5. The occupational therapist interprets the information provided by the occupational therapy assistant and integrates that information into the evaluation and decision-making process.
1. The occupational therapist has overall responsibility for the development of the occupational therapy intervention plan.
2. The occupational therapist and the occupational therapy assistant collaborate with the client to develop the plan.
3. The occupational therapy assistant is responsible for being knowledgeable about evaluation results and for providing input into the intervention plan, based on client needs and priorities.
1. The occupational therapist has overall responsibility for implementing the intervention.
2. When delegating aspects of the occupational therapy intervention to the occupational therapy assistant, the occupational therapist is responsible for providing appropriate supervision.
3. The occupational therapy assistant is responsible for being knowledgeable about the client’s occupational therapy goals.
4. The occupational therapy assistant selects, implements, and makes modifications to therapeutic activities and interventions that are consistent with demonstrated competency levels, client goals, and the requirements of the practice setting.
1. The occupational therapist is responsible for determining the need for continuing, modifying, or discontinuing occupational therapy services.
2. The occupational therapy assistant contributes to this process by exchanging information with and providing documentation to the occupational therapist about the client’s responses to and communications during intervention.
1. The occupational therapist is responsible for selecting, measuring, and interpreting outcomes that are related to the client’s ability to engage in occupations.
2. The occupational therapy assistant is responsible for being knowledgeable about the client’s targeted occupational therapy outcomes and for providing information and documentation related to outcome achievement.
3. The occupational therapy assistant may implement outcome measurements and provide needed client discharge resources.
Supervision of Occupational Therapy Aides
An aide, as used in occupational therapy practice, is an individual who provides supportive services to the occupational therapist and the occupational therapy assistant. Aides do not provide skilled occupational therapy services. An aide is trained by an occupational therapist or an occupational therapy assistant to perform specifically delegated tasks. The occupational therapist is responsible for the overall use and actions of the aide. An aide first must demonstrate competency to be able to perform the assigned, delegated client and non-client tasks.
1. The occupational therapist must oversee the development, documentation, and implementation of a plan to supervise and routinely assess the ability of the occupational therapy aide to carry out non-client-and client-related tasks. The occupational therapy assistant may contribute to the development and documentation of this plan.
2. The occupational therapy assistant can supervise the aide.
3. Non-client-related tasks include clerical and maintenance activities and preparation of the work area or equipment.
4. Client-related tasks are routine tasks during which the aide may interact with the client. The following factors must be present when an occupational therapist or occupational therapy assistant delegates a selected client-related task to the aide:
Depending on the setting in which service is provided; aides may be referred to by various names. Examples include, but are not limited to, rehabilitation aides, restorative aides, extenders, paraprofessionals, and rehab techs
a. The outcome anticipated for the delegated task is predictable.
b. The situation of the client and the environment is stable and will not require that judgment, interpretations, or adaptations be made by the aide.
c. The client has demonstrated some previous performance ability in executing the task.
d. The task routine and process have been clearly established.
5. When performing delegated client-related tasks, the supervisor must ensure that the aide
a. Is trained and able to demonstrate competency in carrying out the selected task and using equipment, if appropriate;
b. Has been instructed on how to specifically carry out the delegated task with the specific client; and
c. Knows the precautions, signs, and symptoms for the particular client that would indicate the need to seek assistance from the occupational therapist or occupational therapy assistant.
6. The supervision of the aide needs to be documented. Documentation includes information about frequency and methods of supervision used the content of supervision and the names and credentials of all persons participating in the supervisory process.
These guidelines about supervision, roles, and responsibilities are to assist in the appropriate utilization of occupational therapists, occupational therapy assistants, and occupational therapy aides and in the appropriate and effective provision of occupational
therapy services. It is expected that occupational therapy policies, the Occupational Therapy Code of Ethics (AOTA, 2005), and continuing competency and professional development guidelines.
American Occupational Therapy Association. (2004). Guidelines for supervision, roles, and responsibilities during the delivery of occupational therapy services. American Journal of Occupational Therapy, 58, 663–667.
American Occupational Therapy Association. (2005). Occupational therapy code of ethics (2005). American Journal of Occupational Therapy, 59, 639–642.
American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and process (2nd ed.). American Journal of Occupational Therapy, 62, 625–683.
American Occupational Therapy Association. (2005). Standards of practice for occupational therapy. American Journal of Occupational Therapy, 59, 663–665.
Sara Jane Brayman, PhD, OTR/L, FAOTA, Chairperson, 2002–2005
Gloria Frolek Clark, MS, OTR/L, FAOTA
Janet V. DeLany, DEd, OTR/L
Eileen R. Garza, PhD, OTR, ATP
Mary V. Radomski, MA, OTR/L, FAOTA
Ruth Ramsey, MS, OTR/L
Carol Siebert, MS, OTR/L
Kristi Voelkerding, BS, COTA/L
Patricia D. LaVesser, PhD, OTR/L, SIS Liaison
Lenna Aird, ASD Liaison
Deborah Lieberman, MHSA, OTR/L, FAOTA, AOTA Headquarters Liaison for The Commission on Practice
Sara Jane Brayman, PhD, OTR/L, FAOTA, Chairperson
Adopted by the Representative Assembly 2004C24
Edited by the Commission on Practice 2009
This replaces the 2004 document Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services (previously published and copyrighted in 2004 in the American Journal of Occupational Therapy, 58, 663–667).
Copyright © 2009 by the American Occupational Therapy Association.