NBCOT Registered Occupational Therapists (OTR) Quiz: Postural Control
20 questions · exam conditions
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Postural ControlQuestion 1 of 20

A client with a new transtibial amputation is learning to perform meal preparation tasks while standing at the kitchen counter. The client reports feeling unstable and fatigues quickly. The OTR observes that the client maintains a rigid posture, bears minimal weight through the prosthesis, and keeps a wide base of support.

To promote functional postural control and body mechanics for this client, what is the therapist's BEST initial approach?

Recommend the client sit on a high stool for all meal preparation tasks to conserve energy and ensure safety.
Provide a walker to be used in the kitchen to increase the client's base of support and reduce fear of falling.
Engage the client in tasks that require graded weight shifting and reaching toward the prosthetic side within a stable environment.
Focus on strengthening the contralateral limb to ensure it can support the majority of the body weight during standing tasks.
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NBCOT Registered Occupational Therapists (OTR) Quiz

NBCOT Registered Occupational Therapists (OTR) Quiz: Postural Control

Practice Postural Control in NBCOT Registered Occupational Therapists (OTR) with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Postural Control, giving you a quick way to practice the rules, question types, and explanations that matter most for NBCOT Registered Occupational Therapists (OTR).

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

A client with a new transtibial amputation is learning to perform meal preparation tasks while standing at the kitchen counter. The client reports feeling unstable and fatigues quickly. The OTR observes that the client maintains a rigid posture, bears minimal weight through the prosthesis, and keeps a wide base of support.

To promote functional postural control and body mechanics for this client, what is the therapist's BEST initial approach?

  1. Recommend the client sit on a high stool for all meal preparation tasks to conserve energy and ensure safety.
  2. Provide a walker to be used in the kitchen to increase the client's base of support and reduce fear of falling.
  3. Engage the client in tasks that require graded weight shifting and reaching toward the prosthetic side within a stable environment. (correct answer)
  4. Focus on strengthening the contralateral limb to ensure it can support the majority of the body weight during standing tasks.
Explanation: The client's postural strategy is compensatory due to fear and lack of confidence in the prosthesis. The key to developing functional postural control is to promote integration of the prosthetic limb into the body schema. This is achieved through graded activities that encourage active weight shifting onto the prosthesis. Reaching toward the prosthetic side naturally facilitates this weight shift in a controlled, task-directed manner. This approach builds trust in the prosthesis and promotes a more symmetrical and efficient posture. A) Sitting is a valid compensatory strategy but does not address the goal of improving standing balance. B) A walker would reinforce a wider, less functional base of support and may hinder integration of the prosthesis. D) Strengthening the contralateral limb would reinforce the asymmetrical weight-bearing pattern the client is already demonstrating.

Question 2

A client recovering from a traumatic brain injury (TBI) exhibits deficits in reactive postural adjustments. They can perform slow, anticipated movements but lose their balance when they encounter an unexpected perturbation, such as bumping into an object or being jostled in a crowd. The client's goal is to return to using public transportation.

Which intervention is specifically designed to remediate the client's deficit in reactive postural adjustments in a safe and graded manner?

  1. Practicing standing on a balance board, attempting to maintain the edges off the floor.
  2. Simulating a bus environment and introducing small, unexpected postural challenges using resistance bands pulled by the therapist. (correct answer)
  3. Teaching the client to consciously widen their base of support and lower their center of gravity in crowded environments.
  4. Having the client walk on a treadmill at varying speeds and inclines to improve automatic gait adjustments.
Explanation: Reactive postural adjustments are best trained by introducing unexpected, external perturbations that force the neuromuscular system to respond and adapt. Simulating the target environment (a bus) provides context, while the therapist-controlled pulls with resistance bands offer a safe, measurable, and gradable way to apply these perturbations. This directly targets the feedback-based control system responsible for reactive balance. A) A balance board involves self-initiated, anticipatory adjustments, not reactive ones. C) This is a valid compensatory strategy but does not remediate the underlying physiological deficit. D) Treadmill walking primarily trains anticipatory adjustments to predictable changes in surface and speed, not unpredictable external perturbations.

Question 3

An industrial worker is referred to occupational therapy with chronic low back pain. A job analysis reveals the worker frequently lifts 30-pound boxes from the floor to a waist-high conveyor belt, using a stooping motion with lumbar flexion. The worker demonstrates poor core muscle activation and limited hip flexibility.

To promote proper body mechanics and reduce injury risk, which intervention sequence is MOST appropriate?

