NBCOT COTA Exam Latest Update 2023
General Environmental Considerations Definition and Maior Concepts - Answer-and Maior Concepts 1.
The environment
... [Show More] "the aggregate of phenomena that surrounds individual and influences (her)
development existence" (Mosey, 1996, p. 171). environment which lives, and exposure to various
settings, influences his or her development and adaptation. The environment facilitate because for
adaptation problem-solving strategies to developed. Conversely, environment can hinder develop- and
adaptation impoverished hostile. 5. A person's abilities, limitations, problems, activities, occupations be
fully under- stood without considerations his/her current and expected environment. 6.
Physical/nonhuman environment. Everything nonhuman (i.e., buildings, objects, tools, devices, animals,
trees). Sensory environment. Visual: lighting, colors, posters all over Auditory: loudness of loudspeakers,
class- room noise. c. Tactile: seating textures. d. Olfactory: pleasant offensive odors. Gustatory: pleasant
offensive 8. Social-cultural/human environment. a. Social roles: organized pattern behavior that
characteristic enerauem defined position social system" (Mosey, 1996, p. 64); for example, student,
parent, worker. Social network: "the of voluntary relationships that make individual's social
environment" (Mosey, 1996, 184). aspects: "the social structures, values norms, and expectations that
accepted shared of people" d. Psychological aspects: environmental character- istics that affect mood
and stress level (e.g., a calming, cheerful envi chaotic, uncomfortable, depressing setting). 9. The AOTA
description environment beyond the physical and social environment to include concept In the AOTA
Practice Framework, context "refere law expected occupant environment Practice ramework expanded
variety interrelated conditions are within and surrounding the interrelated less tangible physical and sto
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Definition and Maior Concepts - Answer-social environments nonetheless exer influence performance"
(AOTA 2008, Contexts include cultural, personal, tempor virtual. (1) "cultural context includes customs
activity patterns, behavior standards, and tations accepted by the society of whi client is a member"
(AOTA "personal context demos individual such age, socioeconomic status, educational that not health
condition" 2008, p. "temporal context includes stages time year, time of day and duration activity,
history" (AOTA 2008, The virtual context refers the "enviro in which communication by mea airways or
computers absence of cal contact" (AOTA 2008, 645); exan e-mail, video-conferencing, web-based
networking.
Legislation Related to the Environment - Answer-Environment 1. Americans with Disabilities Act (ADA):
civil law aimed at allowing full participation in society people with disabilities. Several sections mandate
accessible environie for persons with disabilities. b. Included are policies dealing with public sevic
employment, public accommodations. 2. Omnibus Budget Reconciliation Act dates that restraints
cannot be used without justification, agreement, and documentation 3. Individuals with Disabilities
Education Act (IDEA mandates that children disabilities geine education in least restrictive and most
environment. a. Inclusive models are be used to enable chil to be taught a regular classIOom. b.
Education must prepare iving and emplovment environme child for indepgnd The role of practitioners
environmental ase ment and modification has increased with mentation of the OBRA, and IDEA. (See 4
more specific information on OR IDEA.)
me Role of Occupational Therapy (OT) Practitioners - Answer-2. OT practitioners advocate for and
design environ- ments that use principles of universal design meet physical, sensory, sociocultural,
psychological needs individual. Table 15-1. OT practitioners can help identify settings and approaches
implement the OBRA, and IDEA. porson's environment-living, vocational, a-whether takes place hospital,
nursing school, practitioners familiar with
me Role of Occupational Therapy (OT) Practitioners - Answer-practitioners can advocate for ADA, OBRA,
IDEA compliance to enable individuals function independently-and with least restriction-as possible,
their environment.
The Role of the Team - Answer-1. practitioners part of an interdiscipli- nary team that determines the
needs abilities of an individual with disability specific environ- ment. Basis team construction. a. The
facility which the individual disability presently resides and/or participates. The individual's needs and
her abilities/func tional Geographical location. Funding ity (ie., third-party payers and/or offices
individuals with disabilities). Support caregivers. The should always include the consumer and
caregivers. 4. Professional team members may belong to Rehabilitation Engineers Society of North
America (RESNA) and/or Registry Rehabilitation Technology Suppliers (NRRTS). Both professional
organizations help develop standards measuring tools to ensure proper design, prescription, and
delivery of rehabilitation technology. available the individual with a disabilThe Role of the Team - Answer-5. professional team members. Assistive technology professional (ATP):
analzE consumer needs, help select appropriate assistive technology identified and proid. training in use
the b. Computer design provision of efficient technology. c. trainer: for driving adaptations. subsequent
section driver rehabilitation. Nurse: ensure medical care medication regimes prescribed the doctor. e.
