Você está na página 1de 24

Name: Hayley Meredith & Josee Lundquist

Date: 09/21/1014

Focus Question: Is a consultation treatment model an effective service delivery method for children receiving school-based occupational therapy services?

Rationale for inclusion/exclusion criteria applied to determine which articles should be included in the evidence table:

Inclusion Criteria: This criterion was based on selecting articles that would increase the confidence in the final result. Inclusion criteria supported the focus questions,
increased the quality of the CAT, and were acceptable to review.

All levels of research


Research completed in the past 24 years (1990-2014)
Articles written in English
School-Based pediatric population
Full Text Academic Journals
All disabilities
Qualitative studies
Quantitative studies
Articles published in the United States and Canada

Exclusion Criteria: This criterion was not relevant to answering the focused question and was therefore were not included in the CAT.

Clinical consultation

Author/

Study Objectives

Year

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

Level II

Intervention:

The intervention
success rate was
63%.

Small sample size

Clinical and Community


based practice for OT:

Physician only consultation


Articles published before 1990
Systematic reviews

Kemmis &
Dunn (1996).

Investigate if a weekly
collaborative
consultation between
elementary school
teachers and
occupational therapists
(OT) is a successful
service delivery model
for children to meet
their Individualized
Education Plan (IEP)
goals.

Design:
Cohort Study

Subjects:
7 boys and 3 girls

Weekly 60 minute
meetings with
teacher/therapist pairs
would meet to develop
specific intervention
strategies for the
teacher the following
week.

Remedial and
compensatory
interventions
were equally
successful across
performance
areas with

Subjects obtained
through a
convenience sample.

Children receiving OT
services through
collaborative consultation
successfully meet their IEP
goals.

Program Development:

Author/
Year

Study Objectives

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

5 to 9 years old

Teacher directly carried


out the intervention in
the day-to-day context.

collaborative
consultation.

Had a learning
disability, behavior
disorder, or
developmental
delay.

Teacher evaluated
whether the student met
the goal according to
the criterion set by the
teacher and therapist.

Outcome Measures:
Based on IEP goal
attainment, and whether
a remedial or
compensatory
technique used using
the intervention
documentation form.

Progress reports were


provided at the next
weekly meeting.

Study Limitations

Implications for OT

Weekly collaborative
consultation between the OT
and teacher provide a strong
foundation for successful IEP
goal attainment.

Societal Needs:
Weekly consultative
meetings were beneficial to
the teacher to provide them
with resources to support
interventions and progress
towards IEP goals.

Healthcare Delivery and


Health Policy:
This study supported other
studies being completed in
regard to consultative
services, supporting the
efficacy of collaborative
consultation.

Education and Training of


OT Students:
OT students should be

Author/

Study Objectives

Year

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

trained to include teachers as


part of an interdisciplinary
approach within a school.

Refinement, Revision,
and advancement of
Factual Knowledge or
Theory:
A future study should be
completed to compare
remedial and compensatory
interventions within a schoolbased OT collaborative
consultations service delivery
model.
Villeneuve
(2009).

Critically appraised 2
case studies regarding
collaborative
consultation OT
services in schoolbased setting to
provide program
administrators with
information to aid in
decision making for
service delivery.

Level V

Design: Narrative
Literature Review
Subjects:
Articles that
examined
outcomes of

Intervention:
Ethnographic case
study methods and
socio-cultural activity
theory were used to
examine multiple
perspectives concerning
school-based OT
collaborative
consultation

There are two


fundamental
conditions
necessary for
collaboration
between
educators and
OTs to flourish.
The teacher
needs to fully
understand the

Small sample size

Lack of control
groups

Unrealistic
consultation visits by

Clinical and Community


based practice for OT:
OTs should engage with
educators to define problems
in terms of expectations for
students and negotiate
effective service delivery
approaches to achieve those
expectations.

Author/
Year

Study Objectives

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

school-based OT
collaborative
consultation
services, and
factors influencing
collaborative
consultation.

A search for peer


reviewed research was
conducted using
databases including
CINAHL, ERIC, and
OTseeker.

role and
responsibilities
of the OT, and
the therapist
must understand
school policies,
the curriculum
and the practice
of the individual
teacher.

