Rehabilitation focuses on compensatory strategies and adaptive equipment to maximize independence despite residual deficits.)

4. Which statement BEST describes the goal of the rehabilitation frame of reference?

A. Restore normal movement patterns through neurofacilitation

B. Improve strength and endurance for occupational performance

C. Enable participation through adaptation and compensation (Rehabilitation emphasizes adaptation and compensation rather than remediation of impairments.)

D. Use sensory stimulation to elicit motor responses

C. Enable participation through adaptation and compensation (Rehabilitation emphasizes adaptation and compensation rather than remediation of impairments.)

5. An OT is treating a child with cerebral palsy who demonstrates increased extensor tone during sitting. Which intervention BEST reflects NDT principles?

A. Provide a weighted lap pad to improve attention

B. Use handling techniques to inhibit extensor tone and facilitate trunk flexion (NDT focuses on using facilitation and inhibition techniques to normalize tone and improve postural control.)

C. Strengthen trunk muscles through repetitive sit-ups

D. Teach compensatory strategies for dressing in supine

B. Use handling techniques to inhibit extensor tone and facilitate trunk flexion (NDT focuses on using facilitation and inhibition techniques to normalize tone and improve postural control.)

6. Which concept is central to the neurodevelopmental frame of reference?

A. Movement is based on musculoskeletal integrity

B. Motor learning occurs through repetition of compensatory strategies

C. Normal movement patterns can be facilitated through sensory and handling techniques (NDT emphasizes facilitating normal movement and inhibiting abnormal tone through therapeutic handling.)

D. Independence is achieved through environmental adaptation

C. Normal movement patterns can be facilitated through sensory and handling techniques (NDT emphasizes facilitating normal movement and inhibiting abnormal tone through therapeutic handling.)

An OT is reviewing federal laws to ensure compliance during documentation and service delivery. Which law specifically protects the privacy and confidentiality of client medical information?

A. Americans with Disabilities Act (ADA)

B. Health Insurance Portability and Accountability Act (HIPAA)

C. Affordable Care Act (ACA)

D. Individuals with Disabilities Education Act (IDEA)

B. HIPAA - Rationale: HIPAA establishes national standards for privacy and security of health information, directly influencing OT documentation and communication.

A client’s insurance company denies further OT services after the initial 10 visits. What is the OT’s most appropriate first action to advocate for continued care?

A. Contact the state licensing board

B. Encourage the client to file a lawsuit

C. Provide documentation supporting progress and medical necessity

D. Refer the client to physical therapy

C. Provide documentation supporting progress and medical necessity ✅ - Rationale: Advocacy begins with accurate, evidence-based documentation to justify continued therapy before escalation.

Which statement best distinguishes laws from regulations?

A. Laws are advisory, while regulations are mandatory.

B. Laws are created by agencies; regulations are made by legislatures.

C. Laws are enacted by legislatures, while regulations interpret and enforce those laws

D. Laws are ethical codes, while regulations are organizational policies.

C. Laws are enacted by legislatures, while regulations interpret and enforce those laws - Rationale: Legislatures enact laws; administrative agencies create regulations to implement them.

Moral Treatment Movement

A late 18th-19th century movement that promoted humane treatment of people with mental illness through structured routines, meaningful activity, and dignity instead of restraint or punishment. This movement influenced OT's belief that occupation supports mental health.

Arts and Crafts Movement

A social movement reacting to industrialization that emphasized creativity, handcrafts, and meaningful work. Early OT used crafts like weaving and woodworking to improve both physical and mental health.

Rehabilitation Movement

A medical movement that expanded rapidly after WWI and WWII focused on restoring physical function, independence, and work skills to soldiers and civilians. Led to OT's role in hospitals and physical rehabilitation.

Occupational Science today

An academic discipline that studies the form, function, and meaning of occupation. Looks at how participation influences health, identity, and quality of life across populations.

Comparison of how the Rehabilitation Movement relates to Occupational Science today

Both aim to restore participation, but Rehab Movement is more function/independence & physical disability focused; Occupational Science is broader, theory-driven, and looks at what occupation is and why it matters across populations and cultures.

PEO Model (Person-Environment-Occupation)

A model that explains occupational performance as the interaction between the person, the environment, and the occupation. OT can improve function by changing any one of the three.

Person (P) key ideas in PEO model

skills, abilities, roles, values, spirituality, bodily functions

Environment (E) key ideas in PEO model

physical, social, cultural, institutional, virtual

Occupation (O) key ideas in PEO model

meaningful tasks, activities, and roles.

MOHO (Model of Human Occupation)

A model explaining how people are motivated for occupation, form routines, and perform tasks in context. It uses motivation, roles, habits, and abilities to influence occupational participation. One of the most widely used OT models.

Volition (MOHO)

A person's motivation for occupation based on interests, values, and personal causation (sense of competence).

Habituation (MOHO)

The patterns and routines of dialy life including habits and roles

Performance capacity (MOHO)

a persons physical and mental abilities and how they experience their body when performing tasks

Cognitive Behavioral Frame of Reference (CBT)

A frame of reference based on changing thoughts and beliefs to improve emotional regulation and behavior. Used for anxiety, depression, pain management, and health behavior change.

