A study of voluntary state guidelines for related service provision
Dubner, Wendy Marie
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Occupational therapy (OT) is a profession that works in both medical and educational settings. The role of OT practitioners in schools is shaped by federal legislation and state regulations. The scope of practice and methods of service delivery differ between medically based and school-based OT. The diversity among practice settings can lead to confusion as to the appropriate role and scope of practice of OT in public schools. Thirty states have elected to craft written related service guidelines as a policy tool to further understanding of the role of OT in school-based practice and to facilitate parity of OT services across districts within a state. The purposes of this cross-comparative study were (a) to examine the content of a sample of 12 state manuals using a researcher-developed rubric as a framework for evaluating policy comprehensiveness, (b) to distinguish commonalities and unique features among the sample states through document analysis, (c) to explore factors influencing states’ decisions concerning adoption of written guidelines to provide direction on the role of OT in the public schools, and (d) to discover alternative methods states are using to guide related service provision. Methodological approaches included document analysis, the collection of quantitative data on each sample state, and triangulation of data by verifying the currency of the documents and the accuracy of the findings with various state-level individuals involved in the decision concerning implementing written guidelines. The study incorporated concepts from policy diffusion theory to examine whether selected variables follow adoption patterns as established in the existing policy-diffusion research literature. Findings revealed significant content disparity existed among adopter states and nonadoption did not necessarily equate with state inaction. The tenets of policy diffusion examined in this study (geographic proximity and policy entrepreneur activity) were not definitively supported by the findings. The primary limitation potentially influencing the findings was lack of participant follow-up resulting in data gaps and the inability to include relevant statistical measures. Recommendations for future research and policy development focus on suggestions to expand this study and to further the understanding of the role and scope of practice of school-based OT at the national, state, local and individual levels.