Date Presented 04/02/2022
The objectives of this presentation are to quantify barriers perceived by school-based OT practitioners and the influence of practitioner experience and practice approach. This presentation will provide findings of a survey of school-based OT practitioners. Findings demonstrate that having more than 20 years of experience and using an embedded service model has a significant impact on barriers perceived. This study highlights the specific need for targeted supports to aid OT practitioners experiencing these identified barriers.
Primary Author and Speaker: Steven John Taylor
Additional Authors and Speakers: Paula Costello
Contributing Authors: Janet Brancato, Kayla Donovan, Marvyn Luna, Ann Sayre
PURPOSE: Evidence-based practices for occupational therapy practitioners (OTP) within the school setting are critical for meeting the needs of children. However, numerous barriers limit the translation of evidence into practice. The objectives of this presentation are to quantify barriers as perceived by school-based OTP and the influence of practitioner experience, and practice approach.
DESIGN: This presentation will provide findings of a quantitative descriptive survey of school-based OTP (n = 65). Subjects were recruited through a national professional organization’s web-forum. To participate, subjects must work or have worked within the school setting as an OTP. There were no exclusion criteria. The majority of subjects reported: having more than 20 years of experience as an OTP (46.2%); and 59.2% reported the majority their services being provided through a pull-out model.
METHOD: The survey tool was developed through a panel of content experts from this practice area who provided initial content suggestions, feedback through multiple rounds of revisions, and final approval of the instrument. Topics identified by this panel as being most relevant to this practice setting and included within the survey were: evaluation, practice services, interprofessional collaborative practice (ICP), and use of telehealth.
RESULTS: Findings regarding the evaluation of students indicate the majority of OTP perceive they are able to evaluate students’ educational, and functional needs; with respectively, 93.8 and 95.4% agreeing or strongly agreeing with their ability to perform these tasks. However, 35.4% of respondents disagreed with having sufficient time to schedule and complete evaluations; 26.1% disagreed with being supported to evaluate all students’ needs; and, 9.3% reported an inability to evaluate social needs. The majority of respondents reported being able to incorporate student interests into the therapy process (92.3%); as well as having sufficient knowledge and access to resources for providing evidence based (EB) services (78.5 and 73.8%). However, 26.2% of respondents disagreed with having enough time to see their caseload. Telehealth was reported to be used by 38.5% of respondents. Of these, 92% reported being able to establish rapport with students; 84% reported having sufficient knowledge of telehealth, and being able to use telehealth to support students’ participation in education. However, 28% reported having insufficient telehealth resources. Respondents indicated ICP was believed to be valued among their team-members (82.8%) and that consensus could be achieved among members (83.1%). However, 15.4% reported members of their ICP team did not understand each other’s roles and responsibilities, and 13.8% did not feel effective communication occurred among their team. Having more than 20 years of experience as an OTP and primarily using an embedded service model was found to have a significant effect (p<.05) for multiple areas of practice, including choosing evidenced based standardized assessments (F = 4.3), and use of evidence to support academic participation (F = 6.6). These traits were associated with increased perceived ability in all these areas.
CONCLUSIONS: There is an ongoing need to align practices within the school setting with what is EB practice. While some barriers to EB practice are shared by OTP; there are some nuanced needs identified. This study highlights the specific need for supports to aide OTP with less practice experience and those using pull-out service practice models. Resources targeted to meet these defined needs may be more impactful towards enhancing school-based practices and increasingly demonstrate the unique value of occupational therapy services within the school setting.
References
Grajo, L. C., Candler, C., & Sarafian, A. (2020). Interventions within the scope of occupational therapy to improve children’s academic participation: A systematic review. The American Journal of Occupational Therapy, 74(2), 7402180030. https://doi.org/10.5014/ajot.2020.039016
Brown, T., & Bourke-Taylor, H. (2014). Children and youth instrument development and testing articles published in the American journal of occupational therapy, 2009–2013: A content, methodology, and instrument design review. American Journal of Occupational Therapy, 68(5), e154-e216. https://doi.org/10.5014/ajot.2014.012237
Rose, E., & Seruya, F. (2020). Collaboration, the elusive phenomenon: Perceptions of OTs in the school setting. The American Journal of Occupational Therapy, 74(4, Suppl. 1), 7411505134. https://doi.org/10.5014/ajot.2020.74S1-PO3315
