- Tenodesis grasp
- A functional pinch made when active wrist extension passively tightens the finger flexors; the key grasp at the C6 SCI level.
- Occupational profile
- The first part of the OT evaluation — the client's story: history, values, roles, routines, and chief occupational concerns.
- Analysis of occupational performance
- The second part of evaluation — observing and measuring performance skills, client factors, and context to find supports and barriers.
- Which comes first: profile or analysis?
- The occupational profile comes first; the analysis of occupational performance follows.
- OTPF-4 five domain areas
- Occupations, contexts, performance skills, performance patterns, and client factors.
- OTPF-4 three client factors
- Values/beliefs/spirituality, body functions, and body structures.
- OTPF-4 three performance skills
- Motor skills, process skills, and social-interaction skills.
- OTPF-4 performance patterns
- Habits, routines, roles, and rituals.
- OTPF-4 process side
- Evaluation, intervention (plan → implement → review), and outcomes.
- ADL vs IADL
- ADLs are basic self-care (feeding, dressing, bathing, toileting); IADLs are complex community tasks (cooking, finances, meds, driving).
- MMT grade 3/5 (Fair)
- Full range of motion against gravity with no added resistance — the pivot of the 0–5 scale.
- MMT grade 5/5 (Normal)
- Full ROM against gravity with maximal resistance.
- MMT grade 4/5 (Good)
- Full ROM against gravity with moderate resistance.
- MMT grade 2/5 (Poor)
- Full ROM only with gravity eliminated.
- MMT grade 1/5 (Trace)
- A palpable or visible contraction with no joint movement.
- MMT grade 0/5 (Zero)
- No contraction is felt or seen.
- Below MMT grade 3 is tested how?
- In a gravity-eliminated plane; grades above 3 add manual resistance.
- Goniometry
- Measuring joint range of motion in degrees with a goniometer, compared to AAOS normal values.
- Normal shoulder flexion ROM
- About 0–180°.
- Normal elbow flexion ROM
- About 0–150°.
- Normal wrist flexion / extension ROM
- About 0–80° flexion and 0–70° extension.
- Normal hip flexion ROM
- About 0–120°.
- Normal knee flexion ROM
- About 0–135°.
- Normal ankle dorsiflexion / plantarflexion ROM
- About 0–20° dorsiflexion and 0–50° plantarflexion.
- Criterion-referenced test
- Compares performance to a fixed mastery cutoff — 'did the client meet the skill?'
- Norm-referenced test
- Compares performance to a population sample — 'how does the client rank vs peers?'
- Standardized vs nonstandardized assessment
- Standardized has fixed administration and scoring; nonstandardized (interview, observation) is flexible.
- FIM (Functional Independence Measure)
- An 18-item scale scored 1 (total assistance) to 7 (complete independence) that quantifies burden of care.
- Barthel Index
- A measure of independence in basic ADLs, scored 0–100.
- COPM
- Canadian Occupational Performance Measure — the client rates performance and satisfaction on self-identified occupational problems.
- Standard error of measurement (SEM)
- A statistic showing a test score is an estimate within a band, not an exact value; used to build confidence intervals.
- MMSE
- Mini-Mental State Exam — a /30 cognitive screen; scores below ~24 suggest impairment.
- MoCA
- Montreal Cognitive Assessment — a /30 screen more sensitive than the MMSE to mild cognitive impairment (≥26 normal).
- Semmes-Weinstein monofilaments
- A graded set of filaments used to test light-touch/protective sensation thresholds.
- Stereognosis
- The ability to identify an object by touch alone, without vision.
- Beery VMI
- A pediatric assessment of visual-motor integration.
- Sensory Profile
- A questionnaire assessing a child's sensory processing patterns.
- Bayley Scales
- A standardized assessment of infant and toddler development.
- Pincer grasp age
- About 9–12 months.
- Palmar grasp (voluntary) age
- About 6 months.
- Sits independently age
- About 6–8 months.
- Walks independently age
- About 12–15 months.
- ATNR integration age
- About 4–6 months ('fencing' reflex).
- Moro reflex integration age
- About 4–6 months (startle reflex).
- STNR integration age
- Emerges ~4–6 months and integrates by about 8–12 months (before crawling).
- Plantar grasp integration age
- About 9 months (before walking).
- Rooting reflex integration age
- About 3–4 months.
