American Journal of Occupational Therapy最新文献

{"title":"Association Between Autism Severity and Feeding Behaviors in Children: A Cross-Sectional Study.","authors":"Ayşe İlayda Mutlu, Mustafa Cemali, Fatma Nur Köklü Şimşek, Melek Nur Uygun","doi":"10.1177/19437676261478045","DOIUrl":"10.1177/19437676261478045","url":null,"abstract":"<p><p>ImportanceFeeding difficulties are common in autistic children, but their relationship with autism severity remains unclear.ObjectiveTo examine differences in feeding behaviors according to autism severity and investigate associations between selected autism symptom domains and feeding behaviors in autistic children.DesignCross-sectional study.SettingSpecial education and rehabilitation center.ParticipantsEighty-two autistic children aged 4-8 years participated. Based on Childhood Autism Rating Scale (CARS) scores, 42 children were classified into the mild-to-moderate group and 40 into the severe group.Outcomes and MeasuresAutism severity was assessed using CARS. Feeding behaviors were evaluated using the Behavioral Pediatric Feeding Assessment Scale (BPFAS).ResultsChildren in the severe group showed significantly higher total and subdomain BPFAS scores than children in the mild-to-moderate group (<i>p</i> < .05). Significant positive associations were observed between selected CARS domains and feeding behavior problems. The strongest associations were observed for sensory-related characteristics (taste, smell, and touch response and use), relating to people, and fear or nervousness. In contrast, emotional response showed weaker but significant associations (<i>p</i> < .05). Regression analysis showed that autism severity significantly predicted feeding difficulties and explained 65.1% of the variance in BPFAS scores (adjusted R² = .651, <i>p</i> < .001).Conclusions and RelevanceFeeding behavior problems were more pronounced in children in the severe group, and autism severity emerged as a clinically relevant predictor of feeding difficulties. Sensory-related and socioemotional characteristics demonstrated meaningful associations with feeding behaviors, supporting the importance of individualized and multidisciplinary assessment and intervention in autistic children.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":" ","pages":"1005-1013"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School-Based Occupational Therapy in MTSS: A Call to Action.","authors":"Marco A Leão, Shelly J Lane","doi":"10.1177/19437676261484889","DOIUrl":"10.1177/19437676261484889","url":null,"abstract":"<p><p>School-based occupational therapy practitioners (SBOTPs) are called to move beyond reactive services for students with identified disabilities and contribute to preventive, inclusive supports for all learners. The <i>Every Student Succeeds Act</i> and the adoption of Multi-Tiered Systems of Support (MTSS) create a timely opportunity for SBOTPs to expand their role as Specialized Instructional Support Personnel within school-wide systems. However, current implementation remains limited by conceptual confusion, inconsistent definitions of MTSS tiers, insufficient data collection and progress monitoring, and fragmented service delivery. These challenges restrict SBOTPs' ability to participate fully in school-wide prevention and intervention efforts and perpetuate a narrow view of occupational therapy (OT) as primarily a direct service linked to special education eligibility. This call to action argues for the development of a clearly defined, stakeholder-informed, and evidence-based model for OT practice within MTSS. It also offers recommendations for coordinated action across research, education, and practice to strengthen role clarity, professional preparation, and implementation support. Together, these efforts are essential to advancing inclusive, preventive, and educationally relevant OT services that support participation and success for all students.