On Ideological Shifts in Occupational Therapy Education: Reflections on DEI and the Presidential Executive Order

The Accreditation Council for Occupational Therapy Education (ACOTE) Standards have evolved over time, with the 2023 updates reflecting a continuation of a broader ideological trend in the profession. Specifically, these updates prioritize Diversity, Equity, and Inclusion (DEI) in ways that raise fundamental questions about the balance between professional accreditation requirements and academic freedom. 

The 2018 Standards recognized diversity as an important foundation for occupational therapy education. While encouraging awareness of diversity issues, these standards avoided prescribing specific ideological frameworks. This approach respected the autonomy of educational institutions, allowing them to incorporate diversity as they deemed appropriate while maintaining space for academic freedom and intellectual diversity.

In contrast, the 2023 Standards explicitly embed DEI principles, including equity and justice, as requirements for occupational therapy programs. Faculty are now tasked with demonstrating knowledge of these principles in curriculum design, teaching practices, and student advisement. This shift transforms what was once a suggestion into a mandate, compelling programs and faculty members to adhere to a specific worldview. I view this as a back-door methodology of promoting ideology under the guise of professional preparation - I consider it insidious and a threat to academic freedom.

This approach raises significant concerns. Mandating adherence to DEI frameworks risks undermining intellectual diversity, replacing open inquiry with a single ideological perspective. Occupational therapy is built on principles of critical thinking and individual autonomy—values that may be compromised when faculty and students are required to align with prescribed ideologies.

The recent Executive Order dismantling DEI offices critiques such initiatives as ideologically driven and inconsistent with principles of merit-based governance. ACOTE operates as a recognized accreditor under the US Department of Education (USDE) - meaning that it has to meet certain federal standards  and submit reports to maintain this recognition.

Given this relationship, it is unclear if ACOTE is accountable to USDE for the new order, or to to what degree it needs to curb ideological mandates. I believe that ACOTE would argue that these are professional requirements that fall outside of an executive order; however, I believe this is a flimsy argument in that the DEI requirements have taken on such specificity only in recent years.

Did the occupational therapy profession really change that much between these two sets of standards?

Still, ACOTE has to preserve its autonomy - most probably agree with that. But doesn't that sense of autonomy also extend to the institutions it accredits related to academic freedom? How can ACOTE argue for autonomy when it is requiring ideological conformity from its accredited programs? That is an intellectually inconsistent stance.

For me, the larger question is this: does embedded ideological conformity around DEI enhance the occupational therapy profession as a science-driven and patient-centered profession?  Or does it just push a specific worldview and agenda?

I believe that occupational therapy education should prioritize intellectual diversity over ideological conformity. Open discourse, critical thinking, and evidence-based practices are the bedrock of professional excellence. DEI, while valuable in certain contexts, should be an optional component of curriculum development—one that programs can adapt to their unique missions and goals rather than a blanket requirement.

Moreover, occupational therapy should remain focused on its primary goal: helping people to live meaningful and independent lives. Mandates that impose specific ideological frameworks risk diverting attention from this mission and eroding trust in the profession’s commitment to objectivity and scientific rigor. Ideological mandates violate the social compact that the profession has with the public and they are an affront to the more core principle of academic freedom.

Respecting academic freedom, fostering intellectual diversity, and maintaining a focus on evidence-based practice will preserve the integrity and credibility of the profession. The new executive order provides a useful opportunity for OT academics and their accreditors to reconsider the value it thought it would gain by mandating the DEI ideology.


Comments

Post a Comment

Popular posts from this blog

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...
Read more

Deconstructing the myth of clothing sensitivity as a 'sensory processing disorder'

Please note first that there is no formally recognized clinical designation of  'sensory processing disorder.'   It is a term constructed by occupational therapists that has not been formally recognized by the larger medical community. In our clinic we receive many referrals from local pediatricians when parents have concerns about children being overly sensitive to their clothing.  Most often the children referred are from four to seven years old and the families are severely disrupted by the children's behaviors and responses to clothing issues.  Commonly, children will have severely constricted tolerance for certain outfits, want to wear the same clothes repeatedly, complain that clothing is itchy/scratch/bumpy/wiggly/ouchie, and this all leads to disruption of daily dressing routines.  There is no doubt that the behavioral concerns are very real. The pediatricians tend to be appropriately conservative and provide families with good behavioral manage...
Read more

Occupational therapy education: How to navigate in a Perfect Storm

Image
Please click on and read all of the links - they include critical information that is required for this analysis.   A little over four years ago I stated that there are too many occupational therapy educational programs in New York State .  At the NYSOTA conference legislative information session in 2023 I stood up and suggested that we should all stop taking jobs at these institutions that were seeking to develop new programs.  I thought that if we did not take those jobs that the problem would be solved.  That was not realistic or correct, even if the intention was good. Well karma tends to strike when you make public pronouncements, so I thought I should expand on my perspectives on this topic. At current count there are still ~22 occupational therapy programs and ~11 occupational therapy assistant programs in NY.  Most of the programs are delivered at the master's level.  There are a very small number of entry level doctoral programs, but some of t...
Read more