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Issue Date: July 2015
Published Online: July 01, 2015
Updated: April 30, 2020
Practitioners’ Perceptions of Occupational Therapy in Middle School Settings
Author Affiliations
  • Quinnipiac University
  • Quinnipiac University
  • Quinnipiac University
  • Quinnipiac University
  • Quinnipiac University
Article Information
School-Based Practice / Health Services Research and Education
Research Platform   |   July 01, 2015
Practitioners’ Perceptions of Occupational Therapy in Middle School Settings
American Journal of Occupational Therapy, July 2015, Vol. 69, 6911510129. https://doi.org/10.5014/ajot.2015.69S1-RP203B
American Journal of Occupational Therapy, July 2015, Vol. 69, 6911510129. https://doi.org/10.5014/ajot.2015.69S1-RP203B
Abstract

Date Presented 4/17/2015

In this qualitative study, we explored the practices of occupational therapists working in middle schools to identify current trends in an effort to ascertain what would be considered best practice for adolescents in middle schools as well as to support therapists in understanding their roles in this setting.

SIGNIFICANCE: Approximately 22% of all occupational therapy jobs held in 2010 were in school settings, with the focus of school-based services to ensure that students have access to their curriculum. Occupational therapy supports and interventions in the school context need to match the environmental demands and occupations of the student. Although numerous studies have explored occupational therapy interventions in elementary schools—primarily focusing on handwriting, fine motor development, and performance skills such as sensory perceptual skills—there is a paucity of research exploring interventions in middle schools.
As the population of children eligible for services is aging, occupational therapy practitioners need to examine their current practice patterns to ensure that they align with students’ developmental levels and occupations. The use of more occupation-based, top-down models appears to be more aligned with the needs of students in middle school settings rather than the skill-based, bottom-up focus prevalent in elementary grades; however, there is little research available to support this concept.
In this project, we sought to explore the current role of occupational therapy practitioners working in middle school settings and to examine whether clinicians matched their interventions to the developmental level, environment, and occupations of the student as well as considered the roles and practice patterns within this domain.
METHOD: In this study, we used a qualitative, phenomenological design. Participants consisted of a convenience sample of 9 occupational therapists with at least 50% of their caseload being students in middle school. All data were collected through semistructured interviews. We collaboratively developed the questions. Questions were based on results of a survey of middle school practitioners previously conducted by the principal investigator using the Occupational Therapy Practice Framework: Domain and Process to ensure that the questions aligned with the profession’s standards. The interview questions were piloted with a middle school occupational therapist, and the questions were adapted for clarity. Interviews were transcribed and coded, and subsequent categories were developed. Underlying themes were identified on the basis of categories.
RESULTS AND CONCLUSION: Findings indicate that occupational therapy practitioners do not have a consistent conceptualization of their role in the middle school setting and appear to use similar theories and models as they do in elementary schools to guide their interventions at the middle school level, regardless of the appropriateness. For example, clinicians frequently indicated that they continue to work on foundational skills such as handwriting rather than developmentally appropriate skills. Participants also indicated that the educational system, rather than individual student needs, often dictated what skill areas they addressed.
Although the limitations of this study included limited geographic representation and the use of convenience sampling, the results elucidate the need for guidance in how to deliver age-appropriate, occupation-based services with students in middle schools. This area of study needs further exploration to fully understand how environmental, legal, and system issues affect the role of middle school occupational therapy practitioners.