- Persistent primitive reflex significance
- A reflex that persists past its integration age is a red flag for a neuromotor problem such as cerebral palsy.
- Activity analysis
- Breaking a task into its demands, required performance skills, and contextual facilitators and barriers.
- Occupation
- A meaningful, goal-directed activity or role that occupies a person's time and identity.
- Top-down approach
- Starting intervention from the occupations the client needs and wants to do — the approach NBCOT rewards.
- Bottom-up approach
- Starting from underlying impairments (strength, ROM, cognition); risks treating components in isolation.
- Frame of reference
- A theory-based guide that links assessment findings to intervention choices.
- Biomechanical frame of reference
- Addresses ROM, strength, and endurance for orthopedic conditions with an intact central nervous system.
- Rehabilitative (compensatory) frame
- Adapts the task, tool, or environment and teaches compensation when remediation isn't realistic.
- MOHO
- Model of Human Occupation — explains occupation through volition, habituation, and performance capacity within the environment.
- MOHO volition / habituation / performance capacity
- Volition = motivation; habituation = habits and roles; performance capacity = physical and mental abilities.
- Sensory Integration (Ayres)
- A pediatric frame using vestibular, proprioceptive, and tactile input and the 'just-right challenge.'
- NDT (Bobath)
- A neuro approach that inhibits abnormal tone and facilitates normal movement after stroke or in cerebral palsy.
- PEO model
- Person-Environment-Occupation — performance is the fit among the person, the environment, and the occupation.
- EHP (Ecology of Human Performance)
- A model emphasizing that context strongly drives performance.
- Behavioral frame of reference
- Uses reinforcement, shaping, and conditioning to change behavior.
- Motor learning approach
- Uses practice schedules and feedback (knowledge of results/performance) for task-specific training.
- CO-OP approach
- Cognitive Orientation to daily Occupational Performance — a problem-solving approach used in DCD and other conditions.
- Just-right challenge
- An activity graded so it is achievable yet challenging enough to promote growth.
- Grading an activity
- Adjusting the demand of a task up or down to match the client's current ability.
- Adapting an activity
- Modifying the task, tool, or environment so the client can perform it.
- Long-term vs short-term goal
- An LTG is the overall functional outcome; STGs are the measurable steps that build to it.
- Components of a good OT goal
- Measurable, functional, occupation-based, time-bound, and graded to the client.
- Posterior total hip precautions
- Avoid hip flexion past 90°, adduction past midline, and internal rotation to prevent dislocation.
- Total hip adaptive equipment
- Raised toilet seat, reacher, sock aid, long-handled shoehorn, and an abduction wedge.
- Total knee replacement early precautions
- Avoid kneeling, squatting, and pivoting early in recovery.
- Sternal precautions (post open-heart)
- Avoid lifting more than ~8–10 lb and pushing or pulling up through the arms for several weeks.
- Autonomic dysreflexia
- A hypertensive emergency in SCI at or above T6 from a noxious stimulus below the lesion (often a full bladder).
- Autonomic dysreflexia first action
- Sit the client upright, loosen restrictive clothing, and remove the noxious stimulus; get medical help.
- Unilateral neglect
- An attentional deficit (often after a right-hemisphere stroke) where the client ignores the affected side despite intact vision.
- Unilateral neglect treatment
- Visual scanning and awareness training toward the affected side, with anchoring cues and environmental setup.
- Homonymous hemianopsia
- A visual-field cut losing the same half of the field in both eyes; managed with compensatory head turns.
- Neglect vs hemianopsia
- Neglect is an attention problem (treat with scanning); hemianopsia is a visual-field loss (treat with head turns/setup).
- Frame-of-reference mismatch trap
- An otherwise-correct option is wrong if it conflicts with the frame of reference named in the question stem.
- Therapeutic use of self
- The OT's intentional use of personality, insight, and rapport as part of the therapeutic relationship.
- Standard score / z-score
- A score expressed in standard-deviation units relative to a mean; z = (score − mean) / standard deviation.
- Caregiver training in planning
- Educating family/caregivers, accounting for health literacy, so the plan can be carried out safely at home.
- OT process placement
- The correct next action depends on whether the scenario is at screening, evaluation, planning, intervention, reevaluation, or discharge.
- Evaluation before intervention rule
- You evaluate before you intervene unless an immediate safety threat overrides.
