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Indiana Occupational Therapy Scope of Practice

The Practice of Occupational Therapy

"Practice of occupational therapy" means the therapeutic use of everyday life occupations and occupational therapy services to:

    • Aid individuals or groups to participate in meaningful roles and situations in the home, school, the workplace, the community, or other settings;
    • Promote health and wellness through research and practice; and
    • Serve individuals or groups who are well but have been or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction.

The practice of occupational therapy addresses the physical, cognitive, psychosocial, sensory, and other aspects of performance in a variety of contexts to support engagement in everyday life activities that affect a person's health, well-being, and quality of life throughout the person's life span.

Occupational Therapy Services

"Occupational therapy services" means services that are provided to promote health and wellness, prevent disability, preserve functional capabilities, prevent barriers for occupational performance from occurring, and enable or improve performance in everyday activities, including services that do the following:

Establish, remediate, or restore a skill or ability that is impaired or not yet developed. Occupational therapy services include identifying speech, language, and hearing that are impaired or not yet developed, but does not include the remediation of speech, language, and hearing skills and abilities.

Modify or adapt a person or an activity or environment of a person or compensate for a loss of a person's functions.

Evaluate factors that affect daily living activities, instrumental activities of daily living, and other activities relating to work, play, leisure, education, and social participation. These factors may include body functions, body structure, habits, routines, role performance, behavior patterns, sensory motor skills, cognitive skills, communication and interaction skills, and cultural, physical, psychosocial, spiritual, developmental, environmental, and socioeconomic contexts and activities that affect performance.

Perform interventions and procedures relating to the factors including the following:

    • Task analysis and therapeutic use of occupations, exercises, and activities.
    •  Education and training in self-care, self-management, home management, and community or work reintegration.
    •  Care coordination, case management, transition, and consultative services.
    • Modification of environments and adaptation processes, including the application of ergonomic and safety principles.
    • Assessment, design, fabrication, application, fitting, and training in assistive technology, adaptive devices, and orthotic devices, and training in the use of prosthetic devices. However, this does not include the following:
      • Gait training.
      • Training in the use of hearing aids, tracheoesophageal valves, speaking valves, or electrolarynx devices related to the oral production of language.
      • Remediation of speech, language, and hearing disorders.
      • Fabrication of shoe inserts.
    • Assessment, recommendation, and training in techniques to enhance safety, functional mobility, and communitymobility, including wheelchair management and mobility. However, this does not include gait training.
    • Management of feeding, eating, and swallowing to enable eating and feeding performance.
    • Application of physical agent modalities and use of a range of specific therapeutic procedures used in preparation for or concurrently with purposeful and occupation based activities, including techniques to enhance sensory-motor, perceptual, and cognitive processing, manual therapy techniques, and adjunctive and preparatory activities for occupational performance. However, manual therapy does not include spinal manipulation, spinal adjustment, or grade 5 mobilization.

Advanced Practice

Swallowing Management

An occupational therapist may assess and manage the pharyngoesophageal phase of swallowing, including instrumental evaluations, only if the occupational therapist has done the following:

    • Obtained continuing competency specific to the assessment and management of swallowing disorders.
    • Demonstrated competencies specific to the evaluation and management of pharyngoesophageal swallowing disorders within the practitioner's service delivery setting and with the specific populations through, at a minimum:
      • Professional development or similar advanced training;
      • Successful passage of a written test; and 
      • Demonstrated clinical skills and knowledge.

The competencies required must be annually reviewed and updated.

Citations

IC 25-23.5-1-5

IC 25-23.5-1-6.5

IC 25-23.5-4-2



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