School Occupational Therapy: Classroom Activities and Interventions

Occupational therapy in schools extends far beyond handwriting and scissor skills.

Modern school-based occupational therapy supports students with physical challenges as well as those with developmental delays, learning differences, sensory needs, and emotional or behavioral concerns. Occupational therapists (OTs) work to help students access the curriculum, participate fully in school routines, and develop functional skills needed for academic and social success.

In the United States, roughly 20% of occupational therapists provide services in school settings, highlighting how integral OT has become to education (Clark, Rioux, & Chandler, 2019).

This article summarizes practical interventions, helpful activities and resources, documentation examples, assessment tools, recommended software, and useful readings for school-based OTs.

4 Effective Interventions to Use With Students

Before beginning any intervention, experienced school-based OTs emphasize building rapport with students, meeting them where they are, and partnering with families and school staff (Cahill & Beisbier, 2020). Once those foundations are in place, the following evidence-informed interventions are commonly used in schools.

Fine motor skills

Structured programs can accelerate improvement in hand function. For example, evidence-based curricula designed specifically for OTs provide step-by-step activities, quick screening tools, and record forms to track progress. These programs target skills such as pencil grasp, letter formation, in-hand manipulation, and bilateral coordination.

Visual perceptual skills

Visual perceptual and visual-motor skills can be strengthened through engaging tasks like word searches, crosswords, mazes, tangrams, mirror-drawing, and origami. Low-cost classroom activities using ten frames, pattern copying, and spatial reasoning games help students practice visual discrimination, figure-ground perception, and spatial relations while remaining motivated.

Sensory strategies

For students with sensory processing challenges, techniques that provide deep pressure or proprioceptive input often support regulation and participation. Brushing protocols and proprioceptive activities (e.g., heavy work, joint compressions, resistance play) have been used effectively when implemented by trained clinicians. Always follow training guidelines and district protocols before using specialized sensory techniques.

Attention to task

Flexible seating and movement-friendly classrooms can improve sustained attention and on-task behavior (Anderson & Hartley, 2018). Offering options—such as wobble stools, therapy balls, cushions, standing desks, or quiet corners—allows students to choose supports that match their sensory and postural needs. Collaborating with teachers to integrate these options into classroom routines increases feasibility and consistency.

In practice, combining sensory-rich gross motor activities, transitional tasks, and targeted fine motor work before addressing specific academic goals tends to yield better outcomes. Sensory integration approaches remain among the commonly reported interventions in school-based OT practice and should be paired with meaningful classroom tasks to optimize transfer.

Top 3 Resources & Activities for School-Based OTs

Several well-designed programs and digital tools support skill development and classroom inclusion.

Handwriting curricula that include multisensory instruction, digital student editions, teacher guides, music, and interactive animations can make handwriting instruction engaging and accessible for learners at different levels.

Self-regulation curricula that use simple metaphors (such as an engine or thermometer) provide students with a shared language for states of alertness and practical strategies for moving between low, optimal, and high arousal states.

Keyboarding and typing platforms help older students build efficient typing skills and reduce the functional burden of handwriting on written expression. Structured, leveled lessons combined with motivating activities make digital typing programs a useful addition to school-based therapy goals.

Download 3 Free Positive Education Exercises (PDF)

These evidence-informed exercises support student well-being, engagement, and classroom learning.

Writing Progress Notes: 3 Examples

Documentation practices vary by district, but clear, concise notes are essential for tracking progress, communicating with the team, and meeting legal requirements. Frequency of notes—daily, weekly, monthly, or quarterly—will depend on district policy and individual student needs.

Below are three commonly used approaches to documentation with brief examples to guide your practice.

SOAP notes

SOAP (Subjective, Objective, Assessment, Plan) notes remain a familiar format that captures clinical reasoning and measurable progress.

S: Parent reports, “She can now write her name.”

O: Student wrote 5 of 6 name letters legibly with a visual model.

A: Today the student wrote all 6 letters legibly with verbal cues only; performance shows improvement toward the goal.

P: Continue with handwriting practice; trial magnet letter board and multisensory letter pieces next session to support letter memorization.

Teacher templates

Editable teacher-friendly templates and daily treatment note forms help capture brief anecdotal data, tally repetitions, and record student responses in the moment. These templates can be adapted for individual caseloads and help streamline communication with classroom teachers.

Pre-made logbook

Using a structured logbook or session record provides consistent fields for student name, date/time, session focus, observations, strategies used, and follow-up. This format is practical for clinicians who prefer handwriting or a simple printable record that travels between school sites.

