Occupational therapy is a vital facet of the health care industry as well as one that has been and is expected to continue experiencing explosive growth in the labor market. Occupational therapy targets individuals requiring various levels of attention and therapeutic care who are suffering from disabilities that may be the result of either physical or psychological trauma. It is imperative that those suffering from such trauma seek trained and experienced therapists capable of helping them to not only achieve the heights of human experience that is within their grasp, but to inspire them to believe that they are capable of achieving those heights.
The very term occupational therapy is endowed with an immediacy of connotation that places it solidly within the range of physical rehabilitation for some, but it is imperative to fully apprehend and appreciate the prominence that emotional rehabilitation plays throughout the full range of occupational therapy. Indeed, for many victims experiencing trauma to the extent that they require the services of an occupational therapist, the emotional distress that they seek to move past and heal is far more disengaging from the process of attaining those heights of human experience than the physical distress could ever be.
The significance of emotional healing should not be read in any way as a diminution of the essential role in the process played by physical therapy. This may be especially true when that physical therapy is put to the test in the classroom. The inescapable reality of the educational system is that it is designed in such a way that it is at all times perched precariously on the precipice of engendering systemic limitations on student attainment of the heights of the human experience to which they are endowed by not only their creator, but the government charged with creating that system. Introducing occupational therapy into the academic system via classroom settings is one proven way to expand the potential for ensuring that all students not only become capable of dealing with any physical limitations placed upon them, but also are stimulated to push back against the psychological forces holding them back from facing the difficulty of dealing with those physical disabilities (Daniels, 2010).
Occupational therapy is a health care discipline that seeks to assess and consequently treat both psychiatric and physical conditions in a bid to facilitate appropriate anatomical functioning of the patient while simultaneously preventing to the greatest degree possible any negative impact of that physical disability on the patient’s actualization of independence. The ultimate goal of such therapeutic measures is the achievement by the patient of full functioning within the purview of realistic expectations in order to promote not just an increase in health and well-being but productivity. Occupational therapy therefore is very much considered a patient-focused discipline that sets the goal of promoting the physical and psychological health of the client above all other considerations. This goal may be definitively accomplished through successful integration of the client into the workplace, professional situations, education aspirations and a host of daily routines once deemed difficult or even impossible as a result of the physical or psychological limitations being faced (Polatajko & Cantin, 2010).
The integration of occupational therapy in the classroom carries with it the potential to increase the possibility that students who are currently experiencing a mostly negative impact as a result of one or more physically or emotionally debilitating restrictions can be positively sustained until they are physically and emotionally capable of enjoying more meaningful and productive lives. A substantial element of this long-term process often takes the deceptively simple of encouragement to work together in concert with other individuals not facing the exact or even very similar debilitating conditions.
The concept behind the integration of occupational therapy into a structured classroom environment is strongly based on existing education philosophies that recognize the necessity for holistic nurturing and development of individuals in the process of preparing them for their futures professional lives (Case-Smith, Holland & Bishop, 2011). Therapy is particularly important as a way of facilitating student participation in the activities that can stimulate them to seek other activities capable of helping them attain their goals or just simply assimilate into the patterns of daily social life. This assimilation may either directly or indirectly serve to broaden the realm of influence that guides them toward becoming more successful in meeting both short-term and long-term goals. Individuals with various cognitive, physical, or psychological disabilities tend to be less participative in general and this introduces the need to encourage them to take part in various activities that ultimately bolster their outcomes in various day-to-day activities. The integration of occupational therapy in the regular classroom environment is one of the best methods of ensuring inclusion and participation of all individuals in the classroom in spite of their different psychological and physical limitations.
According to Rens (2014), one can easily integrate several occupational therapy practices into the learning environment with exceptional outcomes especially for the students. Through incorporation of some of the practices used in community based pediatric occupational therapy in teaching, it is possible to increase the reach of the occupational therapist without necessarily confining the individual to the classroom environment. This is possible through training teachers on the basics of occupational therapy and delegating the roles of therapists to trained teachers as is the case in the teaching young students’ fine motor skills aligned to pencil use and handwriting development. The teacher is in the best position to implement occupational therapy strategies as the teaching roles overlap with the basic learning of the young mind. It is also important to note that the school-based occupational therapist has unique duties that one can integrate into the teaching process as opposed to offering the same in an environment separate from the classroom.
