Implementation of Best Practice in the School-based Setting

A clear gap exists between what evidence states as best practice for school-based occupational therapy and what is feasible for practitioners to implement. Evidence establishes that collaborative and contextual practice have a positive effect on student outcomes. Emerging evidence demonstrates that workload models, as opposed to caseload models, could help meet the range of demands on practitioners in order to improve student outcomes. This study aimed to answer the question: What does the implementation of best practices look like for practitioners following a caseload approach compared to those following a workload approach? As described in this study, a caseload approach is when expectations are based on the number of direct intervention minutes or assigned students, while a workload model considers all of the activities and range of demands on practitioners to meet students' needs (e.g. indirect services, teacher consultation, and documentation time). School-based practitioners recruited via social media platforms and e-mail completed an online survey to explore their practices. Responses were analyzed using descriptive statistics and nonparametric tests. Results showed a statistically significant difference between the caseload and workload models and the following practices: professional learning community membership, collaboration with teachers, and the amount of time devoted to direct intervention, teacher/staff consultation, family/caregiver training/consultation, behavioral supports, and contextually-based services. The results support the hypothesis that workload models allow for practitioners to better implement best practices in the school setting. Implications for practice include the need for educating school staff on occupational therapy's role and advocating for a transition to school-based models of practice, such as workload approaches.