Occupational therapy and education: a documentary study on academic training

Introduction: The National Curriculum Guidelines for undergraduate courses in occupational therapy point to training aimed at working in different fields, which includes the field of education. Objective: To identify how occupational therapists are trained to work in the school context, based on the analysis of documents from undergraduate courses in Brazilian occupational therapy. Method: This is a documental study carried out through the analysis of the Political-Pedagogical Project, Curricular Grid and Syllabuses of disciplines of graduation courses in Brazilian occupational therapy. Data were organized in Excel spreadsheets and descriptively analyzed using a qualitative approach. Results: Of the total of 61 undergraduate courses in occupational therapy in Brazil, documents referring to 33 of them were consulted; of these, only half (n=16) present specific curricular components aimed at the area of education, and most of them (n=14) offer such content on a mandatory basis. Regarding the courses that offer specific disciplines on education, it is possible to recognize the importance of approaching these contents in the training of occupational therapists, since, for the most part, they are mandatory disciplines. It emphasizes the importance of investments in the area, considering the guidelines of the National Curriculum Guidelines and the recommendations indicated in specific Resolutions of the area. Conclusion: It is believed that the present study contributes to the advancement of reflections on the training of occupational therapists to work in the school context and encourages further studies on the subject.


Introduction
The National Curriculum Guidelines (DCN) for the occupational therapy course point to a generalist training, with diversified content, and that trains professionals able to work in different contexts, such as in general hospitals, outpatient clinics, offices, social projects, prison systems, companies, therapeutic communities, day care centers and schools (Brasil, 2002).
The document also points out that the objective of the training is for the professional to acquire skills and abilities to identify, understand, analyze and interpret aspects related to the occupational and daily dimension of the human being, and to use different human activities as an instrument of intervention, whatever they may be: the arts, work, leisure, culture, craft activities, self-care, daily and social activities, among others, such as education (Brasil, 2002).
More recently, resolution n. 650, of 4th of December of 2020 was published1 , which deals with the recommendations of the National Health Council to the proposal of National Curriculum Guidelines for the bachelor's degree course in occupational therapy, which points out in Art. 7, item VI, that the professional's performance must be based on the recognition of human needs in the various fields, such as health, social assistance, social security, work, culture, leisure, sport, education, justice and the environment, promoting the engagement in daily activities/occupations/and enabling dignity in the exercise of participation, citizenship and social inclusion (Brasil, 2020).Occupational therapists are dedicated to understanding human activity and their work is focused on areas of daily activity and/or human occupation, among which are activities related to the field of education, which points to the importance of thinking and reflect on the work of the occupational therapist in this area (Gomes et al., 2021).
Several national studies address the role of the occupational therapist in the area of education and reinforce the various possibilities of the profession in this area, as well as the gains obtained through these interventions, which, for the most part, involve the feasibility or facilitation of student participation in activities that make up the school dynamics, whether through adjustments, adaptations, development of resources, guidance, training, development of workshops, singular and territorial accompaniments, articulation of resources in the social field, mediation of conflicts, among others (Pan & Lopes, 2022;Pan et al., 2022;Souto et al., 2018;Fonseca et al., 2018;Calheiros et al., 2016;Rocha, 2007).
In 2018, the Federal Council of Physiotherapy and Occupational Therapy published Resolution n. 500, of December 26, 2018, which recognizes the specialty of occupational therapy in the school context.This describes that the occupational therapist specialized in the school context is the competent professional with specific training to work both in the regular or special school context, as well as in other educational contexts in all modalities and educational levels, with the aim of guaranteeing the inclusion of students in the learning and training spaces of the educational community (Brasil, 2018a).
Despite the recent recognition of the specialty, the role of the occupational therapist in education has been discussed for over 20 years.Rocha (2007) points out that the role of the occupational therapist in education began through Special Education, when the role was more focused on carrying out support activities for educators with students with disabilities.However, several recent national studies point out that the role of the occupational therapist in this field has been involving not only the student, but also the school, the teachers, the family and the school community, expanding its role beyond Special Education (Pan et al., 2022;Fonseca et al., 2018;Rocha, 2007;Cardoso & Matsukura, 2012).
