Victorian primary school teachers' perspectives on collaboration with occupational therapists

Abstract

Introduction

Effective interprofessional collaboration between primary school teachers and occupational therapists is crucial in fostering inclusive learning environments. Occupational therapists work in schools to assist children who require additional support through the recommendation of capacity building strategies. Teachers play a fundamental role in ensuring these recommendations are implemented consistently, making collaboration with occupational therapists important for student performance and participation. However, various factors impact this collaborative process. There is a lack of research on Australian teachers' perspectives regarding collaboration with occupational therapists. Therefore, this study investigated the perspectives of Victorian primary school teachers on collaborating with occupational therapists to identify ways to enhance collaboration.

Methods

This study employed an exploratory qualitative research design. Seven Victorian primary school teachers were recruited through a combination of convenience and snowball sampling. Participants completed online semi‐structured interviews, sharing their personal perspectives and experiences on collaborating with occupational therapists in schools. Interviews were transcribed verbatim and analysed using reflexive thematic analysis.

Consumer and Community Involvement

No consumer or community involvement.

Findings

Two themes were generated from the data, each with several subthemes. The first theme, ‘We need to have everyone working on the same page’ represented a misalignment between the professions and was supported by two subthemes: Defining dynamics and clarifying contributions and Talk to me: clear, concise and frequent. The second theme, Bridging the resource gap, presented various resource constraints and included three subthemes titled: School rules, All hands on deck and Teach me, teach you.

Conclusion

Misalignments in role understanding and communication between teachers and occupational therapists hinder effective collaboration. Moreover, limited resources and inadequate support systems make it difficult for occupational therapists and teachers to better align their practices. Outside of supportive policy changes, strengthening this collaboration requires greater appreciation of each other's role demands, concise communication methods, and supportive information sharing.

PLAIN LANGUAGE SUMMARY

Occupational therapists often work with primary school teachers to support students who need extra help with learning. When teachers and occupational therapists work well together, they can help create classrooms where all children feel included and can do their best. But working together is not always easy. There is little research on how Australian teachers feel about working with occupational therapists.

This study looked at the perspectives of seven primary school teachers in Victoria, Australia. Each teacher took part in an online interview to talk about their views. The interviews were carefully read to find patterns and common ideas.

Two main themes came out of the study. The first theme showed that teachers and occupational therapists are not always on the same page. Teachers said they wanted clearer communication and a better understanding of each other's jobs. The second theme showed that schools often do not have enough time, staff, or resources. Teachers said they needed more support and chances to learn alongside occupational therapists.

The study found that poor communication and confusion about roles can make teamwork harder. A lack of school resources also adds to the problem. To work better together, teachers and occupational therapists need clear ways to share information and understand each other's roles. School policies that support teamwork could also help.

Key Points for Occupational Therapy.

• Occupational therapists should consider teachers' demands to enhance the effectiveness of occupational therapy services in schools.

• Clear, concise, and frequent communication between occupational therapists and teachers is essential for effective collaboration.

• Strengthening relationships with teachers fosters mutual understanding, facilitating alignment of roles and practices.

1. INTRODUCTION

Effective collaboration between primary school teachers and occupational therapists is essential for fostering inclusive and equitable learning environments. Interprofessional collaboration is a partnership between individuals from diverse professional backgrounds who work together to deliver services (Morgan et al., 2015). Specifically in an education context, this means educators and specialists (i.e., allied health professionals like occupational therapists) collaborating or ‘co‐teaching’ in ways that are flexible and driven by both individual and collective learning needs of students (Cook & Friend, 2010; Friend & Cook, 2010). Collaboration plays a critical role in effectively supporting students' academic participation (Benson et al., 2016), particularly in inclusive educational environments (Jeremy et al., 2024b). Inclusive education ensures that all students, regardless of disabilities, are taught together in mainstream schools (Australian Government, 2005, 1992; State Government of Victoria, 2023a; United Nations, 2006). To support such environments, teachers and occupational therapists must have clear understandings of each other's roles.

