The Ultimate School-Based OT Roadmap: From Start to Finish

As school-based OTs, we wear a lot of hats... detective, problem-solver, collaborator, and sometimes paperwork wizard. Our work isn’t just about “doing OT” with students; it’s about following a thoughtful process that ensures every decision is grounded in data, collaboration, and the student’s individual educational needs.

I like to think of the school-based OT process like a road trip. We all have the same destination (helping students access and participate in their education), but how we get there can vary depending on the student, the setting, and the team.

Along the way, there are key checkpoints that keep us on course. If we skip one, or take a wrong turn, we might still arrive… but it’ll take longer, be more frustrating, and probably require more gas than we budgeted.

In this post, I’ll take you through the school-based OT journey from the very first “on-ramp” (screening) to the exciting “final destination” (discharge), sharing why each step matters, how to keep your trip efficient, and a few tools to help you along the way.

1. Screening: The On-Ramp to the OT Highway

Every great road trip starts somewhere, and in OT, that somewhere is screening. This is the gateway to the entire process.

Here’s the thing: screenings can go wrong in two very different but (unfortunately) very common ways:

• They can become too tedious, turning into mini-evaluations that eat up your time and blur the line between screening and assessment.

• Or they can be too simple and subjective, offering little more than “teacher says they struggle” without enough concrete information to make a confident next step.

When this happens, the rest of your OT journey suffers. You might take unnecessary detours like evaluations for students who don’t need them or miss key opportunities to support students early. The whole process can be frustrating and time-consuming.

My solution? I developed a reusable grab-and-go Pocket Screener that gives me just enough structured information to feel confident in my recommendations without overcomplicating the process. It keeps me consistent, fast, and focused on educational access from the start, and the best part? It only takes about 5-10 minutes to administer.

Other ideas for streamlining screening:

• Keep a digital or printed checklist of key functional participation skills by age/grade level. Often, academic standards don't align with developmental milestones and make our jobs a little murky.

• Pair brief teacher interviews with quick classroom observations for a fuller picture. My Pocket Screener includes both!

• Batch screening days so you can stay in “observation mode” and minimize transitions.

Mile Marker: Treat the screening like your GPS calibration. If you don’t set it up right, every turn afterward will be off. This is your gateway, so prioritize it.

2. Evaluation: The Scenic Overlook

If screening is the on-ramp, evaluation is where we pull over to get the big picture view.

As occupational therapists, our role is to support the student’s main occupation which is learning. Standardized tests can give us useful data, but they’re often like zooming in on one tiny landmark—you might see the details, but miss the whole landscape. The more functional your data, the stronger your case for services (or for ruling them out).

That’s why I focus on three essentials in every evaluation:

1. Observation: Seeing the student in their natural school environment (particularly in location(s) where the the dysfunction has been identified during the screening process), interacting with real demands, and navigating real challenges.

2. Functional skills-based assessment: Tools that measure how a student participates in meaningful school activities, even if they don’t always produce neat quantitative scores. I almost always use some variation of my Pre-Writing and Writing Baseline Assessment and my Fine & Visual Motor Skills Baseline Assessment to get a functional picture of each student.

3. Teacher interviews: Information about how the student is functioning within his/her daily routines at school provided by the person who is with them most... Teachers are insanely busy, so I use this Google Forms template to allow them to respond quickly and easily when they have a free moment in their day.

   
   

When we combine these with standardized testing (when appropriate), we get a more accurate map of where the student is now and what road will best get them to success.

Once the team decides to move forward, the evaluation is where you gather the puzzle pieces and put them together.

Streamlining tips:

• Create an evaluation template that blends standardized testing, observations, and team input in one cohesive report. Include placeholders that you can quickly and easily remove when drafting each report.

• Observe before you test to capture environmental factors and real-life demands. This helps you gain perspective on what to focus on for your assessment portion.

• Keep eligibility criteria in mind. School OT is tied to educational impact, not medical diagnosis!

Mile Marker: Think top-down. Instead of asking “What skills does this student have?” ask “How is this student participating in learning?” Then zoom in if you need to.

3. Intervention: The GPS

Once evaluation is done and the team determines services are warranted, you reach your first big intersection:

• Do we take the direct intervention route?

• Or do we start with consultation as the primary service model?

Most of the time, direct intervention is the path chosen, but not always. Consultation can be a valid first choice, especially if it best supports the student’s participation in the least restrictive environment.

No matter which road you take, remember:

• Progress monitoring is your compass.

• Function should always be your destination.

• Reassessment keeps you from driving miles down the wrong road.

Intervention is the heart of what we do, but without good data, it’s impossible to know if we’re making a difference. Service models should fit the student’s needs and can change over time.

Streamlining tips:

• Batch your data collection. Decide how frequently you are going to monitor progress and stick to it. I use Monthly Progress Monitoring Forms to obtain actual student work samples and track progress toward goal areas relevant to each student.

• Keep sessions goal-focused while still engaging and student-centered.

• Build classroom collaboration into your schedule so strategies get reinforced throughout the day.

Mile Marker: Your GPS only works if you check it! Consistent progress monitoring is how you make sure you’re still on the road toward your goals.

4. Consultation: The Travel Guide

Traditionally, consultation is seen as a step-down from direct services, and often, that’s exactly how I use it. It allows me to fade back my direct involvement while still providing guidance, training, and problem-solving to the adults supporting the student.

When done right, consultation can be an incredibly powerful stop on the OT roadmap. Consultation allows students to get more opportunities for practice as strategies are embedded throughout the school day. Think of it like a trial run with guardrails in place.

The challenge? It lives or dies on effective communication. Without clear, ongoing collaboration, consultation turns into “once in a while check-ins” instead of robust support.

That’s why I rely on my Google Forms Consultation Template, which makes it easy to document, share updates, and follow up, even when time is tight for everyone on the team.

Consultation can be just as powerful as direct service, especially when the goal is independence and carryover. It allows strategies to be embedded all day long, not just during your sessions.

Streamlining tips:

• Keep a consultation log so you can track what was discussed and plan follow-ups.

• If transitioning from direct to consult, overlap for a short period to model strategies in real time.

Mile Marker: Consultation is like having a tour guide for your scenic route. They don’t drive the car, but they make sure you see all the right spots and avoid the potholes.

5. Discharge: The Final Destination... Or Is It?

Here’s a mindset shift: discharge isn’t the end of the roadtrip... it's the beginning of the actual vacation!

I like to bring this up all the way back at the initial placement meeting so that everyone on the team is clear about the end goal. That way, discharge isn’t a surprise—it’s the plan from day one.

When we get there, it’s like graduation; a celebration of independence, not a loss of support. The strategies and skills we’ve built don’t disappear, they continue in the student’s daily life.

Discharge is a team decision and should be framed as a success since the student has built the skills or supports needed to participate without OT.

Streamlining tips:

• Track and communicate progress regularly so discharge doesn’t feel like a surprise to the team.

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  Provide a carryover summary so staff can continue strategies independently and implement any referral or transition strategies you suggest.

• Make sure documentation reflects data-based decision-making.

Mile Marker: The sooner you set function as the destination, the more intentional your route will be, and the more meaningful the arrival.

Closing Thoughts

The school-based OT journey is part science, part art, and part navigation skills. By treating each stage like a key stop on a road trip (and making sure your map, tools, and travel companions are ready), you can keep the process efficient, purposeful, and student-focused from the driveway to the destination.