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":" ","pages":"1153-1158"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Mirror Therapy Preceding Augmented Reality in Stroke Rehabilitation: A Randomized Controlled Trial.","authors":"Chia-Jung Lin, Keh-Chung Lin, Mei-Hsiang Chen, Wen-Shiang Chen, Chia Ling Chen, Ya-Ju Chang, Ya-Yun Lee, Grace Yao, Yi-Shiung Hrong","doi":"10.1177/19437676261488791","DOIUrl":"10.1177/19437676261488791","url":null,"abstract":"<p><p>ImportanceAlthough augmented reality (AR) may improve functional outcomes after stroke, the added benefit of mirror therapy (MT) as a priming strategy before AR remains uncertain. A three-arm comparison of MT + AR, AR alone, and conventional therapy (CT) is needed to clarify whether MT priming provides additional benefit.ObjectiveTo examine whether AR, with or without MT priming, improves sensorimotor function, balance, quality of life, and self-efficacy after stroke.DesignSingle-blind randomized controlled trial with 3-month follow-up.SettingFive outpatient rehabilitation clinics.ParticipantsSeventy-seven individuals with first-ever stroke were randomized to MT + AR (<i>n</i> = 26), AR (<i>n</i> = 26), or CT (<i>n</i> = 25).InterventionParticipants received 90-min sessions, 3 times/week for 6 weeks.Outcome MeasuresPrimary outcomes were the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and Berg Balance Scale. Secondary outcomes included sensory function, arm activity/use, self-efficacy, and quality of life. Clinical significance was determined using the minimal clinically important difference (MCID).ResultsThe MT + AR group showed greater improvements in motor and sensory outcomes than AR and CT, with the highest portion of participants exceeding MCID among the three groups. Both MT + AR and AR demonstrated superior gains in balance, arm use, self-efficacy, and quality of life compared with CT, with a higher percentage exceeding MCID. Improvements were maintained at follow-up.Conclusions and RelevanceMT priming enhances AR effects on motor and sensory recovery. AR yields clinically meaningful improvements in function, participation, and quality of life after stroke.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":" ","pages":"1090-1099"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biopsychosocial Factors Facilitating or Compromising Momentary Cognitive Performance in Everyday Environments.","authors":"Raymond Hernandez, Stefan Schneider, Emma Parrish, Laura M Campbell, Jason Fanning, Haomiao Jin, Shawn C Roll, Philip D Harvey, Briana N C Chronister, Jack P Ginsberg, Raeanne C Moore","doi":"10.1177/19437676261473522","DOIUrl":"10.1177/19437676261473522","url":null,"abstract":"<p><p>ImportanceOccupational therapy practitioners often assist a range of clients (e.g., people with schizophrenia, older adults, students, etc.) by addressing their cognitive functioning so they can engage in daily tasks. Thus, a better research-based understanding of real-time biopsychosocial factors that can impact everyday cognitive performance in real life can be useful. Ambulatory cognitive assessments are administered in people's natural environments, making them better suited compared to traditional formal cognitive tests for understanding factors that can impact cognitive performance in real life.ObjectiveTo examine how a range of biopsychosocial factors impact cognitive performance in real life as assessed by eight smartphone-based ambulatory cognitive tests and passively recorded survey response times.DesignSmartphone-based cognitive tests and surveys were completed daily by participants over 10 days. Associations between each cognitive test and biopsychosocial factor were examined in separate multilevel regression models.ParticipantsA total of 393 U.S. adults.MeasuresThe eight cognitive measures covered the domains of processing speed, working memory, recognition memory, and executive functioning. Biopsychosocial factors considered were distractors, prior activity, substances just taken, and psychological state.ResultsCognitive performance was better when participants reported no distractions, were alone, were more focused, had higher levels of energy or excitement, and had greater happiness.Conclusions and RelevanceUnderstanding how biopsychosocial factors affect cognitive performance may assist occupational therapy practitioners and other healthcare professionals in helping clients more deliberately adjust situations to facilitate cognitive performance when needed (e.g., for job tasks, exams, following instructions to take medications, etc.).</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":" ","pages":"992-1004"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Benefit of an OT-Led Modified CBT-I Sleep Intervention for Montana Veterans: A Pilot Study.","authors":"Amanda L Carroll, Tiana Benham, Emily Naughton, Sarah Warren, Kendra Weir, Molly Wollner, John P Nordeck","doi":"10.1177/19437676261485843","DOIUrl":"10.1177/19437676261485843","url":null,"abstract":"<p><p>ImportanceSleep disturbances are highly prevalent among veterans and negatively impact mental health and occupational performance. Occupational therapy (OT) practitioners are well equipped to address sleep as a core occupation through interventions that target habits, routines, and