OTS 188: Everyday Ethics in School-Based OT"
- Jayson Davies
- Nov 3
- 34 min read
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Welcome to the show notes for Episode 188 of the OT Schoolhouse Podcast.
Everyday Ethics in School-Based OT: Navigating Challenges with Clarity & Confidence equips school-based occupational therapists with the tools to confidently address real-world ethical dilemmas that arise in educational settings. Through case studies, decision-making frameworks, and updated guidance from AOTA, FOTA, and state-level regulations, participants will strengthen their ability to apply ethical principles to complex situations involving service delivery, documentation, advocacy, and the use of emerging tools like AI.
This course enhances professional judgment, reduces uncertainty when facing ethical pressures, and promotes alignment with best practices and legal requirements. Ultimately, attendees will leave with actionable strategies to advocate for ethical change within their districts while maintaining student-centered, legally compliant, and neurodiversity-affirming care.
Listen now to learn the following objectives:
Learners will identify and describe modern ethical dilemmas within the school setting.
Learners will apply ethical decision-making frameworks within the school-based setting case study.
Learners will identify strategies for ethical advocacy and communication within the school setting.
Guest(s) Bio
Taylor Poirier OTD, OTR/L, CPRCS
Taylor graduated from the University of St. Augustine – Miami in 2022 with her doctorate in occupational therapy. She began her career with a private pediatric company in Tampa, FL, providing services within private schools and through home health. With a passion for primitive reflex integration across the academic age span, she earned her Certified Primitive Reflex Clinical Specialist certification in Fall 2024.
She is currently working to expand awareness of the scope of occupational therapy in schools within her local community, pushing the boundaries of traditional intervention approaches. In her free time, Taylor enjoys cooking, exercising, and watercolor painting.
Quotes
"Making decisions with confidence will always support your professional integrity."
— Dr. Taylor Poirier
"Our roles and everyone's roles really in the IEP meeting or related situations is to progress that child forward."
— Dr. Taylor Poirier
"If we don't say it, no one else may say it. Advocacy starts with us."
— Jayson Davies, M.A., OTR/L
Resources
🧮 Tools from OT Schoolhouse
OTP Lounge - A forum for asking questions within the OT Schoolhouse community
Episode Transcript
Expand to view episode transcript
Jayson Davies
Hello and welcome to this special edition of the OT school house podcast. This is episode 188 and I'm your host, Jayson Davies. Today we are diving into a topic that affects every decision we make as school based ot practitioners, and that is ethic. In this special episode, we are sharing the live audio content from a course that was recorded inside the OT school house collaborative featuring fellow ot Dr Taylor Poirier. Taylor is also one of our community managers inside of that community, and the information that she shares within this particular course about ethical content within school based ot practitioner is absolutely vital. In fact, it's so vital that many states require a ethics course to be taken by ot practitioners in order to keep their license. In this episode, Taylor brings a fresh perspective on navigating the ethical dilemmas that we face every day in school, from IEP meetings and documentation to emerging technologies like AI in this episode, she'll guide us through practical decision making frameworks that build confidence when facing those challenging situations we all encounter. In case you're wondering, this course is a ot approved for one hour of CEUs, and if you are in a state that requires an ethics course, this can fulfill that need. If you'd like to earn a certificate of completion, access the slides and resources and learn from more than 30 other exclusive school based ot courses. Be sure to join the OT schoolhouse collaborative today at OTSchoolHouse.com, slash collab members also get access to our growing resource library, our goal and treatment bank, as well as live mentorship hours with myself and occasionally with Taylor. Now let's dive into this course with Taylor and learn how to navigate everyday ethics and school based ot with clarity and confidence.
Amazing Narrator
Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies, class is officially in session,
Jayson Davies
all right, and we are officially live. Taylor, the screen is yours.
