Misconceptions and Limitations in School-Based Occupational Therapy

Occupational therapy in a school setting typically involves working with students who have a wide range of developmental, physical, and mental health conditions to help them develop the skills they need to participate in the activities of daily life (ADLs), such as self-care, leisure, and education. The overall goal is to improve the student’s ability to function in the school setting, and to help them achieve their full potential in all aspects of their life. Note that school OT is different than pediatric OT, which may be more diagnosis based. In general, school OT may include working with students on fine motor skills, sensory processing, and adaptive equipment use, as well as developing strategies for behavior management and social skills development.

An occupational therapist working in a school setting may also work closely with teachers, parents, and other members of the school staff to develop an individualized education plan (IEP) for each student. This plan will outline the student’s strengths and needs, and set specific goals and objectives for their occupational therapy treatment. Families are involved in this IEP process every year. The therapist will then work with the student to achieve these goals, using a variety of techniques and strategies.

Some common interventions used in school-based occupational therapy include:

  • Sensory integration therapy, which helps students process and respond appropriately to sensory information from their school environment
  • Fine motor skill development, such as handwriting and cutting with scissors
  • Adaptive equipment training, such as using a computer mouse or keyboard, or seating in class
  • Social skills development, such as problem-solving and communication with peers
  • Behavioral management techniques that may be a barrier to being a student
  • Self-care skills, such as dressing and grooming (less common)

In addition to working with individual students, occupational therapists in a school setting may also provide training and support to teachers and staff to help them understand how to support the students’ needs and accommodations. They may also provide education and resources to parents to help them better understand their child’s condition and how to support them at home. One of the best strengths of school OT is that the interventions are implemented directly in the setting that the child learns.

There are a few limitations to occupational therapy in a school setting. One limitation is that the availability of occupational therapy services in schools may vary depending on the location and funding of the school district, even by state. In some areas, occupational therapy services may be limited or not available at all, which can make it difficult for students with certain needs to receive the support they need.

Section 504 of the Rehabilitation Act of 1973 is a federal law that prohibits discrimination against individuals with disabilities in programs and activities that receive federal financial assistance.

In the context of occupational therapy education, this means that schools offering occupational therapy programs must make reasonable accommodations for students with disabilities, such as providing assistive technology or modifying the curriculum, to ensure that they have an equal opportunity to participate in and benefit from the program.

The Individuals with Disabilities Education Act (IDEA) is a federal law that guarantees a free and appropriate public education (FAPE) for children with disabilities. Occupational therapy is one of the related services that may be provided to eligible students under IDEA.

Under IDEA, occupational therapy services are defined as “services provided by a qualified occupational therapist and includes—
(i) improving, developing, or restoring functions impaired or lost through illness, injury, or deprivation;
(ii) improving ability to perform tasks for independent functioning if functions are retained; or
(iii) preventing, through early intervention, initial or further impairment.”

Another limitation is that occupational therapists may not have enough time to provide individualized therapy services to each student. Due to the large caseloads and limited resources, therapists may not be able to provide as much direct therapy services as they would like to.

Additionally, some students may not be able to fully benefit from occupational therapy services in the school setting if they have severe or complex conditions that require more intensive or specialized therapy services.

Also, occupational therapy may not be covered by all the insurance plans, so students or parents may need to pay out of pocket.

In summary, occupational therapy in schools can have a positive impact on the child’s overall quality of life, and their ability to participate and succeed in the school environment. Occupational therapy can help students with disabilities prepare for transition to adulthood by helping them develop the skills and independence necessary for post-secondary education, employment, and independent living.

Jeff is a licensed occupational therapist and lead content creator for OT Dude. He covers all things occupational therapy as well as other topics including healthcare, wellness, mental health, technology, science, sociology, and philosophy. Buy me a Coffee on Venmo.