  1. First, teach a squat lift technique; then, strengthen the quadriceps and gluteal muscles; finally, introduce core stabilization exercises.
  2. First, provide a back brace for support; then, practice lifting lighter boxes; finally, educate on the risks of poor posture.
  3. First, initiate core stabilization exercises in supine; then, progress to practicing a diagonal lift pattern with light weight; finally, simulate the work task. (correct answer)
  4. First, focus on stretching the hamstrings and hip flexors; then, teach abdominal bracing; finally, recommend ergonomic modifications to the workstation.
Explanation: This sequence follows a logical progression from remediation of underlying deficits to functional application. 1) Initiating core stabilization in a gravity-eliminated position (supine) allows for isolation and activation of key muscles (e.g., transverse abdominis) without the demand of standing. 2) Progressing to a diagonal lift (like a PNF D2 flexion pattern) integrates core stability with extremity movement in a functional, multi-planar motion. 3) Simulating the actual work task is the final step, applying the newly learned motor patterns to the specific context. A) Teaching the technique before the client has the requisite core stability is ineffective. B) A back brace is a passive support and does not correct the faulty movement pattern. D) While stretching and bracing are components, this sequence is less integrated and functional than C.

Question 4

A client with post-concussion syndrome experiences dizziness and nausea during head movements, consistent with a visual-vestibular mismatch. Their goal is to return to working in a busy office where they must frequently turn their head to speak with colleagues and look between their monitor and paperwork.

Which intervention activity is specifically targeted at habituating the client's vestibular system and improving postural control during the required head movements?

  1. Having the client perform smooth pursuit eye exercises, following a slow-moving target without moving their head.
  2. Implementing gaze stabilization exercises, such as keeping the eyes fixed on a stationary target while actively turning the head side-to-side. (correct answer)
  3. Practicing standing balance on a foam cushion with eyes closed to reduce reliance on visual and somatosensory input.
  4. Recommending frequent breaks from computer work and using screen filters to reduce visual strain and fatigue.
Explanation: Gaze stabilization exercises, a core component of vestibular rehabilitation, directly address the visual-vestibular mismatch. By forcing the vestibular system to work with the visual system to maintain focus on a stable target during head motion (activating the vestibulo-ocular reflex or VOR), these exercises help the central nervous system recalibrate and reduce the symptomatic response. This directly remediates the underlying cause of the client's dizziness during the specific functional movement of turning their head. A) Smooth pursuits train eye movements independent of head movements. C) This challenges the vestibular system but doesn't specifically address the conflict created by head motion. D) This is a compensatory strategy for symptom management but does not remediate the physiological issue.

Question 5

An older adult client with severe peripheral neuropathy in both lower extremities and age-related low vision is referred to occupational therapy due to multiple falls during IADLs, specifically when retrieving items from low kitchen cabinets. Assessment reveals significantly increased postural sway on a firm surface with eyes closed. The client's vestibular function is within normal limits for their age.

Given the client's specific sensory deficits, which intervention represents the MOST targeted approach to improve safety and postural stability during this task?

  1. Implement a home exercise program focused on standing on a foam pad to retrain somatosensory contributions to balance.
  2. Teach the client a hip-hinge strategy for bending, instructing them to maintain one hand in contact with a countertop for tactile feedback. (correct answer)
  3. Refer the client for a comprehensive vestibular rehabilitation program to maximize the use of their most intact sensory system.
  4. Recommend high-intensity strengthening exercises for the lower extremities to compensate for sensory loss with increased motor output.
Explanation: The client has compromised somatosensory and visual systems, relying heavily on their intact vestibular system. The most targeted intervention provides a compensatory strategy that enhances sensory input and improves biomechanics. Maintaining hand contact with a stable surface provides reliable somatosensory information to the brain about body position, acting as a substitute for the deficient input from the feet. The hip-hinge technique ensures the client's center of gravity remains within their base of support. A) Training a severely impaired somatosensory system on a foam pad is unlikely to be effective and could increase fall risk. C) While the vestibular system is intact, it is already being used; a general rehab program is less specific than a task-oriented strategy. D) Strengthening is beneficial but does not address the immediate problem of inaccurate sensory information guiding postural control during the specific task.

Question 6

An occupational therapist is working with a client who has a complete T10 spinal cord injury. The client has mastered static sitting balance on a firm surface but demonstrates an inability to control their posture when reaching for objects outside their arm's length, leading to a loss of balance. The client uses a manual wheelchair for mobility.

