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What Parents Need to Know About School-Based Occupational Therapy

Elementary school students in the classroom

Ashley Opp Hofmann

When a school informs parents that it recommends occupational therapy for their child, parents tend to have a lot of questions. Their first question?

What is occupational therapy?

Occupational therapy is a health profession in which therapists and therapy assistants help individuals to do and engage in the specific activities that make up daily life. For children and youth in schools, occupational therapy works to ensure that a student can participate in the full breadth of school activities—from paying attention in class; concentrating on the task at hand; holding a pencil, musical instrument, or book in the easiest way; or just behaving appropriately in class.

Occupational therapists and occupational therapy assistants help students perform particular tasks necessary for participation or learning. “The whole purpose of school-based occupational therapy is to help kids succeed,” says pediatric occupational therapist Leslie Jackson. Occupational therapy practitioners don’t just focus on the specific problem that a child’s disability may present; rather, they look at the whole child and tackle individual tasks, helping students find ways to do the things they need and want to do.

Usually, occupational therapy is provided to students with disabilities. But occupational therapy can be made available to other children who are having specific problems in school. Occupational therapy practitioners also work to provide consultation to teachers about how classroom design affects attention, why particular children behave inappropriately at certain times, and where best to seat a child based on his or her learning style or other needs. Occupational therapy may be recommended for an individual student for reasons that might be affecting his or learning or behavior, such as motor skills, cognitive processing, visual or perceptual problems, mental health concerns, difficulties staying on task, disorganization, or inappropriate sensory responses.

A common manifestation of difficulties in school involves handwriting, in many cases because this is a key “occupation” that students must master to succeed in school. A teacher might notice that a student cannot write legibly or has serious problems in other motor tasks. The occupational therapy practitioner can work with the teacher to evaluate the child to identify the underlying problems that may be contributing to handwriting difficulty. The occupational therapy practitioner looks at the child’s skills and other problems (including behavior), in addition to his or her visual, sensory, and physical capabilities. They also take into account the school, home, and classroom environments to find ways to improve the handwriting or to identify ways the child can compensate, such as using a computer.

Accessing school-based occupational therapy is fairly straightforward, but it is the school team who makes the decision of whether or not a student requires occupational therapy. Not every student needs occupational therapy, even if the student has a disability. Those who do may have problems that the teacher can address after consulting with an occupational therapy practitioner and modifying their teaching technique or the environment for the entire class.

The education team could recommend one-on-one services. Usually these services are integrated as much as possible into the child’s routine to promote better integration of skills.

Students with disabilities have been able to receive occupational therapy at school since the 1975 passage of the Individuals with Disabilities Education Act (IDEA), which served as the original impetus for school-based occupational therapy. The law stipulates that students with disabilities must have access to the occupational therapy if they need it to benefit from special education. In 2001, Congress passed the No Child Left Behind (NCLB) Act which requires schools to improve the academic achievement of all students, including those with disabilities. In 2004, the reauthorization of IDEA extended the availability of occupational therapy services to all students, not just those with disabilities, in order to fully participate in school.

Parents, though, have a lot of the responsibility when it comes to their child’s success in school, and their involvement becomes doubly important when an occupational therapy practitioner enters the picture. First, Jackson suggests getting to know the teachers and occupational therapist.

“Share information about what your child does at home, raise whatever concerns you have, find out what sorts of things you can do with your child to help him or her succeed,” she says.

“Occupational therapy practitioners have important knowledge and expertise to share. Take advantage of it.”