SIGNIFICANCE: Rural schools face many challenges when implementing response to intervention (RTI) initiatives due to an array of circumstances that are intrinsic to these geographic regions (Robinson, Bursuck, & Sinclair, 2013). Rural school-based occupational therapy practitioners may also be at a disadvantage, as they have historically faced long travel times, a lack of resources and equipment, and a lack of accessible peer support from other occupational therapy practitioners in the field (Johnson, Johnson, Zurawski, & Siegel, 2003; Roots & Li, 2013; Wills & Case-Smith, 1996).

INNOVATION: Little research has been conducted related to school-based, occupational therapy practice in rural environments since the mid-1990s. Yet, rural school districts are expected to keep pace with the changing federal legislation calling for the implementation of early intervening services, such as those available to general education students through RtI initiatives (Individuals with Disabilities Education Act of 2004; Pub. L. No. 108-446). Given the changes in school occupational therapy practice since the 1990s and the widespread acceptance of RtI across the nation, an examination of the activities that rural occupational therapy practitioners are involved in, as well as their perceptions regarding their involvement in such activities, is necessary. This presentation describes the results from a national survey focused on occupational therapy practitioners’ perceptions regarding their involvement in RtI, with an emphasis on rural therapists. In addition, it describes the obstacles that rural occupational therapy practitioners identified related to their contributions in RtI as well facilitating factors.

APPROACH AND RESULTS: A postal survey was sent to a random sample of 1,000 occupational therapy practitioners from the American Occupational Therapy Association’s Early Intervention and School Systems Special Interest Section. The survey had a 29.5% response rate (n = 295 occupational therapy practitioners). Nineteen surveys (6.4%) were excluded due to missing or incomplete data. A total of 276 surveys were analyzed.

Occupational therapy practitioners in rural communities (58.1%) were more likely to report participation in early identification of students benefiting from RtI interventions than practitioners in other communities. Practitioners in rural settings were also more likely to participate in universal screenings (33.7%) and to cite a lack of resources as a limiting factor to their work in RtI (77.9%). Occupational therapy practitioners in rural communities may be involved in key RtI practices more often than occupational therapy practitioners in urban and suburban contexts. Rural practitioners report this increased level of involvement despite a perceived lack of resources. More research is needed to understand how rural occupational therapy practitioners are involved in universal screening and how they are “doing more with less.”

Johnson, A., Johnson, S., Zurawski, N., & Siegel, A. (2003). The experiences of being a rural occupational therapist. UW-L Journal of Undergraduate Research. Retrieved from http://www.uwlax.edu/urc/JUR-online/PDF/2003/johnson-et-al.pdf

Robinson, G., Bursuck, W. D., & Sinclair, K. D. (2013). Implementing RtI in two rural elementary schools: Encouraging beginnings and challenges for the future. The Rural Educator, 34(3), 1–9.

Roots, R. K., & Li, L. C. (2013). Recruitment and retention of occupational therapists and physiotherapists in rural regions: A meta-synthesis. BMC Health Services Research, 13, 59. http://dx.doi.org/10.1186/1472-6963-13-59

Wills, K., & Case-Smith, J. (1996). Perceptions and experiences of occupational therapists in rural schools. American Journal of Occupational Therapy, 50, 370–379. http://dx.doi.org/10.5014/ajot.50.5.370