Collaboration in School Settings: A Critical Appraisal of the Topic

With the 2004 reauthorization of the Individuals with Disabilities Education Improvement Act and No Child Left Behind, there has been an increasing emphasis on occupational therapy services that are provided across naturally occurring contexts and routines within the school settings. School-based occupational therapists are interested in maximizing students' achievement and want to know which models of therapeutic intervention are most effective for facilitating students' successful participation within their least restrictive environment. Thus, this critical appraisal of the topic (CAT) sought to answer the following question: For occupational therapists working in school system settings, is there evidence supporting the efficacy of a classroom-based collaborative approach versus a pull-out model of therapeutic intervention for facilitating students' participation in schools? After reviewing 10 articles (Level II-IV evidence), it appears that a collaborative approach to service delivery may be as effective in improving student performance when compared to direct 1:1 pull-out and small group service delivery. However, teachers reported greater satisfaction with services and increased implementation of therapists' suggestions when classroom-based services were provided.