A Case Review: Reframing School-Based Practices Using a Critical Perspective

Abstract

It is well established in the literature that school-based practice is fraught with challenges such as acquisition of appropriate and sufficient resources, communication barriers among professionals, parental burden, and redundancies and gaps in services. The purpose of this perspective paper is to reframe potentially problematic school-based practices using a critical social science perspective, suggesting a vision and strategies for therapists working in school-based practice contexts. We illustrate our approach with a case example. To reframe school-based practices, we begin with Jill's case, exploring it through a critical lens to identify potential issues and opportunities for change. We then trace these findings to our larger dataset from an ongoing program of research, to ensure relevance to the broader context of school-based practice. Reframing of three school-based practice issues are discussed, from: a) advocacy by proxy to collaborative dialogue, b) governing texts to guiding texts, and c) playing the "right" part to having a voice. Although this is a perspective paper based on a case exemplar, we posit how we may reframe and rethink schoolbased practices in pediatric rehabilitation. We suggest that only with a genuine shift in our professional values will we see the enactment of collaborative practice in school-based settings.

Critically reflective practice and its sources: A qualitative exploration

“…The social roles of health professionals, such as advocate, collaborator and communicator, matter to patient care. Without effective enactment of these roles, patients can feel unheard, and experience practitioner conflict or excess burden in navigating systems or advocating for quality and compassionate care . Hence, health professions education (HPE) needs research into what these roles look like in practice, how clinicians come to learn them, and how we might go about teaching or fostering their development.…”

“…' They wrote letters or reports as advocacy tools to be relayed by parents to schools, which unintentionally contributed to conflict between and burdened parents and educators, rather than enabling support and participation for the child . Yet sometimes health professionals found ways to overcome systemic constraints in order to support families and engage positively with schools . Although not named as such by participants themselves, these more productive approaches to this practice area represented the concept of critically reflective practice, thereby sparking the current study.…”

“…Given these theoretical assertions, the health professional roles of advocate, collaborator, communicator and professional, and goals such as compassionate care or systems‐based practice, may benefit from critical reflection as a basic underlying capability or critically reflective practice as an approach for practice in indeterminacy. Related research supports this assertion; for example, clinicians who became hospitalised developed lenses consistent with critical reflection and this, in turn, engendered more compassionate orientations towards care .…”

“…3 Yet sometimes health professionals found ways to overcome systemic constraints in order to support families and engage positively with schools. 2 Although not named as such by participants themselves, these more productive approaches to this practice area represented the concept of critically reflective practice, thereby sparking the current study.…”

Supporting children with disabilities at school: implications for the advocate role in professional practice and education

“…Further, teaching future practitioners about advocacy may require attention to critical approaches that emphasize understanding of the influence of the sociocultural and sociopolitical contexts on practice [ 58 , 99 ]. In order to be able to enact change, practitioners may need to understand how they, their patients/clients and their colleagues are situated in these contexts relative to relations of power and structure [ 58 , 99 , 100 ]. While some competency frameworks describe the health advocate as a crucial role, talk of a change agent could potentially open up other ways of framing this type of work [ 39 ].…”