School-based Practice Research Articles

Development of student goals in school-based practice: physical therapists’ experiences and perceptions

Purpose: Development of individualized student goals is integral to special education. Although United States federal legislation and state, local, and professional guidelines outline preferred goal development processes, actual practice does not always reflect ideal practice. The purposes of this research were to understand how physical therapists develop student goals and to identify facilitators and barriers to development of participation-based goals.Methods: Twenty school-based physical therapists participated in one of five semi-structured focus groups. Two researchers conducted thematic analysis of transcriptions of audio recordings to identify qualitative themes; a third researcher reviewed the analysis.Results: Five themes emerged related to therapists’ recommendations for goal development: (1) Understand the student: The foundation for individualized goal development, (2) Teaming: The critical component to integrate varied perceptions and establish a common vision, (3) Relevant focus of goal: Addressing what is meaningful for a student’s day, (4) Best practices: Embracing professional advances, and (5) Develop and write the goal: The art and science of writing goals. The first four themes also reflected facilitators and barriers to development of participation-based goals.Conclusions: Therapists’ comments reflected striving to follow ideal practice recommendations despite identified challenges. This research helps educational teams understand and reflect on goal development processes.Implications for rehabilitationAlthough writing goals is a foundational task in school-based practice, meaningful goal development is a complex process.School-based physical therapists recommend working closely with students, parents, teachers, and other members of the educational team to establish good communication, trust, and a shared philosophy of collaboration and responsibility for student goalsA thorough understanding of the student serves as the foundation for developing individualized student goals.Educational teams are encouraged to understand professional, federal, state, and local guidelines and embrace professional advances in goal development practices.

Building Resilience and Minimizing Burnout in School-Based Practice

ABSTRACTSchool-based practitioners are at risk of burnout given the complexity of the practice environment and the demands of the workload. This article reviews the concepts of burnout and resilience and applies them to school-based practice. It considers a tiered public health perspective for exploring strategies to foster resilience and manage burnout in school-based practice.

An Empirical Approach to Complete Mental Health Classification in Adolescents.

Using latent profile analysis (LPA), this study empirically identified dual-factor mental health subtypes, with a goal of examining structural stability of emerging latent classes over three high school years. Profiles' relations with distal indicators of well-being, psychosocial distress, and self-reported grades were examined to explore the validity of emerging classes. A sample of 332 high school students reported on their social-emotional strengths and psychological distress during the fall term of their ninth-, tenth-, and eleventh-grade years. In Grade 12, students reported on measures assessing their grades and social-emotional experiences. Independent LPAs for each grade year yielded four mental health subtypes - complete mental health, moderately mentally healthy, symptomatic but content, and troubled - and provided evidence for the structural stability of the dual-factor mental health construct. Across high school years, most students were in the complete or moderately mentally healthy classes, with the troubled class consistently representing the smallest proportion of the sample. Students in classes with higher levels of strengths and lower levels of distress reported higher grades, prosocial contribution to community, and higher life satisfaction, and fewer symptoms of anxiety and depression. Implications and future directions for research and school-based practice are discussed.

School-Based Physical Therapists’ Experiences and Perceptions of How Student Goals Influence Services and Outcomes

Aims: Individualized goals are the foundation for physical therapy services and outcomes. This research describes school-based physical therapists’ (PTs) experiences and perceptions of how student goals impact services and outcomes. Methods: Twenty school-based PTs participated in one of five semi-structured focus groups on goal development and use. Therapists were recruited from 113 therapists who participated in a study of school-based physical therapy outcomes. Two researchers conducted thematic analysis of written transcriptions of audio recordings to identify qualitative themes; a third researcher reviewed the analysis. Results: Four themes emerged related to how goals impact services: (1) the nature of services, (2) intervention strategies, (3) teaming, and (4) flexibility of services. Three themes emerged related to how goals impact outcomes: (1) natural linkages among goals, services, and outcomes; (2) goals impact teaming to achieve outcomes; and (3) specifics of the goal matter. Therapists also reported a range of student and environmental factors that impact services and outcomes. Conclusions: Therapists perceive that goals influence services and outcomes in complex ways, especially due to the flexibility and individualization needed in school-based practice. This study helps school-based PTs understand and reflect on how individualized goals influence services and optimize student outcomes.