Dr. Taylor Poirier OTR/L
Awesome. Thank you so much, Jayson. I am very excited to be here with you guys tonight and those who may be watching the replay later on. I think this is a much needed course, and hopefully it provides some new perspective, and you gain a whole bunch of knowledge from it. So let's go ahead and dive in. So over the course of this evening, this is what we're going to review. We're going to look at ethics. Going to review the code of ethics. We're going to redefine what ethics means. We're going to look at the AI implications and how we can still utilize this amazing tool while remaining ethically compliant. We're going to dive into a decision making framework to build up your confidence in handling those situations as they may arise. We're going to talk about Advocacy and Communication, how you can apply everything that you learn and move it out into a micro and macro level for optimal benefits of your students and those around you. And then lastly, we're going to look at some case studies and apply all of that knowledge our course objectives for the evening, we're going to identify and analyze common ethical dilemmas, hopefully give you some relation to these that you may have already experienced or may you may be experiencing in the future. Help you apply that decision making framework and then actively create strategies to communicate and advocate for those that you serve. So what does the term ethics actually mean if you're anything like me, I remember this from the very first day course of OT school, and they were like, all right, you got to memorize these things. And then it was kind of just onto the other aspects of our job, and now practicing for almost three years. I realized this really plays into our day to day, even maybe session by session. So this is the most updated definition I've received from a ot A, and I have some highlighted things in here, so I'm going to read it, and then we're going to discuss so ethics refers to the obligation of occupational therapy personnel to just demonstrate professional conduct that reflects the fields values when working with clients, families, caregivers, administrators, colleagues, policymakers, payers and other healthcare professionals. It includes applying the A ot a code of ethics to help practitioners face complex ethical problems in practice, research, education and policy. So the big word that really has stuck out to me is the term obligation. It's not as we come across or not my circus, not my monkeys. I'm not going to put my hand in that. It's our duty and our obligation as school based occupational therapists to look at everything through an ethical lens in order to uphold the rights of. Of those that we serve. And not only do we have this obligation, we need to reflect the knowledge and the understanding and really the framework that we work within. We need to reflect that in everything that we do by also upholding our values when working with those across the board. When we're able to do that, we also have the professional integrity we build the rapport, we build the trust, and we really build optimal situations for positive outcomes. And we may think of ethics are in place for just those that we serve, but really they're in place for us. They help guide us. They help produce a framework for us to navigate tough situations. And they're really part of, you know, helping us, even at the macro level, with research, education and policy, policy changes. Now we've redefined ethics. We've looked at the term, what are the code of ethics? From a ot a, these are six, which maybe this is a flashback to grad school, or you've been in touch with it more recently, if you're having to do ethical courses based off your state, but we're going to review them now. So beneficence is promoting the well being of our students. We have justice promoting the fairness and objectivity and all the things that we do for our students. Non maleficence is avoiding harm of our students. And I want you to think of harm not only in the physical sense, but in the emotional and mental veracity, providing accurate and truthful information, whether this is in our assessments, documentation, meetings, collaboration, all of those things, autonomy, which is respecting the right of the individual to self determination, bringing students into What we're doing, having them help themselves with goal creation. You know, what do they love about school? What makes school really tough? How can they feel more successful in school? To help guide some of the documentation and goal writing. And then lastly, is fidelity, which is loyalty and faithfulness to our students, which that's the key component that really helps us build that rapport. If students or children feel comfortable with somebody, they're more likely to, you know, show who they are. They're able to confide in and they're able to feel comfortable enough to have that trial and error that we may need them to as we are building their skills. So in the chat, I'd love to see if or hear if there's any one that jumps out to you, is there one where you're like, oh, wow, like, I'm really doing this actively on a day to day basis, or one where you haven't quite maybe you're not realizing the relevance quite yet. I know for me, I feel like our world's really opening up to our neuro diverse community, and with those, the students with different abilities, and so I feel like a lot of what I'm doing is bringing them into those conversations, having their right for self determination, having their right to advocate for themselves. So autonomy is one that I feel pretty heavily in my practice right now. Do we have any comment? Do we have any flowing in jaysons, or any ones that are sticking out to people I
Jayson Davies
just wrote in there that sometimes within school based OT, veracity sometimes gets tested in the sense that we have limitations put on us by administration and teachers and just the system of school based OT, and so sometimes providing accurate and truthful information, you have to do it in A creative way, because you kind of feel that pull a little bit to go one way versus the way that you want to go sometimes. Yeah, absolutely.
