Hey Reader,

“Occupation-based” is a great term in OT.

But because it sounds so good, it can sometimes get misused (a la "sensory").

So, what does occupation-based actually mean for our evaluations?

First things first: Occupation-based does not mean "no standardized testing."

Occupation-based doesn’t mean we stop using standardized tools or avoid skill-based assessments like the BOT-3.

It simply means we don’t let the skills (like copying overlapping pencil shapes) become the whole story.

Fine motor, visual motor, sensory processing, and executive functioning skills all matter - in context.

So we must ask ourselves:

How are we using those skills to understand participation in real occupations?

Any tool (standardized tests, observations, interviews, work samples, rating scales, student conversations, etc) can be helpful if it helps us to answer how and why school-based participation impacted.

The tool isn’t the point. The occupation is the point.

Your assessment choices (and your interpretation) should always point back to meaningful school routines.

So, how can we ensure our evals are occupation-based?

This is where the occupational profile helps.

In the schools, we’re tasked with looking beyond the student only. Parent input, teacher/aide observations, IEP team priorities, classroom expectations, curriculum demands, peer dynamics, the environment, and more all impact what goes into our final report.

Your occupational profile is what helps you to organize that information and answer the tough questions, like:

• What school occupations are hard right now?
• Where is participation breaking down?
• What routines/environments are involved?
• What does the student care about?
• What strengths can we build on?

With that direction, it’s easier to choose the right assessment tools to follow up with and to write a report that clearly explains why the skill data matters to the school-based occupations.

Want the full conversation + the Occupational Profile template? Check out Episode 202 of the OT Schoolhouse Podcast with Dr. Erin Gaby and Dr. Alysha Skuthan for insights on incorporating the occupational profile and occupation-based assessments during your evals. Listen here and download the School-Based OT Occupational Profile Template.​ ​ Listen now ↗

A quick handwriting example

A skill-focused eval might report decreased VMI, inconsistent letter formation, reduced speed, or decreased fine motor control. That’s useful, but also incomplete.

An occupation-based eval also asks:

• When does handwriting limit participation?
• In which routines (morning work, journal writing, notes, worksheets, written responses)?
• What’s the barrier: handwriting mechanics, idea generation, endurance, attention, tool access, task length, or classroom expectations?
• What will best support participation: therapy, accommodations, assistive tech, environment changes, or collaboration?

By linking the skills, routines, strengths, and barriers all back to participation, we can build a more holistic approach to our therapy.

If we only assess fine motor and VMI skills, we’ll only treat FM and VMI skills.

But if we assess the entire process of handwriting, we open the door to so many more ways to support the occupation of handwriting.

A simple test for your next evaluation

Before you finalize your next OT report, ask:

1. Did I clearly identify the school occupation that is difficult? (Not just the skill area.)
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2. Did my assessment choices help me understand why participation is hard?
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3. Do my recommendations connect back to participation and meaningful school routines?

If yes, you’re on track. If not, revisit the occupational profile.

And for more conversation around why every OT should be using an occupational profile as part of their evaluation (including you), tune into this week's episode of the OT Schoolhouse Podcast! ​

LAST WORD 👋​
​We’ll miss you, Abe!

Last Friday was one of our most frequent OT Schoolhouse Podcast guests’ last day working on behalf of every single one of us.

For nearly the last decade, Abe Saffer worked as a legislative representative at AOTA and fought for us on Capitol Hill in Washington, D.C.

When I wished him a “Happy last day of work” on Friday last week, he responded that he was working on one final update - an updated school-based OT medicaid resource (updates to be made live soon - only available to AOTA members).

Abe is not an OTP, but as he has shared on an episode of the OT Schoolhouse Podcast, OT has had a major impact on his life.

If you haven’t heard him speak and learned from his expertise, tune in to one of several OT Schoolhouse Podcast episodes where Abe has joined me for enlightening conversations about school-based OT policy, reimbursement models, Medicaid, and more.

​OTS 91: What the Every Student Succeeds Act means for OTPs​

​OTS 150: Are OT Practitioners, Mental Health Providers?​

​OTS 157: Shaping Education Policy Through Advocacy as a School-Based OT​

3/21/2025 - The Dept. of Ed. Executive Order - A Special Episode with Abe Saffer, a Senior Legislative Representative at AOTA​

Thank you one more time, Abe, for everything you have done for AOTA, school-based OT practitioners, and every OT practitioner

We wish you the best of luck as you continue to advocate for students in your new role!

Until next time,

Jayson

Jayson Davies, MA, OTR/L
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​Say hi 👋 on Instagram, LinkedIn,
and inside the School-Based OT Collaborative​