- Determining service eligibility
- Synthesizing assessment results against criteria to decide whether the client qualifies for and needs skilled OT.
- Maslow in answer selection
- Meet physiological and safety needs before higher-order, self-actualizing goals.
- Reevaluation / monitoring the plan
- Measuring progress toward goals and modifying the approach, context, or goals through clinical reasoning.
- C6 SCI key milestone
- Wrist extension produces a functional tenodesis grasp; train it and support it with a tenodesis orthosis.
- C5 SCI function
- Elbow flexion (biceps) and deltoids; uses a mobile arm support and universal cuff, needs setup.
- C7 SCI function
- Elbow extension (triceps) → independent transfers, most ADLs, and a manual wheelchair.
- C4 SCI function
- Diaphragm and neck control; dependent for ADLs; uses a power chair with sip-and-puff or mouth-stick controls.
- C8–T1 SCI function
- Finger flexion and intrinsics → independent in ADLs.
- SCI mnemonic C5/C6/C7
- Flexion at C5, tenodesis grasp at C6, extension at C7.
- Radial nerve injury
- Causes wrist drop (loss of wrist and finger extension).
- Radial nerve splint
- A dynamic wrist and finger extension orthosis.
- Median nerve injury
- Causes loss of thumb opposition — the 'ape hand.'
- Median nerve splint
- An opponens or thumb-positioning splint.
- Ulnar nerve injury
- Causes a claw hand of the ring and little fingers.
- Ulnar nerve splint
- An anti-claw or MCP-block splint.
- Carpal tunnel splint
- A resting or cock-up splint holding the wrist in neutral.
- Orthosis categories
- Immobilization (protect healing), mobilization (dynamic, restore motion), and restriction (block a harmful range).
- Before fabricating an orthosis
- Perform a sensory evaluation, pad bony prominences, and use a graded wear schedule.
- Brunnstrom stage 1
- Flaccidity with no voluntary movement after a stroke.
- Brunnstrom stage 6
- Spasticity gone; near-normal isolated, coordinated movement.
- Brunnstrom stages overview
- Motor recovery from flaccidity through emerging then resolving spasticity/synergy to near-normal movement (1–6).
- NDT goal
- Inhibit abnormal tone and facilitate normal movement patterns.
- PNF
- Proprioceptive neuromuscular facilitation — uses diagonal, proprioceptive movement patterns.
- Rood approach
- Uses sensory stimulation to evoke a motor response.
- Constraint-induced movement therapy
- Restrains the unaffected limb to force use and recovery of the affected limb after stroke.
- Rancho Los Amigos levels
- A scale of cognitive/behavioral recovery after TBI (classically I–VIII; revised to X).
- Rancho Level IV
- Confused-agitated — needs maximal assistance and a calm, low-stimulation, safety-first environment.
- Allen Cognitive Levels
- Rate global cognitive ability (1 = profoundly impaired to 6 = normal) to match task complexity and supervision.
- Energy conservation: the four P's
- Plan, prioritize, pace, and position to reduce fatigue.
- Joint protection principles
- Use larger and stronger joints, avoid sustained grips and positions of deformity, and distribute load.
- Energy conservation populations
- Cardiac disease, COPD, rheumatoid arthritis, multiple sclerosis, and other low-endurance conditions.
- Forward vs backward chaining
- Forward teaches step 1 first; backward teaches the last step first so the client ends on success.
- Graded cueing
- Providing the least assistance needed and fading cues as the client improves.
- Dysphagia positioning
- Sit the client upright at about 90° and use a chin tuck during swallowing.
- Dysphagia adaptive equipment
- Adaptive utensils, a plate guard, and a scoop dish, with cautious texture progression.
- Adaptive ADL equipment examples
- Reacher, sock aid, long-handled sponge, dressing stick, and button hook.
- Superficial vs deep heat
- Superficial heat = hot packs, paraffin, fluidotherapy; deep heat = ultrasound.
- Cryotherapy use
- Cold applied for acute or inflammatory conditions.
- TENS vs NMES
- TENS is used for pain control; NMES is used for muscle strengthening and re-education.
- Physical agent modalities role
- They are preparatory methods — they prepare tissue for occupation and are never the end goal of treatment.
- MET level grading
- Under 3 METs is light, 3–6 is moderate, and 6 or more is vigorous activity.
- Burns: anti-deformity positioning
- Position joints opposite the expected contracture (e.g., an axillary burn → shoulder abduction).
