School-Based Occupational Therapy

by Eileen Neary, Assistant Project Manager

For hundreds of years, students in the United States who didn’t quite fit the mold often received no education at all or were even institutionalized. Even after the Education for All Handicapped Children Act (EAHCA or EHA) in the 1970s, many youngsters slipped through the cracks and did not receive an adequate education. Overhauls in recent years, most notably No Child Left Behind (NCLB) in 2002 and the 2004 update of the Individuals with Disabilities Education Act (IDEA), have drastically changed the fates of these students.

In the ten years since IDEA, awareness has continued to grow immensely, and public view has shifted in a positive way. Students facing obstacles in their learning, whether they are physical, emotional, behavioral or otherwise, are now afforded more opportunities than ever to receive a free appropriate public education (FAPE).
The prevalence of school-based occupational therapy (OT), partly in response to these acts, is also booming. Today, occupational therapy ranks on numerous charts as one of the fastest-growing career paths. But what is occupational therapy?

Occupational therapy is a form of therapy designed for all ages to assist in learning and adapting to life [PDF link]. An occupation is defined as any task a person wants or needs to do to get through daily life. This can consist of routines, hobbies, work, play, socialization, etc. There is a wide range of applications of occupational therapy, including the following: early intervention for infants; help for young students practicing skills to thrive in the classroom and in their own lives; workforce readiness for teenagers; help for adults recovering from serious medical procedures like hip replacement or returning to work following a long-term illness or injury; assistance for those of all ages with mood disorders; and even help for those with Alzheimer’s.

School-based occupational therapists (OTs) specialize in helping students in a variety of dimensions, such as with handwriting, school performance, making friends, coping methods, behavioral strategies and sensory integration theory (the theory that the five senses can be acknowledged and used to positively affect a student’s learning environment). For students who may benefit from one-on-one therapy, occupational therapists may be asked to step in to conduct screenings and evaluations, help design a treatment plan or individualized education plan (IEP), and perform individualized or group therapy tailored around the reason(s) a student may not be performing to his or her full potential.

The goal for a school-based occupational therapist is to “support academic achievement and social participation by promoting occupation within all school routines, including recess, classroom, and cafeteria time.” There is already a multitude of benefits from students meeting with an occupational therapist, from helping students make peace with their environment and participate in activities, to assisting students struggling academically, to helping students with mental illnesses and developmental disabilities, and so much more.

The American Occupational Therapy Association (AOTA) held its annual conference in April 2014 in Baltimore. Over the course of a few days, the AOTA conference was an opportunity for thousands of OTs, researchers and educators to meet, hold roundtable discussions, attend seminars, and view research and thesis presentations. All aspects of occupational therapy, including school-based occupational therapy, were discussed.

I spoke with an attendee of this year’s event, Brittany Peters, MS, Occupational Therapy Student (MSOTS), to learn more. Brittany has worked with numerous young students, assisting them in improving self-care and hygiene, schoolwork, chores and social behavior.

At AOTA ’14, Brittany presented a poster on an intervention tool called Child Occupational Self Assessment (COSA). This tool asks students what they are interested in through 25 specific child occupations, whether students perceive themselves to be adequate at completing the task, and how important the task is to the student. COSA can help an occupational therapist and his or her fellow educators to create goals that are intrinsically motivating for a student.

Over the course of the conference, Brittany was able to sit in on other students’ presentations as well as professional seminars and speeches. This year’s keynote speakers were a trio of soldiers representing the Wounded Warriors Project (WWP). They discussed the ways in which occupational therapy helped them recover their independence.

“The best part of OT is that it is very client-centered,” Brittany told me. “For example, when it comes to fine motor improvement, instead of giving a child desk work, we might have them try to draw a dinosaur if that’s what they love, and then stomp around and imitate the dinosaur after. This works on sensory input from the stomping and imaginative play, an important part of cognitive development.”

The reason this works so well? “Drawing upon the intrinsic motivation of the student not only helps to create better outcomes and better neural plasticity, but it is simply fun! This itself is motivation to participate!”

Did You Know?

During World War I, many civilian women worked as “reconstruction aides [PDF link].” These uniformed women were sent to help injured soldiers through massage, basic exercise and education, with the goal to return them to the battlefield or home to the workforce. Reconstruction aides are considered precursors to physical and occupational therapists.