Occupational therapy is concerned with promoting health and well being through occupation. The primary goal is to enable people to participate in everyday life to the satisfaction of self and others, such as in school.

In September 2008, The Discipline of Occupational Therapy, Trinity College, Dublin was invited to participate in a Level 3 pilot project with the NBSS to support better participation by identified students in learning and school life.  The following is a snapshot of the project in one school.

1. Discussions were held with the NBSS National Co-ordinator, Assistant National and Regional Co-ordinators, school Principals and Deputy-Principals to discuss the proposed project with the occupational therapy team.
2. Agreed structures were put in place by the NBSS for developing partnership between teacher, therapists and parents with the agreed aim of improving students participating in learning and lessening of challenging behaviour.Direct lines of communication were agreed and managed by the NBSS.
3. Formal and informal presentations were made to the teaching staff in the school to explain some of the underlying approaches in occupational therapy such as the Person-Environment-Occupation framework and sensory processing difficulties as they may impact on performance in school. Strategies to be used such as peer group learning and a client-centred approach were also outlined. This information sharing assisted in framing expected outcomes for the project.
4. The project ran from the October to May of the school year and in this school 12 students who had a pattern of frequent suspension from class and/or school were identified for the project. All were on a reduced timetable so were not attending many of their Junior Classes classes. The Principal and Deputy Principal were anxious to keep the students within the school system.
5. Parents were invited to meet the occupational therapy team to discuss their child’s interests, strengths and challenges in school, and to explain the programme. Information from teachers and guidance counsellor related to strengths and challenges in managing learning were shared. Parents signed consent forms after this meeting.
6. The occupational therapy team observed some students in their classroom during different subjects, such as maths, home economics and art. The physical, social and cultural environment and routines were noted.
7. A programme of intervention and support was proposed at a meeting with school staff and agreed that the difficulties reported were social and behavioural in nature and it was agreed that a group work approach would be used.
8. Through game playing activities the occupational therapy team were able to identify if the individual had difficulties such as sustaining attention, concentration, language comprehension, motor planning, social awareness and in particular self regulation, rule compliance and inter-personal interaction with classmates etc.  
9. Activities and games were also used, for example to teach self management strategies such as how to control impulses to shout out, to wait your turn, to listen to the instructions for the game,  and to co-operate with others so that a game or activity could be played. As well as group sessions, one to one sessions were used for more detailed assessment and to explore with the students strategies to meet their needs.
10. A modified version of the ‘Alert Program’ was introduced. The Alert Program uses the analogy of a car engine to introduce to students the concept of self regulation – ‘sometimes it runs on high, sometimes it runs on low and sometimes it’s just right.’ Through the Alert Program students learnt how to modulate their engine levels using sensorimotor strategies.
11. Students also developed Personal Goal Plans and identified and targeted their preferred classroom behaviour, including structured achievable and relevant steps to achieve this.
12. Throughout the project students’ views on each session were sought in informal discussion and through a brief feedback questionnaire. Interviews were also carried out with students at the end of the programme.
13. The NBSS conducted an end of project review with school management and teachers, and a written report from the occupational therapy team was presented to the NBSS reviewing their perspective on the project.
14. Reports gathered by the NBSS from school management and staff confirm satisfaction with the various outcomes - ‘ I’ve been here since 1973 and I would have said the NBSS was one of the most positive interventions, but the occupational therapy I thought it was handled very well. Most of the teachers here are very, very positive about the NBSS and about what XXX (occupational therapist) was trying to do.” (Deputy Principal)
15. Students also reported satisfaction with their changed behaviours. The students involved in the project also decided to return to school in September to start the senior cycle course.

 The design of interventions through collaborative approaches between the NBSS, teachers, students, parents with expertise from other disciplines, such as occupational therapy can be particularly beneficial for students with multiple challenges.