How do School-Based Occupational Therapists Work with Participation Interventions at School? : A Systematic Literature Review

Abstract: Children with disabilities are equally entitled to a bright future with education being the cornerstone and a fundamental right for this achievement. Global organizations and policies are fighting for the inclusion of children with disabilities in mainstream schools. Nonetheless, inclusion is not enough if children's participation at school is not guaranteed. The provision of support services to ensure children's participation at school is an obligation of each state. Occupational therapists have a long tradition in the school context characterized by discrepancies. Therefore, this systematic literature review aims to map how school-based occupational therapists work with participation interventions to facilitate the participation of children with disabilities. After a comprehensive search in five databases, a selection process, quality assessment and data extraction, this paper resulted in nine qualitative, quantitative, and mixed design studies. The results presented under the scope of OTPF-3 and fPRC frameworks have revealed that occupational therapists traditionally use push-in and pull-out direct approaches as a medium to enhance the performance skills and activity competence of children. However, there is a shift of occupational therapists toward participation interventions with indirect ways through service delivery models focusing on the school's social and physical environment with their collaboration with teachers being of major importance. Children's establishment of a balanced and healthy school routine, as well as the adoption of a representative student role, are identified as chief aspects of facilitating participation. Results can not be generalized, but this paper gives incentive for further investigation of occupational therapy school-based vitality regarding school participation.