AOTA Patient Safety & Risk Management 2 — Questions and Answers
Question 1: A child with tactile defensiveness becomes agitated and begins hitting during a brushing protocol. What is the FIRST action the therapist should take?
- Continue the protocol to help the child habituate
- Immediately discontinue the activity and ensure the child is calm (Correct answer)
- Reduce brushing pressure and continue at a slower pace
- Ask the child to verbally describe their discomfort
Correct answer: Immediately discontinue the activity and ensure the child is calm
When a client shows signs of distress or aggression during sensory intervention, the therapist must stop immediately to ensure safety before reassessing.
Question 2: Which documentation practice is MOST important for risk management in sensory integration therapy?
- Recording session duration and room temperature
- Documenting baseline sensory profiles before initiating intervention (Correct answer)
- Noting which equipment was cleaned after each session
- Listing all toys used during the session
Correct answer: Documenting baseline sensory profiles before initiating intervention
A documented baseline sensory profile establishes the client's starting point and justifies subsequent intervention choices, which is critical for risk management.
Question 3: A therapist notices a loose bolt on a platform swing before a session. The BEST course of action is to:
- Inform the supervisor after the session ends
- Use the swing but limit the child's movement
- Remove the swing from service and report the defect immediately (Correct answer)
- Tighten the bolt with available tools and proceed
Correct answer: Remove the swing from service and report the defect immediately
Defective equipment must be taken out of service immediately and formally reported to prevent injury; improvised repairs by clinical staff are not appropriate.
Question 4: When establishing a therapeutic relationship that minimizes risk, the sensory integration therapist should prioritize:
- Completing standardized assessments within the first session
- Following the child's lead to build trust and monitor tolerance (Correct answer)
- Introducing the most challenging activities first to gauge limits
- Minimizing parent presence to reduce distractions
Correct answer: Following the child's lead to build trust and monitor tolerance
Following the child's lead allows the therapist to monitor physiological and behavioral tolerance signals while building rapport, reducing the risk of adverse reactions.
Question 5: Which sign MOST strongly indicates that a child is experiencing an autonomic stress response during sensory integration intervention?
- Increased verbal requests for the activity
- Skin pallor, rapid breathing, and pupil dilation (Correct answer)
- Improved bilateral coordination
- Relaxed muscle tone and slow movements
Correct answer: Skin pallor, rapid breathing, and pupil dilation
Skin pallor, rapid breathing, and pupil dilation are autonomic nervous system indicators of a fight-or-flight response, signaling the intervention must be modified or stopped.
Question 6: An occupational therapist providing sensory integration services learns that a client has an undiagnosed seizure disorder. The MOST appropriate next step is to:
- Continue SI therapy while avoiding vestibular activities
- Obtain medical clearance and update the risk screening before proceeding (Correct answer)
- Discharge the client until the disorder is treated
- Add seizure precautions to the session plan and continue
Correct answer: Obtain medical clearance and update the risk screening before proceeding
Medical clearance must be obtained and the risk screening updated to ensure interventions are safe and appropriate given the newly identified medical condition.
Question 7: A parent signs an informed consent form but does not understand that certain sensory activities carry physical risk. The therapist's ethical obligation is to:
- Proceed since the consent form was signed
- Re-explain specific risks in understandable language until the parent comprehends (Correct answer)
- Have the parent sign a second waiver to cover all risks
- Reduce session activities to eliminate all risk
Correct answer: Re-explain specific risks in understandable language until the parent comprehends
Valid informed consent requires that the client or guardian truly understands the risks; signing a form without comprehension does not constitute informed consent.
AOTA Patient Safety & Risk Management 2
A child with tactile defensiveness becomes agitated and begins hitting during a brushing protocol.
What is the FIRST action the therapist should take?