OT

Terms utilized:
Children with
disabilities in
educational settings,
collaboration,
consultation, school
health-services,
occupational therapy,
and motor skills.
Outcome Measures:
Relationship between
school-based OT
collaborative
consultation and
outcomes for students
with disabilities.
Factors that influenced
collaboration between
educators and OTs
Teacher ratings and
stakeholder satisfaction
were considered

Implications for OT

Program Development:
Unclear definition of
consultation

Relevant only to
Canadian context

School board policies, and


curriculum, should be
provided to the therapist to
develop educationally
relevant approaches to
providing services.

Societal Needs:
Dissatisfaction with wait
time for services and visit
frequency can possibly be
addressed with consultative
services.

Healthcare Delivery and


Health Policy:
Education and health
administrators should
provide sufficient time for
teachers and OTs to combine
expertise to support inclusion
of students with disabilities.

Author/

Study Objectives

Year

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

Education and Training of


OT Students:
OT students and therapists
should know how to obtain
and understand school
policies, curriculum, and
classroom practice of the
school in which they provide
services.

Refinement, Revision, and


advancement of Factual
Knowledge or Theory:
In order to better conduct
research regarding OT
collaborative consultation
service delivery model, a
definite definition needs to
be developed.
Case-Smith &
Cable (1996).

Determine the
percentage of time
school-based
therapists spend using
direct/pull-out and
integrative/consultativ
e models of service
delivery, to explore the
attitudes of OTs
toward direct/pull-out

Level II

46-item questionnaire
distributed to OTs by
mail

Design:
Cohort Study

Subjects:

5-point Likert scale was


used to indicate level of
agreement with each
statement.

Consultative
models of
practice were
advantageous for
the teachers and
the students

Survey

Accountability
and outcome

Only AOTA members

development

Small sample size

Clinical and Community


based practice for OT:
A therapist should consider
the students individual needs
to determine the best delivery
model for services.

Author/

Study Objectives

Level/Design/
Subjects

and integrative/
consultative services,
and identify variables
associated with
attitudes toward each.

OTs who were


American
Occupational
Therapy
Association
(AOTA) members

Year

Selected randomly
on the basis of the
following criterion:
-Minimum of 1
year of experience
working as an OT
in a public or
private school
setting, by contract
or by direct
employment.

Intervention and
Outcome Measures

One section was


demographics and the
other consisted of 30
statements designed to
measure attitudes
toward different models
of service delivery.

Results

evaluations were
not issues in
implementing
current models
of integrated
practice in
classrooms
OTs value direct
service delivery,
one-on-one
interactions with
students, and to
establish
relationships
with students.

Study Limitations

Implications for OT

Program Development:
No open-ended
questions for
justification

The service delivery model


should vary according to the
desires and needs of the
student and teacher.

Societal Needs:
Ideally service delivery
models vary according to the
individualized needs of
students and teachers

Healthcare Delivery and


Health Policy:
If individualized needs
determine how OT services
are delivered, then the true
intent of the Individuals with
Disabilities Act has been met.

Education and Training of


OT Students:
Students should be educated
on the benefits and
differences of school-based

Author/

Study Objectives

Year

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

integrated / consultative and


direct / pull-out practice
models as well as their roles
as consultants.

Refinement, Revision, and


advancement of Factual
Knowledge or Theory:
Future research should
consider asking open-ended
questions to improve
understanding of results with
definitive explanations as to
why subjects used particular
service delivery models or
why they held certain
attitudes.
Barnes &
Turner (2001).

Describe the
collaborative team
practices between
teachers and OTs in
one school district.

Explore relationships
between team
practices and student
individual education
plan goals met

Level II

Intervention:

Design: Cohort
study

A questionnaire was
provided to the teachers
containing items about
OT service delivery
practices for students

Subjects:
40 teachers of
students, who
received OT

Six scales about


collaborative team
practices between the
teachers and OT

Results were not


reported in terms
of statistical
significance

Mean percentage
of IEP objectives
met per student
was 61%

Only one school


district in study

Sensitivity to changes
in students skills
limited due to
reporting strategy
(Met or unmet)

Clinical and Community


based practice for OT:
Collaborative practices are
considered vital to
accomplish related
educational outcomes.
Program Development:
The IEP team including the
OT should develop
collaborative team
opportunities within informal

Author/

Study Objectives

Year

Level/Design/
Subjects

Intervention and
Outcome Measures

services
Explore relationship
between team
practices and teacher
perceptions of OT
contributions to
student skill
development.