To improve dynamic sitting balance for functional reaching, which intervention would be the MOST advanced and specific?

  1. Having the client practice holding the static sitting position on an unstable surface like a therapy ball.
  2. Implementing an upper body ergometer program to increase strength and endurance of the trunk and shoulder girdle muscles.
  3. Engaging the client in a game of catch with a heavy ball, requiring them to twist and move their trunk to intercept the ball.
  4. Teaching the client to use a head-hips relationship to control their center of gravity during controlled, graded reaching tasks. (correct answer)
Explanation: For individuals with SCI, postural control of the trunk is achieved by using the upper body and head movement to influence the position of the pelvis and trunk. The head-hips relationship is a key biomechanical principle where moving the head and shoulders in one direction causes the hips to move in the opposite direction. Explicitly teaching and practicing this strategy during graded reaching tasks directly remediates the deficit in controlling posture during dynamic movement. A) Static balance on an unstable surface does not directly translate to the motor planning needed for dynamic, self-initiated reaching. B) Strengthening is a useful preparatory activity but does not teach the specific motor control strategy needed. C) Catching a heavy, unpredictable object would be too challenging and does not allow for the controlled practice of the head-hips strategy.

Question 7

A child with spastic diplegic cerebral palsy demonstrates a crouched gait pattern with excessive hip and knee flexion throughout the stance phase. During a classroom activity that requires standing at a shared table, the child fatigues quickly and has difficulty maintaining an upright posture.

To promote a more extended and stable posture for standing classroom tasks, which piece of adaptive equipment would be MOST beneficial?

  1. A stander with anterior trunk support and a tray. (correct answer)
  2. A posterior walker that encourages trunk extension.
  3. An anterior walker with a seat for rest breaks.
  4. Custom-molded ankle-foot orthoses (AFOs).
Explanation: A stander is designed to provide maximal support for weight-bearing in an upright position. For a child with a crouched posture, a stander with anterior (front) support and pelvic/knee blocks will facilitate hip and knee extension, provide trunk stability, and free the hands for participation in the classroom activity at the table. This directly addresses the postural and endurance challenges in a functional context. B) A posterior walker is for ambulation, not static standing at a table. C) An anterior walker promotes a forward-flexed posture, which would exacerbate the child's typical pattern. D) AFOs are crucial for managing tone and alignment during gait and standing, but they do not provide the necessary trunk and pelvic support for prolonged static standing tasks.

Question 8

A client presents with unilateral vestibular hypofunction following an acoustic neuroma resection. They experience oscillopsia (visual blurring with head movement) and postural instability when ambulating, especially when scanning the environment, such as in a grocery store.

The occupational therapist designs an intervention to improve the client's postural stability during community ambulation. Which activity is the MOST advanced and functionally relevant for this specific deficit?

  1. Having the client walk on a treadmill while maintaining their gaze on a stationary target placed in front of them.
  2. Practicing tandem walking on a firm surface with eyes open to narrow the base of support and challenge static balance.
  3. Having the client walk down a hallway while turning their head to look at targets placed on the walls at varied heights. (correct answer)
  4. Implementing Brandt-Daroff exercises at home to habituate the vestibular system to positional changes.
Explanation: The client's primary functional deficit is instability caused by head movements during ambulation (impaired vestibulo-ocular reflex, or VOR). The most specific and advanced intervention is to combine ambulation with the exact movement that provokes the symptoms. Walking while performing active head turns to identify targets mimics the demands of scanning a grocery store aisle. This activity directly challenges and retrains the VOR during a dynamic, functional task. A) This is a good starting point (gaze stability) but is less advanced than combining it with head turns. B) Tandem walking challenges balance but does not specifically address the VOR deficit. D) Brandt-Daroff exercises are for BPPV, a different vestibular condition involving displaced otoconia, which is not indicated here.

Question 9

An OTR in an acute care setting is preparing to mobilize a patient who has been on bedrest for 5 days and has known orthostatic hypotension. The patient's goal is to transfer to a bedside commode.

What is the MOST critical sequence of actions the therapist should take to promote postural stability and prevent a syncopal event during the transfer?