- Rule of Nines (adult)
- Head 9%, each arm 9%, anterior trunk 18%, posterior trunk 18%, each leg 18%, genitals 1%.
- Burn rehab interventions
- Anti-deformity positioning, splinting, ROM during healing, scar management, and pressure garments.
- Wheelchair seat width
- The widest point of the hips or thighs plus about 2 inches.
- Wheelchair seat depth
- From the posterior buttocks to about 2 inches short of the popliteal fossa.
- Wheelchair hip angle
- About 90° of hip flexion for postural stability.
- Pressure relief for SCI in a wheelchair
- Perform weight shifts about every 15–30 minutes and use a pressure-relief cushion.
- Transfer toward which side?
- Set up transfers toward the client's stronger or uninvolved side for safety and leverage.
- RA joint deformities
- Ulnar drift, swan-neck, and boutonnière deformities; teach joint protection to slow them.
- Low vision interventions
- Improve lighting and contrast, reduce glare, use magnification, and teach scanning and eccentric viewing.
- Amputation pre-prosthetic care
- Residual-limb shaping/wrapping, desensitization, ROM, edema control, and addressing phantom limb pain.
- Cerebral palsy
- A non-progressive motor disorder; spastic is the most common type; managed with NDT, positioning, and adaptive equipment.
- Autism (ASD) OT focus
- Sensory processing, self-regulation, social participation, and ADL independence.
- Sensory integration systems
- Targets the vestibular, proprioceptive, and tactile systems.
- School-based OT under IDEA
- OT is a related service that must support the student's educational goals.
- IEP vs IFSP
- An IEP serves school-age children (3–21); an IFSP serves early intervention (birth–3).
- Mosey's group levels
- Parallel → project → egocentric-cooperative → cooperative → mature.
- Cole's seven steps of group leadership
- Introduction, activity, sharing, processing, generalizing, application, and summary.
- Recovery model
- A mental-health approach centered on hope, empowerment, self-direction, and person-centered care.
- Phantom limb pain
- Pain perceived in a missing limb after amputation; addressed with desensitization, mirror therapy, and education.
- Hemiplegia after stroke
- Weakness on the side opposite the brain lesion (a right-hemisphere stroke causes left-sided weakness).
- Shoulder subluxation after stroke
- Manage with proper positioning and support to protect the flaccid shoulder.
- Alzheimer's disease
- The most common dementia — insidious, progressive memory loss.
- Vascular dementia
- A stepwise cognitive decline following strokes or infarcts.
- Lewy body dementia
- Fluctuating cognition with visual hallucinations and parkinsonism.
- Frontotemporal dementia
- Early changes in personality, behavior, or language.
- Fall prevention / home modification
- Remove throw rugs, add grab bars and a raised toilet seat, improve lighting, and address polypharmacy and vision.
- Aging in place
- Modifying the home and routines so an older adult can live safely and independently at home.
- Backward chaining example
- Teaching shirt donning by having the client complete the final step so they finish with success.
- OTR responsibilities
- The OTR performs the initial evaluation, interprets results, and owns the intervention plan and discharge decision.
- COTA role
- The COTA delivers intervention under OTR supervision and contributes data, but does not independently evaluate or set the plan.
- Can a COTA do the initial evaluation?
- No — the initial evaluation and its interpretation cannot be delegated; only the OTR performs it.
- OT aide role
- Aides perform only non-skilled, delegated tasks under supervision.
- What sets COTA supervision level?
- The COTA's competence, the client's complexity, the setting, and state practice acts.
- Federal vs state practice acts
- When a state practice act is stricter than federal rules, follow the stricter standard.
- Standard precautions
- Treat all blood and body fluids as potentially infectious with every client, every time.
- Airborne precautions + PPE
- Tuberculosis, measles, varicella → N95 respirator and a negative-pressure room.
- Droplet precautions + PPE
- Influenza, pertussis, meningitis → a surgical mask within close range.
- Contact precautions + PPE
- MRSA, C. difficile, scabies → gown and gloves.
- C. difficile hand hygiene
- Use soap and water — alcohol-based hand rub does not kill its spores.
- AOTA Code of Ethics principles
- Beneficence, nonmaleficence, autonomy, justice, veracity, and fidelity.
- Beneficence
- The duty to do good and promote the welfare of others.