In this sense, it is understood that the training of occupational therapists should address theoretical and practical contents, and encourage the development of these skills to compose this field of activity, which suggests questioning about how the training of occupational therapists for the action in the field of education.Folha et al. (2020) carried out a study that addressed the reality of this training and the challenges experienced by undergraduate students in occupational therapy, and pointed out that the opportunity to carry out an internship in occupational therapy in this field is an advance in the region in relation to the field of education, at the same time that it reinforces the importance of greater investments in the area and in studies on the subject.Such investments are even necessary in relation to other regions of the country in order to improve knowledge about the Brazilian reality, also considering the importance of training occupational therapists to work in this field.
Thus, considering the gap found in knowledge in relation to research on occupational therapist training in the school/education context, as well as the importance of better understanding the reality of this training and the recent recognition of the specialty "Occupational therapy in the school context", it is important to know about how this training has taken place in undergraduate courses in occupational therapy in Brazil, including, specifically, in relation to the provision of theoretical and practical content in the area.
Thus, the present work intends to identify how occupational therapists are trained to work in the school/education context, based on the analysis of documents from undergraduate courses in Brazilian occupational therapy, in order to learn about the reality of the theoretical contents and/or practices on the topic.

Methodology
The present study is characterized by research based on document analysis, which is distinguished by the use of documents as a research source, requiring a close look at the information to be collected so that it responds to the research objectives (Creswell, 2010).
According to Gil (2017), documentary research is characterized by the use of materials internal to the institution as a data source, and among the most used are institutional documents.For the author, the research is elaborated through the following stages: a) formulation of the problem; b) elaboration of the work plan; c) identification of sources; d) location of sources and procurement of material; e) data analysis and interpretation; and f) report writing.
Initially, a survey was carried out of undergraduate courses in occupational therapy in Brazil, registered in the Ministry of Education system (MEC) (Brasil, 2022), that were active, offered in the face-to-face modality, linked to institutions of a public or private nature, and whose websites of the institutions made available on the world wide web, in free access, the Political-Pedagogical Project of the course, as well as information on the theoretical and practices offered (matrix/curriculum and syllabi).
Disciplines that were not specific to the area of education were excluded from the present study, even if they addressed some specific content, since it would not be possible to measure the workload allocated to content on the subject.
It should be noted that information from documents with more recent date was privileged.For data collection, a form was prepared that considered the following information: name of the course, geographic location, consulted document (Political Pedagogical Project and/or curricular matrix and/or syllabus), number of specific disciplines in the area of education, title of disciplines related to the area of education, applicability (theoretical and/or practical and/or internship and/or extension), total workload of the discipline and mandatory (optional and/or mandatory).
Data collection was carried out in two stages: a) survey of undergraduate courses in occupational therapy, which was carried out on April 18, 2022; and b) identification of subjects that addressed the area of education/school context, carried out in May and June 2022.

Data collection
The first stage of data collection was carried out by searching for courses in the database made available by the Ministry of Education's e-MEC registration system.At the time of the search, 61 undergraduate courses in occupational therapy were identified, according to the criteria defined for this study.
In the second stage of data collection, after surveying the Higher Education Institutions (HEIs), a search was carried out on the official website of each of the 61 HEIs, in order to identify information about the occupational therapy course, and only 38 provided general information.The other HEIs (n=23) did not provide any information about the course on the institution's website.
Next, a search was made for the course documents on the websites of the 38 HEIs that provided general information, namely: Pedagogical Political Projects (PPP) and/or curricular matrix and/or syllabi, to find information about disciplines/curricular components that were specific to the area of occupational therapy in education/school context.However, only 33 HEIs had at least one of the three documents.
