Identification and characterization of occupational therapists on school-related actions Abstract
Introduction Education is one of the fields of occupational therapy practice; however, little is known about the reality of the Federal District, Brazil, regarding the presence and practices of occupational therapists within the school context.
Objective To identify and characterize occupational therapists from the Federal District, Brazil, who have conducted interventions related to school, as well as to understand their workplace locations and the practices developed.
Method This is a cross-sectional, descriptive, and exploratory study with a quantitative and qualitative approach, involving 40 occupational therapists from the Federal District, Brazil, who responded to an online questionnaire about socioeconomic information, academic background, professional experience, and practices within the school context.
Results The work of occupational therapists in relation to the school context primarily occurs from a clinical standpoint, addressing individual demands. The most cited practices involve guidance for teachers and families, and indication of assistive technologies – practices that contribute to improving the participation of students and staff at school. It discusses the importance of these practices, which respond to necessary demands, and the distance between occupational therapists and the school, which limits the identification of demands intrinsic to the diversity of this environment and the articulation of direct practices in the school space and its surroundings. community from a broader perspective.
Conclusion The absence of occupational therapists as professionals working within the school setting highlights the urgency of discussing the creation of such opportunities. It is believed that studies of this nature can foster reflection and contribute to advancing discussions about a field still open to occupational therapy.
Keywords:
Occupational Therapy; School context; Schools, Education; Mainstreaming; Education
Resumo
Introdução A educação é um dos campos de atuação da terapia ocupacional; no entanto, pouco se sabe sobre a realidade do Distrito Federal, Brasil, em relação à presença e às práticas de terapeutas ocupacionais no contexto escolar.
Objetivo Identificar e caracterizar terapeutas ocupacionais do Distrito Federal, Brasil, que realizaram intervenções relacionadas à escola, além de conhecer os locais de atuação e as práticas desenvolvidas.
Método Estudo transversal, descritivo e exploratório, de abordagem quantiqualitativa, com a participação de 40 terapeutas ocupacionais do Distrito Federal, Brasil, que responderam a um formulário online sobre informações socioeconômicas, formação acadêmica, experiência profissional e práticas no contexto escolar.
Resultados A atuação dos terapeutas ocupacionais em relação ao contexto escolar ocorre, principalmente, a partir do contexto clínico, atendendo a demandas individuais. As práticas mais citadas envolvem orientações a professores e familiares, e indicação de tecnologias assistivas – práticas que contribuem para a melhoria da participação dos estudantes e da equipe na escola. Discute-se sobre a importância dessas práticas, que respondem a demandas necessárias, e o distanciamento entre os terapeutas ocupacionais e a escola, o que limita a identificação de demandas intrínsecas à diversidade desse ambiente e a articulação de práticas diretas no espaço escolar e em sua comunidade sob uma perspectiva mais ampla.
Conclusão A ausência de terapeutas ocupacionais como profissionais atuantes no espaço escolar evidencia a urgência da discussão sobre a criação de tais oportunidades. Acredita-se que estudos dessa natureza podem fomentar reflexões e contribuir para o avanço das discussões sobre um campo ainda em aberto para a terapia ocupacional.
Palavras-chave:
Terapia Ocupacional; Contexto escolar; Escolas; Educação; Inclusão escolar
Introduction
One of the main challenges for schools is the implementation of the inclusive education proposal, which aims to provide accessible and equitable education for all, requiring interprofessional and intersectoral coordination (Cardoso & Matsukura, 2012). Occupational therapists are one of the professionals who work in school settings and have followed the movements advocating for school inclusion. Their role was initially focused on individuals with disabilities, considered the target population of special education, in philanthropic-assistance educational institutions, and later in special classes integrated into the regular education system (Rocha, 2007; Silva & Lourenço, 2016). Over time, this role expanded, also engaging with various groups vulnerable to school exclusion, in dialogue with social policies (Pereira et al., 2021).