Paediatrics remains one of the largest areas of practice within the Australian occupational therapy workforce, with a 6% increase in clinicians reported between 2013 and 2021 (Occupational Therapy Australia [OTA], 2023). Despite this growth, only 2.0% of occupational therapists report working in school settings (OTA, 2023). However, this figure likely underrepresents the true scope of occupational therapy involvement in education, as many clinicians deliver services in schools through private practice or National Disability Insurance Scheme funding as external providers. Although Australian education policy does not mandate the employment of occupational therapists in schools, government guidelines require schools to embed mental health and wellbeing promotion across the curriculum (Victorian Curriculum and Assessment Authority, n.d.; Jeremy et al., 2024a; State Government of Victoria, 2023b), providing an opportunity for allied health support in educational settings.

The delivery of occupational therapy in schools across Australia remains highly variable, with service provision typically being on a one‐to‐one basis, although in some cases a multi‐tiered system of supports (MTSS) is utilised (Jeremy et al., 2024a; Pozorski et al., 2023). Differences between state and territory approaches, as well as the reliance on principal discretion for clinician access to schools, contribute to inconsistency in how occupational therapy roles are understood and implemented. Recent research confirms ongoing confusion regarding the scope of school‐based occupational therapy (Bolton & Plattner, 2020; Smilies et al., 2025), particularly in relation to interdisciplinary collaboration. Teachers often report limited awareness or misunderstanding of occupational therapists' roles, frequently associating their scope with fine motor or sensory support (Benevides et al., 2022; Scannell et al., 2023) or, in some cases, being unaware of the profession entirely (Harutyunyan & Sadlo, 2019). Such misunderstandings can restrict the application of occupational therapy recommendations and reduce the impact of interventions in educational contexts.

Effective occupational therapy in schools relies heavily on collaboration, as teachers are typically responsible for implementing strategies within the classroom (Rens & Joosten, 2014). Improved role clarity and shared professional learning are essential to support this process. Evidence suggests that education and training can enhance mutual understanding between teachers and occupational therapists (Edick et al., 2022; Friedman et al., 2022; Scannell et al., 2023; Wilson & Harris, 2017). Interprofessional training at the tertiary level holds promise for improving collaborative practice across professions (Friedman et al., 2022; Scannell et al., 2023), not only by building teacher capacity but also by enhancing clinicians' understanding of classroom demands (Benevides et al., 2022).

Occupational therapists may provide services in schools such as assessments, classroom observations, and tailored recommendations, which are more often than not delivered via one‐on‐one sessions during school hours (State Government of Victoria, 2023a). However, this model does not typically allow for a consistent clinician presence in schools, making teachers responsible for implementing recommendations in the absence of direct occupational therapy support. This creates a need for effective coordination between families, schools, and clinicians, particularly when strategies—ranging from motor and cognitive skills to emotional regulation and academic participation—require differing levels of teacher involvement. Without well‐planned communication and coordination, the quality and effectiveness of interventions may be compromised.

In most schools, occupational therapy services are delivered by external providers (State Government of Victoria, 2024), contributing to fragmentation in service delivery. Despite strong evidence of the benefits of interdisciplinary collaboration, limited national guidance on best practices hinders consistent implementation. This is further complicated by the demanding educational environment. However, there is limited documentation on in‐class support, suggesting many teachers manage full classes independently. Teachers' responsibilities extend beyond instruction to include planning, assessment, supervision, and administrative duties (Department of Education and Training Victoria [DETV], 2022), leaving minimal time for collaboration with visiting professionals.

This growing pressure is intensified by the increasing enrolment of students with additional learning needs in mainstream schools. In 2024, 25.7% of students enrolled in school received an educational adjustment due to disability (Australian Curriculum, Assessment,, & Reporting Authority, 2024). Supporting these students is essential to uphold inclusive education. Occupational therapists play a vital role in fostering students' independence and participation (OTA, n.d.), yet their involvement may be perceived as an additional burden by time‐poor teachers.

Barriers such as limited time, resources, and policy guidance continue to undermine interprofessional collaboration (Arendse & Hess‐April, 2023; Benevides et al., 2022; Meuser et al., 2022). Teachers often struggle to schedule meetings with occupational therapists, and a lack of face‐to‐face engagement further impedes shared planning and communication (Arendse & Hess‐April, 2023; Hargreaves et al., 2012; Meuser et al., 2022; Suc et al., 2017). Tensions may arise when students are withdrawn from class for therapy, placing additional demands on teachers to support learning catch‐up (Hargreaves et al., 2012). Some clinicians also report feeling unwelcome in classrooms, leading to reduced presence and communication (Benson, 2013; Hargreaves et al., 2012). This disconnect can limit student access to coordinated and effective intervention. Addressing these challenges requires a nuanced understanding of the dynamics between professionals and the broader systemic factors influencing collaboration.

