Executive Functioning in the Schools: Perspectives from Occupational Therapists

Awareness of executive functioning and its relevance to both occupational participation and special education is expanding. This study describes how school-based occupational therapists address executive functioning in practice and determined if this differs from traditional areas. Fourteen occupational therapists from four districts in Michigan completed the 36-item online survey consisting of closed and open-ended questions. A majority of these participants agreed that executive functioning impacts school function and occupational therapists should address it in school; yet, only 33% provided intervention using this lens and 77% indicated this as the area they feel least prepared to address in school-based practice. Executive function practice significantly differed from handwriting (p < .05), sensory (p < .01), and fine motor competency (p < .01); fine motor and sensory evaluation (p < .05); and handwriting intervention (p < .05). Participants described their role with executive functioning as collaborative, supplemental to enhance participation, and applicable to functional organization tasks. Although some occupational therapists are embracing an occupation-based process explicitly considering executive functioning, a majority need continued education, role clarity, and advocacy to more intentionally align their team's services with emerging best practice.