Pushing Occupational Therapy into the Classroom

by Briana Clift
(Orem, UT, USA)

There is new evidence that proves we have been utilizing Occupational Therapy poorly in the school setting. It is currently common for children to be pulled from the classroom in order to receive OT services; however, this has many weaknesses and isn’t using OT to its fullest.

Occupational therapists have a different understanding of children and when paired with the knowledge of a teacher, they can work together to benefit all children in the school and not just those with an IEP. There are factors that have prevented the OT from working within the classroom as well as a stigma that OT is specialized and doesn’t cross over into classrooms. Due to these factors, children are being removed from the classroom for treatment sessions rather than implementing OT to the daily routine.

This article hopes to explain some of the inner workings of this dynamic and how a change of approach could benefit more than just the student.

What is Occupational Therapy & why is it useful in the school setting?

OT is a client-centered practice that looks at individual occupations, such as eating, playing music, sleeping, or handwriting. When a child is referred for one of these issues, the occupational therapist will do an evaluation to determine if she/he demonstrates needs for services. Some children need minor changes to advance their learning abilities, she/he may not have a need for services. If a child does need services, the OT will collaborate to determine goals for the child with the IEP team and will look at personal factors and what interventions will be most beneficial. This may include intervention at:

• The child’s level
• Progressing grasp technique
• The occupation level
• Adapting the paper or pencil
• The environmental level, different sitting positions

Remove the Stigma

The next important factor for integrating OT into the classroom is removing the stigma. A teacher may believe that because OT is a specialized area they don’t have the confidence or knowledge to ask questions. What’s worse is that a misunderstanding of OT may cause the teacher not knowing what kind of information to pass along to the OT.

In the current dynamic, the teacher and OT rarely have time to discuss the child’s progress or areas of concern. A simple wave as the OT is collecting the child for their session may be the most physical communication. While the OT does specialize in areas like handwriting, the teacher could include valuable observations of the child’s daily routine and interaction. When the hierarchal idea is removed and the OT, teacher and child can work in a triadic dynamic the most improvement can be made.

What is the “pull out” method?

Pull out method is when the student is taken out of the classroom to receive therapy. Using the “pull out” method has several downsides. Since an OT is visiting many schools throughout the week, it is rare for a specific space to be reserved for the OT. This makes it difficult for the child to transfer learning when they return to the classroom and adds a difficult variant for the OT to overcome.

For instance, handwriting is nearly impossible for a child to concentrate on in a busy hallway. The “pull out” method also makes it difficult to ensure that treatments are followed through when the OT is gone. This again leads to a lesser degree of transfer learning.

The “Push In” Method

In a “push in” method, the OT works inside the classroom and better understands the demands of that environment. OT sessions more relevant to what is happening within the classroom. The teacher benefits by getting specific instructions straight from the OT rather than third party information from the paraprofessionals.

By working closely with the OT the teacher may be able to take interventions used by the OT, and apply them to other students that don’t require services, but can benefit from an adaptation. One teacher that has used the “push in” method said, “Overall, through my observation of student performance, the proximity of the occupational therapist to the learning support program has significantly improved communication between service providers and has increased the application of student skills to academic tasks.” This encounter proves that a cooperative approach is the most effective method.

Collaborative Approach

Consistent collaboration between OT and teacher is a worthy and suitable way for the students throughout the school to benefit. Through interactions and the development of experience, the teacher and OT share valuable knowledge that allows them both to be experts in the child. Close proximity means this team is able to share progress more easily, brainstorm informally and allow for adaptations to happen fluidly and regularly. This set up also offers a valuable resource for the teacher when looking for answers in dealing with other children. With this use of the dynamic, many children receive OT ideas and suggestions that may prevent intervention being needed at a later stage.

Preventative Factors

There are many challenges that would need to be faced in order to make OT a regular occurrence in the classroom. Developing a schedule that suits both the teacher and OT at the same time would be difficult. Changing the opinions on an administrative level may be challenging; however, would be extremely valuable. Change is never easy, but if a better approach can be taken and can benefit all those involved, the reward will be far worth the turmoil.

A better understanding of the benefits of room sharing is required in the school setting and should be spread to anyone who is involved. The relationship between the OT and the teacher can flow in a synergistic way that creates a better dynamic and flow of progress to the child’s interventions. If parties on all sides of the triad can come to a better understanding the child ultimately wins, which is the main concern for everyone involved.

Bowen-Irish, OTR/L, T. (2013, January 7). Classroom Collaboration. Retrieved February 22, 2016, from http://occupational-therapy.advanceweb.com/Features/Articles/Classroom-Collaboration.aspx
Hofmann, A. O. (n.d.). What Parents Need to Know About School Based Occupational Therapy. Retrieved February 22, 2016, from http://www.aota.org/about-occupational-therapy/professionals/cy/articles/school-consumer.aspx
Silverman, F. L., & Millspaugh, R. (2006). Physical Proximity of Occupational Therapy and Learning Support Instruction: How Room Sharing Can Promote Collaboration for Professionals and Success for Students. TEACHING Exceptional Children Plus, 2(4),

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