In 2016, the creation of the Occupational Therapy and Education Working Group, during the IV National Occupational Therapy Research Seminar, aimed to support the occupational therapist’s role in education, schools, and schooling processes (Pereira et al., 2021). Subsequently, the approval of Resolution no. 500 by the Federal Council of Physical Therapy and Occupational Therapy (COFFITO) began to recognize the specialty of “Occupational Therapy in the School Context” and indicated that the profession’s practices involve working in different educational environments and levels, with the actors who compose these spaces—including the educational community, students, and families—regardless of their living conditions. These practices may require various areas of occupational therapy knowledge, with the aim of enabling or fostering more effective participation of the diverse individuals in occupations and activities related to these settings (Brasil, 2018).
This document contributed to the discussions, presented possibilities for actions, and prompted reflections on other practices aimed at these spaces. In this sense, some Brazilian researchers, inspired by sociological studies, highlight the importance of a professional practice that addresses the diversity of educational demands (Lopes & Borba, 2022a).
Recent studies conducted in various Brazilian regions have addressed the experiences of occupational therapists in relation to education—most of them focusing on schools—and revealed the diversity of professional practices, which may involve the demands of all actors present in these settings and be linked to different theoretical and methodological perspectives (Squassoni et al., 2021; Folha & Monteiro, 2017; Marcelino et al., 2020; Nascimento et al., 2021; Lopes & Borba, 2022b; Farias et al., 2023). These elements reinforce the breadth and complexity of schools and the field of education.
Among the practices reported in Brazilian studies, the following stand out: training teachers on specific topics to equip them, enhance their everyday practice, and reduce feelings of insecurity (Squassoni et al., 2021); intervention via collaborative consultation through strategies built in combination with all actors involved in the inclusive education process, namely: teachers, students, families, and others (Fernandes et al., 2019; Folha & Monteiro, 2017); the recommendation, production, and implementation of adaptations, adjustments, and assistive technology resources to support teachers and enable the participation of students with disabilities in regular schools (Marcelino et al., 2020); the creation of recreational and social spaces for children and adolescents in vulnerable situations in public institutions to promote mental health among them (Nascimento et al., 2021); the execution of workshops of activities and projects with socially and culturally vulnerable young people in public schools to foster connection, monitor demands, and strengthen social participation (Farias et al., 2023), among other possibilities.
Despite the diversity of actions, most studies point to isolated practices, describing interventions conducted in specific cases, as well as interface practices, which seem to indicate that occupational therapists perform school-related actions according to the demands presented by the assisted individuals, through services such as clinics, civil society institutions, health and social assistance centers, and others (Fernandes et al., 2019; Souto et al., 2018).
More recently, a study addressed the practices and challenges of five occupational therapists from the Federal District who conduct school-related actions (Lins et al., 2023a) and revealed the implementation of practices such as training, guidance, and capacity-building of teachers and assistants, as well as curricular, activity, and furniture adaptations, all performed in a challenging context mainly because of schools’ resistance and societal attitudes towards inclusion. The study highlighted the limited knowledge about the reality of the Federal District and the importance of expanding these investigations.
Thus, the aforementioned studies suggest that there is little participation of occupational therapists as professionals hired by the education sector, specifically working in these spaces, and little is known about this reality in the Federal District, including the existence of professionals hired by the education sector. This underscores the importance of investing in research that broadens the discussions and seeks a more comprehensive understanding of this theme. Given this scenario, the present study identified and characterized occupational therapists from the Federal District who perform school-related interventions, in addition to investigating their workplaces and the practices they conduct.
Method
This is a cross-sectional, descriptive, and exploratory study, employing both qualitative and quantitative approaches (Sampieri et al., 2006), with the participation of 40 occupational therapists registered with the Regional Council of Physical Therapy and Occupational Therapy 11 (CREFITO-11), residing and practicing in the Federal District, who had conducted interventions in the school context or in interface with education, and had at least six months of professional experience. Respondents who had not performed any intervention related to education, who represented other states, who had not yet completed their undergraduate studies, and those who responded to the questionnaire more than once were excluded from this study.
Data were collected between June and September 2022 in a virtual, remote environment through a questionnaire created using the Google Forms survey management application. Information was gathered on participant characteristics (gender, age group, year of graduation, educational institution, and workplace), whether they were hired by the education sector to work as occupational therapists in the service, their workplace in that capacity, and practices related to school inclusion conducted either as school-based professionals or from other services.
