Ethics:
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Beneficence
o Well-being
o Safety
o Beneficial
o Not using assessments that are inappropriate or outdated
o Choosing interventions that are beneficial and appropriate
o Doing re-eval in timely manner to determine if goals are being met and if changes should
be made
o Important to terminate service if no OT services are necessary
o Evidenced based care
o Alternative treatment ideas should be made sure it would be safe and beneficial to the
client
o Protecting participants of research studies (determining potential risks)
Nonmaleficence
o Refrain from actions that cause harm
o Doing drugs, drinking while providing services
o Don’t neglect or abandon
o Ensure continuity of care if you need to leave
o Fix your issues
o Avoid complicated relationships
 No dating
 Keep it professional
 Maintain boundaries
o Conflict of interest
o Exploitation
Autonomy
o Right to self-determination, privacy, confidentiality and consent
o Respect the rights and desires of the patient
o Do not try to force the patient to receive services
o EX: if the patient just had a knee replacement and likes to ski or snowboard and wishes
to go we cannot force them to not participate -> provide education instead
o They are their own agent and decision maker
o Applies to research -> they have a right to drop out of the research study
o Fully disclose the risks, benefits, and outcomes and allow them to make an informed
decision – facilitate comprehension and make sure they fully understand the
outcomes**
o Get consent from research participants
o Confidentiality – HIPPA
Justice
o Promote fairness and objectivity
o Timely and ensure access to care when needed
o Provide service in a fair and equitable manner
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Do not provide preferential treatment – provide fair and equitable service and
nondiscriminatory
o Procedural justice
 Uphold and apply institutional rules, local, state, federal and international laws
 Learning the AOTA code of ethics
 NBCOT code of conduct
 Sharing exam content is prohibited
 Holding the required certification – renew license when needed
 Maintain high standards and competence through continuing education
 Delegate to someone with the competence to complete services that you are
not able to complete ethically
 Awareness of current laws and AOTA policies
o Fair, reasonable billing and documentation
o Following reimbursement guidelines
o Accepting gifts – refraining from accepting gifts that would bias you
 Do not accept gifts
o Conducting study – obtaining necessary approvals
o Transparency is important – disclose conflicts of interest
Veracity
o Comprehensive, accurate, and objective info when representing the profession
o HONESTY
o Do not falsify any documentation
o Credit work that is not yours
Fidelity
o Treating colleagues/clients with fairness, respect, and integrity
o LOYAL, faithfulness
o Represent the profession in the best way possible
o Maintain professional relationships with colleagues
o Maintain collaborative relationships
o Do not slander or gossip
FOR and Models
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Ecology of Human performance model
o Ecology: organism and environment
o Human performance: process and result of (person, task, and context)
o How to the context influences performance
o 4 constructs
 Person
 Abilities
 Experiences
 Sensorimotor
 Cognitive
 Psychosocial
 Context
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 Physical
 Social
 Cultural
 Temporal
 Task
 Set of behaviors to accomplish goal
 These tasks form a person’s goal
 Performance
 Interaction with context to engage in task
o Who I want to be
o What I want to do
o Therapeutic intervention approaches
 Establish/restore
 Improve abilities and function
 Adapt/modify
 Modify context and task demand
 Alter
 Find optimal context
 Prevent
 Anticipate problems
 Create
 Opportunities for adaptable and complex performance
Occupational adaptation
o New model/theory
o Client centered, holistic, top down approach
o Internal adaptation process
o The more adaptive, the more functional
o Treatment goal: using meaningful occupational to improve client’s ability to adapt
o Basic elements
 Person
 Desire for mastery
 Environment
 Demands for mastery
 Interaction of person and environment
 Resulting in occupation
 Press for mastery
o Observable outcomes
 Improved self-initiation
 Generalization
 Improved relative mastery
o Make sure its meaningful occupation to increase desire to master to meet demands to
desire in environment
PEO
o Looks at the optimal fit of the person, environment and occupation
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Creates the performance
MOHO
o Motivation
o Intrinsic desires
o What drives that person
Low vision
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Macular degeneration
o Central vision loss
o Increased sensitivity to glare
o Decreased ability to adjust to light changes
o Age related degeneration of macula
o Objects appear distorted in shape and straight lines appear wavy or crooked
o Reading labels is hard
o Difficult with low contrast
Cataracts
o Central vision loss
o Cloudy lens
o Gradual vision loss (1st: central then peripheral)
o Issues with glares
o Darkened vision
o Decreased acuity
o Distortion
o Faded colors
o Poor night vision
Diabetic retinopathy
o Abnormal BV growth -> retinal scarring and attachment
o Impaired central vision -> floaters
o Blindness rare
o Complication with diabetes
o Decreased contrast sensitivity
o Difficulty with color discrimination
Glaucoma
o Tunnel vision
o Peripheral vision loss from increased eye pressure and degermation of optic disc
o Progresses to blindness if untreated
Homonymous hemianopsia
o CVA related
o Loss of ½ visual field in each eye (opposite field of injury)
o Corresponds to side of sensorimotor deficit
Musculoskeletal impairments
Amputations
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Types of terminal devices
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Functional to grasp and maintain hold on an object
Body operated protheses: use of specific scapula and shoulder movements to place
tension on the cable that opens or closes the TD
 Two main types are the hooks and prosthetic hand
 Voluntary opening (VO): hook remains closed until tension is placed on cable
and then it opens. This is more common
 Voluntary closing (VC): hook remains opened until tension is placed on cable and
this it closes
Myoelectric prostheses: uses muscle contractions detected by electrodes to open and
close the TD
 Wrist: uses flexors and extensors to open and close TD
 Trans humeral amp: use biceps and triceps
 Shoulder disarticulations use pectoralis major or infraspinatus