Journal of Occupational Therapy, Schools, & Early

Intervention

ISSN: 1941-1243 (Print) 1941-1251 (Online) Journal homepage: http://www.tandfonline.com/loi/wjot20

Teachers’ perceptions of the role of occupational

therapist in schools

Jeryl D. Benson EdD, OTR/L, Kimberly A. Szucs PhD, OTR/L & J. J. Mejasic MS,
OTR/L

To cite this article: Jeryl D. Benson EdD, OTR/L, Kimberly A. Szucs PhD, OTR/L & J. J.
Mejasic MS, OTR/L (2016) Teachers’ perceptions of the role of occupational therapist in
schools, Journal of Occupational Therapy, Schools, & Early Intervention, 9:3, 290-301, DOI:
10.1080/19411243.2016.1183158

To link to this article: http://dx.doi.org/10.1080/19411243.2016.1183158

Published online: 16 Aug 2016.

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JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION
2016, VOL. 9, NO. 3, 290–301
http://dx.doi.org/10.1080/19411243.2016.1183158

Teachers’ perceptions of the role of occupational therapist in

schools
Jeryl D. Benson, EdD, OTR/La, Kimberly A. Szucs, PhD, OTR/La, and J. J. Mejasic, MS, OTR/Lb
a
Occupational Therapy Department, Duquesne University, Pittsburgh, Pennsylvania; bOccupational Therapy
Department, Theraplay Inc., Limerick, Pennsylvania

ABSTRACT ARTICLE HISTORY

This article explores how teachers in the school system perceive the Received 4 March 2016
role of the occupational therapist. Participants of this study were 47 Accepted 22 April 2016
teachers in the school systems that currently work with an occupa- KEYWORDS
tional therapist in a public or private school. Data were collected via Occupational therapists;
an anonymous online survey and analyzed using descriptive statistics qualitative; school-based
and qualitative coding. The majority of the participants view occupa- practice; teachers’
tional therapists as valuable team members. They report limitations perceptions
to the system that challenge collaborative teaming. The participant’s
desire increased communication and collaboration with the occupa-
tional therapist. Occupational therapy is perceived as a valuable
contribution to the educational team that is underutilized. An
increase in collaboration and communication is indicated to support
the educational process but will require system change.

Occupational therapists assist people by facilitating participation through engagement in

roles and occupations for a more independent life. For children, a primary role and
occupation is being a student. Occupational therapists facilitate the participation of
children with disabilities in student role activities. Typically, support is provided in
academic, social, extracurricular, independent living, and vocational domains. (AOTA,
2010a). Education is identified as one of the key performance areas in the Occupational
Therapy Practice Framework: Domain and Process, third edition, (OTPF-3) and refers to
the “activities needed for learning and participating in the educational environment”
(AOTA, 2014, p. S20). Owing to the profession’s extensive focus on a broad range of
occupations (education, social participation, play, leisure, work, activities of daily living),
occupational therapists are well positioned to make a substantial contribution to services
in schools. For that reason, the school-based setting is a major working environment for
occupational therapists (Jackson, 2007).
The school setting is a critical performance setting for children and youth in the United
States (Swinth, Spencer, & Jackson, 2007). In a student role, children are expected to
engage in a variety of activities throughout their day such as completing homework
assignments in various subjects, taking tests, completing personal self-care activities,
engaging in recess and outdoor activities, socializing with peers, and participating in
sport activities. As these activities are challenging for children with disabilities, the need
for support increases for occupational therapy services, and increasingly, occupational

