Importance: Practitioners working in school settings have a variety of job-related responsibilities in addition to direct service provision. Models of best practice indicate that a workload approach to service delivery allows practitioners to provide effective and productive interventions in the school setting; however, current information related to service delivery by school-based practitioners in the United States is lacking.
Objective: To explore current caseloads, service delivery models, implementation of workload models, knowledge of state and local policies, and job satisfaction of school-based occupational therapy practitioners and how they relate to best practice.
Design: Web-based survey.
Setting: School-based practice.
Participants: Three hundred seventy-one school-based practitioners from across the United States completed the study.
Outcomes and Measures: Investigator-developed survey with both closed- and open-ended questions.
Results: School-based practitioners recruited via social media platforms and snowball sampling completed an online survey. Results indicate that practitioners wanted to move their practice to a workload model but cited lack of administrative support, time, procedural knowledge, and decreased advocacy skills as barriers to implementation. Moreover, despite current philosophy regarding best practice, occupational therapy practitioners continue to provide services outside of the classroom and other natural settings.
Conclusions and Relevance: There seems to be a disconnect between intent (e.g., service delivery in natural settings, expanding the scope of practice) and current practice trends. Practitioners need support to advocate for and implement alternative service delivery models and to incorporate a workload approach to meet the diverse needs of students in educational settings.
What This Article Adds: Practical resources related to caseload and workload guidelines and implementation, service delivery models, and methods of advocacy and negotiation skills are needed to support practitioners as they advocate for changes in their practice.