Evidence for Implementing Tiered Approaches in School-Based Occupational Therapy in Elementary Schools: A Scoping...

Area of Science:

• Occupational Therapy
• Educational Psychology
• Child Development

Background:

• School-based occupational therapy (SBOT) is crucial for supporting inclusion in educational settings.
• Multitiered service delivery models are recognized as key to maximizing school inclusion.

Purpose of the Study:

• To identify and map existing evidence on SBOT interventions in elementary schools.
• To examine interventions for all children, those at risk, and those with diagnoses.

Main Methods:

• A comprehensive literature search of 14 occupational therapy journals (1990-2020) was conducted.
• Studies focused on SBOT, school occupations, and elementary-aged children (excluding pre-K).

Main Results:

• Twenty-two studies reported individual-tier interventions (Tier 2/3), often remedial, with no whole-school approaches.
• Eighteen studies explored multitiered models, emphasizing collaborative consultation with positive outcomes.
• Handwriting and self-regulation were common concerns, but inclusion outcomes were rarely specified.

Conclusions:

• Further rigorous research on individual-tier interventions is needed to guide multitiered SBOT models.
• This review supports occupational therapists in developing evidence-based, contextual, and educationally relevant multitiered interventions for school inclusion.