What is School-Based OT?

Have you ever heard of school-based occupational therapy? Occupational therapy is a wonderful field, and school-based OT is an incredibly interesting part of it. If you’re an OT or maybe even a student who is curious about this position, I’d love to share more about what makes this profession so special.

What is school-based occupational therapy?

Occupational therapy, or OT, is a healthcare profession that focuses on helping individuals gain or regain independence and satisfaction in their lives. Occupational therapists work in various settings with many different populations – from premature infants in the NICU to older adults in skilled nursing facilities. In the school system, OT focuses on helping students access their education. The purpose of school-based OT is to help a child benefit from their educational program.

What kind of things does school-based OT help with?

“Helping a child benefit from their educational program” is obviously very broad! This is by design, because OTs can help with many different aspects of a student’s schooling. While we don’t teach academic subjects like math or reading, we do support pretty much all of the skills that go into being ready to learn about those things! Think skills like:

Activities of daily living
Attention
Assistive technology
Environmental modifications
Executive function
Fine motor skills
Gross motor skills
Leisure skills
Play
Rest and sleep
Seating and positioning
Sensory processing
Social skills
Visual motor skills
Vocational skills

What is the scope of practice for OTs in the schools?

You might have heard that school-based OT has a more limited scope of practice. While I don’t necessarily agree with this, it definitely is more specific than OT under a medical model. Most importantly, school-based OTs must address deficits that have an educational impact. This is opposed to a medical model in which occupational therapy services can address any deficit area for the sake of remediating a deficit (as long as funding sources allow). While these often may end up being the same deficits, the difference is that in the school system, those deficits have to be impacting a student’s access to their education.

Still confused? To put it another way, in the medical model, pediatric OTs help their patients be the best tiny humans they can be in ALL of their roles. In the schools, OTs help their kids be the best students they can be.

Now, this doesn’t mean that all of the things we address in schools are tied to academics. We all know that being a good student involves a lot more than just making good grades. It all just depends on the needs of the specific child.

Do school-based OTs only address handwriting?

Nope! This is a common misconception, even within the OT field! It is true that fine motor skills (and handwriting by extension) make up a large part of the skills a student uses in school, especially in the early grades. But school-based OT can support so much more than this. Some of my favorite memories of working as a school-based OT involve supporting older students at their job site, helping teachers and paraprofessionals support students who are learning to manage clothing fasteners, and supporting executive function needs like work completion and organization.

Do school-based OTs work with every student?

Not necessarily. In general, school-based OTs support students with disabilities. Per IDEA, OT is a related service that is available to any special education student that requires it to access their educational program. Section 504 is another federal law that allows students with disabilities to receive the support they need to be successful in school.

Not every student with a disability will require direct school-based OT services. There are many other professionals working in the school system who help support student needs, and using a multidisciplinary, collaborative approach is key. Students may have deficits that an OT could help support, but they may be better served by someone who is with them more often, such as their teacher. To put it succinctly, each time I identify a deficit, I ask myself this question: “Does this student require the specific knowledge of a school-based occupational therapist to address this deficit?” If the answer is no, the student doesn’t require school-based OT for that area of need.

Beyond this, OTs may also support students through an RtI model. This is a framework that allows all students to get support if needed, even those without diagnosed disabilities. Developing and supporting RtI initiatives is a powerful way for OTs to have an impact on their whole school or district, and often serves as early intervention for students who may need just a little extra boost.

School-based OTs should continue to advocate for their role in supporting their schools globally. Some other ways to do this are participating in Backpack Awareness Day, joining decision-making committees at their schools, and helping to conduct research on OT’s impact on the general education population.

What kinds of tasks do school-based OTs do?

In addition to providing direct OT services, a school-based OT’s day may be filled with the following things:

Assessing students
Observing students in their natural environment
Screening students
Providing consultation for students
Running RtI programs
Providing inservices and trainings for teachers and staff
Attending IEP meetings
Attending other school meetings
Planning treatments
Researching evidence and best practices
Completing documentation of services
Progress reporting
Driving or traveling between schools
Communicating with teachers, administrators, staff, and parents by email or phone
Ordering equipment and treatment materials
Maintaining equipment and assistive technology
Supervising OTAs or OT students

And you can guarantee that there are other random things that will come up. If you’re looking for a job that is a little different every day, this setting definitely keeps things fresh and interesting!

School-based OT is so valuable, and of all the settings I’ve worked in as an OT, it is absolutely my favorite. If you’re looking to take a deeper dive into this setting, I’d love to have you in my signature course, The Dynamic School OT! It teaches you all that you need to know to be successful in this role, even if you’re a newbie! I can’t wait for you to join me in this rewarding profession.