Dr. Taylor Poirier OTR/L
And we'll touch on this a little bit more towards the end, but that really plays into our communication piece and how we effectively communicate more in a strengths based way to really get our point across and help in the best interest of our children. So why? Why is this important to to have at the front of everything that we do? So having ethical awareness, it protects the rights of our students. It also provides or promotes their well being. It helps guide complex school systems like Jayson was saying, some of those, those dual relationships, some of those dynamics can be really difficult to navigate. So having these ethical frameworks of these six, and then the framework for decision making that we'll go over, really help provide context and structure to how we should navigate those things. Having this promotes integrity, which helps build trust with students, families and staff, knowing that you're always upholding these and really the obligation of truth that we have, and this also helps ensures that we're complying with a ot a code of ethics and state laws, everyone's district states, everything has everyone has their own things that may vary. So being aware of this and being informed is the best way to make sure you are always in compliance, so that there isn't a mistake that you may make just out of lack of awareness. So it's always great to be informed in this, and then again, it really supports our professional integrity and the accountability and everything that we do, even those days when we're rushing, always having in mind that we are accountable for every. Action that we make, and there has to be a purpose. And I know there may be a purpose in every action that we have, but documenting in that way, educating in that way, communicating in the way that you may be thinking, so that everyone around you also understands that importance. So when we think of ethical dilemmas, what do we think of after doing some research? These were the top four areas where occupational therapists who were surveyed feel they experience it the most, which is in IEP meetings. Common things that they have a hard time or are really needing to promote is advocacy and the promotion of the job of justice, mandating reporting situations where, you know, trying to avoid harm for the student, and intervening in that way the complexity of relationships, whether that's within school systems, you know, if the families are not, quote, unquote, typical, maybe whoever the situations may involve navigating those in an ethical way, and then also intervention selections, which it did not mention, assessments. But I feel like this can also be extended into that area, making sure that we are selecting assessments and interventions that aren't just out of ease, but are out of necessity and to promote the best optimal outcomes of our students and identify where the support is needed. So everyone's top question, AI is coming in. We know Jayson is a big AI fan and promoter, and he definitely has a lot of insight on this. And something that we want to start bringing awareness to is that AI is an amazing tool, but how can we use this optimally while ensuring ethical compliance in the chat? I'd love if anybody has experience with this already, where they're unsure of when they should have used it if they've already had some issues arise, whether that was themselves or other areas of their practice. I'd love to see and maybe discuss that later on too, about how to navigate some of those situations. So AI is is coming really fast and integrating itself into our practice. It has so many tools in potential to assist or the students that we serve, whether that's progress notes, whether that's intervention ideas, whether that's summaries for notes in general, or progress reports, whatever that's looking like. And while these can be pushed heavily to to save time, maybe expand access, they are always going to carry a risk. Some of the most common concerns that a OTs having as of last year is confidentiality breaches. Data can be getting misused. There's bias or inaccurate recommendations. And something to keep in mind is that AI is such a powerful tool, but it can't outright or out program human experience. I can't out produce our clinical judgment, our education. We can program it as much as possible, but we always need to use it with a critical lens. So a OT, A is emphasizing that we use critical judgment and protection and disclose when AI has been used when necessary. So overall, AI is an optimal tool to use if you conduct critical judgment and reasoning after producing your outcomes. So whether that is, say you're you're wanting to do like a summary note from data for a child that you put in there to add into a progress report, and instead of just copy pasting, putting it into your report and sending it off after you've signed after you've signed it is looking at it, reviewing, making sure everything in there is truthful, making sure everything is grade level appropriate or age appropriate. It has the type of language that you want, that it's including occupational therapy language, and it matches whatever the goals may be on their their IEP.
Jayson Davies
Real quickly. Taylor, I know Chandler, just put into the chat that she's used Gemini at her last travel school placement. Just made sure not to put any personal information for the students into it. I had a question about this. A OT, a document that you're getting some information about AI, because I was unaware that there was really any a ot documents related to AI, and so I was looking at your citations, and it looks like you have something from it's a pre publication. Is that where this is coming from?
Dr. Taylor Poirier OTR/L
Yes, it's kind of like, from what I understand, it's like their version of, almost like a blog post, is where they're kind of having the conversations about it.
Jayson Davies
Okay, so I know obviously a OT, a doesn't update their code of ethics like every year, and I know they go through a large process to update it. So maybe this is a sign of what may be coming then in a future ethics, OT, ethics from a OT, a document. So cool.
