School-Based Occupational Therapists’ Use of Assistive Technology

RESEARCH QUESTIONS:

How confident are school-based occupational therapists in providing assistive technology (AT) and services to children receiving services under the Individuals With Disabilities Education Act?

What types of AT devices and services are provided by school-based occupational therapists, and how frequently are they provided?

What challenges do school-based occupational therapists face when providing AT and services?

RATIONALE: AT has been shown to be beneficial for children with disabilities and complex health needs, yet some studies have shown that pediatric occupational therapists lack confidence in their ability to evaluate, recommend, and implement AT across settings. The confidence of a health care professional may predict if he or she provides appropriate AT devices and services.

DESIGN: A prospective, web-based survey

PARTICIPANTS: All Ohio school-based occupational therapists with an active license were contacted via state licensure board public records. One hundred seventy-four occupational therapists completed the survey.

METHOD: After institutional review board approval, potential participants were sent an initial email including a link to the survey, followed by three reminder emails. The 58-question author-designed survey was created using Survey Monkey and examined the frequency and types of AT recommended, occupational therapists’ confidence levels in recommending AT, and barriers to the recommendation and implementation of AT in the school system. The survey was reviewed by occupational therapy faculty and AT experts for face validity. Participants responded to questions anonymously using Likert scales.

ANALYSIS: Descriptive statistics were used to analyze participants’ responses.

RESULTS: Only 11.26% (n = 17) of respondents felt extremely confident in evaluating a child for AT. Most therapists felt extremely confident in recommending low-tech devices (84.21%; n = 128), although only 10.00% (n = 15) felt extremely confident in recommending high-tech devices. The majority of respondents felt not at all confident recommending (67.32%; n = 103), customizing (65.36%; n = 100), or evaluating a child (60.13%; n = 92) for seating systems or wheelchairs. The majority of respondents also felt not at all confident funding and procuring AT devices (66.89%; n = 101).

Almost half of respondents (n = 76; 49.35%) reported that they never or rarely (1–4×/yr) evaluate children for AT devices or services. The greatest challenges reported were time to keep up with current devices and options (82.44%; n = 122), ability to fund AT devices (77.86%; n = 116), AT-related continuing education courses being offered in the respondent’s area (64.18%; n = 95), and sufficient knowledge about available devices and options (62.59%; n = 92).

DISCUSSION: The study supports the conclusion of Long et al. that school-based occupational therapists are not confident in recommending/evaluating, acquiring, and implementing AT devices. Participants reported that the inability to attend AT-related training is a significant barrier to their provision of AT services. If school-based occupational therapists are not confident in the use of AT and are unable to attend additional training, it is unlikely that they will become more confident with AT. Students are more likely to benefit from the full range of technology available with improved therapist confidence in AT.

IMPACT STATEMENT: AT is a core occupational therapy practice area. Results emphasize the need for training and continuing education to increase therapists’ confidence and the frequency with which they consider AT for students. This could ensure greater access to AT and maximize participation in the school environment.