CONTACT Jeryl D. Benson benson@duq.edu 218 Health Sciences Building, 600 Forbes Ave., Occupational Therapy
Department, Duquesne University, Pittsburgh, PA 15282.
© 2016 Taylor & Francis
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, AND EARLY INTERVENTION 291

therapists’ fast-growing workloads include greater demands for their consultation in this
environment (Jackson, Polichino, & Potter, 2006). According to a recent workforce survey
of occupational therapists conducted by the American Occupational Therapy Association
(AOTA), 21.6% of respondents were employed in schools (2010b). The role of the
occupational therapists in a school-based setting is focused on educational participation
of the student. Occupational therapists identify the student’s strengths and factors that
may be interfering with his or her learning and participation in the context of the
educational activities, routines, and environments (AOTA, 2011). Based on these con-
tributions, the school-based occupational therapist is qualified to contribute to the devel-
opment of the individual education program (IEP), per the Individuals with Disabilities
Education Act [IDEA] (2004) and the Individuals with Disabilities Education
Improvement Act [IDEIA] (2004). These related services are designed to help the IEP
team meet the academic, developmental, and functional needs of eligible children with
disabilities (Swinth et al., 2007).
The IEP team comprises many professionals, including teachers, who largely determine
the specific activities that constitute the “student role” (Swinth et al., 2007). Due to this,
occupational therapists will need to collaborate with various stakeholders, including
students, parents, teachers, principals, special education teachers, and related service
providers, who form the IEP team. Although related services personnel are generally
considered “discretionary” team members, if an occupational therapist is formally identi-
fied as a member of a particular IEP team it is desirable that the occupational therapist
attend the IEP meeting (Jackson, 2007). Occupational therapists are challenged to profi-
ciently blend their role in providing direct hands-on services for students with the team
and system supports (Bazyk & Case-Smith, 2010). With the teacher as a primary con-
tributor to the IEP team, one of the most important professional relationships for the
occupational therapist is with the teacher. By collaborating with general and special
education teachers and participating as a member of the IEP team, occupational therapists
can assist student’s access and engagement in available educational activities (Swinth et al.,
2007).
The collaboration and communication between teachers and OTs is essential for a
student’s success inside and outside of the classroom. Collaboration, as defined by Friend
and Cook (2000) is a specific style of interaction characterized by a volunteer contribution
and the equal status of all parties to engage in the collaborative process as they work
toward a common goal. When discussing a relationship between professionals, Suter et al.
(2009) argued that the ability to work collaboratively has a specific set of expectations. In
the qualitative study of 60 health professionals, effective communication was found to be a
core expectation for collaborative practice. In addition, Suter et al. (2009) found that a
shared respect and appreciation for each other’s roles to be a second core expectation.
Moreover, when the parties collaborate, they will also share decision making, resources,
and accountability for outcomes and will eventually appreciate each other’s interpersonal
style and develop mutual trust (Friend & Cook, 2000).
Although the teacher’s and the therapist’s jobs are to support the child’s role as a
student, at times there is a mismatch between the perceptions of what the teacher and the
occupational therapists want (Bazyk & Case-Smith, 2010). Conflicts in points of view can
be minimized if a consistent, open pathway of communication is maintained between the
disciplines and keeping such pathways open rests equally on all members of the team
292 J. D. BENSON ET AL.