  1. Raise the head of the bed, have the patient perform ankle pumps, move to sitting at the edge of the bed, wait 1-2 minutes while monitoring symptoms, then proceed with the transfer. (correct answer)
  2. Move the patient directly from supine to sitting at the edge of the bed, apply an abdominal binder, and immediately perform the stand-pivot transfer to minimize time in an upright position.
  3. Take the patient's blood pressure while supine, assist them to stand directly from the bed, and then take their blood pressure again to confirm orthostasis before walking to the commode.
  4. Ensure the patient is wearing compression stockings, raise the head of the bed, and then perform a transfer using a mechanical lift to ensure maximum safety.
Explanation: This sequence represents a graded approach to upright positioning to manage orthostatic hypotension. 1) Raising the head of the bed slowly acclimates the cardiovascular system to a more vertical position. 2) Ankle pumps engage the calf-muscle pump to facilitate venous return. 3) Moving to short-sitting is the next step up in orthostatic challenge. 4) Pausing at the edge of the bed allows the blood pressure to stabilize and provides an opportunity to monitor for dizziness or lightheadedness before committing to the full stand. This systematic, graded approach is the standard of care for safely mobilizing patients with orthostatic hypotension. The other options are unsafe (B, C) or do not promote active patient participation (D).

Question 10

An OTR is providing home health services to an 82-year-old client who lives alone and has a significant fear of falling. The client avoids standing for long periods, which has led to decreased participation in meal preparation. Assessment reveals fair static standing balance but poor dynamic standing balance.

To improve the client's postural stability for meal preparation, which activity is the BEST to introduce initially?

  1. Standing at the kitchen counter and reaching into upper and lower cabinets.
  2. Practicing tandem walking across the kitchen floor.
  3. Standing on one leg while washing vegetables at the sink.
  4. Washing dishes while standing at the sink with a wide base of support. (correct answer)
Explanation: The correct answer is D. This activity addresses the client's goal of participating in meal preparation while providing a graded challenge. Standing with a wide base of support offers stability, and the sink provides a surface for stabilization if needed. It addresses static balance endurance in a functional context. A is incorrect because reaching into high and low cabinets requires significant dynamic balance, which would be too challenging initially. B is incorrect as tandem walking is a high-level balance task that is not directly related to meal preparation. C is incorrect because standing on one leg is a difficult static balance task that would likely increase the client's fear of falling and is not a typical posture for this IADL.

Question 11

A client with Parkinson's disease exhibits significant trunk rigidity and has difficulty with bed mobility, specifically rolling from supine to sidelying. The client tends to move their trunk and limbs segmentally and with great effort.

Which intervention strategy would be MOST effective for the OTR to facilitate improved postural control and body mechanics for this bed mobility task?

  1. Installing a bed rail to allow the client to pull themselves over.
  2. Instructing the client in log rolling techniques using verbal and rhythmic cues. (correct answer)
  3. Strengthening abdominal muscles with supine crunches.
  4. Using bed-ladder straps to help the client pull to a sitting position.
Explanation: The correct answer is B. Log rolling encourages moving the trunk as a single unit, which is an effective strategy to compensate for the rigidity and sequential movement difficulties seen in Parkinson's disease. Using verbal and rhythmic cues can help initiate and smooth out the movement, addressing bradykinesia. A is incorrect because using a bed rail is a compensatory approach that encourages pulling with the upper extremities rather than promoting coordinated trunk movement. C is incorrect because while core strength is important, isolated exercises do not directly translate to the motor planning and coordination required for rolling. D is incorrect as it addresses moving from supine to sit, not the task of rolling.

Question 12

An OTR is working with a client who sustained a traumatic brain injury and presents with moderate ataxia. The client's goal is to walk from the therapy gym to the water fountain independently. During ambulation, the client demonstrates a wide-based gait and significant trunk sway.

Which activity would be the MOST therapeutic to improve the client's dynamic postural stability during functional ambulation?

  1. Walking on a treadmill with handrail support.
  2. Carrying a tray with a glass of water to a table. (correct answer)
  3. Performing seated exercises on a therapy ball.
  4. Practicing marching in place with eyes closed.
Explanation: The correct answer is B. Carrying an object, especially one that requires stability like a glass of water, forces the client to engage their core and moderate trunk movements to prevent spilling. This task-oriented approach challenges dynamic postural control in a way that is functional and can improve coordination during walking. A is incorrect because using handrails reduces the balance challenge and does not promote the development of internal postural control strategies. C is incorrect as it addresses seated balance, which may not generalize to the dynamic challenges of ambulation. D is incorrect because closing the eyes would be an excessive challenge for a client with ataxia and could be unsafe.

Question 13

A client with Multiple Sclerosis (MS) experiences significant fatigue and poor postural endurance, making it difficult to stand in the shower to complete bathing. The client wishes to remain as independent as possible with self-care.