Rankings of
OT contribution to the
students skill
development on a 5point Likert scale

Outcome measures:
Four-part Teacher
Questionnaire about OT
with Special Education
Students.

Students IEP goals

Results

The respondents
written
comments
indicated that
collaborative
team practices
were frequently
conducted
informally and
within
immediate
school areas.

Successful
problem-solving
strategies for
students were
developed
through these
discussions. In
contrast, formal
team meetings
appeared to be
difficult to
implement for
many teachers
and therapists

Study Limitations

Implications for OT

and formal school settings to


assist the student to reach
goals

Societal Needs:
Successful collaboration
among teachers and relatedservice personnel
is described as essential for
effective intervention to
occur in todays educational
environment

Healthcare Delivery and


Health Policy:
The OT should schedule
formal consultation meetings
to ensure the best service is
provided to the student and
teacher.

Education and Training of


OT Students:
The OT student should be
trained on how to foster

Author/

Study Objectives

Year

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

collaborative teaming with


the teachers.

Refinement, Revision, and


advancement of Factual
Knowledge or Theory:
Future research should use
IEP percentage
measurements instead of met
or unmet to increase the
sensitivity.

Reid, Chiu,
Sinclair,
Wehrmann, &
Naseer (2006).

Identify and describe


current functional
problems of students
referred for
occupational therapy
school-based
consultation (OTSBC)
services for fine motor
problems and measure
changes in functional
abilities after service
delivery
Identify factors that
influence outcomes of
OTSBC from multiple
perspectives including

Level III

Intervention:

Frequently
identified
problems:

Subjects:

OTs who were all


trained to ensure the
COPM & TAS
administered the
evaluations to students
according to
standardized protocol

91 Students

-Organization
skills

Outcome Measures:

-Desk Skills

Design:
Pretest/Posttest
Part 1

Referral diagnosis
of fine motor delay,
fine motor deficit,
fine & gross motor

-Canadian Occupational
Performance Model
(COPM): Primary
outcome measure of the

-Writing or
printing

7 statistically
significant
variables

Lack of a control
group

Clinical and Community


based practice for OT:

Data collection
limited to a single
organization limiting

Collaborative consultation
services are most effective in
conjunction with direct
services when working with
children with fine motor
deficits.

Generalizability.

TAS measurement
tool only evaluated
for test-retest
reliability and no
other psychometric

Program Development:
OTs should ensure the
teachers have awareness and
understanding of the
students occupational

10

Author/

Study Objectives

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

teachers, service
funders, OTs, students
& their parents

delay, or fine &


gross motor deficit.

OTSBC services

identified:

properties.

-Teacher Awareness
Scale (TAS): Used to
measure the
intermediate outcomes
of the OTSBC services
by assessing the degree
of teacher awareness of
each students problems
and the degree of
teacher implementation
of strategies
recommended by the
OT

-COPM
Performance
Score

performance with fine motor


problems on the resolution of
occupational performance
issues.

-Client Feedback
Questionnaire (CFQ):
Measure how satisfied
the teachers, parents,
and caregivers were
with the OTSBC
services.

-CFQ Teacher
subscale score

Year

Determine how
satisfied the teachers
of these studies are
regarding the OTSBC
service delivery
process.

Societal Needs:
-Teacher
Awareness
(TA) subscale
change score
-Teacher
Implementation
score

-Pencil grip
recommended
to school
personnel
-Pencil grip
recommended
to parents

If intervention is not
provided early, children with
fine motor difficulties are at
risk of motor difficulties that
persist into adolescence and
can lead to the development
of secondary mental health
and educational issues
including poor social
competence, academic
problems, behavioral
problems, and low selfesteem.