With the aforementioned documents in hand, a search was carried out for curricular components whose titles included any of the following keywords: education, school inclusion, school context, educational context, school and/or inclusive education.
After identifying the disciplines, the menus/contents addressed were read to verify whether the discipline was specific to the area or if it only addressed some content related to the area of education.For the present study, only specific disciplines in the area of the school/education context were considered.
Thus, of the total of 33 courses whose documents were consulted, it was identified that only 16 undergraduate courses in Brazilian occupational therapy were within the criteria defined for the present study, that is, they offered specific disciplines focused on the area of school/education context.Data from these courses were organized in Excel spreadsheets and presented in tables, and then data analysis was performed descriptively.

Results and Discussion
The results showed that, of the total of 61 undergraduate courses in occupational therapy in activity in Brazil, most are concentrated in the Southeast region (n=29) and the minority is in the Midwest region (n=4) (Table 1).Note.Adapted based in information from the National Registry of Higher Education Courses and Institutions.
Of the total of 61 courses, only 33 provided free access documents.However, of the total of 33 that provided information on the disciplines, only 16 offered specific disciplines in the area of education/school context, considering the criteria of this study2 .
Table 2, below, presents the HEIs, the titles of the disciplines and other information that made up the sample of this study, according to the form prepared for data collection described in the methodology: The results revealed that most courses offering specific disciplines in the area of education are located in the Southeast region (n=9), followed by those located in the South (n=4), Midwest (n=2) and Northeast regions (n=1).
The Southeast and South regions present a considerable exponent of scientific production on the axis of occupational therapy in the field of education available on the world wide web (Folha et al., 2020).It is possible that this is linked to the fact that the Southeast region concentrates the largest number of courses linked to public institutions in the country, since most publications come from these institutions.
In any case, there are specific studies that address the role of the occupational therapist in the area in some regions of the country, such as in the Southeast region (Fernandes et al., 2019;Cardoso & Matsukura, 2012), in the North region (Folha et al., 2020) and in the Northeast region (Calheiros & Dounis, 2015), for example.In general, they address the actions carried out at school, the training of occupational therapists in the area, field perspectives, among others. 4The documents consulted do not specify the Credit Hours for theory and practice, they only inform the total Hour Load of 27 hours and that the subject has 2 credits.In this sense, it is pointed out that carrying out actions at school and publishing these experiences can contribute to expanding discussions on the area, as well as the possibilities of occupational therapy in the school context.It points to the importance of carrying out new studies on the subject in the most diverse cities and regions of the country to better understand other realities.
According to Table 2, there were no courses in the North that were within the criteria of this study.Despite this, it noteworthy that the only study identified in national occupational therapy journals that addresses training in occupational therapy in the area of education is from the North region.That is, there is a movement to carry out specific training in the area of education in this region, however, it was not possible to identify more details about how this training has happened through the criteria of the present study.
Furthermore, the results that most of the courses that offer these disciplines do so on a mandatory basis (n=14) (Table 2), which implies understanding the importance of this component in the training curriculum, since, by offering the discipline on a mandatory basis, it seems that there is a guarantee that the student will have learned content related to the area, about the work of the occupational therapist in this area and the complexity of the field.
In this sense, in 1994, the Ministry of Education and Sports, through Ordinance n. 1793, recommended the need to complement the training curricula of occupational therapists with the inclusion of contents that deal with ethical, political, and educational aspects, in order to help the process of educational inclusion (Brasil, 1994).
It is also noteworthy that specific disciplines in the area were found in only practically half of the courses consulted (16 of the total of 33 documents consulted), which may point to a possible absence of content about the area of education in the training of occupational therapists.On the other hand, given the limitations of the present study, it is suggested that further studies address the issue and even use other sources for data collection, in order to identify such gaps.
Even so, recent national studies that addressed the training of occupational therapists to work in the area of education revealed the insufficiency or lack of content in the area, and that students needed to seek alternatives for better knowledge, as well as to carry out more research on the area, in order to bring more evidence on the performance of occupational therapy in education (Folha et al., 2020;Calheiros & Dounis, 2015;Cardoso & Matsukura, 2012).
