AOTA Patient Safety & Risk Management 3 — Questions and Answers
Question 1: Which of the following is the MOST critical contraindication for using deep pressure techniques in sensory integration therapy?
- History of sensory-seeking behaviors
- Presence of osteoporosis or fragile bone conditions (Correct answer)
- Mild gravitational insecurity
- Diagnosis of autism spectrum disorder
Correct answer: Presence of osteoporosis or fragile bone conditions
Osteoporosis or fragile bone conditions make deep pressure techniques dangerous due to elevated fracture risk, making them a primary contraindication.
Question 2: During an SI session, a child suddenly vomits after intense vestibular stimulation. The therapist should FIRST:
- Reassure the child and resume the activity at a lower intensity
- Ensure the child's airway is clear and position them safely (Correct answer)
- Document the incident and notify the caregiver at pickup
- Administer water and wait 10 minutes before continuing
Correct answer: Ensure the child's airway is clear and position them safely
Airway protection and safe positioning are the immediate priorities when vomiting occurs during therapy.
Question 3: A therapist is conducting a home visit for SI therapy. Compared to a clinic setting, what additional safety consideration is MOST important?
- Using portable standardized assessments
- Conducting an environmental hazard assessment of the home setting (Correct answer)
- Bringing the same suspended equipment used in the clinic
- Scheduling sessions when siblings are away from home
Correct answer: Conducting an environmental hazard assessment of the home setting
Home environments are uncontrolled and may contain hazards absent in a clinical setting, making a formal environmental hazard assessment essential before beginning treatment.
Question 4: Which principle guides appropriate grading of sensory input to maintain patient safety during SI intervention?
- Begin at maximum intensity to determine tolerance quickly
- Apply the just-right challenge, incrementally adjusting intensity based on response (Correct answer)
- Use the same intensity across all sessions for consistency
- Let the child choose intensity without therapist guidance
Correct answer: Apply the just-right challenge, incrementally adjusting intensity based on response
The just-right challenge principle means matching sensory input to the client's current capacity and incrementally adjusting to promote adaptive responses without causing distress or injury.
Question 5: How should an SI therapist respond when a caregiver insists on continuing an activity that the child is clearly distressed by?
- Honor the caregiver's authority and continue the activity
- Pause the activity, explain the clinical rationale for stopping, and prioritize child safety (Correct answer)
- Ask the child to vote on whether to continue
- Document the caregiver's request and proceed cautiously
Correct answer: Pause the activity, explain the clinical rationale for stopping, and prioritize child safety
The therapist has professional and ethical responsibility for the child's safety and must halt harmful activities while educating the caregiver on the clinical reasoning.
Question 6: A child receiving SI therapy is prescribed a new medication known to affect postural tone. The therapist should:
- Continue therapy unchanged since medication effects are the physician's concern
- Reassess the child's postural responses and adjust activities before proceeding (Correct answer)
- Avoid all suspended equipment until the medication is discontinued
- Contact the pharmacist for a list of all side effects
Correct answer: Reassess the child's postural responses and adjust activities before proceeding
Medications affecting postural tone can alter a child's responses to SI activities, requiring reassessment and modification of the activity plan to maintain safety.
Question 7: In the context of SI therapy, what does 'therapeutic use of self' contribute to patient safety?
- It allows the therapist to bypass standardized protocols
- It enables the therapist to read subtle cues and modulate the therapeutic environment responsively (Correct answer)
- It shifts responsibility for safety to the child's self-regulation
- It eliminates the need for formal risk screening
Correct answer: It enables the therapist to read subtle cues and modulate the therapeutic environment responsively
Therapeutic use of self involves attunement to client cues, enabling real-time adjustments that prevent adverse reactions and maintain a therapeutic window of arousal.
AOTA Patient Safety & Risk Management 3
Which of the following is the MOST critical contraindication for using deep pressure techniques in sensory integration therapy?