The Focus of Occupational Therapy and Occupational Therapy Assistant Services in the Partnering for Change School-Based Model

Our study describes the environmental factors, body functions, and activities and participation, addressed by occupational therapists (OT) and occupational therapy assistants (OTA) in the Partnering for Change (P4C) tiered school-based service delivery model in Ontario, Canada. Thirteen OTs and 10 OTAs in nine schools collected data using service logs organized by categories of occupations. Subsequently, service logs were de-identified, and the data mapped to domains of the International Classification of Functioning, Disability and Health. A beta-binomial model was used to assess the probability that specific environmental factors (e.g. classroom layout), body functions (e.g. self-regulation), and activities and participation (e.g. self-care and productivity-related tasks) were addressed at each service tier (e.g. Tier 1 Universal, Tier 2 Targeted, and Tier 3 Individualized) and by each professional (OT vs. OTA). We employed a Bayesian hierarchical approach to control for individual differences. Results indicated that activities related to productivity, such as handwriting and printing, had the highest probability of being addressed across tiers. Activities related to self-care and leisure were addressed at lower probabilities (<10%) across tiers. Environmental factors were addressed at all tiers, but most notably at Tier 3. OTs addressed a broader range of environmental factors, body functions, and activities and participation compared to OTAs, with significant differences across all tiers. Future research could explore the decision-making processes that influence which environmental factors, body functions, and activities and participation are addressed in P4C, and the nature of OT and OTA collaboration in this service model.