(Bazyk & Case-Smith, 2010). In the school system, communication and collaboration
between teachers is a critical component in the services provided to students. Casillas
(2010a) explored the perspectives of teachers’ affective, social, and environment factors
involved in providing school-based consultation to teachers. The study findings revealed
that increased shared collaboration and communication is needed between occupational
therapists and teachers. In addition, the researchers found that teachers’ understanding of
the occupational therapists role and scope of practice improves through experience and
knowledge within the school system (Casillas, 2010a). In addition, teachers often become
frustrated with the system, a lack of occupational therapists, and lack of communication,
therefore indicating that a more proactive approach for consultation is needed with the
occupational therapist (Casillas, 2010b).
Fairbairn and Davidson’s (1993) study explored the teacher expectations from occupa-
tional therapists working with children in two Ontario public school districts. The major
findings included that all teachers valued the work of occupational therapists in schools
and ultimately expressed confusion and disagreed over the roles of occupational therapists
in schools (Fairbairn & Davidson, 1993). This study shows a history of discrepancy
between the two professions’ collaboration due to the teacher’s lack of understanding of
the roles of the occupational therapist. Nochajski (2002) also found that there is often a
“lack of knowledge about the expertise of professionals” and a “lack of clear role delinea-
tion and philosophical differences of team members towards the education of students,”
which could impact the students overall occupational performance (p. 110).
An important goal in the school-based setting for both professions is enhanced student
education outcomes Barnes and Turner (2001) wanted to uncover the collaboration
processes between the occupational therapist and the teachers, and teacher perceptions
of the occupational therapist’s influences on the student’s progress. One interesting
finding from this study showed that as the occurrence of collaborative teaming increased,
teachers’ perceptions of occupational therapists contributions to student skill development
increased (Barnes & Turner, 2001). This positive correlation between the teacher percep-
tions of the occupational therapist’s contributions to the student’s progress suggests that
successful education outcomes may be influenced by the effective collaboration between
these professions.
Historical literature confirms the value of collaborative teaming (Barnes & Turner,
2001; Fairbairn & Davidson, 1993). The current question is, what has changed? Are
occupational therapists prioritizing team collaboration? Is the collaborative process
acknowledged by the teachers? The purpose of the current study is to explore how
teachers in the school system perceive the role of the occupational therapists in hopes
of creating an impetus for change between the educational team members. The guiding
research question for this study is, How do teachers perceive the role of occupational
therapists in a school setting?

Methods
Research design
Approval from the university’s institutional review board was obtained prior to the start of
the study. This study utilized survey research methods. A 31-question anonymous online
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, AND EARLY INTERVENTION 293

survey was designed by the investigators to provide data to answer the research question.
The survey questions were developed based on conversations with current school teachers
and their perceptions of school-based occupational therapy practice. The survey questions
were created to support data to inform the research question. Section 1 collected demo-
graphic information, Section 2 gathered data regarding employment status, and Section 3
was the result of the researcher/teacher conversations. Section 3 presented 13 questions
garnered from teacher interviews and related to the research question (Table 1). The
survey was electronically mailed to 306 school administrators in Pennsylvania in the first
week of June 2014. The email asked the administrators to forward the request to the
teachers. Because the email was sent to school administrators and not the teachers
themselves, a return rate cannot be determined. The online survey was available during
the first 3 weeks in June. The survey’s aim was to collect demographic information,
employment status, daily routines of the teachers, and information about the teachers’
perceptions of the roles of occupational therapists they have worked with in the school
setting.

Table 1. Teacher perceptions of the roles of occupational therapists online survey.

Section 1: Personal background information
Do you currently work at least 10 hours a week as a teacher? Year you graduated from with your Education degree?
What is your area of teaching? In what state was your college/university of your entry
level degree located in?
How many years have you been employed as a teacher? Please identify if you have earned a post professional
degree:
What is your age? Please identify what you earned your post professional
degree in:
What is your entry level education degree?
Section 2: Employment status
Are you employed full time (30–40 hours/week) or part time Please identify the number of students you currently
(<30 hours/week)? serve in the following age groups:
What state are you currently working in? -preschool (3–5 y/o), k-6 students, 7–12 students
Type of school you work in (check all the apply) Please identify the number of students you currently
serve who have an Individualized Educational Plan (IEP):
—private school, public school, other? Of the children who have an IEP, please list their
diagnoses:
Who is your employer?
Approximately what percentage of your time is provided in
the following locations (should equal 100%)?
—general education classroom (includes classes such as art,
music, etc.), special education classroom, other school
environment (cafeteria, playground), community, other
Section 3: Teacher views on OT school-based services
Have you ever heard of occupational therapy? If, no skip to How frequently do you have contact with the OT?
the next question. If yes, in your own words please briefly
describe, “What is occupational therapy?”
Of the children you serve who have an IEP, how many Describe the nature of your contact with the OT:
currently receive speech language therapy services?
Of the children you serve who have an IEP, how many What is the role of the OT on your educational team?
currently receive physical therapy services?
Of the children you serve who have an IEP, how many What is your perceived contribution of the OT on your
currently receive occupational therapy services? educational team?
Have you ever made a referral for OT services? Please describe in detail, a negative experience you had
with an occupational therapist:
If yes, please identify the reason(s) for the referral: Please describe in detail, a positive experience you had
with an occupational therapist:
Please identify what, if anything, you would like to
change about your relationship with your OT:
294 J. D. BENSON ET AL.

