School-Based Occupational Therapy Interventions Through the Lens of the F-Words Framework: A Scoping Review

School participation plays a critical role in children's development; however, the extent to which school-based occupational therapy (SBOT) interventions align with the 'F-words for Child Development' (Functioning, Family, Fitness, Friendships, Fun, Future) has not been systematically examined.

This study aims to systematically scope SBOT interventions published between 1990 and 2025 and classify them according to the F-words framework.

The review adopted the Arksey-O'Malley scoping review framework as the foundational methodological structure and incorporated Levac et al.'s refinements to enhance rigour. The review was informed by Joanna Briggs Institute (JBI) guidance for scoping reviews, and reporting followed the PRISMA-ScR checklist. PubMed, Scopus and Web of Science were searched using strategies grounded in the OTPF-4 and MeSH. Eligibility criteria included peer-reviewed intervention studies delivered in schools to students aged 3-18 years, published in English between 1990 and 2025.

Of 2406 records, 35 studies met the inclusion criteria. Most originated from North America and Australia. The distribution of interventions across the F-words domains was uneven: Functioning appeared in 34 studies (97%), Fitness in 29 (83%), Fun in 23 (66%), Family in 18 (51%), Future in 11 (31%) and Friendships in only 7 (20%).

SBOT research predominantly emphasizes Functioning and Fitness, while Friendships and Future are comparatively neglected. A more balanced application of the F-words framework would provide a broader understanding of how SBOT interventions are distributed across child development domains.