- Nonmaleficence
- The duty to do no harm.
- Autonomy
- Respecting the client's right to self-determination, confidentiality, and informed consent.
- Justice (ethics)
- Providing fair, equitable treatment and complying with laws and policies.
- Veracity
- Being truthful and representing information accurately.
- Fidelity
- Treating colleagues and clients with respect, fairness, and integrity.
- Practicing beyond competence
- Is unethical; when competency is in question, seek supervision, mentoring, or continuing education.
- Evidence-based practice steps
- Form a clinical question, appraise the research, derive a clinical bottom line, and apply it.
- SOAP note
- Subjective, Objective, Assessment, Plan — the standard documentation format.
- S in SOAP
- Subjective — what the client reports.
- O in SOAP
- Objective — measurable data and observations from the session.
- A in SOAP
- Assessment — the clinician's interpretation, progress, and justification of skilled need.
- P in SOAP
- Plan — next steps, frequency and duration, and goals.
- Skilled documentation purpose
- To justify the medical necessity of skilled OT services for reimbursement.
- Levels of assistance: Independent
- The client performs 100% safely, in a timely way, with no help and no device.
- Levels of assistance: Modified independent
- The client is independent but uses adaptive equipment or extra time.
- Levels of assistance: Supervision
- The therapist gives verbal cues only, with no physical contact.
- Levels of assistance: Contact guard
- The therapist's hands are on the client for safety, with little or no actual effort.
- Levels of assistance: Minimal assist
- The client performs 75% or more of the task.
- Levels of assistance: Moderate assist
- The client performs 50–74% of the task.
- Levels of assistance: Maximal assist
- The client performs 25–49% of the task.
- Levels of assistance: Dependent
- The client performs less than 25%; the therapist does the task.
- Body mechanics for the therapist
- Bend at the knees, keep the load close, avoid twisting, and use a wide base of support to prevent injury.
- Population health / prevention
- Wellness, fall prevention, aging in place, and burnout prevention for self and staff.
- Continuous quality improvement
- Ongoing measurement and refinement of services to improve outcomes and safety.
- Informed consent
- The client with capacity voluntarily agrees to treatment after hearing the risks, benefits, and alternatives.
- Service competency
- Documented evidence that a COTA performs a delegated skill consistently and correctly as the OTR would.
- NBCOT Code of Conduct
- NBCOT's professional standards governing certified practitioners' integrity and conduct.
- Performance skills (definition)
- Observable, goal-directed actions — motor, process, and social-interaction — used during an occupation.
- Habits vs routines vs roles
- Habits are automatic behaviors; routines are sequences of tasks; roles are sets of expected behaviors tied to identity.
- Health management (OTPF-4)
- An occupation in OTPF-4 covering activities to develop, manage, and maintain health and wellness.
- Rest and sleep (OTPF-4)
- A distinct occupation in OTPF-4 covering rest, sleep preparation, and sleep participation.
- Two-point discrimination
- A sensory test of the smallest distance at which two points are felt as separate; finer in the fingertips.
- Proprioception
- The sense of joint position and movement, tested with eyes closed by mirroring or describing limb position.
- Kinesthesia
- Awareness of the direction and extent of joint movement.
- Dexterity assessments
- Tests like the Nine-Hole Peg Test, Box and Block Test, and Purdue Pegboard measure fine and gross hand coordination.
- Edema measurement
- Volumetry (water displacement) or circumferential tape measurement to track limb swelling.
- Grip and pinch strength tools
- A dynamometer measures grip; a pinch gauge measures lateral, tip, and three-jaw-chuck pinch.
- Screening vs evaluation
- A screening decides whether a full evaluation is warranted; the evaluation gathers detailed data to plan care.
- Norm-referenced score: percentile
- Shows the percent of the comparison sample a client scored at or above.
- Developmental milestone: rolls over
- About 4–6 months.
- Developmental milestone: crawls
- About 9 months.
- Developmental milestone: pulls to stand
- About 9–12 months.
- Tripod pencil grasp age
- About 3.5–4 years.
- Protective extension reaction
- A postural reaction emerging ~6–9 months where the arms extend to catch a fall.
- Righting reactions
- Postural reactions (~6 months on) that keep the head and body aligned in space.
- Equilibrium reactions
- Balance reactions (~9–21 months) that maintain the center of gravity over the base of support.