Healthcare Delivery and


Health Policy:
Students with fine motor
difficulties are the largest
population receiving OTSBC
services, therefore there is a
critical need to document this
model and validate its

11

Author/

Study Objectives

Year

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

-School Type

Implications for OT

effectiveness for students


with fine motor difficulties
and other special needs.
Education and Training of
OT Students:
OT students should be
educated and trained on how
to properly and confidently
administer the COPM, TAS,
and CFQ.

Refinement, Revision, and


advancement of Factual
Knowledge or Theory:
Further evaluation of the
TAS measure should be
completed to determine
psychometric properties for
future use.
Wehrmann,
Chiu, Reid &
Sinclair
(2006).

Address the perceived


occupational
performance changes
among students with
fine motor difficulties
receiving OTSBC
services. This phase of
the study was used to
identify factors that

Design:
Qualitative study
Part 2

Subjects:
52 participants

Intervention:

Supports the

Taped interviews were


transcribed by a
professional transcriber.
One author read the
transcribed notes and
looked at the significant
statements/ The other
author did a peer

OTSBC service
used in Part 1 of
study.
OTSBC is
beneficial to
students with
fine motor

All subjects from the


same stakeholder
group.

OTSBC service
provided by a single
organization

Clinical and Community


based practice for OT:
Clarification of the OTs role
is critical and there must be
agreement among the team to
ensure an effective and
efficient service delivery.

12

Author/

Study Objectives

Year
influence outcomes of
OTSBC from multiple
perspectives including
teachers, service
funders, OTs, students
and their parents.

Level/Design/
Subjects

7 Community Care
Access Centres
(CCAC) case
managers, 10 OTs,
14 teachers, and 21
parents of the 91
students involved
in phase 1 of study

Intervention and
Outcome Measures

Results

debriefing session.

difficulties.

Outcome Measures:
Change in Skills
-written communication

Study Limitations

Implications for OT

Timing of study:
Torontos healthcare
system under policy
changes

Program Development:
During the initial contact, the
OT explains with the school
and family about the nature
of the consultative model.

-table top or desk skills


-organizational skills
-self-esteem/confidence
-on task skills in
classroom

Societal Needs: A
consultative service delivery
model can allow the OT to
provide services that benefit
more children with less
resources and better
outcomes.

Facilitators to change
-OT intervention
-team approach
-school environment

Challenges affecting
change
-characteristics of the
student
(social/emotional

Healthcare Delivery and


Health Policy:
Providing formal education
to teachers about fine motor
difficulties to promote early
intervention.

Education and Training of


OT Students:
The OT student needs to be

13

Author/

Study Objectives

Year

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

issues)

Implications for OT

trained to effectively
intervene with both the social
and physical environments of
the students in addition to the
students themselves.

-school system
-service delivery
process

Refinement, Revision, and


advancement of Factual
Knowledge or Theory:

Suggestions for
improvement
-early identification of
fine motor difficulties

With many school-aged


children who need OT
services have limited health
care and educational
resources, so to help these
children it is the
responsibility of OTs to
further examine alternatives
like OTSBC services to
benefit more children.

-More OT visits
-better communication
among team members
-addressing system
issues in healthcare
sector
-addressing issues in
education sector

Dunn (1990).

Compare the provision


of direct services and
collaborative
consultation.

Level I

Intervention:

Design:
Randomized

Students were
randomly assigned to
either direct service
conditions, or
consultation conditions.

All children in
the study
achieved nearly
3/4ths of their
IEP goals.

Small Sample Size

Not all pre-tests were


completed

Clinical and Community


based practice for OT:
Working with students in
their natural life
environments, provides
additional opportunities to

14

Author/
Year

Study Objectives

Level/Design/
Subjects

Intervention and
Outcome Measures

control trial

Outcome Measures:

Subjects:

The Developmental
Programming for
Infants & Young
Children (DPIYC)

12 preschool & 2
kindergarten
students and their
teachers.

IEP goal attainment

Results

Study Limitations

Implications for OT

apply their expertise.


This study
suggests that an
intense level of
interaction
between OTs and
teachers resulted
in a positive
outcome.