Occupational and occupational assistant: refer section. Physical therapist: mobility difficulties individual
encounter the environment. Physician: and assess services and purchases. Psychologist: assist
adjustment indicated. i. Rehabilitation counselor: assess and advise vocational issues. j. Speech language
pathologist: to assess mend augmentative communication aids. Rehabilitation design equipment assist
with modifications adaptive equipme 1. Seating mobility specialist (SMS): seating, positioning, mobility
needs and appropriate recommendations. Social worker: to obtaining funding. evaluae n. Teacher:
children the school system, help any modifications within classroom setting
The Role of the Team - Answer-payer their respective case man- to approve and/or provide funding for
the lividual's needed environmental modifica. dors: provide items requested therapists and required the
individual to function Environmental
individual function Purposes Environmental Evaluation Intervention - Answer-Lientify and prioritize
needs, goals, desires, blem areas individual with disability within his/her environments. huablish the
regarding everyday functional activities within his/her environment. functional use devices being
considered lor particular individual facilitate mastery the environment.
Purposes of Environmental Evaluation and Intervention - Answer-Environmental Identify device's
availability, safety, cs. Determine device's frequency 6. Determine funding financial resources for equipment and/or modifications. a. questionable ethics inter- of the with show him/ her device order top-ofthe-line equipment that is covered his/her insurance, he/she does financial resources self-pay.
Determine environmental constraints. For example, individual be living in flight walk-up apartment
device locked up lobby, opening of vandalism theft. 8. individual with a disability and device allow
reevaluation. Ensure device will for possible modifica tions, upon reassessment of individual change in
found. and everyday Chapter 15
Overall Environmental Evaluation Evaluation of Performance Skills Client Factors*** - Answer-role the
occupational contributes to the evaluation process collaboration with the supervisor. Supervision
required. (2) level supervision required mined by experience established service competence. h. Service
competency be established. OTA cannot independently or inter- evaluation results. Performance are
essential when conducting environmental evalua- for they are allow person function in his/her
environment. LUpon establishment service competency, OIA following areas: Sensory (eg, assess
Getermine there impairment discrimi- nation inluence safety the manipula- devices). driving Visual
perceptual processing skills of Test, standardized to assess visual motor for poten- tial difficulties
computer Musculoskeletal skills range of motion, strength, endurance, assess (1) (4) (5)
Evaluation Performance and Client Factors - Answer-physically devices optimal capability). d.
Neuromuscular (eg. coordination, assess person's mically and environmental manipula- tion). skills (eg.,
following directions and judg- ment, assess is of limitations and able to follow recall operation assistive
technology wheelchairs) use of f. Psychosocial (e.g., support, assess if individual ask assis- tance, needed
the right person). utilize rhyth-
Contextual Evaluation - Answer-manipula- to The contributes evaluation process with OT supervision.
targeted evaluation include: a. Physical considerations. (1) Arrangement furniture. Accessibility items
needed activi- ties safe (3) Housing/workplace Neighborhood characteristics.
Contextual Evaluation - Answer-Environment: Intervention the individual with disability (3)
Opportunities for socialization (4) Sociocultural norms, values, and expectations Social roles:
expectations for performance Availability and of transportation. Overall accessibility. Sociocultural
considerations. independent function. (5) Community resources available. individual's network relation
ships between individual disability
Home Evaluation General Considerations*** - Answer-General Considerations OTAS perform home
assessments and make adap- tations, modifications, and recommendations to anticipated dwelling to
increase safe, independent functioning with OT supervision 2. an individual with disability discharged to
home from facility, evaluation should be discharge The person's current status (abilities and and risks in
home determine need for home modifications adaptaOverall Characteristics of the Home - Answer-good private one-family, family, apartnment, walk-up,
elevator access. 2. Protection from weather/environmental changes. Presence and of driveway. 4. Level
which person lives. Entrance dwelling wheelchair raimp. level entrance, 6. Number of entrances that are
accessible the vidual, Some buildings allow residents to delivery because has ramp. 7. Steps: the number
present outside dwelling, inside dwelling, laundry room, the mailbox, Railings: location and number
railings outside and facing entrance door; presence railings for interior a. Interior should inches ease
grasp. railings should those who walk: 34-38 inches, depending on height. Railings should inches in
diameter nonskid surfaces.
home tions. Overall Characteristics of the Home of - Answer-Door sills: identify where they present,
entrance to dwelling bedroom doors, bathroom doors, kitchen doorway. 10. Elevators: doorway, type
operation. IL. Hallways: width hallway entrance. 12. Doorways: width entrance measure door frame;
frame frame Doorways: of opening for entrance d and throughout dwelling that opened. a. Space
accommodate door swing must be minimum inches needed for using walkers. minimum inches needed
using wheelchairs. 14. Type(s) door handles: handles functional knobs. 15. Identification objects
obstrucin doorways pathways. of pets: can obstacles safety concerns vision, problems, who require
assistive devias 17. Carpeting: wall wall th height of 18. Electrical cords: placed flow traic good condition
or frayed, overloaded underng carpeting. Presence of firm chair the dwelling height. 20. Light
accessibility from varios (standing chair). inches Telephones: number phones, location Lype (e.g.,
cordless, cell, push button rotaryl gency numbers telephone. Presence working smoke detectors. 23.