Dr. Taylor Poirier OTR/L
Yeah, which is really exciting too, to know that they're evolving with the state of technology and evolving with the state of practice, with school based occupational therapy too. So, okay, so the decision making framework, I know I have come across some ethical dilemmas in my time after three years, and there's been opportunities or moments where I've kind of frozen in a. I'm sure, because I'm like, I know that there's going to be a better way to process this. I need, I know there's kind of some data missing. I'm not sure how to move forward. What really is the optimal outcome. And so this decision making framework is to promote confidence in everyone attending and those watching the replay, to start breaking down these situations, to uphold accurately, promote the justice and everything of that nature. So the three parts are to identify the question or problem at hand. Is any portion of the situation illegal? Does any portion of this harm those involved? Does any part of this go against district or school policy? Once you've identified that clearly you're going to start collecting the facts, you need to collect what is relevant to the situation. What is the objective truth from whoever is in involved in that situation? If there's any additional input making sure that it is objective? Is there too much unknown about the situation? Is it more of kind of a here? He Said, She Said, what's this is what I think is happening, is there not enough information to make a true clinical ethical judgment based off of that. You're either kind of elect more, or you can kind of narrow it down from there. The last step is evaluating alternative action. What are, what is the best step forward that's going to uphold the rights of those at stake, what's going to provide the most optimal outcome for the student or for those involved, and how can you ensure your own professional integrity? With that being said, there is something to be said for being informed, and that making decisions with confidence will always support your professional integrity in these situations, being informed whether that is through courses like this that you do, staying up to date in your own state district and our a, OT, a laws, guidelines, policies, being aware of what ethical dilemmas are facing our society at this time are. We're always evolving so being ensured that we are having an evolving lens of this too and how to apply the six codes of ethics to that. And when you make it with confidence, there's no second guessing of what you did was correct, what you did was important for that child. And something else to remember is that with ethical dilemmas, there may be a side of it that someone does not, quote, unquote, win when it comes to identifying what is best for the student. If that means there's going to be a little bit more education that needs to go into XYZ party, then that's the step that we take. If that means that the student is, you know, the parent is, is not fully on board, or whatever that means, to help educate the rights that are at stake, to educate, the access to the education that they need, and everything in that manner, making decisions with confidence, will always support your professional integrity in those moments. So we've, you know, defined what ethics is. We've gone over what a ot a what the six are. We've looked at the common areas where this happens. We've gone over our decision making framework. Now, how do we apply all of these things and push it out into the world and into our daily practice? That is through Advocacy and Communication. Advocacy is part of the fidelity and justice of this. If we educate or advocate for our student to be involved in a process, if we advocate for them to in IEP meetings, if we advocate for them on even a larger scale, we're able to put forth our reputation of our field, we're able to push forward our values and also uphold their optimal outcomes so that they can grow up being successful and confident. This also promotes fair caseloads and workloads. If you guys haven't already taken advantage of the workload caseload tool that we have available at the OT school house, you should this is a great way to gather data, to promote to your higher ups in order to reduce maybe those, those case loads that may not be unethical at the time, but are unmanageable, therefore they the students. Services are not written appropriately. That service are needing to to be altered, providing that data is always the best way to advocate and communicate for change, and that plays into access to OT services as well. Is, what is? What is our realm of OT? What is it that we're capable of doing? What is it that this population is needing? What is this? What are these classrooms? You know, what do they need to be more successful again, Advocacy and Communication is the best way to do that. And if we you know on the little communication that we may have in passing with teachers or with staff or even with parents, if we can start even on that micro level with them, advocating for the skills that we're addressing for the. The capabilities of their students, no matter what diagnosis or classroom style, anything that they're a part of. Same with educators, if we can educate teachers like, Hey, I know you're talking about sensory for XYZ thing, but this is why, this is it promotes their well being. This is how it helps them. This is what you can do classroom why to help the overall involvement and functionality, and something that we may not think of on the forefront a whole lot is ethics on a macro level with policy change. So we can start by, you know, in our schools, but let's look at our local levels. There are town hall meetings that we can be a part of where they're addressing, maybe special resources, maybe different companies, things of that nature, to help give some insight to those that may have a microscopic view of what the neurodiverse community looks like. And then even at the state level, if they are creating these policies or making cuts or anything of that nature, they may not have the full picture, because that's not their realm. They don't they're not as educated. They don't have the background, they don't have the task analysis, breakdown ability that we have. And so going in and educating, providing the data, what is our what is research showing from a OT, a what is the journal of OT saying, what are, what are the trends that we're seeing? What can we promote to them? What can we advocate and communicate for ethical changes in our states and then at the national level as well? And like we had mentioned kind of all throughout, that is the data collection is key from true, objective information that clear communication of the needs and trying to fill it, and also the collaboration OT is a fairly small realm, and so someone may know someone who went to school with this person, and the connections and the networking is so impactful that when you put me just more than one brain together, the opportunities are endless, and the advocacy and the change that can be made really goes a long way. So with all of that being said, we're going to jump into the kind of the case study portion of this, so those that are close to their phone and are able there will be an ABCD option that I'd love for you to post in the chat, so we can kind of get a consensus and then talk about it. All right, so case study number one, you're in OT obviously everyone in an IEP meeting for Mateo, a six year old student with motor coordination difficulties. Mateo's parents primarily speak Spanish, but the meeting begins without an interpreter present. The administrator suggests that you keep it simple proceed with the meeting to save time, the parents are nodding, but appear hesitant and ask very few questions. So the question at hand, what is the most ethical and legally compliant action in this situation? Answer choices is a, continue the meeting, simplified English, some visual aids. B's request to pause and reschedule the meeting until a qualified interpreter is available. C, have bilingual staff member who's not trained quickly summarize key points, or D, complete the meeting as plans, but send home a translated summary for parents to read. So what I'd like to do is kind of use that framework, and again, I can't see the chat box, but using that framework identifying the problem is that we have that English is not their native language, it's not their first language, and so we're conducting a meeting where they are not able to communicate clearly. They're not able to ask questions for clarification, nor are we able to be receptive to any information that they're sharing. So what do we do next? Well, what are the options? What can we do? Can we do? Can we reschedule someone needs to be present so that we can, you know, be have the true information. So do we have a common answer in the box? Jayson, oh, you're muted.
