The figure of occupational therapy in schools is not very present nowadays, there are very few occupational therapists working in schools and even fewer working in regular schools. We believe that the incorporation of occupational therapy at school can provide greater help to the child, his family and the professionals working with him at school. Therefore, in this post we are going to explain the importance of the figure of the occupational therapist in the approach with children and as a consequence the relevance of how the occupational therapist works at school.
The work of the pediatric occupational therapist (OT) tries to address present and future limitations, optimizing and promoting proper maturation and progress in the child. It seeks to provide adequate neurophysiological, emotional and social functional development, with the prevention of disability. The objective of O.T. in pediatrics is to achieve the highest possible degree of independence in the child’s daily occupations, such as play, relationships with peers and adults, grooming, dressing, feeding, use of school materials, etc., as well as through information and advice to the family on management guidelines and adaptations.
The World Federation of Occupational Therapists endorses the educational approach to occupation-based intervention advocated by the United Nations and the World Health Organization that supports all students to carry out daily school occupations. Occupational therapists assist inclusive education by offering school-based practice at all levels of ongoing support and can provide the support and collaboration necessary for occupation performance and reduce barriers to participation for all students, and, in particular, students with specific educational needs.
School-based occupational therapy focuses on self-care tasks, learning activities, school and leisure activities, social activities, and mobility issues (e.g., home to school, school to work). The goal is to maximize the student’s job performance. Occupational performance is the appropriate fit between the student, the educational environment, and the occupations themselves.
Roles of the occupational therapist in the school setting.
In general, some of the main functions that an occupational therapist may perform in the school setting are:
To achieve maximum independence for students through the use of therapeutic activities.
Increase independence in activities of daily living.
Address motor, sensory, cognitive needs that affect access to or participation in the curriculum.
Design activities and/or tasks for the development of motor, processing, communication and interaction skills and abilities.
Advise and accompany to initiate processes of future academic orientation and job orientation.
Advise, guide and coach families and professionals.
Adapt the activity to help the student to compensate the dysfunction.
Adapt school material (both physical and cognitive) in those cases where necessary. Modify the environment to facilitate the attention and functionality of those students who need it.
Provide elements that facilitate the input of sensory information, in those cases in which there are difficulties in sensory processing and are interfering in the learning process.
Advise on the necessary adaptations and reforms to ensure that both the accessibility to the center and inside it is adjusted to the characteristics and needs of students.
Develop and train in orthotics, support products and material to facilitate ergonomics and postural control in those cases of students with motor disabilities or movement disorders, which directly affect the performance of learning and educational activities. Facilitate integration into society as an active and participatory citizen.
Design actions for the prevention of motor, cognitive and sensory processing disorders.The figure of the occupational therapist is not contemplated within the orientation team. The occupational therapist employs a holistic approach to the child oriented to cognitive, sensory and motor development within the context of the overall maturation of the central nervous system for automatic educational function and the execution of skills and the achievement of readiness. During the process of occupational therapy evaluation in school, the therapist analyzes the ability to participate in related activities in that context, focuses on child-context interactions, defines needs and possible problems, and begins to contemplate possible interventions. That is why it is important to have an occupational therapist as a support to the guidance team in order to offer the child help from all areas.
Levels of intervention.
Occupational therapy intervention at school proposes three levels of service delivery:
Level 1: whole class, involves designing alternative ways of performing school activities, if the usual way is preventing children from doing it successfully.
Level 2: group of students, when we detect that a limited number of students present similar difficulties in occupational performance.
Level 3: the individual student, when it is necessary to directly support a child in their performance and participation in any of the school activities that take place throughout the day.
Advantages of the figure of the occupational therapist at school
Any student with difficulties in any of the occupational areas that occupational therapy works (self-care, productivity, leisure and free time) can benefit from an intervention in the school setting, and therefore, the advantages of working with children in the educational center are numerous:
The child remains in his or her environment by adapting the therapy to the curricular objectives being addressed in his or her classroom. Family organization/conciliation is facilitated, saving time by not having to travel to another center after school hours. This will allow to dedicate hours to other extracurricular activities, play, family, study, homework or other type of therapies that the child attends. As it is an intervention within the student’s own environment, no school hours are lost, since they take advantage of playground, dining room or other extracurricular activities. The movement of the therapist to the educational center facilitates and improves direct contact/coordination with the child’s teachers/guardians, which makes it easier to establish specific objectives adapted to the real needs of the context. With this approach, it is possible to address the needs of all children (even if they are mild) that could not be addressed by the guidance team. This way of working helps to assess those cases that are not susceptible to direct treatment but that do require guidelines or strategies for tutors and other professionals in the school.