Integrating School Psychology and Applied Behavior Analysis: a Proposed Training Model

It is critical that schools reduce maladaptive behaviors and increase prosocial behavior through the provision of high-quality evidence-based practices (EBP). School psychologists are uniquely positioned to facilitate the delivery of evidence-based applied behavior analytic EBPs, with regard to the foundational training they typically receive in the areas of assessment, intervention, and consultation. However, the lack of comprehensive behavioral training in school psychology graduate programs exposes an existing training gap. Given a substantial content overlap and the significant contributions ABA offers to school-based practice, school psychology training programs should consider providing a stronger behavior analytic component that will enable program graduates to obtain the Board Certified Behavior Analyst (BCBA) certificate and more effectively address behavioral needs in schools. This paper describes the rationale for integrating a BCBA track into school psychology programs and discusses practical considerations that may arise.

Effect of Animal-Assisted Activities on Children in a Behavioral Classroom: A Pilot Study

Abstract Date Presented 4/21/2018 This mixed methods study examined the effect of animal-assisted activities with a therapy dog on the behaviors of students in a behavioral classroom and perceptions of student and staff. Occupational therapy practitioners can use the findings to inform school-based practice. Primary Author and Speaker: Lou Jensen Additional Authors and Speakers: Amanda Verbrugge, Maxine Holmes, Emily Turner, Candice Palea, Tayte Koussa Contributing Authors: Brenda Coppard, Yongyue Qi

School-based occupational therapists’ service delivery decision-making: Perspectives on identity and roles

ABSTRACTThe purpose of this qualitative study was to explore the context of service delivery decision-making in school-based occupational therapy practice. Participants included 14 occupational therapists. The primary source of data came from semi-structured, open-ended interviews. Open inductive coding was used for in-vivo data analysis. Themes in the data revealed that decision-making is impacted by therapists’ professional identity and their conception of the role of occupational therapy in school settings. Therapists in this study relied mostly on traditional interventions that focused on skill development and was found to be the primary driver of decision-making about service delivery.

Sensory-based intervention in the schools: a survey of occupational therapy practitioners

ABSTRACTAim: The primary purpose of this study was to investigate the role of sensory-based intervention in school-based occupational therapy. The research questions are: 1. How do school-based occupational therapists (OTs) describe the role of sensory-based intervention (SBI) in an educational setting? 2. Which current practice trends influence sensory-based occupational therapy practice?Methods: Descriptive statistics were generated to summarize current school-based practice trends. Qualitative analysis resulted in the identification of categories related to school-based practice. Participants (N = 94) reported the positive impact of sensory-based interventions in the schools, the challenge of the school context, the value of both teacher and team collaboration, the limitations and challenges to parent collaboration, and the sensory resources within the school context.Results: Results indicate that school-based practitioners should focus on educational and social participation of the students.Conclusion: Outcomes indicate the primary means of improving student participation is via team education and advocacy.

The transformation of school-based sex education policy in the context of AIDS in Ireland

While AIDS was neither the initial nor the sole factor, it had a profound impact on the development of school-based sex education policy and practice in 1980s Ireland. Attempts to introduce a national programme of sex education on foot of increasing rates of crisis pregnancy pre-date the AIDS era, but these efforts had been vociferously opposed by conservative Catholic interests. The fear generated by AIDS prompted a shift in what political theorist, John Kingdon terms, the 'national mood' that⁠ coupled with the singular determination of then Minister for Education, Mary O’Rourke, who faced down intense opposition from conservative groups and the Catholic Bishops, created the conditions needed to introduce the AIDS Education Resource – a forerunner to the Relationships and Sexuality Education programme – in post-primary schools throughout Ireland in October 1990.

A Comparison of In-Vivo and Videoconference Momentary Time Sampling Observations of On-Task Behavior

Systematic direct observation (SDO) is frequently used in schools to document student response to evidence-based interventions, determine eligibility for special education services, and provide objective data during high-stakes decisions. However, there are several limitations associated with this widely used data collection tool including a shortage of service providers available to implement it and the significant travel time required for itinerant personnel. Using videoconferencing (VC) software to aid in the implementation of SDO is an intuitive application of technology that stands to increase the feasibility and efficiency with which SDO can be utilized in research and practice. The purpose of this study was to evaluate the reliability and equivalence of the results generated from two modes of SDO, traditional in-vivo SDO and SDO conducted through VC software. The results suggest that VC SDO produces estimates of student on-task behavior that are practically equivalent (i.e., ±3%) to estimates generated through traditional SDO. Furthermore, two frequently used reliability indices indicate that VC SDO results are adequately reliable against traditional in-vivo SDO. Implications for school-based practice are discussed.

