At the OT Schoolhouse, we support school-based occupational therapy practitioners to use evidence, research, and best practices to feel more confident in their role and to avoid burnout.
Being asked to support more students with less?
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Hey , When you are new to school-based OT, the first schools you work in help to form your foundation as a practitioner. You learn:
Right or wrong, those practices start to feel like the way school-based OT is supposed to work. Often, it’s not until years later that you can look back and understand whether what you learned was based on student needs and best practices or driven more by staffing and budget concerns. I bring this up because, across the nation, practitioners are being asked to do more with less. We’re being asked to cut our weekly services to every other week. Our bi-weekly services to monthly consults. And our monthly consults to four times per year… And when every kid is moved to consult, we’re asked: “Why aren’t you exiting more kids?” These are the things that make you scream in your car between schools! 🤯 It’s one thing to recommend a monthly consultation because your clinical reasoning tells you that is what the student needs… It’s a whole other thing to recommend a monthly consultation because that is all you can fit into your already impacted schedule. Conference ReminderThe final days to join the 2026 Back to School Conference are here. Access practical sessions designed for school-based professionals, including strategies for collaboration, evaluation, service delivery, and supporting students across school settings. Access best practices with the Back to School Conference → Consult is not the problemWe have members in the OT Schoolhouse Collaborative that primarily operate from a consultative model effectively and appropriately. They have spent years designing this model to work. It didn’t happen by accident. Nor did it happen by blindly converting every weekly service to a consult model. They identify the students who will benefit most by coaching staff, modifying the environment, building supports into classroom routines, and monitoring progress rather than providing weekly direct intervention. They also know that some kids may need more than a consult service, and they are prepared to provide that when it is called for. Anita Bundy and Diann Dreiling concluded their 2003 article with: The results of this study support the conclusion that consultation is a viable model of intervention in preschool settings and is just as effective as direct–indirect interventions. This may be the most cited research sentence (often without credit) in school-based OT. And if you ask Anita and Diann, they would be the first to tell you that this article had many flaws that should prevent these results from being generalized. They listed them out in the article. The point here is that consult can and does work. And it has, for over 30 years! However, consult should never be a blanket recommendation for every student, especially when it is used as a means to compensate for budgetary and staffing concerns. I would rather fight tooth and nail to get the support the students need than recommend a service I don’t feel will fully support that student. And that is exactly what I have done in my practice. A question worth askingBefore reducing a student’s services next week, ask yourself: If I actually had space for this kid on my caseload, would I make the same recommendation? If the answer is yes, great! You can confidently share the clinical reasoning and data supporting the reduction of services. But if the answer is no, it may be time to slow down and look more closely at what is influencing the decision. You might also ask:
These questions do not remove the realities facing schools. Caseloads, staffing shortages, and financial pressures are real, and they need to be addressed. But recommending fewer services than you feel are necessary is not the right or ethical way to address this concern. Thanks so much for having a read, and I’ll catch you next week! 👋 Jayson P.S. We recently shared two new resources with Collaborative members inside Circle: an ND-affirming evaluation template and an MTSS Tier 1 presentation template inspired by Bryden’s session at the Back to School Conference. Join the Collaborative to access these resources, connect with other school-based professionals, and get extended access to the Back to School Conference. Jayson Davies, MA, OTR/L |
Jayson Davies, OTR/L
At the OT Schoolhouse, we support school-based occupational therapy practitioners to use evidence, research, and best practices to feel more confident in their role and to avoid burnout.
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