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Occupational Therapy Board Exam Study Notes

Complete Reviewer for the Occupational Therapist Licensure Examination (OTLE)

About the OT Board Exam

The Occupational Therapist Licensure Examination (OTLE) is administered by the Professional Regulation Commission (PRC) to assess competency for occupational therapy practice in the Philippines. It evaluates knowledge in enabling meaningful occupation across the lifespan.

Exam Subjects

  • • OT Foundations & Theories
  • • Human Development
  • • Physical Dysfunction
  • • Psychosocial OT
  • • Pediatric OT
  • • Professional Practice

Requirements

  • • BS Occupational Therapy degree
  • • Completion of fieldwork
  • • Passing score: 75%
  • • No subject below 50%

Part 1: OT Foundations & Theories

Core Concepts

Occupation-Centered Practice

  • Occupation: Meaningful, purposeful activities that fill time and bring meaning to life
  • Activity: General class of human actions; not individualized
  • Task: Specific set of behaviors to accomplish a goal
  • OTPF Domain: Occupations, Client Factors, Performance Skills, Performance Patterns, Context/Environment

Areas of Occupation

Basic Activities

  • ADLs: Bathing, dressing, eating, toileting, hygiene, functional mobility
  • IADLs: Meal prep, cleaning, finances, medication management, shopping
  • Rest & Sleep: Preparation, participation, quality

Productive Activities

  • Education: Formal, informal, exploration
  • Work: Employment seeking, performance, retirement
  • Play: Exploration, participation
  • Leisure: Exploration, participation
  • Social Participation: Community, family, peer

OT Models & Frames of Reference

Occupation-Based Models

  • MOHO: Model of Human Occupation (Kielhofner) - Volition, Habituation, Performance Capacity
  • PEO: Person-Environment-Occupation; optimal fit = performance
  • CMOP-E: Canadian Model; spirituality at center
  • OA: Occupational Adaptation; press for mastery

Practice Frameworks

  • Biomechanical: ROM, strength, endurance focus
  • Rehabilitative: Compensation, adaptation
  • Sensory Integration: Ayres; sensory processing
  • Cognitive: Allen's Cognitive Levels
  • Developmental: Age-appropriate skills

OT Process

OTPF Process

  1. Evaluation: Occupational profile + Analysis of occupational performance
  2. Intervention: Plan → Implementation → Review
  3. Outcomes: Measure success, discharge planning

Intervention Approaches:

  • • Create/Promote: Health promotion
  • • Establish/Restore: Remediation
  • • Maintain: Preserve function
  • • Modify: Compensation, adaptation
  • • Prevent: Prevent dysfunction

Part 2: Pediatric OT

Developmental Milestones

Motor Development

AgeGross MotorFine Motor
3 moHead control (prone)Hands open, swipes
6 moSits with support, rollsPalmar grasp, transfers
9 moSits independently, crawlsPincer developing
12 moPulls to stand, cruisesNeat pincer grasp
18 moWalks independentlyBuilds 3-4 block tower
2 yrRuns, kicks ball6 block tower, scribbles

Grasp Development

Progression of Grasp

  1. Reflexive grasp (0-4 mo)
  2. Palmar grasp/Squeeze (4-5 mo)
  3. Radial palmar (5-6 mo)
  4. Radial digital (7-8 mo)
  5. Inferior pincer (8-9 mo)
  6. Superior pincer/Neat pincer (10-12 mo)

Sensory Integration

Ayres Sensory Integration

Sensory Systems

  • Tactile: Touch, pressure, temperature
  • Proprioceptive: Body position, muscles/joints
  • Vestibular: Movement, balance, head position
  • Visual/Auditory: Sight and sound

SI Disorders

  • Sensory Modulation: Over/under-responsive
  • Sensory Discrimination: Difficulty interpreting
  • Sensory-Based Motor: Dyspraxia, postural

Common Pediatric Conditions

Cerebral Palsy

  • • Non-progressive brain injury
  • • Types: Spastic, Athetoid, Ataxic
  • • Distribution: Hemi, Di, Quadriplegia
  • • NDT/Bobath approach

Autism Spectrum

  • • Social communication deficits
  • • Restricted, repetitive behaviors
  • • Sensory processing differences
  • • Visual supports, structured teaching

