School-Based Occupational Therapy in Inclusive Education: A Scoping Review of Roles, Practices, Contexts, and Gaps

ImportanceLiterature on school-based occupational therapy in inclusive education remains dispersed and variable, obscuring how occupational therapy practitioners support collaborative learning environments.ObjectiveTo map existing evidence on the roles, practices, contexts, and gaps of school-based occupational therapy in inclusive education.Data SourcesWe searched Google Scholar, GALE, PubMed, ScienceDirect, ERIC, EBSCOhost, CINAHL, and Scopus for English-language literature published between 2010 and 2025.Study Selection and Data CollectionWe reported the review in accordance with PRISMA-ScR and conducted it using the Arksey and O'Malley framework, refined by Joanna Briggs Institute guidance. We screened primary studies on occupational therapy in inclusive education, charted data, applied qualitative content analysis, and did not conduct critical appraisal.FindingsThe review included 60 studies, primarily utilizing qualitative designs (56.7%) from high-income regions. Occupational therapy practitioners were described across individualized direct-service, collaborative, consultative, capacity-building, and systems-level roles. Practices included skill-focused supports, embedded and tiered service-delivery approaches, environment- and participation-focused strategies. Implementation occurs in mainstream primary schools (55.0%), with fewer studies in early childhood and secondary, transition and higher education contexts. Persistent barriers hindering inclusive practice include educator role ambiguity, high caseload models restricting shared planning time, and overemphasis on structured academic tasks over nonacademic occupations.Conclusions and RelevanceSchool-based occupational therapy in inclusive education is broad, context-dependent, and represented across collaborative, embedded, and participation-focused forms of practice. Advancing this area requires clearer role communication, attention to service location and delivery models, structural support for collaboration, and broader attention to participation across academic and nonacademic school routines.