Documentation software

Many OTs use specialized platforms to document sessions, generate reports, and manage caseloads. These systems may include intake forms, progress-tracking templates, automated report generation, billing features, and secure client communication. Select software that meets your district privacy requirements and supports efficient, high-quality records.

Checklists, Forms, & Assessments for Your Sessions

Thorough documentation and appropriate assessment are cornerstones of effective school-based OT.

Start evaluations with standard checklists, occupational profiles, and parent/teacher questionnaires. Use progress report templates to summarize goal attainment and guide future planning.

Checklists and forms

• School-age screening checklists help identify areas of motor, visual-motor, and sensory concern.
• Quarterly progress report forms provide a concise way to document progress toward IEP goals.
• Occupational profile templates assist with onboarding new students and gathering functional information from families and teachers.

Common assessments

Many OTs rely on standardized tools for baseline evaluation and ongoing measurement. Common instruments include:

• Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)
• Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI)
• Clinical observation tools for motor and postural skills
• Motor-Free Visual Perception Test (MVPT)
• Developmental observation measures for early childhood screening
• Sensory Processing Measure and related caregiver/teacher questionnaires

Districts often mandate specific assessments; choose instruments that align with your evaluation questions and local policies.

Positive Psychology Toolkit — Practitioner Resources

A comprehensive collection of science-based exercises, assessments, and interventions for educators and clinicians looking to support student wellbeing and engagement.

6 Helpful Software Options to Upgrade Your Work

Software can streamline scheduling, documentation, telehealth, and student-facing activities. Consider tools that enhance efficiency while meeting privacy and district requirements.

Documentation and scheduling

Quenza and similar platforms

Comprehensive platforms can host intake forms, homework assignments, progress measures, and secure messaging. These systems allow therapists to deploy activities, collect responses, and export data for reports.

Appointment and practice management

Scheduling tools

Online scheduling apps provide reminders, calendar syncing, and secure hosting. Choose solutions that comply with regional data-protection standards and integrate with your workflow.

Practice management

Dedicated practice-management systems combine scheduling, telehealth, note templates, billing, and reporting to save time and support compliance.

Student-centered apps

Interactive writing and drawing apps

Several free and low-cost apps allow students to practice letter formation, shapes, and drawing in motivating, game-like environments. These tools are particularly useful for early learners and students who need multisensory practice.

Creative drawing and coloring apps

Coloring and drawing apps that include auditory feedback and visual effects can motivate fine motor practice and provide low-stress opportunities for self-expression.

Browser extensions

Chrome extensions and accessibility add-ons—such as voice typing, text-to-speech, and reading supports—help students with fine motor, literacy, and attention challenges. Many extensions offer teacher licenses or free versions tailored for educators.

Our 3 Favorite Books on the Topic

1. Best Practices for Occupational Therapy in Schools — Clark, Rioux & Chandler

This comprehensive guide addresses school-based practice across ages, including transition planning, assistive technology, and strategies to increase student participation. It includes templates and practical guidance for documentation and program design.

2. Self-Regulation Interventions and Strategies — Teresa Garland

This practical resource outlines more than 200 strategies and interventions to help students with autism, ADHD, and sensory challenges manage arousal, attention, and behavior. It is well-rated for clinicians and classroom teams.

3. Occupational Therapy Activities for Kids — Heather Ajzenman

Geared toward families and clinicians, this book offers 100 games and exercises for young children to build motor, cognitive, and social-emotional skills. Many activities adapt easily for classroom use.

PositivePsychology.com’s Useful Resources

Occupational therapists who support social communication and self-regulation may find adjacent resources helpful, such as guides on social-skills training, mindfulness activities for children, engagement strategies, and goal-setting worksheets. These materials can complement OT interventions and support whole-class or small-group implementation.

A Take-Home Message

School-based occupational therapy aims to align a student’s abilities with the functional demands of school life. Research shows that only a small portion of classroom time is spent on handwriting, yet OT encompasses far more than handwriting instruction—supporting participation, regulation, access to learning, and transition skills.

As the scope of school-based OT grows, clinicians and school systems should strive for intentional, evidence-informed practices that bridge service goals with classroom realities. The strategies, tools, and resources described here can help therapists deliver meaningful, measurable supports that improve student engagement and success.

We hope these suggestions enhance your practice. Consider integrating a few new tools or protocols this term to broaden the options available to the students you serve.