Thus, it is important for occupational therapy courses to include, in their curriculum, content from the education area to guarantee spaces for discussions and practical actions that are powerful strategies for strengthening the area and for a better understanding of the possibilities of the profession (Borba et al., 2021;Folha et al., 2020;Calheiros et al., 2016).In this sense, Borba et al. (2021, p. 9) state that "other studies and analyzes need to be promoted that can recognize the diversity of perspectives and propositions in the area for the education sector", and it is believed that such initiatives can contribute to the advancement of reflections and in the offers of contents about the area.
Regarding applicability, the results showed that most subjects are theoretical (n=7), followed by those offered in a theoretical-practical way (n=4) (Table 2).
However, two disciplines were also found that are offered as an internship, and one that is offered in a theoretical-extensionist way.The other disciplines identified did not specify their applicability.
Considering the complexity and transversality of the occupational work in the area of education, it is considered important that the contents addressed are applied in a theoretical-practical way.In this sense, Folha et al. (2020) point out that it is essential that curricula offer opportunities for contact with the area so that academics can seek theoretical-practical deepening.
It is understood that the articulation between theory and practice can contribute to a better appropriation and development of the theoretical bases to support the practices and to make better use of the discipline.In addition, carrying out practical activities can even contribute to the recognition of the profession in these spaces, as well as to the expansion of job opportunities.
It is noteworthy that the results of the present study brought a specific discipline in the area that is offered in a theoretical-extensionist way.This is a novelty foreseen in Resolution n. 7, of December 18, 2018, of the Ministry of Education and Culture, which aims to deepen dialogues on the area and bring students closer to professional practice and performance, considering the demands of the region in which training is offered (Brasil, 2018b).
This result points to a recent change that has occurred in undergraduate courses, in general, which have gone through the process called extension curricularization, and it is believed that, considering the possible changes that should occur based on this process, the replication of the present study in the near future may present results different from those being presented in this opportunity.
Regarding the number of specific disciplines in the area of education, most courses (n=14) offer only one specific discipline (Table 2), and only two courses offer two specific disciplines in the area.In addition, it was found that most subjects (n=11) comprise more than 60 hours of specific workload (Table 2).
National studies that addressed the academic training of occupational therapists pointed to the low number of hours dedicated to specific contents in several areas of activity of the profession, such as education (Folha et al., 2020), social occupational therapy (Pan & Lopes, 2019), mental health (Lins, 2015), health services management (Santos & Menta, 2017) and primary health care, for example (Oliver et al., 2012).
The DCN (Brasil, 2002) point out that occupational therapist training should be generalist, and involve content from different areas of the profession, in order to present the various possibilities of occupational therapy; however, in general, the courses have a limited workload to offer this diversity of content.Therefore, it is understandable how challenging it is to organize the curriculum in order to guarantee the general training recommended in the DCN, considering the different areas of the profession, including those that have been emerging in recent times.Furthermore, it is understood that a graduation is not enough to involve all the content necessary for the graduate to have complete confidence in working in a specific area, which reveals the importance of continuing the professional training process after graduation.However, it reaffirms the urgency of thinking about this issue in view of a broader training that embraces the diversity that constitutes Brazilian occupational therapy.Pereira et al. (2021) investigated the propositions of occupational therapists in and for schools in Brazil and identified four thematic axes of knowledge production and practices in the field, social inclusion, school inclusion, children with disabilities and dialogue with occupational therapy; resources and devices for the practice of occupational therapy at school; early childhood education, child development and its interface with occupational therapy; and, finally, childhood, adolescence and youth in situations of social vulnerability, public school and occupational therapy.Such results reflect the diversity and expansion of the field, bring demands from the professional field, and reveal an important warning to look at graduation and think about the possibilities of training directed to this field that has been taking shape.