For recruitment, a text was shared on social media platforms WhatsApp, Facebook, and Instagram to promote the research topic and objectives, and a link was provided for interested people to access the information and begin the participation process (research details, signing of the Informed Consent Form, and finally, access to the data collection form).
The collected data were organized, quantified, and tabulated using an Excel® spreadsheet, analyzed according to the categories derived from the questions in the form, and discussed in the light of contemporary theoretical frameworks of occupational therapy in the school context, legislative documents, and public education policies.
This text is part of a broader study conducted within the research group “Caminhos: formação, educação e terapia ocupacional” [Paths: education, training, and occupational therapy], linked to the occupational therapy program at the University of Brasília (UnB) – Faculty of Health Sciences and Technologies, and was approved by the Research Ethics Committee of the UnB under Opinion no. 5.369.909, following the guidelines and regulatory norms of Resolution No. 466/2012 of the National Health Council (CNS).
Results and Discussion
Information regarding sociodemographic, academic, and professional aspects was collected to contextualize the participants.
Of the 40 participants, 36 (90%) were women, and four (10%) were men. Similar results have been found in studies conducted in different Brazilian states, which indicate that more than 80% of occupational therapists are women (Mariotti et al., 2016; Krug, 2014; Souza et al., 2018). In the Federal District, the profession also appears to have a predominantly female workforce.
Given that most participants in this study were female, it was decided to use the female gender when referring to these professionals.
This study revealed that the majority of participants were between 21 and 30 years old (n=30; 75%), followed by those aged 31 to 40 (n=7; 17%) and those aged 41 to 50 (n=3; 18%). Other studies have also included samples composed of young occupational therapists with recent qualifications (Mariotti et al., 2016; Graeber et al., 2018).
It is possible that this information is a result of the data collection method of this study, which may have limited the reach to other professionals. It is suggested that future studies use other data collection methods, such as visits to services that employ occupational therapists and/or broader dissemination of the study.
Concerning the participants’ educational institutions, the majority graduated from the University of Brasília (UnB) (n=36; 90%), followed by the Pontifical Catholic University of Goiás (PUC-Goiás) (n=2; 5%), Pontifical Catholic University of Campinas (PUC-Camp) (n=1; 2.5%), and Federal University of São Carlos (UFSCar) (n=1; 2.5%). It is worth noting that this result was expected, since this study focused on occupational therapists working in the Federal District, where UnB is located – currently the only public university in the Central-West region that offers an undergraduate program in occupational therapy.
Participants were asked about their professional workplaces and indicated more than one place of employment. Of the 36 who responded to this question, just over half reported working in clinical contexts within the private sector (n=24; 51%), as shown in Table 1.
Occupational therapists participating in this study work in various settings; however, it is notable that the majority are linked to the healthcare sector. Similar results were found by Souza et al. (2018), who identified the occupational therapists’ areas of practice in the state of Sergipe and reported that most professionals worked with child neurodevelopment in private clinics and offices, or hospitals. In this sense, it is hypothesized that this may also be the reality of the profession in other Brazilian regions, and it is suggested that further studies aim to verify this information.
Regarding work in education, Souza et al. (2018) reported that, in Sergipe, only 10% of occupational therapists worked in this field. In the present study, despite its focus on education, it was identified that only 6% (n=3) of participants were employed in this sector (two in daycare centers and one in a private school), and none indicated working in the public education system, which suggests the possible absence of occupational therapists in these settings in the Federal District.
Occupational therapy plays an important role in schools; however, it raises the question of whether the obstacles to hiring occupational therapists as part of school teams in the Federal District are related to a lack of interest in this area, a lack of opportunities, or the existence of more attractive offers in other fields of the profession.
Additionally, it is considered that the lack of recognition by much of the sector and the absence of legal documents providing for such hires constitute one of the greatest barriers to the insertion of occupational therapists in schools and other educational contexts. This demands investments in studies, reflections, and mobilization that highlight the need for these professionals, aiming to secure their place on teams.