Program Development:
Including the teacher in the
intervention planning, and
allowing them to be more
hands on, can make them feel
more positive about the
situation and be more willing
to consider new intervention
options.

Societal Needs:
The OT services provided
impact more that the
immediate child outcomes,
and consider the others
within the same environment.

Healthcare Delivery and


Health Policy:
Additional support from
education professionals with
more expansive strategies
may serve OTs as well as
agencies who re-evaluate

15

Author/

Study Objectives

Year

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

priorities for financial, space,


and program allocation in a
changing political
environment.

Education and Training of


OT Students:
The choice to provide direct
services and/or consultation
is frequently based on the
therapists past experience
and training; therefore it
would be beneficial for a new
OT grad in a school-based
setting to have an
experienced mentor.

Refinement, Revision, and


advancement of Factual
Knowledge or Theory:
This pilot data suggests that
therapists should consider the
potentially broader impact of
their services beyond the
immediate child outcomes
achieved from traditional
service provision strategies.
Dreiling &

Compare the

Level III

Intervention: OTs

Both models of

Small sample size

Clinical and Community

16

Author/

Study Objectives

Year
Bundy (2003).

effectiveness of a
consultative model of
intervention with a
directindirect
intervention for
meeting goals of
preschool students
with mild motor
delays.

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Design: Single
group, pretest and
posttest, quasiexperimental

provided consultation
to teams working with
11 children for 40
weeks. Another OT
provided direct-indirect
treatment to 9 other
children for 40 weeks.

intervention
were found to
help students
meet their goal at
approximately
the rate
expected.

Subjects:
22 children
between 3 and 5
years of age

Outcome Measures:
The study measured
motor outcomes with
standardized motor skill
assessments

Gross or fine motor


visual motor delays

Current IEP
requiring OT

Not receiving
private OT services
during study.

Peabody
Developmental Motor
Scales

Learning
Accomplishment
Profile

Developmental Test of
Visual-Motor
Integration.

Consultation
group: met or
exceeded
expectations on
56% of goals
Directindirect
intervention
group met or
exceeded
expectations on
50% of goals.

Study Limitations

Implications for OT

based practice for OT:

1 geographic area
used

Variability of
diagnoses

Cognitive and
behavioral
development not
controlled

To allow the OT to provide


services to an increased
population, this study
supports the consultation
model is a viable intervention
approach and is as effective
as a direct-indirect
intervention.

Program Development:
A consultative model
requires the same amount of
time or more that a direct
intervention to initiate the
service delivery model.
However, the amount of time
required will decrease with
program maturation.

Societal Needs:
A consultation service
delivery model provides
more support for children
with disabilities within the
classroom and is more
beneficial than direct services

17

Author/
Year

Study Objectives

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

once a week.

Healthcare Delivery and


Health Policy:
All team members associated
with a collaborative
consultation model should
meet regularly to establish
and carry out suggested
strategies for intervention.

Education and Training of


OT Students:
OT students should be aware
of their role in consultation
and how to carefully consider
the number of objectives that
will be carried out by the
educators to fulfill a
successful intervention plan.

Refinement, Revision, and


advancement of Factual
Knowledge or Theory:
Limit study to specific
diagnoses like delayed motor

18

Author/

Study Objectives

Year

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

skills, and all other


developmental areas.
Control amount of
intervention provided at
home by parents
Bayona,
McDougall,
Tucker,
Nichols &
Mandich
(2006).

Explore if children
with fine motor
difficulties receiving
school-based OT
consultation services
have improvement in
written
communication and
fine motor skills.

Level III

Intervention:
OTs provided

Design: Single
group, pretest and
posttest, quasiexperimental

Subjects:
23 students (19
boys and four girls)
completed the
study.

five to ten visits for


each participant
throughout the
school year as
mandated by the School
Health

Significant
difference in pretest to post-test
measures on the
written
communication
sub-scale of the
VABS-C and on
the written work
subscale of the
SFA.

Support Services
Program for the region.

Intervention
included the following:
collaborative
identification of
target areas, assessment
of skills as well as the
development and
provision of
consultation strategies

Significant
pretest to
posttest
difference was
found on the
using materials
subscale of the
SFA.

