AOTA Lists Five ‘Practices to Avoid’

Choosing Wisely program offers practical advice for consumers

Earlier this month, the American Occupational Therapy Association (AOTA) announced recommendations for providing evidence-based OT solutions. This was accomplished in the form of a list of ‘Five Things Patients and Providers Should Question’:

  1. Don’t provide intervention activities that are non-purposeful (e.g., cones, pegs, shoulder arc, arm bike). Using valued activities is at the core of occupational therapy. Meaningful activities are motivating, build endurance, and increase attention.
  2. Don’t provide sensory-based interventions to individual children or youth without documented assessment results of difficulties processing or integrating sensory information. Sensory issues are complex, and an intervention that does not address the correct problem can be ineffective or even harmful.
  3. Don’t use physical agent modalities (PAMs) without providing purposeful and occupation-based intervention activities. Using heat, cold, mechanical devices, electrotherapeutic, and other agents without incorporating a purposeful activity is not occupational therapy.
  4. Don’t use pulleys for individuals with a hemiplegic shoulder. Overhead pulleys often lead to shoulder pain among stroke survivors and other individuals with hemiplegia, and should be avoided. Gentler, controlled range of motion exercises and activities are preferred.
  5. Don’t provide cognitive-based interventions (e.g., paper-and-pencil tasks, table-top tasks, cognitive training software) without direct application to occupational performance. Occupational therapy interventions related to cognition should be part of an activity that is important to the person.

More information on AOTA’s Choosing Wisely program is available on the organization’s website.

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