title: School-based occupational therapy for children with fine motor difficulties: evaluating functional outcomes and fidelity of services.
abstract: Consultative occupational therapy services are becoming widely used in the school environment. However, few studies have evaluated the utility of and the process by which these services are delivered. This study examined whether the written communication and fine motor skills of 23 children with fine motor difficulties improved after receiving school-based occupational therapy from a program whose mandate was to deliver services according to a consultation model of service delivery. In addition, the study assessed the process of service delivery, including treatment fidelity, or the extent to which consultation services were implemented as intended. Statistically significant and practically meaningful improvement was found in written communication on the Vineland Adaptive Behavior Scales-Classroom Edition (VABS-C) and School Functional Assessment-Version 3.0 (SFA), and in fine motor skills on the SFA, but not on the VABS-C. An examination of the service delivery process revealed that therapists deviated from a purely consultative model, with 86% providing some direct therapy to children. Parents were mostly satisfied with services received, whereas teachers were indifferent or somewhat dissatisfied. Treatment fidelity is taken into consideration when discussing study findings. Recommendations to enhance school-based occupational therapy services delivered according to a primarily consultative model, and suggestions for future research, are provided.
authors.affiliation: Thames Valley Children's Centre, London, ON, Canada.
authors.forename: Claudia L
authors.initials: CL
authors.lastname: Bayona
authors.forename: Janette
authors.initials: J
authors.lastname: McDougall
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Tucker
authors.forename: Megan
authors.initials: M
authors.lastname: Nichols
authors.forename: Angela
authors.initials: A
authors.lastname: Mandich
mesh_terms: D002648:Child; D002675:Child, Preschool; D003258:Consumer Behavior; D019988:Children with Disabilities / Q000534:rehabilitation*; D004739:England; D005178:Faculty; D005260:Female; D006801:Humans; D008297:Male; D017146:Models, Organizational; D019957:Motor Skills Disorders / Q000175:diagnosis / Q000534:rehabilitation*; D009788:Occupational Therapy / Q000379:methods / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D010290:Parents; D012017:Referral and Consultation; D012572:School Health Services / Q000458:organization & administration*