Reality and practices of occupational therapy in school contexts in the Federal District
To understand the reality of occupational therapists’ work in the Federal District, participants were asked if they had ever been hired by the education sector; however, of the 40 participants, only seven reported having had this experience, in the following settings and forms of practice: early childhood and elementary schools (n=4), consultancy for schools (n=1), owner of a daycare and preschool where she also works as an occupational therapist (n=1), and an educational material company (n=1). These results suggest some involvement of occupational therapists with education, while also indicating their limited presence in these environments, which restricts the possibilities for intervention.
In contrast, in other countries like the United States, which pioneered the inclusion of occupational therapy in schools, the profession is regulated and systematized in educational settings (Borba et al., 2021; Souza, 2021). In Portugal, the work of occupational therapists in schools also seems common, with interventions occurring in various spaces such as individual rooms and areas outside the school community (Maia et al., 2016).
In Brazil, to date, Resolution no. 500 of COFFITO (Brasil, 2018) recognizes this specialty of the profession and mentions the various settings in which professionals can work in the school context: multifunctional rooms, universities, social centers, regular schools, special schools, hospitals, the third sector, and homes. However, this resolution alone may not be sufficient to ensure the participation of occupational therapists in these settings, highlighting the need for recognition by the education sector for the development of effective policies that foresee the hiring and concrete inclusion of occupational therapists.
On the other hand, considering the participants’ indications about the places and forms of work in the school context, national studies have also pointed to work in the various mentioned contexts (schools, daycare centers, and consultancies), presenting them as possibilities that advance the inclusion of occupational therapists in education (Gebrael & Martinez, 2011; Marcelino et al., 2020; Baleotti & Zafani, 2017; Folha & Monteiro, 2017).
Daycare centers, for instance, are recognized as a favorable space for child development, providing reduced vulnerability and appropriate stimulation for a child’s healthy development (Jurdi et al., 2018). Thus, it is believed that the knowledge of occupational therapy can contribute to the goals of these spaces.
Noteworthy—considering the reality revealed in this study—is a professional who works as both the owner and occupational therapist of a daycare school – a service that has become a partner of the occupational therapy program at the UnB and which began offering supervised internships in occupational therapy for the course focused on the field of education. This internship is considered a significant advancement for education and the profession in the region. In addition, it is important to understand the practices conducted and the results obtained from this experience to reflect on new possibilities for the field.
It is reported that one of the criteria for participation in this study was having performed, currently or in the past, interventions in schools or in interface with education. Although only three participants were directly hired by the education sector, all 40 participants had conducted practices related to the school context, even from other workplaces.
It is understood that it is important for occupational therapists to engage in actions from other work contexts to meet the needs of those who seek them, promote intersectoral and interprofessional coordination, fill the gap of occupational therapists in the education sector, establish partnerships, and publicize the profession’s work in this area, or even as a way to effectively enter the education sector. On the other hand, it is reiterated that it is essential to expand and include occupational therapists in school contexts to conduct actions from, in, and for education, aiming, among other goals, at consolidating a field that is still developing in Brazil and globally.
In any case, regardless of the starting context, this study identified the practices performed by participants related to schools. To do so, they were asked to describe an intervention situation and indicate: who requested the occupational therapist, whether there was a visit to the school, the practices performed in the intervention, and the results obtained.
When asked about the main actors requesting the occupational therapist for school-related demands, it was found that most requests came from the school/teacher and family, as indicated in Table 2.
The study by Duarte et al. (2018), conducted in Rio de Janeiro, revealed that schools are the main referrers to the services of the Child and Adolescent Psychosocial Care Center (CAPSij). This result indicates that schools play an crucial role in detecting student needs and become a fundamental and privileged space for actions promoting school and social inclusion.
In this regard, studies involving professionals from the public education network point out that teachers feel unprepared to identify and manage everyday demands, expressing feelings of insecurity and inadequacy, even among those who have completed specialization courses aimed at the target audience of special education, for example (Rocha et al., 2022; Squassoni et al., 2021). This highlights the importance of interprofessional collaboration to organize inclusion processes, as well as enabling reflections on teachers’ tools for practice, their mental health, and the working conditions to which they are subjected.
