AOTA Ethics & Professional Standards 3 — Questions and Answers
Question 1: A school-based OT certified in sensory integration is pressured by an administrator to discharge a student prematurely for budgetary reasons. The ethical course of action is to:
- Discharge the student because the administrator has final authority
- Document clinical reasoning, communicate concerns, and escalate if the student's welfare is at risk (Correct answer)
- Continue services without informing administration
- Transfer the case to an uncertified aide
Correct answer: Document clinical reasoning, communicate concerns, and escalate if the student's welfare is at risk
OTs must document clinical rationale and advocate for client needs while following appropriate channels for dispute resolution.
Question 2: When an OT uses a proprietary sensory integration assessment tool, ethical use of that tool requires:
- Only using it with clients who can afford to purchase the tool
- Completing required training and following the standardized administration protocol (Correct answer)
- Adapting the protocol freely based on client presentation
- Sharing the assessment materials with other professionals for efficiency
Correct answer: Completing required training and following the standardized administration protocol
Ethical test use requires adherence to standardized administration procedures and completion of any required training specified by the test publisher.
Question 3: An OT in private practice offers a 'sensory integration package deal' that bundles a set number of sessions for a flat fee paid upfront. The primary ethical concern is:
- Charging fees that may not align with the individualized needs of each client (Correct answer)
- Violating insurance billing requirements
- Failing to obtain informed consent
- Practicing outside the scope of occupational therapy
Correct answer: Charging fees that may not align with the individualized needs of each client
Predetermined session packages may prioritize financial arrangements over individualized clinical decision-making, conflicting with client-centered care principles.
Question 4: The AOTA Occupational Therapy Practice Framework guides ethical SI practice by:
- Specifying exact SI protocols to follow for each diagnosis
- Providing a conceptual foundation for occupation-centered, client-centered service delivery (Correct answer)
- Replacing the need for standardized assessments
- Mandating use of Ayres Sensory Integration exclusively
Correct answer: Providing a conceptual foundation for occupation-centered, client-centered service delivery
The OTPF provides the conceptual foundation that supports occupation-centered and client-centered practice, which underpins ethical SI service delivery.
Question 5: A client's family asks an OT to falsify documentation to support a disability accommodation request. The ethical obligation is to:
- Comply if the OT believes the child genuinely needs the accommodation
- Refuse and explain the legal and ethical obligations to accurate documentation (Correct answer)
- Provide a vague report that does not technically misrepresent the data
- Defer the decision to the supervising physician
Correct answer: Refuse and explain the legal and ethical obligations to accurate documentation
Falsifying documentation violates the ethical principles of Veracity and Justice and may constitute fraud, regardless of the OT's belief about the client's needs.
Question 6: Which best describes 'dual relationship' concerns in sensory integration practice?
- Providing both assessment and treatment to the same client
- Having a personal or financial relationship with a client that could impair professional judgment (Correct answer)
- Working in both school-based and clinic-based settings simultaneously
- Holding certification in more than one specialty area
Correct answer: Having a personal or financial relationship with a client that could impair professional judgment
Dual relationships occur when personal, financial, or other ties to a client create actual or potential conflicts with the OT's professional obligations.
Question 7: An OT is asked to co-treat a client with a professional who uses a sensory-based intervention that has no evidence base and contradicts established SI principles. Ethically, the OT should:
- Participate if the family consents
- Refuse to co-treat and discuss evidence-based concerns with the colleague and team (Correct answer)
- Adapt the unproven techniques into a hybrid approach
- Report the colleague to their licensing board immediately
Correct answer: Refuse to co-treat and discuss evidence-based concerns with the colleague and team
Beneficence requires the OT to protect the client from potentially harmful or ineffective interventions and to promote evidence-based practice through collegial dialogue.
AOTA Ethics & Professional Standards 3
A school-based OT certified in sensory integration is pressured by an administrator to discharge a student prematurely for budgetary reasons.
The ethical course of action is to: