The purpose of this study was to identify the perceived appropriateness, extent, and types of services provided by occupational therapists to children with emotional disturbances in public schools. A nationally mailed survey was conducted of randomly selected school occupational therapists derived from the American Occupational Therapy Association School System Special Interest Section list. The sampling frame was 982 with a response rate of 48% (n = 476). Eighty-seven percent of all respondents were supportive of school occupational therapy for students with emotional disturbances, although these students made up only a small proportion of their caseload. The therapists indicated that a variety of intervention approaches were used with most targeting educational areas, especially handwriting. The most commonly reported intervention was sensory integration. Many respondents perceived that they could not provide effective interventions because they were not appropriately trained. Perceived lack of knowledge and confusion about occupational therapy's role may lead to underutilization of occupational therapy for addressing the complex needs of children with emotional disturbances. Further research and discussion are needed in the profession to arrive at consensus regarding what approaches are most appropriate and effective in schools.

Children with emotional disturbance frequently have difficulty regulating their classroom behaviors. Many have co-occurrence of other disabilities, such as sensory processing problems, which compound difficulties in school participation. This exploratory project evaluated the 8-week-long use of the Alert Program within the classroom setting for seven children with emotional disturbance. Five children with emotional disturbance served as a control group. Self-regulation, behavioral adjustments, and sensory processing skills as reported by the children and teachers were evaluated. Changes from pretest to posttest indicated that children who received the Alert Program demonstrated a small improvement on all measures while performance of the control group remained relatively constant or decreased. These preliminary results indicate programs that target self-regulation skills may be useful in helping to improve self-regulation of children with emotional disturbance.

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This paper describes a reciprocal service-learning project between Master of Occupational Therapy (MOT) students and a Head Start program on the Texas-Mexico border. Education of occupational therapy students at the University of Texas Health Science Center at San Antonio includes local community learning experiences. However, this project challenged the students and faculty to step outside of and beyond their boundaries to address the unique needs of children in Del Rio, Texas. In a reciprocal service-learning situation, students provided developmental screenings, presentations, and classroom suggestions to the Head Start staff. In turn, the Head Start staff reciprocated by providing presentations and classroom cultural inclusion experiences to the students. The project outcomes suggest that collaborative participation can give students and their community partners broader frameworks from which to view enablement and a sense of mutual responsibility. From this starting point students can be encouraged to explore issues of social inclusion and occupational justice.

This article presents the textual analysis of the responses of 373 occupational therapists working in school systems across the United States of America who responded to the question "List any obstacles to providing occupational therapy services to school aged students with severe emotional disturbance" on a recent survey. The purpose of the analysis is to describe some of the barriers and solutions to the provision of occupational therapy services to school aged students with emotional disturbance. The 754 responses received were categorized into themes. The themes which emerged from the occupational therapists' responses were: (1) role confusion; (2) limited knowledge base; (3) identification and provision of occupational therapy services; (4) administrative factors; (5) lack of efficient teaming; (6) classroom