Participants
The target population for this research study included all general and special education
teachers who have worked with occupational therapists in Pennsylvania schools. A total of
47 teachers responded to the anonymous online survey, which included 37 special educa-
tion teachers and 10 regular education teachers. All of the participants who responded
taught in public schools in the state of Pennsylvania, worked full time (30–40 hours per
week), and were employed directly by the school district. The participants worked with
children from preschool age through 12th grade, with an emphasis on grades K–12. Refer
to Table 2 for specific demographic information.

Instruments
An anonymous online survey using www.surveymonkey.com was designed by the inves-
tigators and was completed by the participants. The aim of this survey was to gather
information about the teachers’ perceptions of the role of occupational therapists in the
school system.
The participants were asked to access the online survey via a unique link.
Participants who provided electronic consent were routed to the survey. There were
three sections and 31 questions (Table 1). The first section sought personal back-
ground information of the teacher, such as area of teaching, years of employment, and
educational degrees. The second section of the survey gathered information on the
employment status of the teacher. For example, work status (full time (30–40 hours/
week) or part time (< 30 hours/week), type of school he or she worked in, the
employer, and the children the teacher interacted with on a daily basis. The final
section requested information from the teacher about his or her views on school-based
occupational therapy services in an open-ended question format. The questions were

Table 2. Demographic details of the participants.

Demographic component Participants
Age range (years) 24–65
Mean age (years) 41
Teaching area
Special education 37
Regular education 10
Highest level of education
BS/BA 21
MS/MA 26
Mean years employed as a teacher (years) 14
Year graduated with education degree
Year (mean) 1997
Year (range) 1975–2013
No. of students served by age groups (range)
Preschool (3, 4, and 5 y/o) 0–8
K–6 students 0–47
7–12 students 0–100
Type of school participants teach in
Public schools in Pennsylvania All
Full time or part time?
Full time (30–40 hours per week) All
Employer?
Employed directly by school district All
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, AND EARLY INTERVENTION 295

focused on the services of the teacher’s pupils, whether the teacher had ever made a
referral to an occupational therapist, teacher contact with the occupational therapist,
and the role of the occupational therapist on the team and prompting descriptions of
experiences with an occupational therapist (Table 1).

Data analysis
The data for this research study was collected over a 3-week period. The number of participants
was not predetermined as the researchers continued to seek participants until the survey was
discontinued at the end of the 3-week period. Demographic data were compiled and summar-
ized using frequency distributions tables and represented via descriptive statistics using statis-
tical software. The data analysis of the open-ended questions utilized 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 experiences of the teachers related to their
perceptions of occupational therapists within their individual school environments.

Results
Data analysis of the responses from the participants brought to light four key themes that
represented teacher’s perceptions of school-based occupational therapists. These were (I)
The good, the bad, and the ugly; (II) Communicate and collaborate! (III); OT’s role
regarding and contribution to the IEP team; and (IV) Teachers want MORE! (Table 3).

(I) The good, the bad, and the ugly

The good
When the participants were asked to describe a positive experience they had with an
occupational therapist, the majority of the participants offered insights. The data analysis

Table 3. Participant responses to the survey.

Question
What is OT?
Reason for referral
Contribution of the OT
What would you change?
Describe a negative experience
Results
49% reported OT addresses performance component issues
20% reported OT addresses occupational issues
15% reported OT addresses disability issues
73% make a referral for handwriting
35% make a referral for sensory
30% make a referral for fine motor
19% make a referral for visual-perceptual-motor
11% make a referral for gross motor
7% make a referral for ADL
7% make a referral for cognition
77% said OT is a valuable member of the team
53% reported wanting to work with the OT more!
37% reported a good relationship with OT therefore no need for change
53% could not identify a negative interaction
25% reported OT not fulfilling the responsibilities to the child and/or team
296 J. D. BENSON ET AL.

revealed the following three subthemes: (1) Occupational therapy is an important factor
for providing support for classroom participation; (2) occupational therapists are student-
focused; and (3) occupational therapists are great team members.

