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Board debates sensory-integration scope and asks staff to prepare consumer guidance
Summary
Board discussed OT scope boundaries for sensory-integration and sensory-processing interventions after association surveys reported non-OTs providing such services without OT oversight. The board directed staff to prepare draft website guidance and assigned the education-and-outreach committee to develop consumer materials.
The California Board of Occupational Therapy devoted substantial time May 20 to clarifying how sensory-integration and sensory-processing interventions relate to the OT scope of practice and how to protect consumers when non-OT personnel perform sensory-based services.
OTEC/OTAC representatives told the board their survey found sensory-based interventions delivered by unlicensed or non-OT personnel (behavior technicians, BCBAs, speech-language pathologists and paraprofessionals) and reported examples of unsafe or inappropriate application. "Several respondents specifically reported that sensory interventions, sensory diets, feeding interventions... are being implemented by individuals without occupational therapy training or oversight," an association representative said.
Board members asked how interventions would differ when practiced by OTs versus other providers. Board member Erin Schwier said the outward activities may look similar to lay observers but stressed that "the difference is in the training and in the potential risk to the consumer," emphasizing assessment, clinical reasoning and oversight. She related instances where improper use of tools (weighted vests, swings) had created safety concerns.
Legal counsel and staff outlined options and limits: the board can clarify language in regulation and produce consumer-facing guidance; expanding the statutory scope to make the practice exclusive to OTs would be a legislative action and likely requires association sponsorship. Counsel recommended working with DCA and associations when statutory or multi-license approaches are contemplated.
The board agreed to assign the soon-to-be-reactivated Education and Outreach Committee to develop draft consumer-facing language and asked staff to prepare material for the board's website. The association representatives said they would discuss legislative options with their lobbyists but welcomed the board's outreach approach.
Next steps: staff will draft consumer-facing guidance and bring materials to the reactivated Education and Outreach Committee for review; associations may pursue legislative options separately if they decide that statutory change is necessary.
