• Occupational Therapy in a School Setting

    From The American occupational Therapy Association, Inc.

    School occupational therapists and occupational therapy assistants are key contributors within the education team. They support a student’s ability to participate in desired daily school activities or “occupations.” School occupational therapists (and occupational therapy assistants, under the supervision of the occupational therapist) support academic and non-academic outcomes, including social skills, math, reading and writing (i.e., literacy), behavior management, recess, participation in sports, self-help skills, prevocational/ vocational participation, transportation, and more. Because of their expertise in activity and environmental analysis, practitioners are particularly skilled in facilitating student access to curricular and extracurricular activities. They play a critical role in educating parents, educators, administrators and other staff members. They offer services along a continuum of prevention, promotion, and interventions and serve individual students, groups of students, whole classrooms, and whole school initiatives. They collaborate within the education team to support student success. 

    Occupational therapy practitioners have specific knowledge and expertise to increase participation in school routines throughout the day. Interventions include:

    • Conducting activity and environmental analysis and making recommendations to improve the fit for greater access, progress, and participation
    • Reducing barriers that limit student participation within the school environment
    • Providing assistive technology to support student success
    • Supporting the needs of students with significant challenges, such as by helping to determine methods for alternate educational assessment and learning • Helping to identify long-term goals for appropriate post-school outcomes
    • Helping to plan relevant instructional activities for ongoing implementation in the classroom
    • Preparing students for successfully transitioning into appropriate post–high school employment, independent living, and/or further education

    Occupational therapy practitioners are key contributors within the educational team. They help to address both mental and physical health. They collaborate with a variety of partners, such as:

    • Students, to help them to develop self-advocacy and self-determination skills in order to plan for their future and transition to college, career/employment, and community living; improve their performance in learning environments throughout the school (e.g., playgrounds, classrooms, lunchrooms, bathrooms); and optimize their performance through specific adaptations and accommodations
    • Parents, to support their engagement with school activities such as attendance in individualized education program (IEP) meetings with cultural sensitivity, or to assist in homework management issues by monitoring stress levels and volume of work
    • Educators and other school support staff, to offer curricular modifications to support diverse learning abilities and to meet state learning standards
    • Paraeducators, to support child success and promote safety within the school environment such as reducing autism wandering on playgrounds (e.g., physical and behavioral assistance needs)
    • Administrators, to provide training for students, staff, and parents, such as offering recess promotion strategies or contributing to anti-bullying initiatives, as well as to recommend equipment for schools and ways to modify existing buildings and curriculum to allow access for all

    Occupational therapy services for students with special needs are determined through the IEP process. School-based occupational therapy is available for students who are eligible for special education. Occupational therapists complete evaluations and assessments, and work with other members of the school-based team to help determine what is needed for a student to receive a free, appropriate public education in the least restrictive environment.


    American Occupational Therapy Association, American Physical Therapy Association, & American Speech-Language-Hearing Association. (2014). Workload approach: A paradigm shift for positive impact on student outcomes. Retrieved from http://www.aota.org/-/ media/Corporate/Files/Practice/Children/APTA-ASHA-AOTA-Joint-Doc-Workload-Approach-Schools-2014.pdf

    Cohn, E. S., & Lew, C. (2010). Occupational therapy’s perspective on the use of environments and contexts to support health and participation in occupations. American Journal of Occupational Therapy, 64(Suppl.), S57–S69. http://dx.doi.org/10.5014/ ajot.2010.64S57

    Frolek Clark, G., & Chandler, B. (2014). Best practices for occupational therapy in schools. Bethesda, MD: AOTA Press.