Pediatrics: Pass the OT Module 2 Part 1

An OTA is working with a 7-year-old boy who has Down Syndrome. One of the therapy goals is to improve the boy’s fine motor skills, specifically his in-hand manipulation. What activity would achieve this goal?

Place 3 coins in the child's hand and ask him to post the coins into a piggy bank, one coin at a time.

This activity requires the child to manipulate the coins within his hand (in-hand manipulation) and place them one by one, which helps improve his dexterity and coordination.

A COTA® is working with a 6-year old child who has a sensory processing disorder. A key therapeutic strategy is to determine play activities that would foster an optimal arousal level and a “just-right” challenge. There are however certain activities which elicit responses that indicate the child has reached his sensory threshold. What responses would the COTA® most likely observe to confirm this? Select the best 3 choices.

• The child splays his legs out toward the ground when the therapist pulls him on a scooter board and picks up speed

  • This behavior shows that the child is likely feeling overstimulated by the increased speed, leading to a defensive response.

• The child hugs the rope ladder tightly as he climbs and stops after advancing 1 rung above the floor

  • This indicates the child is feeling unsure or overwhelmed, and the need for physical control or safety suggests they have reached their sensory threshold.

• The child wiggles his legs and rolls side-to-side while in the middle of a matching card game as he is laying prone on his elbows

  • This response shows difficulty with maintaining focus and self-regulation, likely due to sensory overload, as the child is unable to stay still and engage with the task.

At what age does a toddler begin to scoop food with a spoon and bring it to his or her mouth?

15 to 18 months.
15 to 18 months. The normal developmental sequence for self-feeding skills progresses as follows:
5-7 months: Take cereal/baby food from spoon
6-8 months: Attempt to hold bottle
6-9 months: Sucks more than bites and grab spoon and bangs or sucks
9-13 months: Finger-feeds self soft table foods (macaroni, peas, dry cereal)
12-14 months: Dip spoon in food, bring to mouth
15-18 months: Scoop food and bring to mouth

A child with Down syndrome has an inferior pincer grasp and can hold a tiny object between the pads of his finger and the thumb. What is the next fine motor grasp pattern to develop?

Fine pincer grasp

This grasp involves using the tips of the thumb and index finger to hold small objects, which is a more refined and precise grip compared to the inferior pincer grasp

A 7-year-old boy has an occupational therapy goal to work on his in-hand manipulation. What task would help this student develop complex rotation?

Flipping a pencil to use the eraser end

Complex rotation involves rotating an object 180 degrees or more with the fingers, such as when flipping a pencil to use the eraser end. This movement requires the child to manipulate the pencil in a precise way, promoting the development of complex rotation.

At what age does the Symmetric Tonic Neck Reflex (STNR) start to become integrated?

8-12 months The purpose of STNR is to prepare for crawling. STNR appears at 4-6 months and should integrate from 8 to 12 months.

You observe a 7-month-old baby who is sitting and playing on the floor being knocked off balance by the family dog. The baby immediately reacts by extending and abducting his arm to the side (opposite to the side hit by the dog). What reflex is this infant demonstrating?

Sideways parachute (UE protective extension to the side)

This reflex is a protective reaction in which the baby extends and abducts their arm to the side when off balance, helping to protect themselves from falling. It typically emerges around 6-7 months of age.

This condition occurs within the first four weeks of a pregnancy when the developing spine of the fetus (neural tube) fails to close properly. Damage to the nerves and spinal cord can occur. The exact cause is unknown but it seems to run in families. What is this condition called?

Spina bifida

Spina bifida occurs when the neural tube, which forms the early spinal cord and brain, fails to close properly during early development, leading to damage to the spinal cord and nerves. It often occurs within the first four weeks of pregnancy and may have a genetic component.

When the one corner of a newborn baby’s mouth is stroked, the baby automatically turns his face towards the stimulus, whilst making a sucking motion with his mouth. What is this reflex?

Rooting reflex

This reflex helps the baby find the nipple for feeding. When one corner of the baby's mouth is stroked, the baby turns their head toward the stimulus and makes a sucking motion. It typically appears at birth and is important for early feeding.

What reflex is elicited by applying pressure to an infant’s gums?

Phasic bite reflex

This reflex causes the infant to automatically bite down when pressure is applied to the gums. It is a normal part of infant development and helps with early oral motor control.

A child is able to independently unbutton a shirt which has smaller buttons, at what age?

Typically, a child can manage fastenings in this progression.
– 1 1/2 to 2 years: Unzips zipper with large tab
Pulls large zipper tab up if adult holds bottom taut
– 2 years: Unbuttons large (1-inch) buttons
– 2 1/2 to 3 years: Buttons 3 large (1-inch) buttons, may not do in correct order
– 2 1/2 to 3 1/2 years: Unzips and unsnaps clothing while wearing it
– 3 to 4 1/2 years: Can close front snap on clothing
Can button and unbutton while wearing front-opening clothing
– 4 1/2 to 5 years: Can open all fasteners on any article of clothing
– 5 to 6 years: Can hook and zip up a zipper while wearing the clothing

At what age can a child be expected to start experimenting with a fork by stabbing their food?

24-30 months

Which developmental step will follow next for a 15-month-old girl who has recently mastered scooping food such as yogurt, pudding, and apple sauce and is now bringing it to her mouth?

Drinking from a straw.
Developmental sequence of the skills:
Holding spoon and banging it: age 6-9 months
Finger-feeding cereal and crackers: age 9-13 months
Dipping a spoon in food: age 12-15 months
Scooping food with a spoon: age 15-18 months
Drinking from a straw: Age 18-24 months