Focus on Participation

Occupational therapy practitioners (OTPs) help children and youth participate in meaningful activities (occupations) in order to promote physical and mental health and quality of life. Occupational therapists (OT) and occupational therapy assistants (OTA) are referred to as OT practitioners (OTPs). Specifically, OTPs focus on the following performance areas:

  • Education/school work (e.g. attending in class, handwriting, managing classroom materials)
  • Play and leisure (e.g. playing during recess; after-school leisure participation)
  • Social participation (e.g. making friends, getting along with others, self-regulation)
  • Activities of daily living (ADLs; e.g., eating, dressing, hygiene)
  • Instrumental ADLs (e.g., preparing meals, shopping, managing money, grocery shopping)
  • Sleep and rest (sleep hygiene, making time to relax and refresh)
  • Health management (learning about and taking care of one’s mental and physical health)
  • Work (e.g. pre-work activities such as helping clean up after activities)
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OTs are skilled in analyzing the interaction between the student’s ability to successfully participate in an everyday activity (e.g. play and social interaction during recess, eating lunch) and how to modify the activity and/or environment in order to promote successful participation. In addition to having a sound knowledge of the physical and sensory requirements of a task, OTs are skilled in addressing the social and emotional aspects of participation.

All OTs have pre-professional education in mental health and mental disorders (e.g. can recognize symptoms associated with depression, anxiety, or other mental health conditions), facilitating activity-based groups, and using of activities to promote positive mental health. OTs do ‘doing therapy’ not ‘talk therapy’. We help students learn about and develop emotional competencies using a combination of therapeutic use of self and meaningful activities. Check out AOTA's (American Occupational Therapy Association) School Mental Health Toolkit

To learn more about occupational therapy, go to the American Occupational Therapy Association's website at www.aota.org.  Occupational therapists (OTs) and occupational therapy assistants (OTAs) provide services in diverse settings with people from birth to old age (e.g. schools, community centers, clinics, hospitals, and home health). The term occupational therapy practitioner (OTP) refers to both OTs and OTAs. 

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The role of OTs for Every Moment Counts

The role of OTs for Every Moment Counts is one of change leader and mental health promoter – to help teachers, school support staff, administrators, and families in promoting successful participation and enjoyment during academic (classroom, art, PE) and non-academic (recess, lunch, after-school) times of the day for students with and without disabilities and mental health challenges.

Although Every Moment Counts programs and strategies have been developed by OTs, we encourage implementation by interdisciplinary school providers (e.g. teachers, cafeteria & recess supervisors, related service providers, and para-educators). An important aspect of Every Moment Counts is to ensure that all students with and without disabilities and/or mental health challenges are fully integrated into all school environments and are able to participate and enjoy social interaction with peers. All of the model programs focus on embedding interactions and activities associated with enhancing feelings of mental well-being and happiness in children and youth (e.g. promoting enjoyment, developing strengths, participation in health-promoting activities).

Integrating OT in Natural School Contexts

Traditionally, OT's role in the schools has focused on serving students with disabilities by restoring function and adapting the task or environment to promote participation. However, the reauthorization of IDEA (Individuals with Disabilities Education Act) and NCLB (No Child Left Behind) has created new opportunities for OTs to contribute to health promotion and prevention in all children. The shift to include promotion and prevention models of service delivery has broadened the role of OT to serve all students in general and special education. Because the law mandates that services be provided in the general education environment to the maximum extent possible (i.e. least restrictive environment), OTs and other related service provides need to integrate services in natural school settings throughout the day as opposed to ‘pull-out’ intervention in isolated therapy rooms.

Interventions embedded in natural contexts (classroom, art, cafeteria, recess) versus isolated therapy rooms addresses the needs of students with disabilities without removing them from class time. Such integrated services also foster social interaction and the development of friendships among students with and without disabilities. In addition to addressing the needs of students with disabilities, integrated services also promotes positive mental health and academic success in students at-risk of developing mental or physical health challenges as well as those without disabilities.

The overarching goal of Every Moment Counts is on inclusion of students with disabilities and/or mental health challenges during all aspects of the school day and extracurricular after-school activities.

Close collaboration among all relevant school personnel is essential when integrating services in natural contexts. Planning time is essential. Collaboration with interdisciplinary team members and families is emphasized in all model programs and embedded strategies.

References: 

Bazyk, S. (Ed.). (2011). Mental health promotion, prevention, and intervention with children and youth: A guiding framework for occupational therapy. Bethesda, MD: AOTA Press. 

American Occupational Therapy Association (AOTA). (2020a). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74 (Supplement 2).

AOTA School Mental Health Toolkit. Free and downloadable at https://www.aota.org/Practice/Children-Youth/Mental%20Health/School-Mental-Health.aspx

Cahill, S., & Bazyk, S. (2019). School-Based Occupational Therapy. In Jane Clifford O’Brien & Health Kuhaneck (eds.). Case-Smith’s Occupational Therapy for Children & Adolescents (8th edition). Mosby. 

Bazyk, S. (2019). Best practices in supporting mental health: Promotion, prevention and intensive services. In Gloria Frolek Clark, Rioux, & Barbara Chandler (eds.). Best Practice in School Occupational Therapy (2nd edition), AOTA Press.

Bazyk, S. (2019). Occupational therapy’s role in school mental health. In C. Brown, V. Stoffel, & Munoz, J. (eds.) Occupational Therapy in Mental Health: A Vision for Participation. F. A. Davis.

Bazyk, S. (2016). A public health approach to children’s mental health in occupational therapy. In Christine Manville (ed.). Mental Health Practice for the Occupational Therapy Assistant. SLACK.

Conway, C., Kanics, I., Mohler, R., Guidici, M. S., & Wagenfield, A. (2015). Inclusion of children with disabilities: Occupational therapy’s role in mental health promotion, prevention and intervention. AOTA School Mental Health Information Sheet. 

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