The integration of occupational therapy interventions in the regular classroom environment aims to help individuals especially children participate in both school and various social situations while further bolstering the acquisition of skills especially for those recovering from trauma and accidents. It also helps provide some form of social support especially for those in their recovery phase following various physical, emotional, and cognitive changes. Silverman (2011) acknowledges the need for inclusion in the regular classroom of individuals with various disabilities as it is evident that most physical limitations have no impact on the educational outcomes of the students. Rather, students with physical disabilities do not necessarily have to fail in their career aspirations simply because they are different from other students. The inclusion of occupational therapy in the regular classroom is one of the ways of ensuring inclusion when it comes to providing quality education to the population. A co-teaching model is feasible with both the teacher and occupational therapist taking part in teaching. While this is acceptable, it introduces some form of misalignment while hinting at special treatment for the disabled, a situation that negates the whole aspect of inclusion in the classroom. Alternatively, providing the necessary skills to the regular teacher will help abet this problem in that the teacher will provide guidance to all students in the classroom in spite of their physical abilities. This will further ensure that the students have a sense of belonging while bolstering acceptance and building confidence in individuals in spite of their limitations (Silverman, 2011).
Strategies rely on the various stage of development with a focus on movement, self-regulation, and the development and reinforcement of fine motor and handwriting or pencil skills for children. According to Walcott (2014), the occupational therapist must focus on ensuring that the students are for instance able to concentrate in the classroom, a situation reinforced by ensuring that each student is encouraged to focus by remaining in a particular position in the classroom for the length of a lesson. Walcott (2014) further states that it is necessary to introduce practices such as the use of energizers during lessons, courageous pacers, as well as yoga. These practices, which are physical in nature help, ensure that the individuals in the classroom are distracted albeit for a short period through these activities in a bid at ensuring they remain focused on the teacher for a considerably longer period directly aiding in bolstering the level of concentration. The courageous pacers strategy for instance entails the use of body challenge cards and practicing with water bottles as well as the use of flip charts during the lesson. The regular exercises during the lesson help by acting as distracters helping divert the attention of the students towards the areas that the lesson plan covers. This strategy works by ensuring that the students set out exercising goals during each lesson or even prior to the lessons and during lesson breaks. Pacer strategies can further include a short on the spot jog in the classroom or even a short run around the classroom block during the course of the lesson. The exercises that the students can engage in are limitless and depend on the desired physical therapy outcomes as well as the environment within which teaching takes place. Stretching as well as breathing exercises are easy to employ in an environment where there is inadequate space for outdoor exercises. On the other hand, the inclusion of physical exercise lessons in the lesson plan is beneficial and one of the better ways of ensuring that students benefit from adequate physical therapy (Walcott, 2014).
A proven strategy for occupation remediation has been that termed “direct therapy” which has been described as the most familiar type of therapy, but also one in which many questions regarding proper implementation have been raised (Bundy 1991). Direct therapy is simply industry nomenclature for remediation that utilizes direct interaction between students separated into small groups or in singular one-on-one situation. The biggest benefit to directly therapy is that, in theory, it serves to create the least restrictive environment in which to engage the therapy itself. Another positive factor is that direct therapy is one of the most appropriate when the focus of the therapy is on developing a single, specific skill or ability that can be successfully integrated into daily routines to enhance the patient’s overall emotional state and stimulate psychological well-being (The American Occupational Therapy Association, Inc., 1997.)
Behavior intervention strategies are also important for the realization of self-regulation in occupational therapy in the classroom. Self-regulation relies largely on brain gym, sensory strategies, as well as alertness. The alert program strategy relies on a speed engine analogy designed to teach young individuals how to behave and self regulate themselves in their day-to-day activities. The speed engine analogy entails the aspects of wrong and right as well as low and high to teach self-regulation. Included in the strategy are games and activities that seek to improve the aspect of sensory processing among the children (Polatajko & Cantin, 2010). One can implement self-regulation using the alert strategy in various ways including the use of meters based on the ability that a child has to perform various tasks and the corresponding speed at which they practice the same. This can run in three stages over a week with the first stage entailing the identification of speed in the answering of questions as well as in the completion of various classroom activities. Various students have various abilities in terms of answering questions and processing information pertaining to various classroom activities hence the ability for some to complete tasks faster than others in the same classroom do. The second stage covers aspects of experimentation on the methods seeking to change the students. The aim of doing this is ensuring that they are able to perform as expected in terms of speed in answering questions and keeping up with the other students in the classroom. The third stage is the regulation of the speedometers developed in the first stage. The students self regulate with this regulation going on both in the school as well as at home. Ensuring that students are able to improve on their performance by developing benchmarks from which improvement is determined as well as targets that they should beat in their quest for self-improvement. Therapists must ensure they help the students in the realization of self-regulation by providing the motivation as well as the objectives and strategies necessary. Supervision is further encouraged on the part of the parents and guardians to ensure that the program is adhered when the children are at home.