Therapists’ perceptions of the 3:1 Service Delivery Model: A workload approach to school-based practice

ABSTRACTIn recognition of their many roles, school-based practitioners have been encouraged to reframe their job-related responsibilities in terms of their workload, rather than their caseload. The purpose of this phenomenological study was to explore school-based therapists’ perceptions of the 3:1 Service Delivery Model, which aligns with a workload approach, and to determine if practitioners felt that when using the Model, they were able to manage their workload responsibilities, more so than when using a traditional service delivery approach. Five occupational therapy practitioners and five speech-language pathologists, working in school-based practice, with experience utilizing the 3:1 Service Delivery Model, completed an online survey and a semi-structured interview to explore their perceptions of their use of the 3:1 Model in their practice. All the interviews were recorded and analyzed for recurring themes once the data was transcribed verbatim and coded. A thematic analysis revealed that practitioners felt the 3:1 Model supported their use of differentiated service delivery that was contextually based, expanded their scope of practice, increased work efficiency, and was heavily influenced by stakeholder support. Implications for practice included the need for transparency and consistent expectations when utilizing a workload approach, including determining how time is utilized outside of direct service delivery, and the need to advocate for manageable caseload numbers, allowing for service delivery that meets the individualized needs of students and stakeholders.

Revitalizing the OT role in school-based practice: Promoting success for all students

ABSTRACTWith the advancement of healthcare initiatives and legislative mandates, occupational therapists are facing the demand of providing health promotion and prevention services to a variety of populations — including students in public schools. In addition to these mandates, pioneers in the field of occupational therapy forecasted the importance of comprehensive health services for all individuals. Therapists in school-based practice have traditionally focused on a 1:1 service delivery model with a more impairment-based focus. However, school-based occupational therapists should expand their role to promote mental health of school-aged children and assist administrators in implementing response to intervention programs. These services are needed to ensure successful educational outcomes for special education students, as well as students in the general education population. To improve general health and well-being of all students, occupational therapists must move beyond a direct service model approach and explore alternate service delivery models. Occupational therapists are equipped with legislative support and encouragement from the profession to revitalize the role of school-based occupational therapy.

Toward Feasible Implementation Support: E-Mailed Prompts to Promote Teachers' Treatment Integrity

Although high levels of intervention implementation are more likely to lead to improved student outcomes, educators struggle to maintain high implementation levels over time. School psychologists might provide research-supported, consequence-oriented supports (e.g., performance feedback) to promote educators' implementation, yet these are reactive and potentially time intensive. This study evaluated whether a proactive, ­antecedent-oriented support (i.e., daily, preprogrammed e-mailed prompts) could effectively promote educators' implementation. Findings indicate that for 3 of 4 teachers who participated in this multiple baseline single case design study, implementation of the class-wide behavior intervention improved upon receiving e-mailed prompts. In addition, increases in praise, decreases in corrective statements, and corresponding improvements in student outcomes were noted. This initial study suggests that prompts may be a feasible and effective Tier 1 implementation support that can be incorporated by school psychologists to support educators responsible for delivering interventions in the classroom. Additional implications for future research and school-based practice are discussed.

Preparing occupational therapy students to address mental health promotion, prevention, and intervention in school-based practice

ABSTRACTDirectors of entry-level occupational therapy (OT) programs were surveyed regarding how their programs prepare students to become mental health practitioners in schools. Analysis of quantitative data included descriptive statistics to examine participants’ ratings of their program’s ability to prepare students for mental health practice. We found that OT education programs address the role of school-based occupational therapists but provide limited didactic and experiential learning opportunities relating to OT’s role in mental health promotion, prevention, and intervention in schools.