- Psychodynamic frame of reference
- Addresses unconscious conflicts and the therapeutic relationship in mental-health practice.
- Cognitive-behavioral therapy (CBT)
- A frame that restructures maladaptive thoughts to change feelings and behavior.
- Dialectical behavior therapy (DBT)
- A skills-based approach for emotion regulation, distress tolerance, and interpersonal effectiveness.
- Clinical reasoning types
- Procedural, interactive, conditional, narrative, and pragmatic reasoning guide OT decisions.
- Anosognosia
- A lack of awareness of one's own deficit, common with right-hemisphere stroke and neglect.
- Apraxia
- Difficulty performing a learned motor task on command despite intact strength and sensation.
- Discharge planning
- Determining the safest setting and supports for the client as skilled OT ends.
- Setting whiplash trap
- Adjacent questions can be in completely different settings — re-orient to the client and setting each time.
- Safety as the top tie-breaker
- When options compete, eliminate any that introduce risk; the safest option wins the tie.
- Client-centered care
- Decisions support the client's stated goals, values, and culture rather than clinic efficiency.
- Caregiver health literacy
- Adapt teaching to the caregiver's reading and comprehension level so the plan is followed.
- Occupation-based vs preparatory
- Occupation-based intervention uses meaningful activity itself; preparatory methods set the stage for it.
- Weight-bearing precautions
- NWB, TTWB/TDWB, PWB, WBAT, and FWB statuses gate transfers and lower-body ADL training.
- Cardiac precaution in planning
- Monitor vital signs and exertion; stop activity for symptoms or when systolic BP exceeds ~180.
- Brunnstrom in planning
- Use the client's recovery stage to choose between facilitation, synergy work, and isolated-movement tasks.
- Mobile arm support
- A device that supports the arm against gravity so a client with proximal weakness (e.g., C5 SCI) can self-feed.
- Universal cuff
- A strap that holds a utensil or tool in the palm for clients who cannot grip.
- Built-up handles
- Enlarged handles that reduce the grip needed — useful in arthritis and weak grasp.
- Sliding board transfer
- A board bridges two surfaces so a client (e.g., C6–C7 SCI) can scoot across with less lift.
- Stand-pivot transfer
- A transfer in which the client stands, pivots toward the destination, and sits, often toward the stronger side.
- Wheelchair tilt vs recline
- Tilt keeps the seat-to-back angle and redistributes pressure; recline opens the angle and can cause shear.
- Pressure ulcer prevention
- Pressure relief, repositioning, appropriate cushions, and skin checks; the Braden scale screens risk.
- Scar management
- Pressure garments, silicone, and massage to limit hypertrophic scarring after burns or injury.
- Desensitization
- Graded sensory input to reduce hypersensitivity after nerve injury or amputation.
- Mirror therapy
- Using a mirror reflection of the intact limb to reduce phantom limb pain or aid stroke recovery.
- Splint wear schedule
- Begin with short periods and increase gradually while monitoring skin and tolerance.
- Hand: resting hand splint
- Positions the wrist and hand in a functional resting position to prevent contracture.
- Tendon repair protocols
- Graded early controlled motion protocols protect a repaired tendon while preventing stiffness.
- Spasticity management
- Positioning, stretching, weight-bearing, splinting, and (medically) tone-reducing agents.
- Cognitive rehabilitation
- Remedial (restore) and compensatory (memory aids, external cues) strategies for cognitive deficits.
- Errorless learning
- Teaching that prevents mistakes during acquisition, useful for clients with significant memory impairment.
- Metacognitive strategy training
- Teaching the client to self-monitor and self-correct performance (e.g., goal-plan-do-check).
- Work simplification
- Reorganizing tasks and the environment to reduce steps and energy demand.
- Visual scanning training
- Structured practice of attending across the visual field, used for neglect and field cuts.
- Driving / community mobility
- Assessed for safety, with adaptive controls or alternative transportation recommended as needed.
- Feeding texture progression
- Advance from purees to soft to regular textures cautiously, coordinated with the dysphagia evaluation.
- Adaptive feeding equipment
- Plate guard, scoop dish, weighted or built-up utensils, and a nosey cup for safer self-feeding.
- Borg RPE scale
- A 6–20 rating of perceived exertion used to grade and monitor activity intensity.
- Burn depth classifications
- Superficial (1st degree), partial-thickness (2nd degree), and full-thickness (3rd degree).