Although the importance of teacher‐clinician collaboration is well recognised, existing literature is limited—particularly from the perspective of teachers in Australia. Most studies adopt the occupational therapist's viewpoint, risking bias and overlooking opportunities to tailor collaborative models to classroom realities. Understanding teachers' perspectives is essential to building sustainable, effective partnerships that support both professions and, ultimately, student outcomes. Teacher insights can inform practical, context‐sensitive frameworks that enhance the integration of occupational therapy into education.

Given Australia's diverse educational systems and decentralised policy approaches, context‐specific research is needed to clarify the role of occupational therapists in schools. There remains a significant gap in national policy and formal guidelines regarding occupational therapy practice in education. Whereas OTA (n.d.) acknowledges that collaboration with educators is best practice, it is not legislated, resulting in role ambiguity and inconsistent collaboration. Addressing this gap is critical to informing future policy, strengthening school‐based occupational therapy, and ensuring inclusive, coordinated support for all students.

This study therefore aimed to gain a comprehensive understanding of Victorian primary school teachers' perspectives on collaborating with occupational therapists in schools to enhance collaborative practice. The guiding research question was as follows: ‘What are the perspectives of Victorian primary school teachers on collaborating with occupational therapists?’

2. METHODS

2.1. Ethical considerations

Ethical approval was obtained from Deakin University Human Ethics Advisory Group (HEAG‐H 74_2024) prior to the commencement of this study. Informed consent was acquired from all participants, both in written and verbal form, who received a Plain Language Statement outlining the research, their rights, and the option to withdraw at any time until data analysis.

To ensure confidentiality, each participant was assigned a re‐identifiable code (e.g., ‘Participant 01, Participant 02’, etc.) and no identifying details of the participant or their school were disclosed. Data were securely stored on a password protected computer in a Research Data Store, accessible only to the research team. All data will be stored for 5 years and securely disposed of following this period.

In Victoria, research involving schools requires both university human research ethics approval and additional approval from the relevant education systems or sectors as required. These additional processes do not replace ethics approval but ensure that research is appropriate for, and permissible within, each school context. For Victorian Government schools, approval to conduct research must be obtained from the Department of Education, which oversees research activity across all government schools (State Government of Victoria, 2025). Although an application was submitted, approval was not granted within the study timeframe and was subsequently withdrawn. Therefore, no participants were recruited directly from government schools. For Catholic schools within the Melbourne Archdiocese of Catholic Schools (MACS), system‐level approval was required. Following consultation with the Author Three, written approval was granted by MACS, allowing access to schools under its authority. Independent schools, which operate autonomously, did not require sector‐level approval. Instead, once university ethics approval was secured, researchers could approach individual schools directly to seek participation. For independent schools and MACS schools, it was then at each school principal's discretion to advertise the research study to the staff cohort.

2.2. Research design

This study employed an exploratory qualitative research design to investigate teachers' perspectives on collaborating with occupational therapists in schools. Qualitative research involves gathering and exploring non‐numerical data to understand others' beliefs and attitudes (Patton, 2015, as cited in Liamputtong et al., 2016), making it particularly suited towards gaining deep and nuanced understandings of the research question. The exploratory approach, a strategy used to investigate topics that have not been extensively studied (Liamputtong et al., 2016), was suitable given the relatively limited research on this topic from the Victorian teachers' perspective.

2.3. Participants and recruitment

Participants needed to meet the following inclusion criteria: (1) a minimum of one‐year primary school teaching experience; (2) at least one sustained interaction (ongoing contact for the purpose of a student) with an occupational therapist while in a teaching role; and (3) English speaking. Individuals with less than 1 year of teaching experience and no interactions with an occupational therapist were excluded. To avoid bias in the interviews, individuals known to Author One were also excluded. A total of seven participants were recruited, providing a sufficient sample size for the nature of this research (Creswell, 2013).