environmental contexts.ObjectiveTo examine the feasibility and acceptability of a community-based, OT-led modified cognitive behavioral therapy for insomnia (CBT-I) program for veterans with self-reported sleep disturbances and to explore associated changes in sleep, occupational performance, and mental health outcomes.DesignSingle-arm, pre-post pilot feasibility study with exploratory quantitative analysis.SettingCommunity-based veteran organization in Montana.ParticipantsNine veterans enrolled; seven completed the 5-week program.InterventionA 5-week OT-led modified CBT-I program consisting of weekly group education and individual OT sessions.Outcomes and MeasuresSleep quality and disturbance (PROMIS-SD, PSQI), occupational performance and satisfaction (COPM), depression (PHQ-9), anxiety (GAD-7), and quality of life (SF-12). Feasibility outcomes included recruitment, attendance, retention, and acceptability as assessed via postintervention feedback survey.ResultsParticipants demonstrated improvements in sleep, occupational performance, and mental health, with no changes in health-related quality of life. Attendance and retention were high, and all participants who completed the intervention reported positive acceptability and willingness to recommend the program.Conclusions and RelevanceOT-delivered, modified CBT-I appears feasible and acceptable in community-based settings and may be associated with improvements in sleep, occupational performance, and mental health among veterans. These findings highlight the potential role of OT in expanding access to sleep interventions, particularly in rural contexts where specialized sleep services are limited.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":" ","pages":"1054-1061"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Validity of the Bimanual Observation of The Hands (BOTH) for Assessing Bimanual Coordination in Individuals Post-Stroke With Fair-to-Good Motor Ability.","authors":"Yishai Bachar Kirshenboim, Nitsan Omer, Manar Ghanayem, Debbie Rand","doi":"10.1177/19437676261478048","DOIUrl":"10.1177/19437676261478048","url":null,"abstract":"<p><p>ImportanceThe Bimanual Observation of The Hands (BOTH) is a new observation to assess bimanual coordination post-stroke, which has potential to provide clinicians with a simple and functional tool.ObjectiveTo examine the reliability and validity of the BOTH in individuals post-stroke.DesignCross-sectional study.SettingCommunity and in-patient rehabilitation center.ParticipantsIndividuals post-stroke with fair-to-good motor ability of the affected upper extremity.InterventionNot applicable.Outcomes and MeasuresThe BOTH includes eight functional bimanual activities. Additional measures included the Purdue Pegboard Test (PPT; dexterity), ABILHAND (perceived functional use), Box and Block Test (BBT; functional ability), Rating of Everyday Arm-Use in the Community and Home (REACH; daily hand-use), and the Functional Independence Measure (FIM; independence in daily living). Internal-consistency, inter-rater, and test-retest reliability were evaluated using Cronbach's α, intraclass correlation coefficients (ICCs), and Wilcoxon tests. Validity was assessed by Spearman correlations between the BOTH and the PPT, ABILHAND, BBT, REACH and FIM (convergent) and by comparing participants with lower versus higher motor ability (known-groups).ResultsFifty-one adults post-stroke (31.4% women; age 33-88 years) participated. BOTH demonstrated excellent inter-rater reliability (ICC=0.96-0.98), good test-retest reliability (ICC=0.83-0.86), and excellent internal consistency (α>0.90). Strong-moderate correlations supported convergent validity. Known-groups validity was established.Conclusions and RelevanceThe BOTH is a reliable and valid observational tool for assessing bimanual coordination post-stroke. Accurate information regarding bimanual coordination can guide treatment planning to improve functional use of the hands. Further studies are needed to confirm these findings and evaluate responsiveness.