AOTA Emergency Procedures & Response 3 — Questions and Answers
Question 1: Which of the following best describes the OT's role when a child with sensory modulation disorder shows signs of a psychiatric crisis during therapy?
- Continue sensory intervention to regulate the nervous system and resolve the crisis
- Maintain client safety, stay calm, call for additional support, and follow facility crisis protocol (Correct answer)
- Immediately discharge the child to reduce environmental sensory load
- Increase proprioceptive activities to ground the child and prevent escalation
Correct answer: Maintain client safety, stay calm, call for additional support, and follow facility crisis protocol
The OT's role in psychiatric crisis is to ensure safety, activate support systems, and follow established protocols rather than independently managing the crisis through sensory intervention.
Question 2: An OT is working with a child in a sensory gym when another staff member reports a gas leak in the building. The child is in the middle of a calming deep pressure activity. What should the therapist do?
- Complete the deep pressure protocol before evacuating to prevent sensory dysregulation
- Immediately stop the activity, guide the child out of the building, and avoid using electrical switches (Correct answer)
- Open windows in the therapy room to dilute the gas before evacuating
- Call parents to inform them before initiating evacuation
Correct answer: Immediately stop the activity, guide the child out of the building, and avoid using electrical switches
Gas leak protocol requires immediate evacuation while avoiding electrical switches that could create a spark; no therapeutic activity justifies delaying evacuation.
Question 3: A therapist notices bruising patterns on a child's arms that are inconsistent with the reported sensory-seeking fall behaviors. What is the appropriate response?
- Increase proprioceptive activities to reduce self-injurious sensory seeking
- Document findings objectively and report suspicion of abuse to the appropriate child protective agency (Correct answer)
- Discuss the bruising directly with the accompanying caregiver before making any report
- Refer the child to a pediatrician and wait for their findings before acting
Correct answer: Document findings objectively and report suspicion of abuse to the appropriate child protective agency
OTs are mandated reporters; suspicion of abuse must be reported to child protective services without waiting for confirmation or discussing suspicions with the suspected abuser.
Question 4: During aquatic sensory integration therapy, a child slips beneath the water and is not breathing when retrieved. After calling for help, what is the immediate next step?
- Begin rescue breathing and CPR if trained and certified to do so (Correct answer)
- Place the child in a side-lying position and wait for emergency responders
- Perform the Heimlich maneuver to expel water from the lungs
- Assess the child's sensory arousal level before initiating any intervention
Correct answer: Begin rescue breathing and CPR if trained and certified to do so
A non-breathing child requires immediate CPR by trained personnel; rescue breathing and chest compressions should begin while awaiting emergency services.
Question 5: A school-based OT is delivering sensory integration services when a lockdown is announced. A student with sensory defensiveness begins to panic. The BEST action is to:
- Take the student to their sensory room immediately for calming input
- Follow lockdown protocol—lock and barricade the door, turn off lights, keep the student calm and quiet in place (Correct answer)
- Bring the student to the hallway where they can move freely to self-regulate
- Call parents to provide remote calming instructions
Correct answer: Follow lockdown protocol—lock and barricade the door, turn off lights, keep the student calm and quiet in place
Lockdown procedures must be followed exactly; the therapist must secure the space and keep the student as calm as possible within the locked room.
Question 6: When a child with proprioceptive-seeking behaviors becomes aggressive and begins hitting the therapist during a session, what is the recommended first response?
- Apply a physical restraint technique to control the child's movements
- Increase the intensity of proprioceptive input to meet the child's need
- Create physical distance, use calm verbal redirection, and activate crisis support if needed (Correct answer)
- End the session and document that the child is not appropriate for sensory integration
Correct answer: Create physical distance, use calm verbal redirection, and activate crisis support if needed
Creating safe distance and using calm de-escalation are preferred over physical restraint; crisis support should be activated per facility protocol if aggression continues.
Question 7: An OT providing sensory integration therapy observes a child exhibit sudden pallor, loss of muscle tone, and unresponsiveness lasting 30 seconds, then spontaneous recovery. This presentation is MOST consistent with:
- A vasovagal syncope episode requiring emergency evaluation (Correct answer)
- Typical sensory shutdown response that can be managed with graded sensory input
- A meltdown episode requiring deep pressure and environmental modifications
- Breath-holding behavior that requires parental counseling only
Correct answer: A vasovagal syncope episode requiring emergency evaluation
Sudden loss of tone, pallor, and brief unresponsiveness followed by spontaneous recovery indicates a possible vasovagal or cardiac event requiring urgent medical evaluation.
AOTA Emergency Procedures & Response 3
Which of the following best describes the OT's role when a child with sensory modulation disorder shows signs of a psychiatric crisis during therapy?