Jayson Davies
Yep. That helps when I hit the hit the button, yeah. So we got Holly in, and I'm not sure who iPhone is yet, but I think I might know it is and live all saying B request a pause and reschedule the meeting until a qualified interpreter is available. Yeah, I think that's the accurate answer, right? Yep. Now I'm interested to see if that's actually the answer that that most IEPs actually go with, even when we're present, because I know firsthand that that is not always the case.
Dr. Taylor Poirier OTR/L
Right, and that's when that advocacy and the communication piece and being aware that it's not what's best for everybody else to save time, but what is the ethical option so that all parties are understanding and are able to converse appropriately for that child, an idea actually states that information should be provided in the native language to ensure meaningful participation, so upholding our national laws there.
Jayson Davies
Yeah, and Liv in the chat just said she's seen C a lot. We're having a bilingual staff member who's not trained come in and quickly summarize key points. And yep, I have seen that one quite. Often as well. I've had a come up as well, right where we just try to see it simplified. Haven't had D but I'm interested now, because just recently, Apple released their new air pods that can translate in real time. So I'm interested to see what role technology can play in some of this to help out. So, yeah, yeah, absolutely. Chandler says C was done a lot too, bringing in a bilingual staff member, yep, and, but I will say this too. From the flip side, my wife being an administrator in a school she like doesn't like this either, because she is now losing a staff member who is supposed to be helping out, whether it's in a classroom or in the office and whatnot. So Liv brings up the question, you know, how would we approach this with administration? Sounds to me, sound to me, admin and just want to save money. I voiced that I'm not legal. Yeah, and I, I'll let you respond.
Dr. Taylor Poirier OTR/L
Taylor, yeah, I think with administration, because they do see it as like time on the clock, like money is, you know, my time is precious, where the money that it may be spent to kind of have relocated subs, all of those things in those times for meetings, but at the end of the day, we, we don't want to be liable for a lack of information, and parents to agree to something that they're not understanding, because there's already that language barrier in like that OT, in the OT language and common, common language that are used in IEP meetings. So to to just move through the motions, we're also not getting insight from the parent. We're not gaining we're not gaining a reciprocal conversation to identify what's best for that child. And so at the end of the day, that's when you you educate that, okay, these are, this is what my governing national organization, states are within my ability, and therefore I'm going to uphold the ethical importance for the child that I serve, and that doesn't have that I'm not promoting the justice or the fair access to information by, you know, going with anything but the correct answer here. And like I said earlier this, these are moments that are going to be tough conversations, because one party may feel, well, I don't have the time, but at the end of the day, our roles, and everyone's roles, really, in the IEP meeting or related situations, is to progress that child forward and identify the best needs for accessing their education or accessing their individualized education programs.
Jayson Davies
Yeah, and I'll just add too I feel like, Oops, that's not what I meant to do. Teachers have ethical guidelines as well, and I don't know them. I've got the California Teachers Association guidelines up on my screen. I was trying to look at them really quickly. But teachers have guidelines. Administrators have guidelines. Speech and language pathologists have guidelines. And I think a lot of times, we're all sitting in the meeting and we know that b is the right answer, but we're also thinking about our schedule, and we're thinking about how many, you know, we have six people that we had to coordinate to get to this IEP, and no one wants to reschedule. And I get that. But a lot of times when this comes up, from what I've seen is that people are almost waiting for someone to speak up and say, Let's reschedule. And unless someone does, once one person speaks up, everyone kind of goes with it, like, Yeah, that's probably the best idea. Let's reschedule, la, de da, de da, but if no one speaks up, that's when you end up going with C and it's just easier in the moment to find someone else than it is to think about the craziness that is to reschedule. But it only takes one person, I guess. What I'm trying to say is only really takes one person to speak up. And to be honest, every single person there again. I don't have the SLP ethics guidelines, but they probably have something similar. And it just takes one of us to speak up and say something.
Dr. Taylor Poirier OTR/L
Yeah. And it goes into also being informed enough to have the confidence in or in order to make that, you know, maybe controversial statement or non preferred statement in those moments.