The bad
The participants were asked to describe a negative experience they had with an occupa-
tional therapist. From the responses, 53% could not identify a negative interaction and
22% responded with answers that were categorized as “The Bad” and identified occupa-
tional therapy as “not important.” The participants reported scenarios in which the
occupational therapist was distant and made minimal to no contribution to student
progress. One participant stated, “I think occupational therapists should be more involved
with the students they work with in order to help them make progress.”

The ugly
The remaining participants (25%) reported the negative experience was in regard to the
occupational therapist not fulfilling the responsibilities to the child and/or team. The
participants reported that responsibilities not being met by the occupational therapist were
(a) no direct interaction with the teachers/students, (b) not attending IEP and regular
meetings, and (c) lack of communication/collaboration between therapist and teacher.
One reported, “not attending scheduled meetings, not contributing to IEPs in a timely
fashion.” Another reported, “lack of communication and didn’t come three weeks in a
row.” The teachers did not report on their own availability to the occupational therapist or
how their availability impacted the relationship.

(II) Communicate and collaborate!

Participants reported that communication and collaboration between the teacher and
occupational therapist was lacking. The participants reported that the occupational thera-
pist was not directly interacting with the teachers and students on a daily basis and not
attending meetings with the team members and that there was a lack of communication/
collaboration between therapist and teacher. Methods of communication and the nature of
contact with the occupational therapist varied. Participants reported occupational thera-
pists to be in one of five categories related to contact with the teacher: (a) the collaborator,
(b) the consultant, (c) the regular, (d) the quarterly updater, and (a) Where’s the OT?

● The collaborator (11%): The occupational therapist works with the teacher to develop
and implement a plan for the student. The participants reported this could be in the
form of the therapist and teacher having a conversation and discussing strategies that
could be tried in the classroom, working together to manage schedules for students,
and having frequent conversations.
● The consultant (30%): The occupational therapist provides consultation services to
the teacher by providing input and strategies to solve a problem. These consultation
services can be through email, face to face, or through phone calls.
● The regular (39%): The occupational therapist provides regular information regard-
ing services. The participants reported that this could be in the form of emails, phone
calls, face-to-face communication, being present at the IEP meetings, providing
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, AND EARLY INTERVENTION 297

services within the classroom, completing quick “check-ins” on students, pulling

children from the classroom, and giving suggestions for the classroom to the teachers
to enhance student success.
● The quarterly updater (12%): The occupational therapist provides a quarterly update
on progress and adjustments to plan of care. The participants reported that this could
be in the form of providing progress monitoring of IEP goals, coordinating schedules
for conferences and students, and sending one email per marking period with
updates on the student.
● The minimalist (8%): The occupational therapist is present only at the IEP meeting and
has no other contact unless requested. The participants reported that this could be in the
form of just a greeting or passing by in the hallway, a call to remind them of a session
with the students, or just receiving a copy of the report from the occupational therapist.

