Educational participation of children born preterm: The contemporary role of school-based occupational therapy
DOI:
https://doi.org/10.14295/bjs.v5i12.902Keywords:
prematurity, occupational participation, school-based occupational therapy, neurodiversity-affirming practice, multi-tiered systems of supportAbstract
Advances in neonatal intensive care have transformed the survival rates of infants born prematurely, resulting in a growing demographic of children with early-arrival histories entering formal education systems. While severe, high-risk neurodevelopmental diagnoses are typically established during infancy, the more subtle, low-severity "echoes" of prematurity frequently remain dormant, manifesting later as significant barriers to occupational participation in the classroom. This narrative literature review synthesizes contemporary evidence regarding the educational experiences of children born preterm and examines the role of school-based occupational therapy (SBOT) in promoting occupational participation within inclusive educational environments. Deliberately shifting away from traditional bottom-up, deficit-remediation models that seek to "normalize" the child, this paper explores how the nuanced legacy of prematurity impacts the core occupations of the student-specifically academic performance, social participation, and play. Grounded in the Occupational Therapy Practice Framework: Domain and Process (4th ed.) and neurodiversity-affirming paradigms, the review highlights the central role of SBOTs in utilizing Universal Design for Learning (UDL), Multi-Tiered Systems of Support (MTSS), and environment-centric adaptations. Ultimately, the paper advocates for a top-down, collaborative, and systemic approach to optimize the occupational engagement of students navigating the late-emerging challenges of premature birth.
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