NBCOT Occupational Therapy Certification Practice Exam

A child with cerebral palsy and limited postural stability is ready for toileting. What should be the first element to consider in the treatment plan?

1. Training in management of fasteners

2. Utilization of foot supports

3. Provision of a seat belt

4. Training in climbing onto the toilet

The correct answer is: Utilization of foot supports

In developing a treatment plan for a child with cerebral palsy who has limited postural stability and is ready for toileting, the first element to consider is the utilization of foot supports. This approach addresses the child's need for stability and support while on the toilet, which is crucial for achieving proper posture and ensuring safety during this task. Foot supports can enhance the child's ability to maintain an upright position and provide a solid base, which is essential for balance. It also helps to engage core muscles, promoting better posture and control while sitting. This foundation can significantly enhance the child's overall ability to use the toilet independently or with minimal assistance. Other components, such as training in management of fasteners or provision of a seat belt, can come into play later in the treatment plan. While these aspects are indeed important for facilitating independent toileting, they do not first address the fundamental need for postural stability that foot supports provide. Similarly, training in climbing onto the toilet is an important skill, but it assumes that proper stability and positioning are established first, which foot supports directly help to achieve.