Jayson Davies
yeah. And then I mean, sorry, really quickly, is after the fact, right? Then I would have a real conversation with the admin and be like, hey, after, you know, have a successful reschedule. Maybe, like, Hey, I just wanted to check in. Like, do we have any policy about this, or is there something? Because it's one thing you know, when you speak to your national organization. Sometimes that sounds like a little pompous, but if you can speak directly to the district policy or the school's policy, that's even better. But most of us don't know our district or school policy, so we can figure out if our school has a policy, we can put that in place and then maybe advocate for there's so a lot of districts will use, like a telephone, like there's a contracted agency that you can just call in and they'll translate in the moment. And so districts and set something up like that. So yeah, yeah.
Dr. Taylor Poirier OTR/L
Or maybe in order to find if your district has those policies, is, you can use AI to summarize. OTs and I didn't ask the question, yeah, exactly.
Jayson Davies
Pretty darn good now, so.
Dr. Taylor Poirier OTR/L
Yeah, awesome. All right, we'll move on to our.
Jayson Davies
Liv hopefully that helped a little bit. Let us know if you have any follow ups.
Dr. Taylor Poirier OTR/L
Yeah, that was a great question. A great insight, too. All right. Case study number two, Jonah is a fourth grader with an ASD diagnosis. Teacher. Teachers report he often rocks in his chair, hums quietly during independent work and avoids eye contact when spoken to. These behaviors do not disrupt his learning or others in the class, but some staff express concern about social appropriateness. In your assessment, you find Jonah is completing grade level work, using self regulation strategies effectively and participating in group activities when given written instruction and predictable transitions, Jonah says, rocking and humming make him feel calm and focused. What is the most ethical approach? Is it a encourage him to stop rocking and humming, because social norms should take priority over his self regulation. B, document the teacher's concerns and focus interventions on modifying Jonah's behaviors to appear more socially appropriate, even if this increases his stress. C, support Jonah's regulation strategies while educating staff about neuro diversity and the importance of respecting behaviors that are functional or D, ignoring the teachers entirely in focus, only on academic performance, without addressing social or behavioral expectations.
Jayson Davies
So we've got a C in the chat from Holly, and I think C is my response Chandler's response to is C. And yeah, we can have a discussion, because this is a really multifaceted one, and I like to have conversations about this one.
Dr. Taylor Poirier OTR/L
So C is, C is our, our answer, supporting functional self regulation strategies, respects Jonah's autonomy and aligns with ethical principles of beneficence and non non Maleficent feel like I always have a hard time saying that word. And also promotes inclusion, educating staff about neurodiversity helps balance classroom expectations and student centered practices, options A and B, kind of you know, risk harm by suppressing the functional coping strategies may impact the self esteem, the confidence because he was doing so well at school. So then to know what he what tool was being used, decreased his functionality in the room. Can you obviously have mental and emotional impacts. And then D also neglects the the collaborative nature of school based practice. So while we may not agree with the teachers insight or comments, that doesn't mean we should eliminate the opportunity for education and alternative collaboration.
Jayson Davies
Yeah, so I want to kind of go on this one and go a little bit further, because there's two different scenarios where it's similar, but but it changes it up completely. One is when you have parents from the classroom coming in and saying their child is unable to learn because a peer is humming and rocking. And I think that complicates this even more. And yeah, I just opening up a conversation about that a little bit, because every student has the right to learn, and how do we say, well, this kid needs that, that kid needs that. And sometimes they conflict a little bit. This kid needs quiet, but this kid needs the ability to to hum and rock potentially. And I think that opens up some tough conversations. And I, personally, I think the only real answer is to just sit down as an IEP team, or as a grade level team, as a school team, and, you know, problem solve. But yeah, just interested maybe in your thoughts. Taylor.
Dr. Taylor Poirier OTR/L
Yeah, no, I absolutely agree. I also think it opens the door for kind of education to the rest of the class too, not specifically on what that student specifically is doing, but the overarching, you know, action, which is self soothing techniques, coping strategies. Do these other children have strategies if they're suddenly becoming very distracted by what this child's doing? Do they not have a set of their own? Do they not know how to innately find those strategies while they're working in the classroom? Can there be education on the these are things that we can do to help all of our bodies and our brains stay focused to learn. And part of that to them would go back to the IEP meeting and collaborate like if that is not an option or it is a it doesn't produce a different outcome from anyone, whether the student that we're talking about here, Jonah, or the alternative students whose parents are now coming in with potential complaints. What are the actual options for these How much is it impacting the classroom? What are the can any observations be done? Maybe during specific times? Where works getting completed, where maybe those complaints have been coming from, because at the end of the day, you're right. Every student has, you know, the right to to learn and access their education within the rooms. But at the same time, some of those things can be due to not potential, not necessarily ignorance. That's not the right word I would like to use, but the just the lack of awareness of what others may also need to feel successful.