This study did not involve schools or teachers to gain a more in-depth understanding of this reality in the Federal District, and it is suggested that future research addresses this gap. In any case, it is considered that working with teachers is also part of the occupational therapist’s practice in the school context, which can be conducted through guidance, lectures, training, and collaborative partnership to promote inclusion and offer tools for practice, aiming to reduce feelings of powerlessness and enable more effective referrals of demands (Lins et al., 2023b). Moreover, occupational therapy can contribute with actions promoting care and health directed at teachers by creating spaces for exchanges and sharing, discussion circles, using integrative and complementary practices, helping to organize routines with guidance on rest and sleep, among other strategies.
This study also indicates that families are among the main actors requesting occupational therapy services for school-related demands, underscoring the importance of aligning practices with these individuals. Families play a fundamental role in ensuring the effectiveness of referrals and other actions necessary to improve school participation and promote school and social inclusion. Moreover, families can be the focus of interventions through listening, guidance, clarification, and follow-up, among other approaches.
Rocha et al. (2018) presented an intersectoral action involving professionals from a health service, education, students, and an occupational therapist to promote the school inclusion of a child with cerebral palsy and intellectual disability, who lived at home, was socioeconomically vulnerable, and had weakened social networks. These authors pointed out that the school inclusion of this child required actions that preceded the process, meaning that the intervention began by facilitating access to basic rights and network support, implemented through the provision of clinical care to the child’s parents, access to the Continuous Cash Benefit (BPC), acquisition of a wheelchair and shower chair provided by the Basic Health Unit, and access to a hippotherapy service – actions that supported access to the school. Subsequently, coordination with the school occurred, requiring intense professional participation to ensure that the child could regularly engage in activities.
In other words, the work of occupational therapists in schools to promote inclusion is complex and may require intersectoral actions, demanding that these professionals coordinate the assurance of rights, promote the exercise of citizenship, and foster the social participation of students, families, and educators, which can support access, permanence, and successful inclusion. Thus, it is emphasized the development of strategies to broaden intersectoral dialogue through coordinated and partnership-based actions with education, health, social assistance networks, and others that may be necessary.
When asked whether they had gone to schools to conduct interventions, 33 out of 40 participants (82.5%) responded affirmatively, six (15%) responded negatively, and one (2.5%) did not answer the question.
It is worth noting that most professionals who participated in this study were not directly hired by the education sector but were linked to clinical services and performed occasional actions in or for schools in response to specific demands. It is believed that the role of the occupational therapist may require closer contact with schools, which could contribute to a more open dialogue and strengthen the relationships with the actors involved in the interventions. This can occur through guidance, training, workshops, as well as through recommendations and follow-up on adaptations, adjustments, or assistive technology resources, for example.
It is understood that occasional actions performed from other contexts can respond to demands that emerge from the school and help facilitate or enable student participation in everyday activities. However, it is also understood that this distance may exclude the identification of demands that are only perceived when the occupational therapist is embedded in the school context, which go beyond individualized needs and also consider the collective and the activities that compose the dynamics of that space.
Furthermore, all 40 participants reported the practices carried out in relation to the school context freely and indicated more than one response. The most frequently mentioned practices included guidance for parents and educators (n=23; 28%) and adaptations/assistive technology (n=17; 21%), as shown in Table 3.
The results presented in Table 3 corroborate the findings of other national studies. Cunha (2017) conducted a study in the state of Piauí and identified that occupational therapists provide general guidance to teachers on the use of assistive technology resources and furniture adaptations as strategies for promoting school inclusion. In the state of São Paulo, Cardoso & Matsukura (2012) reported that the most common practice of occupational therapists related to inclusive education is providing guidance to parents and teachers, whereas Lins et al. (2023b) described a proposal for training public school teachers to promote student inclusion. In the state of Pernambuco, Marcelino et al. (2020) indicated actions such as performance analysis, meetings with parents and professionals, accessibility assessments, conducting lectures, creating assistive technology resources, among others. In the state of Pará, Folha & Monteiro (2017) presented a collaborative consultancy experience in which activity and material adaptations were suggested to improve handwriting, along with guidance to educators on the use of the resources.
