Date Presented 04/02/2022

This presentation presents findings from a mixed-methods study that explored (1) supports and barriers to students’ academic participation and (2) educators’ perspective on direct OT consultation in a therapeutic day school setting. In addition, opportunities to support teachers and students in establishing a positive classroom culture will be discussed.

Primary Author and Speaker: Evguenia Popova

Contributing Authors: Anna Shakeshaft

IMPORTANCE: Challenges with behavioral regulation and social interaction present a barrier to occupational participation for children and youth with disabilities and can significantly impact academic performance. Literature supporting the use of occupation-based interventions that target mental health, positive behavior, and social interaction skills has been growing in occupational therapy (Cahill et al., 2020). Within a school setting, collaborative consultations that target effective classroom management strategies have been shown to improve students’ functional performance within the student role (Selanikyo et al., 2018). Research also suggests the efficacious nature of OT intervention in increasing social-emotional and self-regulatory skills for children and adolescents (Arbesman et al., 2013; Case-Smith, 2013). Nevertheless, anecdotal evidence suggests that many students continue to be removed from the classroom due to disruptive behavior.

OBJECTIVES: This study examines (1) supports and barriers to students’ academic participation and (2) educators’ perspectives on the benefits of direct occupational therapy consultation to increase students’ participation in the classroom.

DESIGN: Exploratory mixed-methods study. Setting: Kindergarten-12th grade therapeutic day school. Participants: Educators (n = 4) and students (n = 21). The students’ diagnoses included: Autism Spectrum Disorder (ASD), Attention-Deficit Disorder, Attention-Deficit/Hyperactivity Disorder (ADHD), Dyslexia, Oppositional Defiant Disorder (ODD), Anxiety, Depression, & Post-Traumatic Stress Disorder (PTSD). Intervention: Participants received eight weeks of a researcher-led one-on-one consultation to decrease challenging student behaviors and increase students’ classroom participation. Outcomes and Measures: Pre- and post-test data were collected from the educators using the: Teacher Self Efficacy Scale, Short Child Occupational Profile (SCOPE), Occupational Therapy Psychosocial Assessment of Learning (OTPAL), and semi-structured interviews. In addition, the researcher completed pre- and post-test classroom observations using the SCOPE, OTPAL, School Function Assessment (SFA), and structured fieldnotes. Finally, educators completed a Consultation & Training Satisfaction Survey at the end of the study.

RESULTS: Four themes emerged from the semi-structured interviews with the participants: (1) occupational identity and competence within student role, including internal and external contributors; (2) social disruption, including passive and active disengagement; (3) responsive teaching, including one-to-one and team-based strategies; and (4) community building, including peer mentorship and overall classroom culture. Students’ motor skills and activity performance on physical tasks were the most significant supports to the student’s classroom engagement. Communication skills, process skills, and activity performance on cognitive/behavioral tasks were the most significant barriers. Students experienced difficulty following classroom routines, forming positive habits required for classroom participation, and demonstrated limited identification with the student role. Educators perceived three key benefits to direct occupational therapy consultation: (1) outlet for discussing challenging student behaviors; (2) learning how to use mindfulness strategies; and (3) education on and implementation of adaptive equipment and environmental supports for students.

CONCLUSIONS & RELEVANCE: This study offers an expanded understanding of supports & barriers to students’ academic participation in a therapeutic day school setting. Further, this study highlights opportunities for interpersonal collaboration and the benefits of occupational therapy consultation in this setting.


Arbesman, M., Bazyk, S., & Nochajski, S. M. (2013). Systematic review of occupational therapy and mental health promotion, prevention, and intervention for children and youth. American Journal of Occupational Therapy, 67(6), e120-e130.

Cahill, S. M., Egan, B. E., & Seber, J. (2020). Activity-and occupation-based interventions to support mental health, positive behavior, and social participation for children and youth: A systematic review. American Journal of Occupational Therapy, 74(2), 7402180020.

Case-Smith, J. (2013). Systematic review of interventions to promote social–emotional development in young children with or at risk for disability. American Journal of Occupational Therapy, 67, 395–404.

Selanikyo, E., Weintraub, N. & Yalon-Chamovitz, S. (2018). Effectiveness of the Co-PID for students with moderate intellectual disability. American Journal of Occupational Therapy, 72(2), 7202205090.