COTA Exam
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| Postural Control and Positioning | determining seat height: feet should be on the ground. measure distance from bottom of child's shoe to crease behind knee. proper seat height is 1 to 2 inches less than this distance | determining seat depth: measure the distance between the back of the seated child's hips and the crease behind their knee. proper seat depth should be 1 to 2 inches less than this distance. the child's hips should rest firmly against the back of the chair | determinging tabletop height: measure the distance between the floor and the child's elbows while the arms are hanging at the child's side. the most functional tabletop height is about 2 inches higher than this distance.
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| Positioning Problems and Simple Solutions | signs the child may need more stability: straddling the seat, wrapping the feet around chair legs, slouching, rocking, sitting on their feet, sliding to side or front of chair | if the child's feet cannot rest firmly on the ground, then telephone books, small boxes, and foam blocks can be used as footrests for support |
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| Seating Alternatives | rocking chairs, air filled cushions, or therapy balls can be used for children who rock or fidget too much | children who are unable to stay seated for long periods of time can stand to complete schoolwork. they can use a podium, countertop, or other raised surface to promote a straight back | children who are unable to sit safely due to physical limitations may need seat belts, armrests, or side supports for stability
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| Computers | children can use computers if they have difficulty handwriting | keyboard options: alphabetically arranged, one-handed, and pointer (one-finger) | word prediction programs can reduce oculomotor demands. other programs include voice recognition and pointing to the monitor
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| Communication Boards | children who are unable to speak may need communication boards with pictures, symbols, or words in order to communicate | the larger the vocabulary, the larger the board. large vocabularies may require several pages or an entire book | OT practitioners work with SLPs to determine how large pictures need to be, what kind of borders need to be around pictures, whether the child's fine motor skills are adequate for pointing to the pictures
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| Telephones | telephone adaptations include large buttons or large print, can be hooked up to computer, speakerphones, hands free headsets, and holders for phone receivers | children may need written scripts for follow during phone conversations. they should be taught not to give out personal information |
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| Call Lights | call lights are used for individuals who have a hearing impairment | lights are attached to doorbells or phones so that ringing causes the lights to blink |
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| Emergency Systems | used to alert emergency medical technicians or fire department | children may need to work on judgement skills - learning what an emergency is |
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| Environmental Control Systems | complex environmental control systems are individualized for clients who may need help operating common household appliances | examples include lights, television, heating and air, or door locks |
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| Safety Procedures | safety issues need to be addressed immediately | prevent self-injury or aggression by reducing overstimulation and increasing pleasing input | helmets, consistent behavior managment plans, reducing demands, and providing one-on-one supervision may ensure safety
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| Emergency Responses | children should be able to communicate their name, address, and phone number in case of an emergency. teachers, caregivers, and practitioners can be involved | evacuation chairs may be need for children in wheelchairs. facility or OT staff may be responsible for aquiring chairs or training personnel on evacuation chair use | children need to be aware of what a stranger is. this can be done by giving them concrete definition of what a stranger is
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| Nutrition | poor nutrition may be due to poor oral-motor skills, oral defensiveness, limited access to healthy food, limited knowledge of nutrition, food allergies or sensitivity, gastrointestinal problems, limited food preferences | interventions include deciding the right time to eat, create a positive eating atmosphere, make food visually interesting, talk about the food, give them extra time to eat, offer food in order of nutritional priority |
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| Physical Fitness | the goal is to perform fun, realistic activities to promote physical fitness. to maintain cardiovascular fitness, children need to engage in a physical activity at least 3 times a week for 20 minutes each | underlying skills may need to be improved in prep: muscle tone, ROM, strength, gross and fine motor function | joint protection: always use strongest joint for task, avoid forces that push wrist toward ulnar side of hand, bear weight on palm rather than knuckles
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| Rote Learning | the acquisition of routine behaviors that may not be completely understood or performed with sincerity by the individual using them | usually acquired through memorization or repetition |
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| Optimum Level of Arousal | alertness and readiness for the job at hand. is required for learning | do muscle work or movement before a challenging task, deep breathing, oral activities such as small treats, cubicles, wearing headphones with or without music, seat cushions or adaptive seating, quiet environment | Wilbarger Deep Pressure and Propriceptive Technique can be done every hour to 2 hours for children with sensory defensiveness
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| Techniques to shape positive attitudes and increase self-esteem | praise child's attempts, use a "matter-of-fact" approach, avoid using workds "good" or "bad" | give concrete instructions, make sure last words heard by child explain desired behavior, be genuinely caring and have a sense of humor | practice self-awareness, do not take child's actions personally
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| IADL | more complex than ADLs (ie: they require more cognitive skill, problem solving, and judgement) and include more interaction with the environment |
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| Communication Device Use | devices include writing equipment, telephones, keyboards, computers, commnication boards, telecommunication devices for the deaf, braille writers, emergency call systems, and environmental control systems | COTAs can assess the child's ability to use the devices, chose or adapt devices to fit special needs, help develop skills needed to operate devices, train them in operation, and help use devices during daily functions | COTAs need to be trained by the OTR in using communication devices
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