Down Syndrome

  • • Trisomy 21
  • • Hypotonia, joint laxity
  • • Cognitive delays
  • • Early intervention critical

ADHD

  • • Inattention, hyperactivity, impulsivity
  • • Executive function deficits
  • • Sensory strategies
  • • Environmental modifications

Part 3: Physical Dysfunction

Neurological Conditions

Stroke/CVA

  • • Hemiplegia/Hemiparesis
  • • Brunnstrom stages (1-7)
  • • Constraint-induced movement therapy (CIMT)
  • • Task-oriented approach
  • • Visual-perceptual deficits common

Traumatic Brain Injury

  • • Rancho Los Amigos Levels (I-VIII)
  • • Cognitive rehabilitation
  • • Behavioral management
  • • Community reintegration

Spinal Cord Injury

  • • Level determines function
  • • C5: Elbow flexion (tenodesis grasp)
  • • C6: Wrist extension
  • • C7: Elbow extension, transfers
  • • Adaptive equipment essential

Multiple Sclerosis

  • • Demyelinating disease
  • • Fatigue management critical
  • • Energy conservation
  • • Work simplification

Orthopedic/Hand Therapy

Hand Injuries

  • Flexor tendon repair: Duran protocol; early protected motion
  • Extensor tendon zones: I-VIII; varies by zone
  • Carpal tunnel: Median nerve; night splint
  • Trigger finger: A1 pulley; splinting

Upper Extremity

  • Rotator cuff: Progressive ROM → strengthening
  • THR precautions: Posterior approach restrictions
  • Burns: Positioning, pressure garments, scar management

Adaptive Equipment

ADL Devices

  • • Sock aid, long-handled shoehorn
  • • Reacher, dressing stick
  • • Built-up handles
  • • Rocker knife, plate guards
  • • Bath bench, grab bars

Mobility Aids

  • • Wheelchair prescription
  • • Transfer boards
  • • Bed mobility aids
  • • Home modifications

Part 4: Psychosocial OT

Mental Health Conditions

Mood Disorders

  • Depression: Anhedonia, fatigue, sleep changes
  • Bipolar: Manic and depressive episodes
  • • Behavioral activation
  • • Activity scheduling
  • • Routine establishment

Schizophrenia

  • • Positive symptoms: Hallucinations, delusions
  • • Negative symptoms: Flat affect, avolition
  • • Allen Cognitive Levels assessment
  • • Social skills training
  • • Supported employment

Anxiety Disorders

  • • GAD, Panic, Phobias, OCD, PTSD
  • • Relaxation techniques
  • • Graded exposure
  • • Mindfulness-based interventions

Substance Use

  • • Role disruption common
  • • Leisure exploration
  • • Lifestyle redesign
  • • Relapse prevention

Psychosocial Assessments

  • Allen Cognitive Level Screen (ACLS): Leather lacing task; levels 1-6
  • MOHOST: Model of Human Occupation Screening Tool
  • COPM: Canadian Occupational Performance Measure; client-centered
  • Interest Checklist: Leisure/interest exploration
  • Role Checklist: Past, present, future roles

Group Process

Group Development Stages (Tuckman)

  1. Forming: Orientation, dependency
  2. Storming: Conflict, resistance
  3. Norming: Cohesion develops
  4. Performing: Productive work
  5. Adjourning: Termination

Part 5: Assessment & Documentation

Standardized Assessments

ADL Assessments

  • FIM: Functional Independence Measure; 18 items, 1-7 scale
  • Barthel Index: 10 ADL items
  • KELS: Kohlman Evaluation of Living Skills
  • AMPS: Assessment of Motor and Process Skills

Pediatric Assessments

  • PDMS-2: Peabody Developmental Motor Scales
  • BOT-2: Bruininks-Oseretsky Test
  • PEDI: Pediatric Evaluation of Disability Inventory
  • SPM: Sensory Processing Measure

Documentation

SOAP Note Format

  • S (Subjective): Client's report, feelings, concerns
  • O (Objective): Measurable observations, data, assessment results
  • A (Assessment): Clinical reasoning, progress analysis
  • P (Plan): Future interventions, goals, frequency

SMART Goals:

Specific, Measurable, Achievable, Relevant, Time-bound

Example: "Client will don shirt independently using one-handed technique within 3 minutes, 4/5 trials by discharge."

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