A Transdisciplinary Team Model for School-Based Sensorimotor Programming

Abstract Date Presented 3/31/2017 This qualitative research proposes a model for transdisciplinary team collaboration and sensorimotor program implementation in special education for adolescents with autism spectrum disorder, intellectual disabilities, or both. This new model will advance school-based occupational therapy practice. Primary Author and Speaker: Laura GreissHess Contributing Authors: Brooke Czuleger, Emily Garnica, Jessica Phung, Maciej Rzepka

Contemporary Issues in School-Based Practice for Students With Autism Spectrum Disorder

Contemporary Issues in School-Based Practice for Students With Autism Spectrum Disorder

Play in natural environments: A pilot study quantifying the behavior of children on playground equipment

ABSTRACTPlayground design is critical to school-based practice, insuring access and use for all children. The play behavior of children with special needs is qualitatively and quantitatively different than their typically developing peers. However, empirical data is needed to support the therapeutic value of playground equipment used with school-aged children. Thirty-two hours of videotape was collected from 140 children who were typically developing (male = 56%) and 41 children with a variety of developmental disabilities including autism, ADHD, sensory and regulatory disorders (male = 76%), ages 3 to 15 years. Six pieces of playground equipment were analyzed using a behavioral coding system for sensory features, social interaction, self-regulation, motor skills, and play levels. Content validity of the behavioral coding scheme was obtained through a case study. Proprioception was enhanced through active use of the playground equipment. Increased verbalizations and positive affect were observed across all pieces of equipment. Symbolic play, novel use and motor planning were fostered. Regaining regulation and expressions of self-esteem were quantifiable. Correlations support relations between proprioception and social interaction; positive affect and social interaction; motor planning and self-esteem; and play levels with positive affect and social interaction. Improvements in regaining regulation, self-esteem, and postive affect were demonstrated through the case study analyses. Playground behaviors could be described using a behavioral coding scheme that includes sensory features, social interaction, self-regulation, motor skills, and play levels. This behavioral coding system validated the features of an inclusive playground and quantified the effectiveness of intervention.

Goal Development Practices of Physical Therapists Working in Educational Environments

ABSTRACTAims: The aims of this study were to (1) describe the practices that school-based physical therapists use in developing student goals, and (2) identify facilitators and barriers to development of goals that are specific to participation in the context of the school setting. Methods: 46 school-based physical therapists who participated in a previous study on school-based physical therapy practice (PT COUNTS) completed a questionnaire on goal development. Frequencies and cross tabulations were generated for quantitative data. Open-ended questions were analyzed using an iterative qualitative analysis process. Results: A majority of therapists reported that they frequently develop goals collaboratively with other educational team members. Input from teachers, related services personnel, and parents has the most influence on goal development. Qualitative analysis identified five themes that influence development of participation-based goals: (1) school-based philosophy and practice; (2) the educational environment, settings, and routines; (3) student strengths, needs, and personal characteristics; (4) support from and collaboration with members of the educational team; and (5) therapist practice and motivation. Conclusion: Goal development is a complex process that involves multiple members of the educational team and is influenced by many different aspects of practice, the school environment, and student characteristics.

An exploration of teacher perceptions toward occupational therapy and occupational therapy practices: A scoping review

ABSTRACTMany occupational therapists work in school-based practice, where collaborative consultation between teachers and therapists is critical for intervention effectiveness. This scoping review explores teacher perceptions toward occupational therapy (OT). Three themes emerged: (1) teachers’ confusion over the OT role and scope of practice; (2) teachers’ desire for more reciprocal communication and more frequent opportunities to collaborate with occupational therapists; and (3) teachers’ desire for occupational therapists to have increased awareness of the needs and constraints of classroom contexts. Implications for occupational therapists, as well as potential strategies to address these emergent themes within education and school-based practices, are discussed.

An Exploration of Teacher Perceptions toward Occupational Therapy and Occupational Therapy Practices: A Scoping Review.

ABSTRACTMany occupational therapists work in school-based practice, where collaborative consultation between teachers and therapists is critical for intervention effectiveness. This scoping review explores teacher perceptions toward occupational therapy (OT). Three themes emerged: (1) teachers’ confusion over the OT role and scope of practice; (2) teachers’ desire for more reciprocal communication and more frequent opportunities to collaborate with occupational therapists; and (3) teachers’ desire for occupational therapists to have increased awareness of the needs and constraints of classroom contexts. Implications for occupational therapists, as well as potential strategies to address these emergent themes within education and school-based practices, are discussed.