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North Carolina Occupational Therapy Scope of Practice

Definition of Occupational Therapy

“Occupational therapy” means a health care profession providing evaluation, treatment and consultation to help individuals achieve a maximum level of independence by developing skills and abilities interfered with by disease, emotional disorder, physical injury, the aging process, or impaired development. Occupational therapists use purposeful activities and specially designed orthotic and prosthetic devices to reduce specific impairments and to help individuals achieve independence at home and in the work place

Occupational Therapy Evaluation, Treatment, and Consultation

"Occupational Therapy evaluation, treatment, and consultation" include the following:

    • Remediation or restitution of performance abilities that are limited due to impairment in biological, physiological, psychosocial and developmental process;
    • Adaptation of skills, process or environment, or the teachings of compensatory techniques in order to enhance performance;
    • Disability prevention methods and techniques which facilitate the development or safe application of performance skills;
    • Promotion of health and wellness to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction; and
    •  Interpretation of the physical, cognitive, psychosocial, sensory, and other aspects of performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

The Practice of Occupational Therapy

Methods or strategies selected to direct the process of interventions such as:

    • Establishment, remediation, or restoration of a skill or ability that has not yet developed or is impaired;
    • Compensation, modification, or adaptation of activity or environment to enhance performance;
    • Maintenance and enhancement of capabilities without which performance in everyday life activities would decline;
    • Health promotion and wellness to enable or enhance performance in everyday life activities; and
    • Prevention of barriers to performance, including disability prevention.

Evaluation of factors affecting activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation, including:

    • Client factors, including body functions (such as neuromuscular, sensory, visual, perceptual, cognitive) and body structures (such as cardiovascular, digestive, integumentary, genitourinary systems);
    • Habits, routines, roles, and behavior patterns;
    • Cultural, physical, environmental, social, and spiritual contexts and activity demands that affect performance; and
    • Performance skills, including motor, process, and communication/interaction skills.

Interventions and procedures to promote or enhance safety and performance in activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure and social participation, including:

    • Therapeutic use of occupations, exercises, and activities;
    • Training in self-care, self-management, home management, and community/work reintegration;
    • Development, remediation, or compensation of physical, cognitive, neuromuscular, sensory functions and behavioral skills;
    • Therapeutic use of self, including one's personality, insights, perceptions, and judgments, as part of the therapeutic process;
    • Education and training of individuals, including family members, caregivers, and others;
    • Care coordination, case management, and transition services;
    • Consultative services to groups, programs, organizations, or communities;
    • Modification of home, work school or community environments and adaptation of processes, including the application of ergonomic principles;
    • Assessment, design, fabrication, application, fitting, and training in assistive technology, adaptive devices, and orthotic devices, and training in the use of prosthetic devices;
    • Assessment, recommendation, and training in techniques to enhance functional mobility, including wheelchair management;
    • Driver rehabilitation and community mobility;
    • Management of feeding, eating, and swallowing to enable eating and feeding performance; and
    • Application of physical agent modalities, and use of a range of specific therapeutic procedures to enhance performance skills.

Skilled Occupational Therapy Services

"Skilled occupational" therapy services when rendered by an occupational therapist or occupational therapy assistant means functions that require the exercise of professional occupational therapy judgment, including the interpretation of referrals, screening, assessment, evaluation, development or modification of intervention plans, implementation of intervention, reassessment, or discharge planning.


N.C. Gen. Stat. 90-270.67

NCAC 38.0103

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