The practices revealed by this study were also noted by Maia et al. (2016), who addressed the reality in Portugal, reporting actions such as cooking sessions, activities of daily living, movement sessions, autonomy and functionality groups, transdisciplinary interventions, among others.
Brazilian authors have pointed to collaborative consultancy as a strategy used by occupational therapists in the school inclusion process (Baleotti & Zafani, 2017; Gebrael & Martinez, 2011; Folha & Monteiro, 2017). Through collaborative consultancy, knowledge and efforts can be gathered in a non-hierarchical way to make decisions and plan interventions based on the subjective needs of students (Baleotti & Zafani, 2017).
Regarding this strategy, Folha & Monteiro (2017) revealed that one of the demands highlighted by an educator was difficulty handling materials. In this sense, through collaborative consultancy, the following strategies were proposed: adaptations in activities and materials, guidance on how to use wider-diameter pencils, introduction of activities that stimulate fine motor and visuomotor coordination, and adaptations in writing activities.
Gebrael & Martinez (2011) conducted a study with 10 teachers and 10 students with low vision in regular early childhood education, presenting an example of collaborative consultancy performed by occupational therapists aimed at expanding the repertoire of strategies and resources for teachers to strengthen students’ independence. To this end, a preliminary study was conducted on the children’s abilities in self-care tasks, as well as the teachers’ repertoire, to develop a program called PRÓ-AVD. This collaborative consultancy resulted in an increased repertoire of teachers in hygiene and feeding activities for students with low vision.
Thus, it is observed that the role of the occupational therapist in the school context seems to primarily facilitate more effective student participation through necessary adaptations, as well as working with school professionals by enhancing their behaviors and strategies.
The practices reported in this study, as well as in the aforementioned research, aim to overcome barriers that may prevent or hinder full and effective participation in schools, and therefore align with public policies in the field (Baleotti & Zafani, 2017; Brasil, 2007, 2015, 2018).
These practices are important and should be part of occupational therapists’ repertoire in school settings; however, they reveal two points that deserve attention. One is that most of the cited practices involve guidance and performing occasional actions, revealing the professional’s distance from the school space and the actors who frequent it. This is understandable given that most of the participants in this study work in clinical settings. Nevertheless, this distance limits the identification of other demands that may emerge from the school, such as barriers related to interactions with different people and cultures, various social markers of difference (social class, race/ethnicity, gender, sexuality, disability, etc.), difficulties in school access and permanence, issues related to the school staff, including feelings of powerlessness and frustration, preparation for transitions and life stages, among others. These demands could be identified through the integration of occupational therapists as part of the school team.
The other point to consider is that, possibly due to the fact that the practices mentioned in this study often originate from the clinical context, some seem directed at specific and individualized populations, reminiscent of actions performed at the start of the profession’s work in schools, particularly with people with disabilities (Rocha, 2007).
The target population for special education is a focus of occupational therapists’ work in schools, but it is not the only one. The school is considered a broad and complex context, composed of a diverse population that may have needs related or unrelated to their living conditions, and these needs, when interfering with school participation, can be the focus of occupational therapy actions, both individually and collectively. More effective integration into schools could foster more collective actions, strengthen relationships with the school community, enable a more detailed understanding of everyday life, and promote dialogue more aligned with theoretical and methodological frameworks in the field of education.
The work from clinical settings remains important; however, it is recognized that the profession has invested in and expanded its possibilities, incorporating practices that involve everyone who has needs that compromise or prevent full participation in activities that compose the school’s dynamics, whether related to formal learning content, participation in academic, professional, or cultural activities of the school, transitions between life stages, or not, regardless of diagnoses or similar aspects. Moreover, such practices should reach not only students but also teachers, school professionals, families, and the communities where the school is located, both individually and collectively.