Presence heaters wood-buming 24. Presence emergency call system gency exit
Bedroom Considerations - Answer-size of bed, height floor to mattress, ape mattress wheeled frame or
not, posi- ae bed (against the wall freestanding). the from which the individual with sability enters/exits.
3Ahiliy change location, if needed. LAessibility dothes and dresser drawers. Suficient available for
bedside commode, Considerations anded
Bathroom Considerations bathrooms - Answer-Considerations Number bathrooms home. location of
bathroom(s) relative to bedroom. room, kitchen, and living spaces impor- individual. Width of bathroom
doorway. of bathing the individual with disability peforms (ie. sponge bath) previ- ously and currently. of
shower/tub: separate stall, glass door with curtain-enclosed tub shower, fashioned claw-legged tub.
Bathroom Considerations - Answer-Presence and location grab bars for toilet and bath/shower (the soap
dish and towel bar are bars). home rental, landlord's agreement to grab bars to installed needed. 7.
Height of sink, and toilet. Presence a mat or surface in shower/tub. 9. Presence of throw outside
shower. 10. Availability handheld 11. Presence of antiscald valves and/or faucets. Location of toilet
paper holder.
Kitchen Considerations - Answer-Considerations old Location preparation that ual uses most frequently
(i.e., oven, microwave, stove). Presence of countertop the stove and sink, between stove and
refrigerator. Accessibility of food, pots, pans, prepara- tion materials. Direction opening refrigerator,
cabinetry, and/ or pantry doors. Presence of charged extinguisher. 6. Presence of and/or
Fall Prevention and Management Falls Etiology, Prevalence, Prognosis*** - Answer-Etiology, Prevalence,
Prognosis unintentional causing one make unexpected contact ground floor. and fall injury are major
health concern 1or the elderly. figures follow FTovided the need for ỢT practitioners to be active the
prevention falls. These statistics will be the NBCOT examination. Between 30% of persons over age of
fall each year. Note: be greater because are based only upon reported falls. Twenty-four percent of falls
result soft and fractures. CFalls are the leading cause of death the eklerly, 12% all for persons aged older
by falls.
balance Etiology, Prevalence, Prognosis unintentional of - Answer-Falls factor admissions e. Women
more risk for falls men, due their increased incidence of osteoporosis; aged whereas 42% of women of
the same age fall. Within 6 of fall, more two-thirds of elderly who fall Results of Fractures: Most
common sites the pelvis, hip, femur, vertebrae, humerus head. b. Increased and c. confidence to
function independently. d. Decreased engagement in activity and restriction activities that result
physical decondi- tioning and deterioration, contributing to like- lihood reoccurrence, Increased risk
recurrent falls.
Evaluation of Risk Factors for Falls - Answer-Falls OTA contributes evaluation process OT supervision a.
Upon establishment of service competency, can collect about extrin- factors contribute to Intrinsic
factors requiring evaluation. a. Age-related changes reduced sensory capacity (1) (a) Presbyopia
(decreased acuity) (b) vision low-light situations is reduced. (c) perception. (2) Vestibular Vertigo.
Postural with vision results compound risk b. Age-related changes neuromuscular system. (1) Decreased
of neurons result decreased reaction response Decreased number fibers extremity strength and (3)
combination above factors difficulties from and maintaining c Comorbidity and pathological including
congestive heart arrhythmias, hypotension, cerebrovascular disease, riosclerosis and atherosclerosis,
diabetes mellitus. d. Medication side effects polypharmacy. Delirium and/or f. Anxiety and/or
depression. Cognitive span, distract- ibility, impaired judgment. Prior within year. i. Fear of falling lead
decreased mobility progressive deconditioning, which increase falls. Extrinsic factors requiring
evaluation: safety hazards within the environment predispose one and (1) Floors: uneven, presence of
throw rugs. Toys or other left floors stais. (3) Pets foot. (4) High-pile carpets. Low-lying furniture. (6)
Stairs, excessive steepness, lack of loose handrails. (7) footwear.
Evaluation of Risk Factors for OTA - Answer-Poor lighting glare. Poor thresholds. Extension cords. (11)
furniture other unstable objects support. (12) Improper transfer techniques. (13) Problems with
adaptive equipment, las needed equipment, excessive equipm Bathroom (1) grab (2) thilization unstable
to for support. (3) Toilet seat low. (4) Wet floor is) of wet sink surface for supp (6) floor. c. Kitchen. (1)
Low doors open. Step stool without Chairs (4) Wet surfaces rug floor. d. (1) too high (2) Movement bed.
Reaching into closets. room. (1) Wires and/or clutter (2) Chairs too high too pile loose lighting.
Interventions to Prevent - Answer-distract- Interventions Intervention based upon the determinatin
individual's problems the factors identified in evaluation 2. OTA implements intervention with Of sion
to; a. Eliminate or minimize all fall factos disease manage medication. Improve functional mobility (1)
resistive strengh weights and o exercises to strength, endurance (2) Passive range of motion (PROM)
indicated joint (3) Specific coordination training Neuromuscular reeducation (5) Balance (a) Sit and stand
positions. (b) Static (c) Turning, walking staits (10) [Show Less]