- Spinal precautions / log roll
- Maintain spinal alignment and log-roll the client when spinal stability is a concern.
- Hemiplegic dressing technique
- Dress the affected arm first and undress it last to ease the task.
- One-handed techniques
- Adaptive methods (e.g., rocker knife, suction brushes) that let a hemiplegic client do ADLs independently.
- Group intervention purpose
- Provides peer support, social skills practice, and graded activity in mental-health and rehab settings.
- Sensory diet
- An individualized schedule of sensory activities to help a child stay regulated.
- Handwriting Without Tears
- A structured, multisensory handwriting program used in pediatric school-based practice.
- Reimbursement: medical necessity
- Skilled OT must be reasonable and necessary and require the skills of a therapist to be reimbursed.
- Medicare basics for OT
- Part A covers inpatient; Part B covers outpatient OT; documentation must justify skilled, defensible care.
- Incident reporting
- Document and report adverse events (falls, errors) to support safety and quality improvement.
- Confidentiality / HIPAA
- Protect client health information; share only what is necessary and authorized.
- Mandatory reporting
- Practitioners must report suspected abuse or neglect of vulnerable clients to the proper authorities.
- Cultural competence
- Delivering care that respects the client's culture, beliefs, and preferences.
- Supervision documentation
- Record supervisory contacts and service competency to comply with regulation and payer rules.
- Accreditation vs licensure vs certification
- Accreditation evaluates programs; licensure is the legal right to practice; certification (NBCOT) verifies competence.
- OTR credential maintenance
- NBCOT certification renews every 3 years with required professional development units (PDUs).
- Quality / outcome measurement
- Using standardized outcomes and program evaluation to demonstrate effectiveness.
- Emergency response: seizure
- Protect the client from injury, do not restrain or put anything in the mouth, time it, and position on the side after.
- Burnout prevention
- Self-care, workload management, and supervision to sustain safe, competent practice.
- Delegation rules
- Delegate only tasks within the assistant's or aide's competence and scope, with appropriate supervision.
- Ethics: distributive justice
- Fair allocation of limited resources and services across clients.
- Informed refusal
- A client with capacity may decline treatment after understanding the consequences; document it.
- Standard precautions vs transmission-based
- Standard precautions apply to all clients; transmission-based add specific PPE for known/suspected infections.
- Allen Cognitive Level Screen (ACLS)
- A standardized leather-lacing task used to estimate a client's Allen Cognitive Level.
- Reflex testing position
- Primitive reflexes are tested by presenting the specific stimulus (e.g., head turn for ATNR) and observing the response.
- Norm- vs criterion-referenced (peds)
- Norm-referenced ranks a child against peers; criterion-referenced checks whether a specific skill was mastered.
- Functional cognition assessment
- Observing real tasks (cooking, money management) to judge how cognition affects daily performance.
- Conditional reasoning
- Imagining the client's whole future context to shape the intervention plan.
- Narrative reasoning
- Understanding the client's life story and the meaning of illness to guide care.
- Pragmatic reasoning
- Accounting for practical constraints (time, resources, reimbursement, setting) in planning.
- Brunnstrom stage 3
- Spasticity peaks and the client can move within synergy patterns voluntarily.
- Flexor synergy (UE)
- Scapular retraction, shoulder abduction/external rotation, elbow flexion, forearm supination.
- Extensor synergy (UE)
- Scapular protraction, shoulder adduction/internal rotation, elbow extension, forearm pronation.
- Compensation vs remediation
- Remediation restores the impaired skill; compensation adapts the task or environment around it.
- Cock-up (wrist extension) splint
- A static splint supporting the wrist in extension, used for wrist drop and carpal tunnel relief.
- Dynamic vs static splint
- A dynamic splint applies a mobilizing force to restore motion; a static splint holds a fixed position.
- Aspiration precautions
- Upright positioning, chin tuck, appropriate textures, slow pace, and supervision to prevent food entering the airway.
- Hip kit
- A set of adaptive tools — reacher, sock aid, long-handled shoehorn, dressing stick — for total hip precautions.
- Plan of care frequency/duration
- Documentation specifying how often and how long skilled OT will be provided toward the goals.
- Code of conduct violation response
- Report and address conduct that breaches NBCOT or AOTA standards through proper channels.
- Scope of practice
- The range of services an OTR or COTA is legally and competently permitted to provide.
