Why I am not writing entries for a while.



...because street-level occupational therapists sometimes need a break.

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Reflecting on the AOTA Code of Ethics: A 2025 Crossroads

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In light of the proposed 2025 revisions to the AOTA Code of Ethics, I feel compelled to respond—not just as a practitioner and educator, but as someone who has been observing and writing about the profession’s ethical evolution for over a decade. This post reflects on concerns raised in the new draft and situates them in a broader historical context drawn from earlier critiques I published in 2011, 2013, 2014, and 2015. When Ethics Become Ideology The proposed 2025 Code of Ethics contains well-meaning language that reflects cultural currents around equity, inclusion, and advocacy. However, the revised document appears to shift the Code away from its core purpose—guiding ethical behavior—and toward promoting a specific ideological framework. It contains language and assumptions that may unintentionally alienate practitioners, obscure clarity in enforcement, and conflate professional conduct with political conformity. A Critical Logic Problem The most serious concern is the...
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On retained primitive reflexes

Each year I receive several emails from colleagues about 'retained primitive reflexes.'  I am also seeing an increased number of reports from local 'health care' providers who are documenting these alleged problems so I thought I would write a summary of my opinion on this topic.   Predatory 'health care' providers including some OTs, PTs, chiropractors, and behavioral optometrists are creating a new 'market' for treating this alleged 'problem.'  Parents should be very wary of these practitioners and other professionals should challenge these practices whenever they are seen. The following is the kind of information that causes concern and was provided to me by a colleague as a sample from a student's IEP: The student continues to demonstrate the following retained primitive reflexes that at times interfere with his ability to demonstrate appropriate adaptive responses: Fear Paralysis Reflex, Moro Reflex, Palmer Reflex, Tonic Labyri...
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The Ant Mill of Occupational Therapy: A Profession Trapped in Its Own Spiral

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Being in program development mode has given me both the time and headspace to think more deeply about some of the broader dynamics shaping our profession. The release of AOTA’s newly published Vision Statement and the proposed changes to the Code of Ethics have provided a catalyst for deeper reflection. Ethics in occupational therapy can feel distant or overly academic—something shaped by committees and frameworks rather than day-to-day practice. I’m someone who has worn both hats—a street-level OT who’s spent too much time in academia—and that gives me a particular vantage point for reflecting on where we’ve been and where we might be headed. I’m writing this for the lunch-bucket practitioners out there—the ones grounded in clinical realities—who have sensed that something in our professional dialogue feels increasingly unfamiliar or prescribed. But I think we need to bring these conversations down to earth. We need to pull chairs into a circle, metaphorically speaking, and talk thr...
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