Unable to account
for amount of direct
services received

The small sample


size and lack of a
control group
makes generalization
to a broader
population more

Clinical and Community


based practice for OT:
If teachers reported
indifference or mild
dissatisfaction with the OT
services this could
significantly impact practice
because recommendations by
OTs using s consultation
method rely on school staff,
including teachers, to carry
out the recommendations.

difficult.
Program Development:
Taking a more holistic
approach that involves team
decision making with the
teacher may help to integrate
the recommendations
into the classroom and
provide teachers with a

19

Author/
Year

Study Objectives

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

and recommendations
to teachers and parents.

greater satisfaction with the


services

Outcome measures (a)


Measures of Function

Societal Needs:

Vineland Adaptive
Behavior Scales Classroom Edition
(VABS-C)
School Function
Assessment - Version
3.0 (SFA)
(b) Measures of
Therapy Process
Consultation
Summary Form
Checklist for
Strategies Employed by
Classroom Teachers
Client Satisfaction
Questionnaire
School-Based
Occupational Therapy
Questionnaire

This study determined that a


combination of direct and
consultative model of therapy
may be the most beneficial
for children with fine motor
difficulties.

Healthcare Delivery and


Health Policy:
This study demonstrated that
even in a school-based OT
consultation model, direct
therapy may be provided by
the therapists because in
order to be client centered
they may feel the need to
spend one-on-one time with
the student before leaving
recommendations to be
carried out by someone else.
Education and Training of
OT Students:
OT students should be aware

20

Author/
Year

Study Objectives

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

of a childs learning process


and what is least restrictive to
an individual because
children may not develop
new skills as easily as adults
within an environment with a
lot of contextual interference
such as in a classroom
setting.

Refinement, Revision, and


advancement of Factual
Knowledge or Theory:
It is important that further
research
be completed to address the
possible benefits and
consequences for clients
receiving consultative
models of school based OT
intervention to better guide
practicing OTs.

21

Author/

Study Objectives

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

Presents a rationale for


specialized service
personnel to use fluid
models of service
delivery and explains
how specialized
services personnel
make decisions about
the blend of service
delivery methods that
will best serve a child.

Level V

Existing research was


reviewed in regard to
topic.

Results showed
that to establish
fluid service
delivery models,
therapists need
to:

This study was


limited to one
individual and the
results may not be
generalizable to other
young children.

Clinical and Community


based practice for OT:

Year
Case-Smith &
Holland
(2009).

Design: Case
report

Subject:
4 year old girl
who has cerebral
palsy with spastic
quadriparesis.

The subject attended a


neighborhood early
childhood program and
received weekly OT,
physical therapy (PT),
and speech language
pathologist (SLP).

Therapists provided
direct services and
consultation to the
teacher for feeding,
bathroom
independence,
communication, and
mobility.

The SLP and OT


collaborated with the
teachers to determine
how the device would
fit in a busy classroom
environment.

-Plan together
with teachers so
the model
selected meets
the teachers
preferences

-Design flexible
scheduling
systems that
emphasize
inclusive
practice

-Maintain
precise records
about when and
how services are
provided.

This research can help teams


make decisions about the
levels and types of service
that will optimally benefit
young children with
disabilities.

Program Development:
It is important to consult with
the teacher to make sure the
model and interventions
being utilized meet the
teachers preference.
Societal Needs:
Interdisciplinary teams
should be utilized within a
collaborative service delivery
model to ensure all of the
childs needs are met.

Healthcare Delivery and


Health Policy:
The literature explains that

22

Author/
Year

Study Objectives

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

direct and consultative


services provide
unique benefits to children
and a
flexible service delivery
model allows OTs to meet
the evolving needs of
children within dynamic
environments.

Education and Training of


OT Students:
The OT student needs to be
trained about how to properly
document how the services
are provided to allow the
teacher to carry out the
intervention without the OT.

Refinement, Revision, and


advancement of Factual
Knowledge or Theory:
Further case reports should
be completed with increased
sample size and various
diagnoses to allow for

23

Author/
Year

Study Objectives

Level/Design/
Subjects

Intervention and
Outcome Measures

Results

Study Limitations

Implications for OT

generalizability.

24