NBCOT Occupational Therapy Certification Practice Exam

A student learning to activate a switch for a communications device is having difficulty due to excessive muscle tone. What should the OT do next?

1. Reposition the switch to facilitate access

2. Passively stretch the student's upper extremity

3. Use a brightly colored switch for visibility

4. Use systematic behavioral reinforcement through shaping

The correct answer is: Reposition the switch to facilitate access

Repositioning the switch to facilitate access is a strategic approach when a student is experiencing excessive muscle tone. By adjusting the position of the switch, the occupational therapist can accommodate the student's needs for both accessibility and comfort, which may help reduce the impact of muscle tone on the student’s ability to activate the switch effectively. Accessibility optimizes the student's chance of success in using the communication device, which is crucial for enhancing their communication skills and overall engagement. Conversely, passively stretching the student's upper extremity might provide temporary relief; however, it does not address the immediate need for improved access to the switch. Utilizing a brightly colored switch may enhance visibility, but if the physical access to the switch is not optimized, the modification won't resolve the underlying challenge posed by muscle tone. Systematic behavioral reinforcement through shaping can be beneficial for learning new skills, but it’s essential first to ensure the physical environment and tools being used are appropriate and conducive to the student's current abilities. By prioritizing the repositioning of the switch, the occupational therapist is directly addressing the accessibility challenge created by the muscle tone.