(III) Occupational therapist’s role and contribution on the IEP team

When the participants were asked to describe, “What is occupational therapy?” several responses
were generated (Table 3). Occupational therapy was defined as addressing performance
components that affect classroom participation in students such as “fine motor skill training,”
“sensory diet and sensory processing,” “self-regulation training,” and “visual/motor integration.”
Occupational therapy was also defined as an intervention that assists people with their
independent living skills, for example, “a person that helps a person in the everyday life skills.”
Lastly, the participants defined occupational therapists as working with people who have a
disability, such as “working with children who have physical handicaps that limit their abilities.”
Even though all the participants gave different definitions of what occupational therapy is, the
general message was that occupational therapy is important in the life of the students.
When describing the role of the occupational therapist on the IEP team, 77% of the
participants explained that the occupational therapist was a valuable member of the team.
One participant reported, “She contributes to the meetings and provides support on areas
that need to be worked on for more success in the classroom.” Another participant
reported, “She is a very important piece and contributes greatly to helping parents and
teachers in understanding the importance of what she does in therapy and how it relates
to the education of students.” In addition, it was reported that occupational therapists
have “their own expertise,” provide feedback with student progress to the teachers and
how to assist in the classroom, and keep themselves involved with the participants in
regard to students. The participants appreciated the occupational therapist for providing
suggestions and strategies that assist in supporting classroom participation for their
students. One stated, “She has provided me with ideas that are “outside the box.”
Another explained, “She has always been helpful, helps to provide sensory tools that can
help our students such as pencil grips, weighted spoons, and a writer’s weight.” A third
reported, “I had an occupational therapist work with students, evaluate them and help me
to get materials that I was unable to get to assist my students.”
Although most participants had positive statements about the role of the occupational
therapists, many reported that the occupational therapist was not a strong member of the
team due to contextual limitations placed on the occupational therapist in the school
environment. Participants reported that the occupational therapist is not fully integrated
with the educational team owing to their “high caseload numbers and itinerant status.”
298 J. D. BENSON ET AL.

Another problem identified was the lack of direct interaction of the occupational therapist
with the teachers on a regular basis and not assisting with planning classroom success for
the students.

(IV) Teachers want MORE!

The final theme was related to wanting “more!” The teachers want the occupational
therapist to be more directly involved in the school and interacting with teachers/students
on a regular basis. Participants want the occupational therapist to spend more time in
their building/classroom, spend more time with the students, and have more flexibility in
their schedules. One explained, “I know their caseloads are large, but I would like more
interaction with them and for them to be working with the students more.” Some
participants explained they want more of a collaborative relationship with their occupa-
tional therapist to help support students together effectively; for example, one reported, “I
would like to have an open relationship with our occupational therapist and receive
strategies than can support students in all environments.”

Discussion
Teachers have been identified as a key component in the successful integration of occupational
therapy strategies to support student success in a school context (Benson, 2013). The findings
from this study concur, showing that the teacher-therapist relationship is vital to promoting
success for children with disabilities in the school environment. Casillas (2010b) found that
more shared collaboration and communication are needed between occupational therapists
and teachers. A major theme that emerged from this study was also collaboration and
communication. The results of this study indicate that collaboration and communication
between teachers and occupational therapists needs improvement. Casillas (2010b) reported
that teacher’s understandings of the occupational therapists role and scope of practice
improves through experience and knowledge within the school system, teachers often become
more frustrated with the system’s lack of occupational therapists and lack of communication,
suggesting that a more proactive approach for consultation is needed In this study, the
participants reported that therapists’ communication frequency varied from minimal contact
to providing regular updates on the student’s progress to a collaborative relationship with the
occupational therapist. Even though a high percentage of respondents reported that regular
updates were given on a day to day basis (39%), a low percentage of respondents felt that they
had a collaborative relationship with their occupational therapist (11%). Evidence suggests
that as the occupational therapist/teacher collaboration increases, the teacher’s perception of
student progress increases (Barnes & Turner, 2001; Benson, Salls, & Perry, 2010; Casillas,
2010b). For school-based occupational therapists, it is vital to engage in school-based best
practice to develop a collaborative relationship with the teacher.
Another outcome of the study was teacher perception of the role of the occupational
therapist on the IEP team. The participants viewed the occupational therapists as a
valuable member of the IEP team for contributing to the meetings, giving suggestions
that support classroom performance, and helping teachers/parents understand the role of
occupational therapy. But participants cited limitations of the system as a limitation in the
occupational therapist–teacher relationship. The current findings indicate that the
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, AND EARLY INTERVENTION 299

participants regarded occupational therapists as valuable team members who facilitate