Jayson Davies
Yeah. And then I think the other question that this begs a little bit is, when that type of question about, you know, I want you to work on social appropriateness, comes from a parent, because that is, then, yes, we're thinking about the child, but the parent is, to a degree, part of the child, in this case, right? Like they are part of the client, per se. And yeah, any thoughts you might have, if we're getting a lot of push from a from a parent or from an advocate that, hey, we really want to work on our student not humming while he's doing work. Have you ever had to address the head or any recommendations?
Dr. Taylor Poirier OTR/L
Yeah, so I am actually going through that right now. I have a parent to the languages I want my son trained to engage in a public classroom with no support. Stage two, autistic boy and joyful as can be. He, you know, needing a lot of prompting and things like that. And what the language is looking like with mom right now is I the word training. I said, Okay, what does that mean to you? What does that mean in your own cultural context? What does that mean for you and dad? What does that look like in your home versus school? Because the school environment he's in now is going to look different, if you would love for him to be transferred into a public school setting and thinking helping them understand kind of to this child may not always be a this child is not going to always be a third grader or look like eventually he will grow up and be an 18 year old, you know, young adult and a 30 year old man and The skills that are trained and for a classroom context don't always benefit them in the long run. So trying to really find that middle ground to where you're being respectful of their wishes, but also helping them understand our our knowledge and our context and our understanding of the realm of neurodiversity and what that looks like across the lifespan that's been helpful. We're still in the early stages, but that's been a process that's been helpful thus far, right? Case study number three, you're currently managing a 30 student caseload. Your district recently introduced an AI powered platform that suggests intervention activities and generates progress notes, the AI recommendation seem efficient, but you notice that some suggested strategies may not be developmentally appropriate for certain students. Administrators encourage you to use the AI outputs to save time and meet documentation deadlines. How should you ethically utilize the new AI platform? A critically evaluate the suggestions, use them as a starting point, if appropriate, and ensure all intervention planning and documentation reflects your personal judgment, while maintaining transparency with your team. B, follow the AI generated recommendations exactly as written to same time and meet. Documentation, expectations, meet. Doc, yeah. Documentation, expectations C, ignore the AI tool entirely and continue documenting, manually, avoiding any integration of technology. D, delegate the AI generated recommendations to support staff without reviewing them to streamline productivity.
Jayson Davies
We got some A's in the chat.
Dr. Taylor Poirier OTR/L
Wonderful, everybody. It's answer a so I feel like we have it written like out like this. It seems very apparent, but I feel like in the moment, while you're trying to rush and do things, it can feel maybe that something might get missed. So just really having that clinical judgment always tapped in, really, yeah, do you have any Jayson with all of your AI experience and knowledge and research? Do you have anything specifically on this portion?
Jayson Davies
I mean, I haven't heard of a program that's doing that. I mean, I know we have our goal generator, right, that will spit out some interventions and whatnot, but, I mean, we're very careful to put at the end of each goal right, like that. This is AI generated, and at the end of the day it's it's you that should be debating whether or not these interventions are appropriate for for your student. I can see districts as a lot of I don't know of any one particular district, but we are seeing this within the workforce in general, right? Like the use of AI should save everybody time, therefore, when you should need less employers. But if you're not to this part yet, I would want to say school based ot practitioner, we need to make sure that we're getting on whatever team is considering AI if we're being pushed to do AI. And I think I would kind of do the same thing with a I would push back, I in a very respectful way. I would push back, and if I had to, I would pull evidence from wherever I could to show that to my administrators. I would walk through maybe a case study with my administrator to show them my reasoning for why I disagree with the AI bot, yeah, and just kind of let them know one thing that I was going to bring up, I think was on case study one and but it applies to all three, is that it if we don't bring things up, it's really kind of on us, but if we bring up our concerns to our administrators, we're letting them share the not the blame, but we're letting them share this common experience with us, that it is awkward, that it is unethical, that we do have to be mindful of a OT, a ethics code and NBC, OT, and they probably have to be mindful of their ethics codes whether or not they're thinking about it in the moment. So even if it's even if you don't necessarily do the right thing in the moment, it's okay to come back later and say, You know what, I think I messed up here. I should have done something a little bit differently. I want to talk to my administrator. About it.
