A COTA is teaching discriminative sensory reeducation techniques to a client who has a median nerve surgical repair. Which method is appropriate for discriminative sensibility reeducation? The BEST choice.

• A. Educate the client to avoid working around machinery
• B. Advise the client to use vision to compensate for sensory loss
• C. Educate the client to identify items by touch with vision on a daily basis
• D. Train client to both localize and discriminate textures

Answer: (D)

Discriminative sensory reeducation aims to retrain the brain to interpret tactile information after nerve injury. The key idea is to help the hand “re-learn” what touches feel like by focusing on precise sensory tasks, not by avoiding danger or relying on sight. Training should progressively challenge the patient to determine where touch is occurring (localization) and to distinguish different tactile qualities (textures). This dual focus—where am I being touched and what does the touch feel like—helps restore tactile gnosis and cortical representation after median nerve repair.

Training the client to localize touch and discriminate textures directly targets those sensory skills that need reestablishment, making it the best fit for this scenario. In contrast, guiding the person to avoid machinery addresses safety rather than reeducation, and encouraging daily identification of objects by touch with vision left on relies on sight instead of honing tactile discrimination. Similarly, using vision to compensate for sensory loss during training does not promote the tactile retraining the exam is asking about.