Learn more about school based occupational therapy and how OTs support students in the school-setting.
For people who aren’t familiar with our profession, there is always some confusion regarding the job title “occupational therapist”. The most common one I hear when I tell people that I’m an occupational therapist is “ oh, so you help people find jobs?“
But if you’re reading this post, chances are that you probably already know that the word “occupation” when it comes to OT is related to helping people accomplish the occupations (daily tasks, routines, and activities) that bring a sense of purpose and meaning to people’s lives.
On top of the misconceptions about our job title, there can be even more confusion about our role when you take into account the countless practice settings where you can find OT‘s. For pediatric occupational therapists like myself, these settings can include hospitals, rehabilitation facilities, outpatient clinics, clients’ homes, mental health settings, schools, and more!
The role of an occupational therapist can vary a great deal between different settings. As a pediatric OT who has spent most of my career delivering occupational therapy in elementary schools, primary schools, and preschools, I thought it would be helpful to outline what the role and responsibilities of a school based occupational therapist looks like and how it differs from the role and responsibilities of OTs in other settings.
What is school based occupational therapy?
Occupational therapists in the school system are focused on supporting a child’s overall ability to participate as successfully and fully as possible in the school environment. OT’s focus often includes: fine motor functioning, sensory processing, visual motor and visual perceptual skills, self-care skills/activities of daily living, social skills, cognitive skills and executive functioning, and more!
OTs in schools are part of the special education team that can include, special education teachers, general education teachers, school psychologists, speech language pathologists, physical therapists, and other professionals as well as students’ parents and caregivers.
School based occupational therapists evaluate students to determine whether school occupational therapy services are recommended as part of the IEP (individualized education plan). If it is recommended that a child receives occupational therapy at school, the OT will set goals and objectives related to supporting the child’s success and independence at school. Every year, the team holds an IEP meeting where the IEP is reviewed and updated based on the child’s progress. Every 3 years, students are re-evaluated by the entire special education team to determine which services continue to be recommended.
Throughout the school year, school based OTs constantly collaborate and consult with a child’s teacher, parents, and other professionals on the IEP team to ensure that skills are being introduced, practiced, and generalized across the school environment.
What does a school based therapist do?
School based OT is specifically concerned with students’ ability to access the educational environment safely and as independently as possible, including the classroom, hallways, cafeteria, playground, bus, etc. This role differs, sometimes significantly, from the roles of clinic-based or home-based occupational therapists, who are able to address the child’s functioning at home and around the community.
According to IDEA (Individuals with Disabilities Education Act), school OT is a related service that provides support to a child with an identified disability so that they can benefit from special education. This can take the form of direct interventions, consultation/collaboration with the educational team, accommodations, and modifications. In contrast, outpatient therapy in a clinic setting focuses on providing services that support a child’s ability to independently and efficiently access their home or the community and approach evaluation and treatment using the medical model rather than the educational model.
These are areas that school based occupational therapy commonly focuses on:
As an OT in the schools, we might ask the following questions:
Can the child access and effectively demonstrate fine motor skills needed to use the materials and supplies needed to participate in class (e.g. accurate cutting with scissors, efficient grasp on writing utensils)?
Can they demonstrate visual motor coordination for tasks like coloring, drawing and legible handwriting?
Can the child access and efficiently use technology devices needed in the classroom?
Do they require sensory supports or other accommodations to promote alertness, attention, or self-regulation?
Can they manage their personal materials independently (backpack, coat, shoes/boots, clothing fasteners, bathroom needs)?
Can the child maintain organization of their desk, locker, and other personal spaces?
Can they navigate the cafeteria independently (managing the lunch line, opening containers, using utensils)?
Does the child require seating or positioning supports to maximize posture, alertness, attention, etc.?
Can the child transition between activities throughout the school day without difficulty?
Can the child interact with their peers appropriately, demonstrating fulfilling friendships and social engagement?
Want to learn more about Occupational Therapy in Schools?
Check out this post, where I outline a day in the life of a school based occupational therapist.
Here’s a free printable school-based occupational therapy handout about the role of a school occupational therapist from AOTA.
If you’re new to the profession, figuring out how to find an occupational therapy mentor can be tricky! Click the link to learn more!