Brain gym strategies on the other hand rely on the premise that constant coordinated movement leads to optimal learning on the part of the student. Brain gym strategies therefore require the incorporation of a multifaceted approach that covers academics, memory development, physical coordination of the individual, concentration, as well as skills bordering on organizational abilities of the individual. Integrating occupational therapy in the curriculum and further training the teachers on aspects of occupational health introduces a cost effective way of introducing this important discipline in the school curriculum. The teachers play a major role in imparting knowledge to students therefore embracing the aspect of therapy and combining it with the regular curriculum will indirectly help reach the individuals that might be in need of the same without implying any additional effort or extending additional support which can easily lead to a failure in realizing the objective of imparting knowledge on all regardless of their abilities and limitations. The fact that the use of teachers as occupational therapists presents minimal intrusion into the daily lives of the students makes this a good approach for use in the diverse classroom (Taras, Brennan, Gilbert, & Reed, 2011).
Significantly, the Constructive Alignment Theory as created and developed by Biggs and Tang (2007) has been deemed highly successful as a means of integrating curriculum alignment through the inclusion of observed learning outcomes, traditional teaching learning activities and standards-based assessments. Without a properly developed and, even more importantly, regularly maintained and situationally updated method of curriculum alignment, the graduated occupational therapist cannot learn the skills and abilities and develop the level of mental and emotional discipline require to implement all the knowledge they have attained—and must continue to attain—into the classroom in any meaningful and significant fashion (Barrie 2007).
The sensory strategy is an important aspect of the second strategy mainly because this stage focuses on aspects of the coordination and development of motor skills. The stage looks into practical aspects of therapy including changes in the seating position within the classroom, movement within the room, which aids in the realization of such activities as changing reading materials by way of passing the same to each other, allowing the individuals to eat snacks, as well as allowing water bottles in class. This is mainly because the mouth is considered an important element in therapy as it an important organizing center (Ockner, 2011). The sensory aspect relies on regular practice thus the need to ensure that individuals are encouraged to experiment both in and out of the classroom. Practices such as allowing students to rest and experiment by way of providing recess time as well as break time during the regular study period help improve the cognition as well as sensory development of the individual (Sitko, 2015). Practices such as allowing students to practice doodling or even modeling items help them improve their sensory faculties through encouragement to express their feelings.
The inclusion of art subjects is another important component of therapy as this helps individuals develop their unique way of expressing their ideas for instance through drawing, music, or even carving. The acceptance of the various forms of expression helps improve the sensory aspects of the students directly encouraging them to participate fully in regular classroom activities. Allowing students to doodle is one of the strategies employed by the handwriting without tears (HWT) program, a prewriting program that seeks to train young students on fine motor skills aligned to pencil use and handwriting development (Walcott, 2014). The HWT strategy is actually a brain gym strategy as it seeks to sharpen some of the motor skills that help individuals learn letters and eventually print them out in the correct shapes. The inclusion of these strategies aligns to aspects of occupational therapy mainly because of the focus on motor skill development. It is also necessary to consider the fact that many young students join the educational system with various conditions that require the attention of occupational therapists. A study by Taras, Brennan, Gilbert, and Reed (2011) focusing on a handwriting skill development program named Write Direction incorporated into the kindergarten educational curriculum is a good example of the importance of fine motor development at an early age. The strategy which entails a fourteen week long practice sought to ensure that kindergarten pupils were trained on good finger and hand skills with a culmination in good letter printing skills as well as good handwriting and the development of motor skills aligned to hand and vision coordination. The outcome of the study points towards the differences in the individuals taught based on sound occupational therapy practices and those trained based on the regular educational curriculum. Those trained using occupational therapy principles emerged as better compared to those trained in the regular curriculum style, a situation that points out the importance of integrating physical therapy in the regular classroom. Furthermore, the fact that it is often difficult to identify individuals with poor motor and cognition skills, as they tend to have other strengths that cover up their limitations makes it imperative to have teachers who understand aspects of occupational therapy to ensure that all pupils ultimately attain their milestones in the desired way. Furthermore, the use of occupational therapy practices in teaching has the potential to improve the overall outcome of all the pupils in the classroom thus the need to integrate this important discipline in the regular classroom.
