Abstract
Purpose School is a primary setting for pediatric occupational therapy practice, yet little is known about the provision of school-based occupational therapy in many countries internationally. The purpose of this study was to explore current school-based occupational therapy practice for the first time in Ireland to gain insight into current and potential service provision and to identify new directions and potential pathways for development. Methods This descriptive quantitative study utilized a cross-sectional online survey to gain the perspectives of the population of pediatric occupational therapists working regularly in schools across Ireland. Respondents were recruited through convenience and snowball sampling. Data were analysed through qualitative content analysis and descriptive statistics. Results The survey elicited 35 responses, yielding a 21.2% estimated response rate. Findings demonstrated that respondents provided therapy services in schools most commonly on a weekly (28.6%) or monthly (34.3%) basis, with only 5.0% working in the same school on a weekly or fortnightly basis. The majority of respondents (54.3%) used a direct therapy approach with a child, rather than coaching or modelling, to primarily address sensory, hand function, or daily living needs. None used a whole class or whole school (universal or tiered) approach. While respondents (54.3%) generally viewed collaborative practice as a strength of school-based practice, they also identified barriers to collaboration in schools. A core barrier is related to how services are constructed across health and education, with differing philosophies of service provision. The majority of respondents (75.0%) reported that they had not received any training to deliver evidence-based practice in therapy provision specific to school-based practice. Implications for Practice. This study indicates that therapists require continual education on evidence-based school practice as it applies in an Irish context. Furthermore, clarification of school therapy roles and service delivery models are required in order to determine how they contrast with traditional clinic roles. This will enable therapists to strengthen the coordination of service delivery between health and educational services to maximize the outcomes of school-based practice.
Highlights
School-based occupational therapy (SBOT) is an area of increasing international attention reflected by the first publication on this topic by the World Federation of Occupational Therapy (WFOT) in 2016
This research is aimed at contributing to the knowledge gap surrounding SBOT practice in Ireland by exploring the question: what is school-based occupational therapy according to pediatric occupational therapists working in schools in Ireland? The aims of the study were to describe current pediatric occupational therapy service delivery and practices in SBOT and to investigate and explore their knowledge and utilization of evidence-based practice in SBOT
Respondents mainly worked in settings specific to Autism Spectrum Disorder (ASD) and Developmental Coordination Disorder (DCD) (n = 24, 68.6%)
Summary
School-based occupational therapy (SBOT) is an area of increasing international attention reflected by the first publication on this topic by the World Federation of Occupational Therapy (WFOT) in 2016. Therapists are guided to do this by identifying students’ strengths and resources to find solutions and in turn limit or remove challenges in learning. This expands on the American Occupational Therapy Association’s (AOTA) guidance on SBOT practice, which emphasizes the use of expertise to enable children to prepare for and engage in significant learning and developmental activities within the school environment [2]. To date, while it is apparent that occupational therapists have a role to play in schools, there is limited evidence as yet on how this occurs in relation to wellbeing and the tools and Occupational Therapy International intervention approaches utilized that enable participation [5]
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