Movement Matters: Developing school-based occupational therapy practice in Irish post primary schools.

Abstract

Occupational therapists face challenges of practice development when working in emerging settings. This study provides an understanding of the process of developing practice in Irish mainstream post primary schools with adolescents with social, emotional and behavioural difficulties (SEBD). This is a collaboration between the National Behaviour Support Service, Department of Education and Skills and the Discipline of Occupational Therapy, Trinity College Dublin. A school-based self-regulation programme called "Movement Matters" is the focus. Methods: An embedded mixed method design was applied to three objectives. The first was to describe and critique the context of occupational therapy practice that led to the development of the Movement Matters Programme (qualitative). A matrix analysis was applied to 12 documentation sources such as peer reviewed journals; NBSS web based information; course manuals; and teacher training courses to critique if and how the programme reflected core occupational therapy theory and values as stated in the vision for the service (MacCobb 2012). The second was to analyse student attitudinal and behavioural measures pre and post participation in the Programme (quantitative). The "Strengths and Difficulties Questionnaire" (SDQ) and "Pupil Attitude to Self and School" (PASS) provide triangulated data from the student, parent and teacher collected for 39 targeted students. The third was to map the clinical reasoning process of the occupational therapists who developed and observed the programme in use (qualitative). This is achieved by analysing qualitative data delivered through three semi structured group interviews with two occupational therapists who developed the programme over the course of a twelve-month period of its national piloting. Main Findings: The mixed method approach was successful in achieving the research objectives. All the key principals of occupational therapy practice described by MacCobb (2012) are evident in the critique. The PASS and SDQ data created a profile that provides insight into how 39 students from an underserved population (SEBD) experience school. This profile differs from a UK national study norms in most areas, particularly around self-efficacy, self- determination, and motivation as learners. Occupational therapists' clinical reasoning suggests that the Movement Matters Programme was effective as a self-regulation programme for targeted students. The co-occupation activities of the programme created a social environment which promoted the development of collaborative relationships between teachers and students, acknowledged as central to effective interventions with students with SEBD. Important learning about practice development emerged and recommendations for the profession are provided. The most relevant finding to emerge from this study was that a new interdisciplinary scholarship of practice approach (Fitzgerald and MacCobb, 2017) generated new knowledge in this emerging area.