success for students in the classroom, but the demands on the occupational therapist
within school-based practice leave the teachers wanting more. The participants cited high
caseloads and the occupational therapists’ itinerant status as a barrier to best practice.
School programs are at rising demand for occupational therapy services, and increasingly,
occupational therapists’ fast-growing workloads include greater demands for their con-
sultation in this environment (Jackson et al., 2006). Occupational therapists need to
consider how services are provided in the school context. Teachers and other members
of the IEP team, not the occupational therapist, largely determine the specific activities
that constitute the role of the student (Swinth et al., 2007) and by extension the role of
occupational therapy. Yet, if the role of occupational therapy in the schools is not fully
understood, the occupational therapist may not be given the opportunity to fully con-
tribute to the team. One aspect of school-based–occupational therapy services is to
support educational participation. Supporting educational participation can occur through
direct service provision or via consultation with the team. Bazyk and Case-Smith (2010)
suggest the importance of creating a balance between direct services and teacher supports
to help the child. The school-based occupational therapist needs to create a role that
includes balance in the relationship with the teacher in support of student progress. This
study, along with past research, indicates that the occupational therapist–teacher colla-
boration as a focus of student outcomes is an important piece of school-based practice
(Bazyk & Case-Smith, 2010; Swinth et al., 2007). This study contributes to the conversa-
tion regarding the occupational therapist’s role in making that happen. Although school-
based occupational therapy is an important part of the team, the occupational therapist
needs to assume the leadership role in facilitating the process. The teachers recognize
occupational therapy as a strong contributor to student outcomes, but the teacher is not
seeking the support of the occupational therapist. The school-based occupational therapist
needs to advocate for the therapist’s place on the team and contribution to student
outcomes.

Limitations and future research

The limitations of the current study concern the sample size and bias. The study shows limited
transferability due to the sample being limited to one geographical area, the state of Pennsylvania.
The educational system in Pennsylvania is unique to the state and therefore the results should be
considered in that context. It is imperative that additional research on this topic be executed to
increase generalizability by having a larger sample size in terms of both quantity of the
participants and inclusion of a larger geographical area in order to find similarities and
differences between states and regions. For this study, the flow of the research had the investi-
gators sending the survey to administrators and teachers in the month of June when most
teachers were getting ready for summer break. The investigators believe that if the survey had
been sent out during a different time of year the number of participants would have been greater.

Implications for practice

Potential clinical implications from this research study focus on the need for occupational
therapists to improve the ability to work effectively and collaboratively as IEP team
300 J. D. BENSON ET AL.

members. The results of this study indicate that school-based occupational therapists can
do the following to enhance their practice:

● Educated teachers about the specific role of the occupational therapist on the IEP
team and in the school context.
● Asked teachers what communication style and frequency is preferred.
● Establish a collaborative relationship by having a physical presence in the school and
in both formal and informal meetings.
● Expand the role of occupational therapist on the IEP team as appropriate by
explaining OTs’ domain of practice and giving appropriate suggestions for each
child.
● Advocate for system change related to workload. Time to support the IEP team
process should be an expectation not a luxury.

Conclusion
The results of this study highlight the importance of communication and collaboration
between team members. Teachers indicate that occupational therapy is an important part
of the process of ensuring student success, yet teachers express frustration related to the
limitations of the system and therefore the limitations of the occupational therapist.
Typically, school-based occupational therapists have high workloads and little flexibility,
which contributes to a reduced level of communication. To provide the best services in an
educational context the occupational therapist needs to advocate for the profession. It is
crucial for school-based occupational therapists to have a voice in the educational system,
therefore, allowing for improvement in communication and collaboration among team
members. School-based occupational therapists should educate the teachers, administra-
tion, and parents about the role of occupational therapy in schools. As awareness of the
role of occupational therapy increases, system change becomes a possibility. Collaboration
and dynamic teaming is within the reach of the school-based practitioner, but we need to
advocate for system change in support of the students and profession served.

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