In this sense, it is believed that the occupational therapist’s role as a school professional can contribute to the perception of these and other demands specific to this context. On the other hand, it is emphasized that occupational therapy education is still strongly linked to health actions. While this can also be a challenge for adopting practices focused on education, it is believed that investment in specific training in the field of education can contribute to providing practices that meet the profession’s goals in relation to education, involving the feasibility/improvement of school occupations, occupational performance, social participation, citizenship, autonomy, and inclusion.
Additionally, participants were asked about the results obtained from their practices, and 31 of them reported positive information, while two provided other accounts regarding these interventions. Among those who reported positive results, providing more than one response, the data revealed improvements in participation and school performance (n=13), as presented in Table 4.
It is noted that occupational therapists realize that their practices contribute to improving student participation in activities that make up the dynamics of the school context, preparing the school team to cope with everyday situations better, and reducing frustrations. Some participants (n=7; 20%) only reported that the results were satisfactory, without offering further details.
It was also found that practices can lead to other initiatives that support occupational therapists’ actions in schools, such as making referrals and scheduling follow-up consultations.
Various studies have reported significant results from occupational therapy practices in school contexts, reinforcing the importance of these professionals’ roles in these spaces (Cardoso & Matsukura, 2012; Fonseca et al., 2018; Lins et al., 2023a).
Cardoso & Matsukura (2012) presented results similar to those of the present study, highlighting successful actions such as preparing and/or training school staff and teachers and increasing student participation and autonomy in school activities. These data demonstrate the potential of the occupational therapist’s role in schools, in synergy with the school team and students. The intersection between occupational therapy and the school team expands opportunities for team approaches, while maximizing student learning and permanence (Squassoni et al., 2021).
On the other hand, two participants shared other accounts of their practices. One occupational therapist reported that the school made the adaptations she requested but was unable to manage them satisfactorily, causing embarrassment to the student and leading to the abandonment of the adaptation. Another participant reported that there was not enough time to observe the results.
The lack of preparation of school staff for the inclusive education process is one of the main barriers to the work of occupational therapists in the school context, and the presence of occupational therapists in schools can facilitate the implementation of projects (Fonseca et al., 2018). The accounts presented here reinforce the premise of the relevance of occupational therapists’ presence in school contexts in the Federal District, both for identifying demands, as previously discussed, and for greater adherence to and understanding of proposals, in addition to ensuring follow-up, continuity, and more effective results.
Final remarks
This study presented aspects of the reality and practices of occupational therapists in relation to school contexts, finding that, in most cases, these practices are directed at schools but focused on individual student needs and performed from a clinical context.
The main actions conducted by occupational therapists involve guidance for teachers and families, as well as recommendations for adaptations and assistive technology resources, which are perceived by professionals as important contributions to improving student participation in school activities, preparing the team for everyday school life better, and reducing frustrations.
It is considered that the identified reality highlights important practices that address necessary demands. However, it is evident that the occupational therapist’s distance from the school hinders the identification and response to individual and collective demands that are intrinsic to the diverse population and to the space where school practices occur, especially in public institutions. These results highlight the gap of occupational therapists in the education sector in the Federal District, the focus of this study, as well as in other regions of Brazil.
We reaffirm the importance of this research for addressing a little-explored reality and presenting relevant elements for discussion, in addition to contributing to the consideration of possibilities for occupational therapy in education in the Federal District, adding to other studies on the theme.
It is suggested that new studies involve a greater number of professionals, including those who have already been or are hired by the region's education sector, to understand more comprehensively aspects such as the length and duration of employment, among other details.
It is considered that the development of similar studies in other regions of the country can contribute to a better understanding of the connection between occupational therapy and schools, as well as promote the advancement of discussions about the various possibilities for the profession in this context.
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1
This study is part of a broader research titled “Occupational Therapy in the school context: reality, challenges and potential”, under the responsibility of the first author.
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How to cite:
Lins, S. R. A., Correia, R. S., & Farias, M. N. (2024). Identification and characterization of occupational therapists on school-related actions. Cadernos Brasileiros de Terapia Ocupacional, 32(spe), e3681. https://doi.org/10.1590/2526-8910.ctoAO283236812
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Funding Source
The Federal District Research Support Foundation (FAP-DF).
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Section editor
Profa. Dra. Beatriz Prado Pereira
