Fundamentals of Pediatric Practice – OT / NBCOT® Exam Study Guide

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Study Guide

OT Referral

  • A specific diagnosis or
  • A functional problem


  • Top-down approach
  • Consider the child holistically
  • Client-centered interventions and practice
  • Identify the concerns and priorities of both the child and family
  • Identify their interests, difficulties, and preferences

Functional Improvement

  1. Providing interventions to enhance performance.
  2. Adapting activities and modifying the environment.
  3. Consulting, educating, and advocating for the child.


  • Physical
  • Social
  • Cultural factors

The overall goal is to function in a safe environment to promote function, exploration, play, learning, and social interaction.


  • Inclusion with peers and family
  • Most natural environment
  • Cultural awareness and family values
    • Family composition and hierarchy
    • Decision-makers
    • Level of expected independence
    • Feeding and sleeping practices
    • Discipline
    • How much help the family expects to seek
    • Communication styles
    • How disability is perceived


  • Occupational profile – find out child’s functional strengths and limitations.
  • Assessment and analysis of performance
    • Standardized evaluations
    • Structured observation
    • Focused interviews
  • Environment – multiple environments, constraints on the child’s functional performance.

The child’s most important occupation is play.

Designing Interventions

  • Optimize the child’s active engagement.
  • Provide a just-right challenge.
  • Establish a therapeutic relationship, including with caregivers.

Implement assistive technology where appropriate.

Children with disabilities may often benefit from modifications to the environment.

Always consider the child’s safety and comfort.