Abstract
This study explored the perceptions and practices of OT practitioners working in middle-school settings. There is an overall paucity of research specifically intended for evaluating and providing interventions for middle-school students. In an attempt to address this issue, this study intended to better understand practitioners’ perceived needs, daily practice patterns, and factors that influence their clinical reasoning in determining goals and interventions.
Primary Author and Speaker: Sonia Rodrigues
Additional Authors and Speakers: Francine Seruya
There is a large of body of scholarship regarding school-based interventions at the preschool and elementary level however, there is a paucity of literature that addresses the current practice patterns or effectiveness of interventions for the middle school population. As the needs of children of middle school age are different than those of elementary school children, an exploration of how occupational therapy practitioners (OTPs) shift their areas of focus to align with the needs of the older child within educational systems is warranted. The purpose of this study was to explore the current daily practice patterns of OTPs working in middle school settings to determine the alignment of service delivery with guidelines regarding best practice, adherence to legal mandates and the ability to address the occupational needs of children in middle schools. A researcher designed, web-based survey with a total of 37 Likert-scale, multiple choice and open-ended questions was used for this study. The survey collected demographic data and included questions related to evaluation practices, types of interventions and factors that influenced clinical reasoning in goal setting and service provision. Participants from all regions of the country were recruited via invitation utilizing state professional associations, professional social media pages and additional participants were recruited through snowball recruitment strategies. The survey was opened for a total of 8 weeks. Sixty-four OTPs met the inclusionary criteria of practicing within the US with current state licensure and having at least 25% of the students in their caseload between 10-15 years old in a middle school setting. The demographic data and closed-ended questions of the survey were analyzed using basic descriptive statistics. The data from the open-ended questions were thematically analyzed using terms and concepts that emerged from the participants’ responses.
The majority of the survey participants were from the NorthEast, directly employed by school districts, and practicing for seven or more years in a middle-school setting. Results indicated that practitioners are primarily utilizing direct individual interventions outside of the natural classroom setting more than 75% of the time. OTPs reported primarily addressing body functions and structures and performance skills rather than occupation based concerns. They indicated that they frequently address goal areas such as handwriting, fine motor skills and sensory processing but they identified occupation-based goal areas such as socialization and life skills as being more important for students in middle schools to develop. OTPs identified that executive functioning and assistive technology skills are also important to address with middle school students. This finding indicates a divide between clinical reasoning and service delivery. Participants indicated that they find it difficult to implement interventions that are occupation based, support best practice, and align with federal legal mandates. They believe their challenges in providing services to children in middle schools in part are due to the lack of current and available resources as well as decreased administrative support. Practitioners identified the need for educational and evidence-based resources to guide them and also aid in advocating for appropriate service delivery in the middle school setting. These results further support the need for increased resources and education for OTPs working within middle school settings. The findings provide initial insight into the need for more contextual and occupation based interventions that align with federal mandates to address the distinctive characteristics and needs of students in middle school.
Giordanella, D., Dulanie, J., Chubet, C., Rotko, C., & Seruya, F. M. (2015). Practitioners’ perceptions of occupational therapy in middle school settings. American Journal of Occupational Therapy, 69(Supplement_1), 6911510129p1-6911510129p1. doi:10.5014/ajot.2015.69S1-RP203B
Seruya, F. M., & Ellen, K. M. (2015, June). Role of the middle school occupational therapist: An initial exploration. Early Intervention & School Special Interest Section Quarterly, 22(2), 1-3.