In this sense, it is emphasized that the school is a context that permeates the daily lives of children and young people and that, in fact, needs to be addressed in the most diverse contents that make up the training in occupational therapy, including because it is an interdisciplinary area and transverse.Therefore, seeking theoretical support from the perspective of interdisciplinarity can develop the integration of contents, guarantee the construction of broad, rich knowledge, and strengthen and address the complexities involved in this field (Farias et al., 2022;Folha et al., 2020).Still, it is possible that other curricular components linked to the PPP of the consulted courses address these contents in a transversal way with a focus on education, but whose documents did not present the criteria defined for this study.
Given what has been said, it is noteworthy that during the data collection of the present study, disciplines that were not specific to the area of education were identified, but whose syllabi mentioned the approach to content related to the area.In this group, we have as an example the discipline "Occupational Therapy and Public Health, Education and Social Assistance Policies", from the Universidade Federal da Paraíba, and the discipline "Occupational Therapy in changes in development and school contexts", from the Centro Universitário UNIRB, which were not considered for the present study due to the impossibility of measuring the workload dedicated to specific contents, as well as the topics covered.
Another relevant point is the fact that there were few courses that provided information about the disciplines, which even made it difficult to collect data for this research.In addition, regarding the PPP accessed, some documents were old, had been published more than 10 years ago and may not represent the current reality of these formations.
The PPP are documents that must depart from the reality of the HEI, inform about aspects related to the course, such as forms of admission to the course, professional profile, curriculum matrix, course menus, complementary activities, activities related to research, teaching, and extension, among others.This is important information that addresses the details of the course, and that may be relevant, even for future academics.Therefore, it reinforces the importance of periodically updating these contents so that they can follow changes in the different contexts and sectors of care of the profession.
In this sense, it is suggested that new studies be carried out, in order to deepen this analysis involving the participation of students, graduates, coordinators and teachers.

Final Considerations
The present study made it possible to learn about how occupational therapist training takes place in Brazil based on the analysis of specific curricular components in the area of education, available in the of undergraduate courses in occupational therapy.
The study sought to broaden the view of the education area by highlighting aspects related to the academic training of occupational therapists, by presenting the importance of offering disciplines in the area and by reflecting on possible investment strategies in this training during and after graduation, among them , the increase in the workload of the subjects, the offer of mandatory and/or optional subjects, the carrying out of research and extension projects focused on the area of education.
Considering the HEIs that do not provide information about training on the website, as well as the course documents that do not explain the specific contents of the education area in the curriculum, it is suggested that new studies consider other forms of data collection so that it is possible to identify such elements.
At the same time, it is important to emphasize the limitations of the present study regarding the fact that it is possible that there are curricular components that address the area of education, but that have not been identified through the methods used in this study.In addition, it is possible that some information was out of date, as well as pedagogical political projects that could even be in the process of reformulation and whose data presented in this research may not represent the current reality of the courses.
Still as a limitation of the present study, there is a documentary research, and it is pointed out that the involvement of other sources of information could add to the discussion and stimulate reflections for a better deepening of the reflections on the training of the occupational therapist in the area of education.In this sense, it is suggested that further studies include the participation of coordinators, teachers, students and/or graduates for a better understanding of this reality.
Far from pointing out the problems or somehow exposing the Higher Education institutions that offer occupational therapy courses, this research sought to make a difference for the training of occupational therapists in education by presenting data on the current reality of offering specific disciplines the area of education and the identification of potentialities and gaps in training, based on a documental analysis.
It is hoped that this study will encourage course coordinators, professors, students, researchers, among others, to plan and carry out the strategies presented in this study, as well as to present other possibilities that expand and advance this training, including for give rise to the creation of possible job opportunities in the area for graduates of the course.

Table 1 .
Number of undergraduate courses of occupational therapy in Brazil by region.

Table 2 .
Content aimed at the area of education in undergraduate courses in occupational therapy in Brazil.Table referring to the results obtained from the analysis of the Course Pedagogical Project and Curricular Matrix of the Occupational Therapy courses.