Which combination of intervention strategies is MOST appropriate for the OTR to recommend to promote safe and independent bathing?

  1. A daily routine of standing tolerance exercises and use of a standard bathtub mat.
  2. Use of a shower chair and a long-handled sponge. (correct answer)
  3. Installation of brightly colored grab bars and a bath transfer bench.
  4. Scheduling bathing for the evening and using a handheld shower head.
Explanation: The correct answer is B. This combination directly addresses the client's primary problems. A shower chair provides postural support, conserving energy and reducing the balance requirements of the task. A long-handled sponge allows the client to reach their lower body without bending over, further reducing postural demands and fall risk. A is incorrect as it focuses on remediation (standing tolerance) without providing immediate, safe solutions for the functional task. C is incorrect because while grab bars are useful, a transfer bench is for getting into a tub, and the core issue is standing endurance during the shower. D is incorrect as scheduling bathing in the evening is often contraindicated for MS due to fatigue, and a handheld shower head alone doesn't solve the postural stability problem.

Question 14

An OTR in an early intervention program is working with a 12-month-old child with generalized low muscle tone. The child has difficulty maintaining a prone-on-elbows position and struggles to lift their head against gravity, which limits exploratory play on the floor.

Which play-based intervention would be MOST effective for promoting postural stability and trunk extension in this child?

  1. Placing the child in a supported sitting position surrounded by pillows.
  2. Engaging the child in reaching for toys while lying prone over a small therapy ball. (correct answer)
  3. Encouraging the child to pull to a standing position at a low table.
  4. Holding the child in the air in a 'flying' position (prone extension).
Explanation: The correct answer is B. Placing the child prone over a therapy ball provides support to the trunk while facilitating active head and trunk extension against gravity. Reaching for toys makes the activity purposeful and engaging, encouraging weight shifting and activation of postural muscles. A is incorrect as it focuses on a different developmental position (sitting) and uses passive support rather than promoting active muscle use. C is too advanced for a child who has not yet mastered prone extension. D is a passive intervention where the therapist does the work; it does not promote the active motor control the child needs to develop.

Question 15

An OTR in an acute care setting is treating a 68-year-old client on post-operative day 2 following a total hip arthroplasty (posterior approach). The client needs to transfer to the toilet. The OTR is concerned about the client maintaining balance while adhering to hip precautions.

Which intervention is MOST important for the OTR to implement to ensure safety and proper body mechanics during this transfer?

  1. Have the client pivot on the non-operative leg without assistive devices.
  2. Instruct the client to reach for the sink to pull themselves up from the toilet.
  3. Ensure the use of a raised toilet seat and instruct the client to push up from the toilet armrests. (correct answer)
  4. Practice the transfer first to a low therapy stool to increase the challenge.
Explanation: The correct answer is C. A raised toilet seat prevents excessive hip flexion, a key posterior hip precaution. Using armrests to push up promotes proper body mechanics, uses upper body strength for stability, and prevents the client from breaking precautions by leaning forward too far. A is unsafe and does not account for post-operative weakness and pain. B is incorrect because pulling up from a fixed object like a sink can cause trunk flexion (breaking precautions) and is less stable than pushing up from a secure surface. D is contraindicated as it would force the client into excessive hip flexion and is an unsafe way to grade the activity.

Question 16

An OTR is working with a 25-year-old client with a T10 complete spinal cord injury. The client has mastered static sitting balance on the edge of the mat but has difficulty maintaining balance when reaching for objects during grooming tasks at the sink.

Which intervention would BEST address the client's dynamic sitting balance for improved function in self-care?

  1. Placing a mirror in front of the client for visual feedback during grooming.
  2. Having the client wear a thoracic binder for increased trunk support.
  3. Having the client practice reaching for objects in multiple directions just beyond arm's length. (correct answer)
  4. Strengthening the client's biceps and deltoids with free weights.
Explanation: The correct answer is C. This activity directly challenges the limits of the client's stability in a controlled manner. Reaching beyond arm's length requires active use of head-and-hips relationship and trunk musculature (above the level of injury) to maintain and regain balance, which is the specific skill needed for the grooming task. A provides feedback but doesn't actively challenge balance control. B is a compensatory device that provides external support, which may hinder the development of the client's own intrinsic postural control. D is incorrect because while UE strength is important, this intervention does not directly address the primary problem of dynamic trunk balance.