The acceptance of the fact that there are students in the regular classroom that require occupational therapy interventions to ensure they develop in a manner that encourages independence and further fosters the need to impart knowledge to all in an impartial manner is one of the main reasons behind the need to incorporate occupational therapy in the classroom. The aspect of participation in the classroom environment is for instance an area of importance as it helps in ensuring that students have equal opportunities especially now that it is a fact that individuals with various emotional, physical, or psychological challenges often find it difficult to participate optimally in some activities. It is on this basis that strategies such as the use of courageous pacers are in place in a bid at encouraging movement and even motivating students. Physical fitness goes hand in hand with proper growth and the development of the various faculties associated with the acquisition of knowledge from the classroom. By introducing exercises such as running around the classroom block and even encouraging brain gym strategies in the classroom it becomes relatively easy to motivate individuals in spite of their developmental disabilities. Another important aspect in the proper development of the growing child aligns to the aspect of collaboration. Most of the learning in the classroom environment is an outcome of collaboration between the teacher and the student. The strategies employed in occupational therapy in education border on inclusion of both the students and the teachers in the realization of the various educational outcomes. The addition of the occupational therapist that also doubles as the teacher helps improve the outcomes with the students emerging winners in terms of ample development. The need to avoid separation or segregation of students based on their abilities is another important issue that supports the need for integration of occupational therapy in the classroom. Furthermore, these strategies help bolster the thinking capacity of the students which translates to better performance as well as nurturing creativity with this having a direct impact on the future of the students (Case-Smith, Holland & Bishop, 2011).
Overall, the integration of occupational therapy in the regular classroom by way of various strategies including the training of teachers on occupational therapy principles and practices for use in the classroom is a necessity if all the individuals undergoing the regular educational system are to attain their learning objectives in spite of their abilities or shortcomings. Ensuring that all students benefit from dignified treatment by their peers as well as the teaching faculty is perhaps one of the main reasons behind the need for special training of teachers. This is especially the case for teachers involved in early childhood education, as it is at this stage that most of the deficits aligned to poor cognition as well as physical and motor skills are identifiable and consequently remedied through the provision of the right training for the pupils.
Barrie S. (2007) A conceptual framework for the teaching and learning of generic graduate
attributes. Studies in Higher Education, 32(4), 439-58.
Biggs J, Tang C. (2007) Teaching for quality learning at university. 3rd ed. Maidenhead:
Open University Press.
Bundy, A.C. and R.A. Carton. Conceptual Model of Practice for School System Therapists.
Chicago: University of Illinois, 1991.
Case-Smith, J., Holland, T., & Bishop, B. (2011). Effectiveness of an Integrated Handwriting Program for First-Grade Students: A Pilot Study. American Journal of Occupational Therapy, 65(6), 670-678.
Daniels, N. (2010). Peer Interactions and Their Benefits during Occupational Therapy Practice
Placement Education. British Journal of Occupational Therapy, 73(1), 21.
Occupational Therapy Services for Children and Youth under the Individuals with Disabilities
Education Act. Bethesda, MD: The American Occupational Therapy Association, Inc., 1997.
Ockner, S. (2011). Five Practical Sensory Strategies for the Classroom. Retrieved from
Polatajko, H., & Cantin, N. (2010). Sensory Information Exploring the Effectiveness of
Occupational Therapy Interventions, Other Than the Sensory Integration Approach, With Children and Adolescents Experiencing Difficulty Processing and Integrating. American Journal of Occupational Therapy, 64(3), 415-429.
Rens, L. A. (2014). Investigating the Experiences in a School-Based Occupational Therapy
Program to Inform Community-Based Pediatric Occupational Therapy Practice. Australian Occupational Therapy Journal, 61(3), 148-158.
Silverman, F. (2011). Promoting Inclusion With Occupational Therapy: A Co-teaching Model. Journal of Occupational Therapy, Schools, & Early Intervention, 4(2), 100-107.
Sitko, E. (2015). Sensory Strategies for the Classroom. Retrieved from http://occupational-therapy.advanceweb.com/Web-Extras/Online-Extras/Sensory-Strategies-for-the-Classroom.aspx
Taras, H., Brennan, J., Gilbert, A., & Reed, H. (2011). Effectiveness of Occupational Therapy Strategies for Teaching Handwriting Skills to Kindergarten Children. Journal of Occupational Therapy, Schools, & Early Interventions, 4(3-4), 236-246.
Walcott, D. (2014). School Based Occupational Therapy: Classroom Based Programs to Support Student Performance (1st Ed). New York: NYC Department of Education.