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":" ","pages":"1025-1033"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-Environment-Occupation Fit in Autistic College Students: A Mixed-Methods Study of Social Participation.","authors":"Susan Iliff, Nicole Richard Williams, Siobhán Collins, Meris Gilliam, Abby Hill, Tori Knox, Alina Randall","doi":"10.1177/19437676261487169","DOIUrl":"10.1177/19437676261487169","url":null,"abstract":"<p><p>ImportanceSocial participation is a core occupation influencing health, identity, and belonging in college students. Limited research examines participation among autistic students within a person-environment-occupation (PEO) framework.ObjectiveTo examine social participation among autistic and non-autistic college students by comparing participation rates, satisfaction, motivations, and perceived barriers and exploring differences in lived experience and PEO fit.DesignMixed-methods convergent parallel design integrating quantitative survey data and qualitative content analysis.SettingA mid-sized, private university in the southeastern United States.ParticipantsA convenience sample of undergraduate students living on campus (<i>N </i>= 49; 23 autistic, 26 non-autistic).Outcomes and MeasuresAn anonymous survey of self-reported participation hours, satisfaction ratings, activity involvement, motivations, and barriers. Analyses included Welch's t-tests and a chi-square test; qualitative data were analyzed inductively and integrated.ResultsGroups reported similar activity types, participation rates (<i>p</i> = .14), satisfaction (<i>p</i> = .63), and barriers (<i>p</i> = .61). Overall, 62% reported at least one barrier, most commonly time. Qualitative findings revealed differences in experience: autistic students more often described internal barriers (e.g., anxiety, difficulty identifying activities), whereas non-autistic students emphasized interpersonal challenges. Both groups desired greater campus engagement.Conclusions and RelevanceComparable participation outcomes may mask differences in experience and PEO fit. Occupational therapy can support meaningful engagement through neurodiversity-affirming, contextually responsive approaches that enhance accessibility, fit, and a sense of belonging.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":" ","pages":"1078-1089"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Associations of Driving Status and Occupational Dysfunction With Health Outcomes After Acquired Brain Injury.","authors":"Shuto Takehara, Tasuku Sotokawa, Yuta Tauchi, Rie Sakamoto, Yoshihiro Kanata, Kazuhisa Domen","doi":"10.1177/19437676261478046","DOIUrl":"https://doi.org/10.1177/19437676261478046","url":null,"abstract":"<p><p>ImportanceDriving facilitates community involvement after acquired brain injury (ABI). While driving cessation can lower quality of life, the long-term health impacts of driving resumption, and how baseline occupational dysfunction (OD) affects them remain unclear.ObjectiveTo investigate the longitudinal associations between driving status (resumption vs. cessation) and health outcomes following ABI and determine whether baseline OD influences these associations.DesignRetrospective longitudinal cohort study using linear mixed-effects models for trajectory analysis.SettingSingle inpatient and outpatient driving rehabilitation program at a Japanese medical center.ParticipantsSixty-two patients with ABI who completed driving assessments and follow up.Outcomes and MeasuresPhysical component summary and mental component summary (MCS) scores from the eight-item short-form health survey, Zung self-rating depression scale (SDS) scores, and life-space assessment (LSA) scores, with the baseline classification and assessment of occupational dysfunction score as the primary moderator.ResultsDriving resumption was significantly associated with MCS (β = 6.409), SDS (β = -7.310), and LSA (β = 22.768) score improvements. These associations were most pronounced in patients with higher baseline OD (e.g., interaction β for MCS = 0.152, <i>p</i> < .01; interaction β for SDS = -0.149, <i>p</i> = .01).Conclusions and RelevanceDriving resumption is associated with clinically meaningful improvements in mental health-related quality of life, depressive symptoms, and life space, particularly in patients with severe OD at baseline. These findings highlight the importance of assessing baseline OD during driving rehabilitation to understand better and support the long-term wellbeing and community participation of patients with ABI.