Question 17

An office worker is referred to OT with complaints of chronic neck and upper back pain. The OTR observes that the client sits with a forward head posture and rounded shoulders while working at the computer for prolonged periods.

To promote improved body mechanics and postural control, what is the MOST comprehensive intervention for the OTR to implement?

  1. Providing a schedule of stretches to be performed every hour.
  2. Recommending a high-back ergonomic chair with lumbar support.
  3. Completing a workstation ergonomic assessment and providing education on neutral posture. (correct answer)
  4. Applying hot packs to the client's upper back for 15 minutes before work.
Explanation: The correct answer is C. This is the most comprehensive approach. An ergonomic assessment identifies and addresses environmental factors (e.g., monitor height, keyboard position) contributing to poor posture. Client education empowers the worker to understand and maintain a neutral posture, addressing the behavioral component. This combination of environmental modification and education is most effective for long-term change. A is a good component of a plan, but without addressing the root cause at the workstation, it's less effective. B is a possible recommendation, but a full assessment is needed to determine the best chair and other modifications. D is a preparatory modality for pain relief and does not correct the underlying postural problem.

Question 18

A client with cerebellar ataxia demonstrates significant postural sway when standing to perform IADLs, such as brushing teeth at the sink. The client over-relies on vision for stability and becomes very unsteady if they look away from a fixed point.

What is the MOST appropriate compensatory strategy for the OTR to teach the client to improve stability during this task?

  1. Closing the eyes briefly to increase reliance on proprioceptive systems.
  2. Standing with a widened base of support and maintaining light touch contact with the sink. (correct answer)
  3. Performing the task while seated on a stool.
  4. Practicing single-leg stance to quickly improve balance reactions.
Explanation: The correct answer is B. Widening the base of support increases the client's stability biomechanically. Light touch contact on a stable surface provides additional somatosensory feedback to the brain about body position and sway without providing significant physical support, which helps the client modulate their posture more effectively. A is unsafe and would likely lead to a loss of balance in a client with ataxia. C is a valid adaptation, but it avoids the standing task rather than providing a strategy to improve performance in standing. D is an excessively difficult remedial exercise that is not a compensatory strategy and would be unsafe for this client.

Question 19

A 78-year-old resident of a skilled nursing facility has progressive thoracic kyphosis, which causes them to slump forward in their wheelchair. This posture makes it difficult for them to eat safely, leading to coughing during meals.

Which intervention should the OTR prioritize to improve the client's postural stability for safer feeding?

  1. Providing pureed foods and thickened liquids to prevent aspiration.
  2. Trialing a wheelchair seating insert, such as a lumbar support or lateral trunk supports. (correct answer)
  3. Leading a daily group exercise class focused on seated yoga and stretching.
  4. Teaching the client to perform a chin tuck before every swallow.
Explanation: The correct answer is B. The root of the functional problem (unsafe eating) is poor positioning. Addressing the postural instability with adaptive seating provides external support to maintain a more upright and aligned posture. This is the foundational step to enable a safer swallow. A addresses the symptom (aspiration risk) but not the cause (poor posture); this is a diet modification that the SLP would primarily recommend. C is a good general intervention for mobility but does not provide the specific, sustained support needed during meals. D, the chin tuck, is a swallowing strategy, but it will be much less effective if the client's overall trunk posture is not addressed first.

Question 20

A 10-year-old child with Developmental Coordination Disorder (DCD) is reluctant to participate in playground activities. The child has difficulty with anticipatory postural adjustments, causing them to be slow and clumsy when navigating uneven surfaces or climbing equipment.

Which occupation-based intervention would be MOST effective for improving the child's dynamic balance and postural control for playground participation?

  1. Practicing static standing balance on a BOSU ball in the clinic.
  2. Creating and navigating a multi-step obstacle course with varied surfaces and climbing elements. (correct answer)
  3. Using video games that require balance on a pressure-sensitive board.
  4. Enrolling the child in a group yoga class to improve body awareness.
Explanation: The correct answer is B. An obstacle course directly simulates the demands of a playground environment by requiring the child to make continuous, anticipatory postural adjustments while moving through a sequence of motor tasks. It is purposeful, engaging, and allows the therapist to grade the difficulty of various elements. A is a decontextualized preparatory activity that may not generalize well to the dynamic, unpredictable nature of a playground. C can be a useful tool but lacks the whole-body, variable nature of navigating real-world obstacles. D is a beneficial activity for body awareness but is less specific to the dynamic, goal-directed postural control needed for a playground.