Dr. Taylor Poirier OTR/L
Yeah, absolutely. And that goes back into making the informed decision, but also then the obligation that if you realize that that wasn't the most optimal choice, and now you're realizing full circle what could have been done, that is your obligation to then go and share that and have that conversation and advocacy component for sure. All right, our last case study. All right, you're a school based occupational therapist working with Jordan, a 13 year old student with autism and social emotional challenges Jordan shares privately with you that appear in their class has been teasing and bullying them online. Jordan specifically asked that you do not tell anyone as they fear retaliation at the same time you notice that the bullying may also involve other students and could escalate. The school has anti bullying policies and administrators often expect staff to report incidences that could affect the student's safety or the school climate. What is the optimal action to maintain ethical practice? Is it a keep Jordan's disclosure entirely confidential, respecting their request and trusting them to handle the situation themselves? Report the bullying immediately to administrators and parents without consulting Jordan to ensure strict adherence to school policy. See, discuss with Jordan the importance of safety and school policy, collaborate on a plan for reporting and disclose only information to relevant school personnel while minimizing risk of retaliation or D, ignore the disclosure, focusing only on Jordan's ot goals and do not involve the school or parent.
Jayson Davies
I'm going to give a collective C, C says and C has says, OT, and by the way, thanks for joining us and and was iPhone got it now. Thanks for changing your name. Yeah. So C, yep.
Dr. Taylor Poirier OTR/L
So this scenario really highlights ethical tension between confidentiality, student autonomy and the duty to protect them. C really balances the respect for Jordan's privacy and autonomy with the legal with the ethical and legal responsibility to prevent that harm and the harm of others, and involves the collaboration with problem solving, partial disclosure and transparency, where a, you know, risks harm by ignoring the overall danger for Jordan and others. B, could damage that trust, escalate anxiety, and then again, doing harm to our student and D, just overall, neglects both ethical responsibility and the school policy.
Jayson Davies
I think the especially, the key in the key words, in my opinion, in letter C, is that only necessary information is being shared like we and working with, working with Jordan a little bit, letting him know, you know, yes, I need to tell people, but I'm going to limit your exposure as much as I can. I'm only going to share what's what's relevant and important. And, you know, eventually we might have to disclose that it's you, but yeah, relevant information?
Dr. Taylor Poirier OTR/L
Yeah, absolutely. And it maintains that rapport established with that child, especially at 13, that's such a core age where there's so many more things at play other than just their school challenges. There's that social component. There's as their bodies are changing, as their their roles are shifting as they're getting older as well. So having someone that they feel safe and comfortable with, that knows supports them, especially in the school setting, is really important. So that C really encompasses maintaining all of that. All right, so an overview of everything that we've discussed tonight. Truly, it is our obligation to the students to best serve them and their goals through an ethical lens while also advocating and communicating effectively on those it's our job to be aware of ethical decision frameworks very like. The one that we learned tonight to instill confidence informed decision making and overall professional integrity. It's our job to stay up to date on any changing practices, to maintain ethical literacy. And lastly, Advocacy and Communication Always will best serve our populations for optimal success. So as Jayson and I kind of had stated earlier, is that if we don't say it, no one else may say it. So if we are the ones to to step in, it's really our, our best way to to serve them. So if you've kind of, if you've either been a part of this course tonight, or you're watching the replay, and you're like, This is all awesome, but where do I, where do I start to understand these guidelines? Where are these policies coming into play? Where do I? Where do I find this information? The best places to go is look at a ot a website. They have guidelines for the school and EI services. It's always great to go back and reference our practice framework. When we're looking at everything that our job is and what we value. It's really great to reference that and how it applies idea section 504, of Rehabilitation Act, those are all great places just to review and what they encompass, so that we can continue making ethical decision frameworks, and then also looking into your state organizations and your district organizations. What are those policies looking like? What do you need to be aware of? And if someone else in these meetings or situations are not aware. How can you make yourself aware? And those are all great places to start. So that concludes the the end of the presentation. Again, I am the OT School House meeting manager, if I if you haven't already learned, but I'd love to connect further. That is my email, whether that's questions about this, questions about the collaborative or wanting to just connect in general, I'd love to, you know, do that further with everybody, because, again, networking is the best way to get big ideas and push change. So thank you so much for everyone who joined. Anne was watching the replay.
Jayson Davies
All right. Thank you so much for joining us for this ethical journey with Dr Taylor Poirier. If you found this content helpful and want to access the slides, the resources and more content, just like this, I invite you to join us inside the OT school house collaborative. As I mentioned earlier, this episode was actually recorded as part of our live professional development series that happens every month within the collaborative, and we would love to have you join us there as a member, you'll not only get access to this course as well as the certificate of completion since you just took the course, but you'll also get access to over 30 other live and on demand, a OT, a approved courses, our growing resource library, the OT, school, house, goal and treatment Bank and other live mentorship opportunities with myself and others, where we can discuss ethical dilemmas like this one and so much more. School Based ot can be isolating, but it doesn't have to be. Join our community of like minded school based ot practitioners at ot schoolhouse.com/collab we'd love to have you there. Thanks so much for listening to this episode of the OT school house podcast. I'll see you next time, as we continue to improve school based ot practice all together.
Amazing Narrator
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