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 6","pages":"1034-1044"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GenAI in Occupational Therapy: A Survey of Adoption, Ethical Concerns, and Training Needs.","authors":"Adam Lockwood, Ryan Farmer, Tara Mansour","doi":"10.1177/19437676261478044","DOIUrl":"https://doi.org/10.1177/19437676261478044","url":null,"abstract":"<p><p>ImportanceOccupational therapy practitioners are rapidly adopting generative artificial intelligence (GenAI) tools in clinical settings, yet little is known about current usage patterns, ethical concerns, or training needs specific to the profession.ObjectiveTo examine how occupational therapy practitioners are using GenAI in practice and explore their ethical concerns, and training needs.DesignCross-sectional survey study.Participants277 occupational therapists; 77 occupational therapy assistants with a mean age of 40.8 years and a mean of 14.8 years of occupational therapy practical experience.Outcomes and MeasuresSelf-report questionnaire examining AI usage patterns, perceived advantages and limitations, ethical and institutional factors influencing adoption, and training preferences.Results48.9% of participants reported using GenAI in the past 6 months, with common applications including answering work-related questions (38.7%) and generating clinical content. Primary concerns included preference for human judgment (46.2%), accuracy and reliability (45.7%), and ethical issues (38.2%). Only 6.2% reported formal institutional GenAI policies, and 94.8% never entered personally identifiable information into GenAI systems; only 12.2% obtained informed consent from clients, caregivers, or other relevant parties to use GenAI. While 68.3% believed practitioners should receive GenAI training, 42.2% reported receiving no training, with most (73.2%) desiring formal webinar-based instruction.Conclusions and RelevanceOccupational therapy practitioners reported significant GenAI use. Participants also noted substantial concerns about ethical implementation, data security, and loss of clinical skills. Findings suggest that critical gaps in formal training and institutional guidance exist. Evidence-based frameworks and structured educational initiatives to ensure GenAI integration aligns with client-centered, ethical practice standards are needed.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"80 6","pages":"1014-1024"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School-Based Occupational Therapy in Inclusive Education: A Scoping Review of Roles, Practices, Contexts, and Gaps.","authors":"Paolo Miguel Pangue Bulan, Noah Patrick Kudera Madrazo, Shelter Anne Candol Hernando, Arianne Daphne Aliño Besabella, Mykka Claudette Phua Getubig, Princess Maie Fajardo Salanatin, Shafika Roejean Alcontin Manlosa, Anna Martina Calledo Fabiaña, Stephanie Kate Niña Mozo Torralba, Dale Ashley Yu Kuizon","doi":"10.1177/19437676261481398","DOIUrl":"10.1177/19437676261481398","url":null,"abstract":"<p><p>ImportanceLiterature on school-based occupational therapy in inclusive education remains dispersed and variable, obscuring how occupational therapy practitioners support collaborative learning environments.ObjectiveTo map existing evidence on the roles, practices, contexts, and gaps of school-based occupational therapy in inclusive education.Data SourcesWe searched Google Scholar, GALE, PubMed, ScienceDirect, ERIC, EBSCOhost, CINAHL, and Scopus for English-language literature published between 2010 and 2025.Study Selection and Data CollectionWe reported the review in accordance with PRISMA-ScR and conducted it using the Arksey and O'Malley framework, refined by Joanna Briggs Institute guidance. We screened primary studies on occupational therapy in inclusive education, charted data, applied qualitative content analysis, and did not conduct critical appraisal.FindingsThe review included 60 studies, primarily utilizing qualitative designs (56.7%) from high-income regions. Occupational therapy practitioners were described across individualized direct-service, collaborative, consultative, capacity-building, and systems-level roles. Practices included skill-focused supports, embedded and tiered service-delivery approaches, environment- and participation-focused strategies. Implementation occurs in mainstream primary schools (55.0%), with fewer studies in early childhood and secondary, transition and higher education contexts. Persistent barriers hindering inclusive practice include educator role ambiguity, high caseload models restricting shared planning time, and overemphasis on structured academic tasks over nonacademic occupations.Conclusions and RelevanceSchool-based occupational therapy in inclusive education is broad, context-dependent, and represented across collaborative, embedded, and participation-focused forms of practice. Advancing this area requires clearer role communication, attention to service location and delivery models, structural support for collaboration, and broader attention to participation across academic and nonacademic school routines.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":" ","pages":"1111-1132"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}