Techniques: cognitive restructuring, thought logs, graded exposure, coping skills training

Neurodevelopmental Frame of Reference (NDT)

A frame of reference focusing on normalizing movement patterns and posture for clients with CNS damage. Often used for stroke and cerebral palsy.

Techniques: handling, facilitation/inhibition of movement, postural control, normalized movement sequences during functional tasks

Compare Cognitive Behavioral and Neurodevelopmental FORs

NDT Primary Focus: Movement, posture, physical function

CBT Primary Focus: Thought patterns, emotions, and behaviors

NDT Targeted Conditions: Neurological impairments like stroke, cerebral palsy, traumatic brain injury

CBT Targeted Conditions: Mental health conditions like anxiety, depression, and disorders requiring behavioral change

NDT Intervention Method: Hands-on facilitation and guided movement

CBT Intervention Method: Cognitive restructuring and behavioral techniques

Rehabilitative Frame of Reference

A frame that focuses on compensating for deficits rather than remediating them. Uses adaptive equipment, environmental modification, and task adaptation to maximize independence.

Adaptive equipment

reachers, sock aids, built-up handles, and wheelcahirs

Environmental Modifications

grab bars, ramps, rearranging kitchen for accessibility

Task modification

changing the method or sequence to allow participation

Goal of rehabilitative FOR

maximize independence and participation, even if underlying impairment remains

AOTA

The national professional organization that sets ethical standards, promotes advocacy, provides continuing education, and defines the vision of OT. Founded in 1917

Accreditation Council for Occupational Therapy Education (ACOTE)

recognized by the U.S. Department of Education as the accrediting agency for all occupational therapy higher education programs (both OTR and OTA) in the United States

American Occupational Therapy Foundation (AOTF)

The charitable, scientific education organization that supports occupational therapy research and promotes understanding of the field, through evidence and research, among the general public.

American Occupational Therapy Political Action Committee (AOTPAC)

An unincorporated committee comprised of members of AOTA, AOTPAC's purpose is to further federal legislation that supports the profession of occupational therapy through lobbying efforts.

Assembly of Student Delegates (ASD)

Meeting annually, this committee has a representative from each OT And OTA educational program that represents their peers. The ASD provides a forum for OT students to express concerns and have input in AOTA and its related affairs.

NBCOT

The organization that administers the national certification exam required to become an OTR or COTA

State regulatory boards

government agencies that issue licenses and protect the public by enforcing OT practice laws

WFOT (World Federation of Occupational Therapists)

This organization represents occupational therapists worldwide. They are a network of 101 other member organizations (including AOTA) and serve to promote practice on a global level through research and education.

Americans with Disabilities Act (ADA) 1990

Passed by Congress in 1990, this act banned discrimination against the disabled in employment and mandated easy access to all public and commercial buildings. Basically, a law that ensures accessibility and prohibits discrimination against people with disabilities

Vision 2025

AOTA's statement is that occupational therapy maximizes health, well-being, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living.

Vision 2030

AOTA's updated vision emphasizes equity, inclusion, and participation for all people through meaningful occupation.

The vision 2025 to 2030 shows what?

Together they show OT shifting from only individual rehab to population health, justice, and societal participation.

student advocacy

actions students take to support the OT profession, such as legislative outreach, education, ethical practice, and professional involvement

beneficence

The ethical duty of doing good or causing good to be done; duties of OT should be congruent with credentials and experience. The Standards of Practice describes the role of the OT as being solely responsible for directing the evaluation process.

An example of an ethical issue in beneficence

An occupational therapist has been working on the same fine motor goal with a child for the last two years. The parents question if the child is benefitting from the therapy.

ethical issue example of nonmaleficence

An occupational therapist is working with a patient who has been in a motorcycle accident. The occupational therapist and physical therapist had planned on getting the patient out of bed together but the physical therapist is late so the occupational therapist decided to get the patient out of bed alone. While attempting to get the patient out of bed the patient falls to the floor.

nonmaleficence

the ethical duty to do no harm to clients, avoiding actions that could injure or exploit clients

autonomy

a client's right to make an informed decision about their own care.

example of a violation of autonomy

Making changes to discharge plan (e.g., recommending SNF instead of home) without involving the client in decision-making

Restricting a capable client's access to phone or visitors against their wishes.

forcing a client to participate in treatment that they refused

justice

Appropriate supervision in accordance with official documents and rules is necessary. The Standards of Practice indicate that the OT initiates and directs screenings, evaluations, and reevaluations, while the OTA can participate in delegated tasks and report results to the OT.

Ethical issue example of justice

An OTA is given multiple patients to screen for services. The OT is out of the office for a few days and unreachable. The OTA has never performed a screen but assumes it is okay since it is not technically and evaluation. The OTA conducts the screens and decides which clients will receive services and those that will not. When the OT returns to the office they have two new evaluations to complete and no additional information. The OTA does not tell the OT about completing the screens or the results.

fidelity

The ethical value of loyalty, trust, respect, and integrity in professional relationships. Essential for safe OT/OTA collaboration and working together

Veracity

Accurate and objective information; truthfulness and honesty in therapy