Occupational Therapy's Role in Schools: A Survey of Occupational Therapy Practitioners.

Importance: Limited evidence exists surrounding the diverse, multifaceted nature of responsibilities and challenges among school-based occupational therapy practitioners (SBOTPs).

Objective: To describe a service delivery model, feedback provision, intervention approaches, roles and responsibilities, and factors contributing to intervention decisions for SBOTPs.

Design: A descriptive electronic survey design with closed- and open-ended questions for January-March 2024.

Setting: School-based practice Participants: Participants included 500 SBOTPs across the United States, with the majority having 10 or more years of experience (39.6%) and a master's degree (58.9%).

Outcomes and measures: Survey questions describing intervention approaches and frequency of use, service delivery methods, feedback provision, duties, and demographics.

Results: Most SBOTPs in elementary school provided direct intervention in therapy rooms (74.2%), whereas SBOTPs in middle and high school primarily provided consultative services (69% and 75.63%, respectively). Feedback was reported to be provided during required reports and meetings across all settings (86.27%, 88.7%, and 91.18%, respectively). The most frequently reported interventions used for SBOTPs in elementary and middle school addressed fine motor skills (98.6% and 69.5%, respectively), whereas those in high school primarily addressed life skills (56.5%). Reportedly, mental health and literacy participation were rarely addressed. Education, years of experience, and caseload size affected choices across all settings.

Conclusions and relevance: This study clarifies the roles of U.S. SBOTPs, demonstrating how their expertise supports individual student needs and broader educational goals. By understanding and leveraging SBOTPs' contributions, schools can better address their student populations' diverse needs, ensuring the opportunity to succeed academically and socially. Plain-Language Summary: This study describes a service delivery model, feedback provision, intervention approaches, roles and responsibilities, and factors contributing to intervention decisions for school-based occupational therapy practitioners. We asked 500 practitioners what interventions they use and how often, how they provide the interventions, how they communicate the child's progress, and other tasks for which they are responsible across school settings. In elementary schools, participants said that they provide interventions in therapy rooms, whereas middle and high school practitioners consulted more with teachers and staff to support students. Our participants said that, primarily, they use fine motor and handwriting interventions in elementary and middle school but focus on developing life skills in high school. Few participants said that they address mental health or literacy, but research shows that they can and should. Many participants reported that they give feedback in required reports or meetings but wished that they had more time to provide regular feedback to students and families.