Participants were conveniently recruited from Catholic schools in the Melbourne, Victoria Archdiocese, and independent schools in Geelong and Melbourne. Convenience sampling, which involves sourcing participants based on their accessibility and availability (Patton, 2015 in Liamputtong et al., 2016), was used by selecting schools listed on the MACS website, which provided contact information of school principals. Over a two‐month period, a total of 150 Catholic and independent school principals were contacted via email by Author One. The introductory email explained the purpose of the study and included the Plain Language Statement. Principals were invited to share the research study with their teaching staff at their discretion. Teaching staff who received the invitation were then asked to contact the research team if interested in participating. Plain Language Statements and consent forms were distributed to teachers upon their contact with the research team; the participants were screened for eligibility through email correspondence, and suitable times were scheduled for interviews. Snowball sampling was also used to broaden the pool of potential participants. Teachers who consented to participate were invited to share the recruitment information within their professional networks to assist in recruiting additional participants (Liamputtong et al., 2016). Five participants were recruited through this method.

2.4. Data collection

Semi‐structured, one‐on‐one interviews were used to collect data. Interviews are widely used in qualitative research due to their ability to capture in‐depth insight and nuanced understandings of a topic (Patton, 2015, as cited in Liamputtong et al., 2016), proving relevant to exploring the research aims.

The interview questions were developed and reviewed collectively by the research team based on the foundations of the research question, the Canadian Interprofessional Health Collaborative [CIHC] (CIHC, 2024) framework, and other relevant literature. Whereas it is typically helpful to pilot interview questions, due to the strict timeline of the research project this was not possible. As Authors Two and Three had extensive expertise in working with teachers and in schools, the research team was satisfied the questions were appropriate for educators. The interview questions are presented in Table 1.

TABLE 1.

Interview schedule.

Question number	Question	Follow‐up prompt or questions (if applicable)
Teachers' understanding of occupational therapy
1	I understand you have worked with occupational therapists (OTs) before, in your words could you tell me what an OT does?
2	From your experience, can tell me about what that might look like in your classroom and your school.
3	Does your school have any policy or expectation around how to work with OTs?	Does your school have any restrictive policies around OTs coming into the school? Can you tell me more about this?
4	Do you recall working with OTs ever being covered within your teaching degree?	Could you tell me about this? Did you have any exposure or experience to OTs in teaching placements?
5	Have you ever had to make a referral for one of your students to see an OT or discussed with a parent the need for a student to see an OT? Could you tell me about that?
Teachers' experience on collaborating with occupational therapists in the school context
6	How often do you work with OTs in the school setting?	Do you have an OT employed within the school, or do they come from external organisations? From your knowledge how many external organisations does your school work with for OT? How often in the past have you worked with OTs?
7	How do you prefer working with an OT?	Do you prefer when they take students out of the classroom or when they stay in the classroom? Do you prefer when the OT has consultation with you and when they involve you in the strategies or recommendations Do you prefer when they work directly with the child and the parents?
8	How do you find implementing recommendations and strategies from OT? Is it realistic within the classroom?
9	Could you tell me about what communication with OT looks like?	How often do you communicate? Is it face to face, via email, or over the phone? What do you find to be helpful and why? What is not helpful?
10	What type of communication have you found to be most effective?
11	Can you tell me about some positive experiences about working with OTs? Why was this positive?
12	Can you tell me about some negative experiences about working with OTs? Why was this negative?
13	Thinking about how you work with OTs, would there be anything you might change to foster a good professional relationship?	What elements do you feel contribute to effective collaboration with occupational therapists?
14	In your opinion, what types of supports or structural components would facilitate more effective collaboration between teachers and OTs?	Is it information from your school, tertiary education about working with OTs, or political influences such as policy and legislation?
Perspective of occupational therapy impact on student performance
15	When an OT has worked with one of your students, what kind of change have you seen within that child at school?	Have you found any differences in skills such as handwriting, social skills, organisation, executive functioning (like planning, sequencing, initiating tasks), fine motor skills like tying shoelaces and opening lunchboxes, gross motor like playing in the playground and performance in P. E, self‐regulation, or toileting? How do you feel OTs impact student progress?
16	Do you feel that OTs are beneficial to schools and student learning? Could you tell me more about this?
17	What suggestions or recommendations do you have for OTs and teachers working together in a school to support effective collaboration?
18	Is there anything else you would like to add to the discussion today?

Seven interviews were conducted. Each interview lasted 30–45 minutes via Zoom Video Conferencing, which facilitated both the recording and transcription of interviews. The use of an online platform was selected to increase the accessibility and convenience for participants, who were in various geographical locations. The use of this software was approved in the ethics processes, and participants were required to again confirm their assent to record at the time of interview. Following generation of transcripts by Zoom Video Conferencing, Author One reviewed each transcript alongside the audio recording to ensure the automatic transcription was accurate. This process also assisted in data familiarisation.

Each interview began with eight demographic questions about participant age, gender, qualifications, and experience (e.g., ‘How many years have you worked as a primary school teacher?’). This was followed by 19 set, open‐ended, interview questions related to their personal perspectives of collaborating with occupational therapists (e.g., ‘Could you tell me about what communication with occupational therapists looks like?’ and ‘How do you prefer working with occupational therapists?’). Given the semi‐structured interviewing style, spontaneous follow up questions on interesting points were asked throughout to increase depth in data (Liamputtong et al., 2016).

Using the recordings of the interviews, each was transcribed verbatim by Author One. Transcripts were returned to each participant for member checking prior to the commencement of data analysis. This process allowed participants to review and confirm the accuracy of their responses, enhancing credibility and confirmability (Henderson & Rheault, 2004).

2.5. Data analysis

Data were analysed using reflexive thematic analysis (Braun & Clarke, 2022) to identify key themes by evaluating patterns in teachers' perspectives collaborating with occupational therapists. The analysis process followed the six steps of Braun and Clarke's (2022) thematic analysis method: (1) familiarisation with the data, (2) coding the data, (3) generating initial themes, (4) reviewing and developing themes, (5) refining, defining, and naming themes, and (6) producing the report.

To ensure the trustworthiness of this qualitative research, multiple strategies were employed throughout the analysis process (Creswell. & Creswell, 2018). Data coding was conducted inductively using NVivo software (Lumivero, 2023), with Author One assigning codes to segments of data that were conceptually relevant to the research aims (Clarke, 2021). An example of codes is presented in Table 2. To support credibility and dependability, two transcripts were independently coded and then cross‐checked by members of the research team, enabling a shared understanding of coding practices and emerging concepts.

TABLE 2.

Example of coding quote.

Data

Codes

Oh, [integrating and implementing OT recommendations] is certainly not something that I feel you ever nail 100%. It's something that you are constantly working on and obviously finding time to integrate. We do a lot of individual education plans and behaviour plans and certain students are on, you know, safety plans, and these kinds of things, and these are all informed by a lot of [the OT] recommendations to allow these students to have success. Often there can be quite a few recommendations and sometimes they're not necessarily‐ they might not be friendly to, you know the school environment to necessarily do daily, or they might be great in theory, but you know, knowing the student, knowing what they need, you're not going against what the recommendation is, you know going back and you know whether it's an OT or we have lots of other professionals with recommendations. You're not throwing it back in their face and saying it doesn't work but sometimes it's just about prioritizing what's gonna have the greatest impact and also be the most efficient.

Challenges in implementing OT recommendations Teacher confidence in implementing OT strategies is low Reports from OT aren't useful Reports from OTs aren't meaningful or school‐friendly Teachers have experience Teachers know their students Too many recommendations that maybe are not useful/meaningful Input is coming from lots of places for teachers; this could be overwhelming Teachers want good outcomes for their students Teachers are time poor Teachers want efficient and quality strategies

Ongoing reflexivity was also central to the study's rigour. AL maintained a reflexive journal throughout the data analysis period to document evolving thoughts and areas of uncertainty. This practice deepened her immersion in the dataset and allowed for critical reflection on her own assumptions and interpretations. Weekly meetings with the broader research team served as a forum for debriefing, collaborative discussion, and supervisory support.

Following initial coding, codes were grouped into summary topics and refined into broader themes through collaborative team discussions. An example of the codes aligned with each eventual theme is presented in Table 3. Researcher triangulation at this stage helped ensure the analytical decisions remained grounded in the data and aligned with the study's aims. Themes were defined and named through an iterative and collaborative process, and ultimately presented in a way that addressed the research questions while maintaining fidelity to participants' perspectives. These strategies collectively enhanced the transparency and rigour of the analytic process, ensuring that the findings are trustworthy, meaningful, and contextually situated.

TABLE 3.

Example of code clusters for topic summaries prior to naming themes.

