Occupational Therapy Services in School-Based Practice: A Pediatric Occupational Therapy Perspective from Ireland

Abstract

Purpose. School is a primary setting for pediatric occupational therapy practice, yet little is known about the provision of school-based occupational therapy in many countries internationally. The purpose of this study was to explore current school-based occupational therapy practice for the first time in Ireland to gain insight into current and potential service provision and to identify new directions and potential pathways for development. Methods. This descriptive quantitative study utilized a cross-sectional online survey to gain the perspectives of the population of pediatric occupational therapists working regularly in schools across Ireland. Respondents were recruited through convenience and snowball sampling. Data were analysed through qualitative content analysis and descriptive statistics. Results. The survey elicited 35 responses, yielding a 21.2% estimated response rate. Findings demonstrated that respondents provided therapy services in schools most commonly on a weekly (28.6%) or monthly (34.3%) basis, with only 5.0% working in the same school on a weekly or fortnightly basis. The majority of respondents (54.3%) used a direct therapy approach with a child, rather than coaching or modelling, to primarily address sensory, hand function, or daily living needs. None used a whole class or whole school (universal or tiered) approach. While respondents (54.3%) generally viewed collaborative practice as a strength of school-based practice, they also identified barriers to collaboration in schools. A core barrier is related to how services are constructed across health and education, with differing philosophies of service provision. The majority of respondents (75.0%) reported that they had not received any training to deliver evidence-based practice in therapy provision specific to school-based practice. Implications for Practice. This study indicates that therapists require continual education on evidence-based school practice as it applies in an Irish context. Furthermore, clarification of school therapy roles and service delivery models are required in order to determine how they contrast with traditional clinic roles. This will enable therapists to strengthen the coordination of service delivery between health and educational services to maximize the outcomes of school-based practice.

Occupation‐centred practice and supervision: Exploring senior occupational therapists' perspectives

“…This research also found that practice in a public education setting can have a negative impact on occupational therapy practice through role expectations, as well as documentation and professional language expectations. These findings were consistent with research into school‐based education settings which revealed a pressure to conform to setting specific practice expectations, such as the collaborative model of practice and a lack of understanding of the occupational therapy role by education staff (O'Donoghue et al, 2021). Finally, findings show that in private practice, disability services funding in Australia may lead to a focus on reporting standardised outcomes in preference to occupation‐centred practice.…”

Position Paper on School-based Occupational Therapy

“…Mit Hilfe dieses Instruments kann erhoben werden, wie die Umwelt die Partizipation der Schüler*innen beeinflusst, und auch verändert werden kann. Eine Querschnittstudie aus Österreich zeigte auf, dass Schüler*innen entscheiden können, welche Umweltanpassungen nötig sind, um deren Partizipation zu ermöglichen [10].…”

“…Diese Form der Unterstützung ist in anderen Ländern wie den USA, Kanada, Neuseeland, aber auch schon in Europa, wie z. B. in den Niederlanden, Schweden oder Irland möglich [2,[8][9][10].…”

We Need to Completely Change the Way We Look at Therapy: Occupational Therapy in Specialist Schools

“…Therapy is typically provided by therapists visiting the school and is delivered individually or in small groups where children have similar needs. This approach is similar in Ireland (O'Donoghue et al, 2021) and Greece (Strogilos, Lacey et al, 2011) whereby occupational therapists are employed by the health or education boards and attend schools by appointment. In the US and Canada occupational therapists are commonly employed by a school district and visit children at school.…”