An Exploration of the Role of Sensory-Based Theory in School-Based Occupational Therapy

PURPOSE: The American Occupational Therapy Association (AOTA; 2009) has acknowledged sensory integration as one of the several theories that occupational therapists (OTs) use when working with children in school-based settings. Sensory integration is used with children who have sensory-related issues that affect their ability to participate in meaningful activities and behave accordingly at school (AOTA, 2009). The purpose of this study was to explore the role of sensory-based intervention (SBI) in school-based occupational therapy practice. The research questions were as follows: (1) How do school-based OTs describe the role of SBI in an educational setting? (2) Which current practice trends influence sensory-based occupational therapy practice?

DESIGN: Through the use of a mixed-design study, descriptive statistics and open-ended responses were used to support study outcomes. Descriptive numeric data from the completed questionnaire were compiled and summarized (frequencies, means) using statistical software, and responses to open-ended questions were analyzed using the constant comparative method of qualitative analysis.

METHOD: Licensed occupational therapists with at least 2 yr of clinical experience in a school setting while working a minimum of 10 hr/wk were purposively recruited via an email blast to members of the Pennsylvania Occupational Therapy Association and school district administrators within the state. Ninety-two school OTs were surveyed regarding the use of SBI in the schools, assessment, intervention, equipment, and resources. Participants also provided data on teaming and collaboration related to SBI. Data were collected over a 6-wk period. The number of participants was not predetermined as the researchers continued to seek participants until the survey was discontinued. Demographic data were compiled and represented via descriptive statistics using statistical software.

The data analysis of the open-ended questions used the constant comparative method, which began with a line-by-line reading of the text. Units of text were identified as a data point, and the data points were categorized into groups based on related content. From the groups, open codes were identified. Next, the investigators reviewed the data and determined axial codes to represent the data. Finally, themes were identified via a discussion among the researchers of the data to represent the lived experience of the OTs related to their perceptions of SBI within their current practice.

RESULTS: Results revealed current practice trends and themes. Practice trends revealed indicated that a large majority of school-based OTs (77%) responded positively to the question, “Do you feel sensory-based intervention is appropriate within a school setting?” Twenty-three percent of the participants reported that SBI in the schools is appropriate “sometimes,” 100% of the OTs reported that their caseload included children with a diagnosis of autism spectrum disorder (ASD), and 71% reported they were currently working with children with attention deficit hyperactivity disorder (ADHD). Traditionally, children with a diagnosis of ASD and/or ADHD benefit from occupational therapy services using an SBI approach (Parham & Mailloux, 2015). Emerging themes when using SBI were improvement in student performance in the areas of attention, self-regulation, and learning with an increase in overall educational participation. Challenges to school-based occupational therapy that emerged were the importance of collaboration with and education of team members. By far, the biggest challenge reported was the contextual limitations of providing services in a school context.

CONCLUSION: The results of this study indicate that school-based OTs need to educate professional team members about SBI to promote awareness and carryover. Sensory-based strategies to enhance student performance areas should be included in students’ individualized education plan. Finally, to address contextual challenges, OTs need to be able to generate creative solutions for incorporating SBI strategies in the school setting.

IMPACT STATEMENT: School-based OTs disclosed that sensory-based intervention is an appropriate approach to use in schools. Results of this study reveal practice patterns used by school-based OTs and contribute to a greater awareness of prevalence of and current trends in sensory-based interventions in school-based practice.

References

Ahn, R. R., Miller, L. J., Milberger, S. M., & McIntosh, D. N. (2004). Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. American Journal of Occupational Therapy, 58, 287–293. https://doi.org/10.5014/ajot.58.3.287

American Occupational Therapy Association. (2009). Providing occupational therapy using sensory integration theory and methods in school-based practice. American Journal of Occupational Therapy, 63, 823–842. https://doi.org/10.5014/ajot.63.6.823

Parham, L. D., & Mailloux, Z. (2015). Sensory integration. In J. Case-Smith & J. O’Brien (Eds.), Occupational therapy for children and adolescents (7th ed., pp. 258–303). St. Louis, MO: Mosby Elsevier.