AOTA Ethical & Legal Considerations 2 — Questions and Answers
Question 1: An OT practitioner using sensory integration intervention suspects a colleague is providing SI therapy without the required certification or training. What is the ethical obligation according to AOTA's Code of Ethics?
- Ignore it unless a client complaint is filed
- Report the concern through appropriate channels to protect consumers (Correct answer)
- Confront the colleague publicly in a team meeting
- Defer the decision entirely to the facility administrator
Correct answer: Report the concern through appropriate channels to protect consumers
AOTA's Code of Ethics requires practitioners to report concerns about unethical practice through appropriate channels to protect client welfare.
Question 2: A parent asks an OT to continue sensory integration therapy beyond what the evaluation supports as necessary. The practitioner should:
- Continue therapy to maintain the therapeutic relationship
- Recommend continued services to satisfy the parent's request
- Discontinue or modify services based on clinical evidence and document rationale (Correct answer)
- Refer the family to another provider without explanation
Correct answer: Discontinue or modify services based on clinical evidence and document rationale
Practitioners must base service decisions on clinical evidence and sound judgment, not solely on client or family preference.
Question 3: Which federal law most directly governs the rights of school-aged children with disabilities to receive occupational therapy services, including sensory-based interventions?
- Americans with Disabilities Act (ADA)
- Individuals with Disabilities Education Act (IDEA) (Correct answer)
- Section 504 of the Rehabilitation Act
- Health Insurance Portability and Accountability Act (HIPAA)
Correct answer: Individuals with Disabilities Education Act (IDEA)
IDEA mandates free appropriate public education and related services, including OT, for eligible children with disabilities.
Question 4: An OT documents 'sensory processing disorder' as a diagnosis in a client's medical record. What is the primary legal and ethical concern with this documentation?
- The term is not billable under any insurance code
- SPD is not a recognized DSM or ICD diagnosis, so using it as a medical diagnosis is inaccurate (Correct answer)
- The client has not consented to the documentation
- The documentation requires a physician co-signature
Correct answer: SPD is not a recognized DSM or ICD diagnosis, so using it as a medical diagnosis is inaccurate
Sensory Processing Disorder is not recognized in the DSM-5 or ICD-10, so documenting it as a medical diagnosis is clinically and legally inaccurate.
Question 5: A third-party payer denies reimbursement for sensory integration therapy, stating it is 'experimental.' The best ethical response by the practitioner is to:
- Abandon SI methods and switch to a different approach immediately
- Bill the client directly without informing them of the denial
- Advocate for the client using evidence-based research supporting SI efficacy (Correct answer)
- Agree with the payer and document that SI is not evidence-based
Correct answer: Advocate for the client using evidence-based research supporting SI efficacy
Ethical practitioners advocate for clients by providing payers with current research evidence supporting the efficacy of SI intervention.
Question 6: When obtaining informed consent for sensory integration intervention, the OT must ensure the client or guardian understands which of the following?
- Only the projected cost of services
- The nature of the intervention, expected outcomes, risks, and alternatives (Correct answer)
- The therapist's certification credentials only
- The facility's billing and payment policies
Correct answer: The nature of the intervention, expected outcomes, risks, and alternatives
Informed consent requires disclosure of the nature of treatment, expected benefits and risks, and available alternatives so the client can make an autonomous decision.
Question 7: Under HIPAA, an OT may share a child's sensory processing evaluation results with the child's teacher without parental consent in which situation?
- When the teacher is directly involved in the child's care and the information is necessary for treatment (Correct answer)
- Whenever a school employee requests the information
- Only after the child turns 12 years old
- When the school pays for the OT services
Correct answer: When the teacher is directly involved in the child's care and the information is necessary for treatment
HIPAA permits disclosure of protected health information for treatment purposes to other members of the care team without separate authorization.
AOTA Ethical & Legal Considerations 2
An OT practitioner using sensory integration intervention suspects a colleague is providing SI therapy without the required certification or training.
What is the ethical obligation according to AOTA's Code of Ethics?