General education inclusion of students with significant disabilities: the role of the school-based occupational therapy practitioner

Since the passage of The Individuals with Disabilities Education Act (IDEA) in 2004, it has been mandatory for disabled children to be educated with non-disabled children within public agencies to the greatest extent possible. While school systems have responded by creating academic and functional programs better suited for educating students with disabilities, they tend to be self-contained environments with limited opportunities for exposure to typical peers throughout the school day. The inclusion of special education students, especially those with significant impairments, is currently not meeting the expectations set forth by IDEA. The reasons for this vary widely and have led to the pervasive restrictive placement of students with extensive support needs (ESN) despite the numerous benefits of inclusive placement presented in available research. This manuscript will compile the existing evidence on the educational placements of significantly disabled students and use it to paint a picture of the current state of inclusion, identify the barriers to its implementation, list the benefits of inclusion for all students, and discuss how occupational therapy practitioners can facilitate, enhance, and expand inclusion of these children. This manuscript serves as a call to action for school-based occupational therapy practitioners to expand their role in this setting by emphasizing their unique skill sets to educators and fully utilizing their strengths to act as advocates for the significantly impaired students they serve.