SIGNIFICANCE: This research addresses the need for school-based occupational therapists (OTs) to expand their practice to address postsecondary transition goals of students with disabilities as mandated under the Individuals with Disabilities Education Act. The Ohio Department of Education funded this study in response to the needs of adolescents with disabilities for improved postsecondary outcomes. The study matches evidence of OTs’ effectiveness in adults’ return to work, life skills, and assistive technology with evidence that interventions in these areas improve transition outcomes. This study has the potential to expand school-based practice beyond elementary levels through a cost-effective, peer group approach.

APPROACH: In this mixed-methods study, we used a concurrent, fixed, multiphase design to study occupational therapy secondary transition services for adolescents with disabilities. We respond to the following qualitative research question: How do OTs provide transition services to student participants?

Transition services are a coordinated set of activities designed to improve success in adult life, including further education or employment, independent living, and community integration. Education programs must provide evaluation of, and instruction in, these activities based on the students’ strengths, needs, and interests. These youths face poor adult outcomes, including unemployment, underemployment, and lives of poverty.

METHOD: In the qualitative portion of this design, we used grounded theory, which relies on comparative analysis to produce a substantive, detailed, and clinically relevant theoretical description. Therapists and students joined the study for 2 academic yr in two staggered cohorts. Therapists were supported via workshop, online resources, and researcher visits. Transition assessments were administered to each student at the start and end of the intervention period. The settings took place in typical occupational therapy intervention locations within 10 Ohio school districts. Study participants included 49 students with high-incidence disabilities who were 14 to 16 yr of age, and 14 occupational therapy practitioners. Qualitative data of the study included monthly therapist reflective notes, monthly therapist team meetings, and individual therapist interviews. We comparatively described transition practices using grounded theory, HyperRESEARCH software, and therapists’ discussions of theoretical memos.

RESULTS: The grounded theory includes transition assessment, the individualized education program (IEP) process, collaboration, interventions, and the special challenges of time management and service to adolescents. Interventions addressed self-determination, social skills, prevocational exploration, and life skills. A cost-effective peer group intervention approach was developed. Of particular interest were therapists’ role changes, schedule management, transitions to vocational schools, and OT/occupational therapy assistant (OTA) teaming.

CONCLUSION:This 3-yr theoretical description of occupational therapy transition services across 10 Ohio school districts offers a cost-effective model for the expansion of school-based practice to serve the transition goals of adolescents with high-incidence disabilities.