Topic summary	OT role understanding	Communication	Conflict and tensions	Environmental constraints
Example codes in candidate theme	OTs work on self‐regulation OTs work on fine motor skills OT is hard to define OTs work with students for funding Older teachers may not understand OT OT is broad Trying not to get confused with speechies	Email communication is difficult Teacher prefers short and straight to the point information Face to face communication is practical Need for increased communication All student supports should be working on the same page Long reports are overwhelming	Teachers have experience Teachers know their students Teachers are time poor Teachers want efficient and quality strategies Pressure to implement strategies teachers do not agree with Teachers/OTs see behaviour in different contexts Teachers feel unheard Power imbalance	Increased teacher admin time Parent constraints Difficulty to access OT in school Education support staff availability Teachers are time poor Funding implications Lack of clear school policy Lack of clear broader policy (?State,? Australia)

2.6. Positionality statement

AL, a final‐year Bachelor of Occupational Therapy (Honours) student, gained valuable insights into interprofessional collaboration with teachers through an eight‐week primary school placement. This experience highlighted the challenges in coordinating occupational therapy involvement in the school environment and underscored the need for improved processes to enhance collaboration. It sparked her interest in exploring this topic further. EC is an occupational therapy academic and has 15 years of experience as an occupational therapist, primarily working in paediatrics. CM has 21 years of experience as an occupational therapist, also with extensive experience in paediatrics and working in school‐based settings. Both CM and EC have clinical experience collaborating with teachers.

3. FINDINGS

3.1. Participants

Seven primary school teachers participated in the study, aged 26 to 48 years, including six females and one male. Teaching experience varied from 4 to 25 years, with differing frequency of experience collaborating with occupational therapists. The group included two teachers from Catholic schools and five from State Government schools (via snowballing). Further details are presented in Table 4.

TABLE 4.

Participant demographics.

	Age	Gender	Highest qualification	Current role	Years of primary teaching experience	School type
Participant 01	39	Female	Postgraduates diploma	Mental health and wellbeing leader	10	Catholic
Participant 02	36	Female	Bachelors	Classroom teacher	10	State Government
Participant 03	26	Female	Bachelors	Classroom teacher	4	State Government
Participant 04	47	Female	Bachelors	Learning Diversity Leader	25	Catholic
Participant 05	28	Female	Masters	Disability inclusion leading teacher	7	State Government
Participant 06	48	Female	Bachelors	Classroom teacher	13	State Government
Participant 07	28	Male	Bachelors	Classroom teacher	4	State Government

3.2. Themes

Two key themes were generated by the research team during data analysis. The first theme, ‘We need to have everyone working on the same page’, represents the core issue of misalignment between teachers and occupational therapists. This includes two subthemes, Defining dynamics and clarifying contributions, and Talk to me: Clear, concise and frequent. The second theme, Bridging the resource gap, presents the various resource constraints and was further divided into several subthemes: School rules, All hands on deck, and Teach me, teach you. The theme organisation is visualised in Figure 1.

FIGURE 1.

Theme organisation.

3.2.1. ‘We Need to Have Everyone Working on the Same Page’

The first theme describes the misalignment between occupational therapists and teachers as a significant barrier to effective collaboration. Participants consistently referenced elements of misalignment in areas such as practices, understanding and disciplinary differences, emphasising that ‘we need to have everyone working on the same page’ (Participant 05), suggesting that this is currently not the case. Logistical challenges also proved to contribute to misalignment:

It is hard because … they don't work at a school … having time to meet would be nice to throw goals back and forth and discuss what works well in the classroom and what works well in the [occupational therapy] sessions because it might look very different … and that's hard, because obviously they'd have other students to get to and then we're teaching. (Participant 03)

whereas teachers and occupational therapists are applying a different lens (e.g., education versus occupational therapy) in practice which often contributes to misalignment, there is a clear desire to bridge this gap to support collaboration: ‘If the teacher and [occupational therapist] could work hand in hand … that would be really helpful’ (Participant 03).

Defining dynamics and clarifying contributions

This subtheme describes the role confusion between teachers and occupational therapists from the teacher perspective and highlights its hindrance on collaboration. Participants often struggled to define the occupational therapy role within the school setting: ‘Well, it's a tricky one’. (Participant 01), ‘Good question. Sometimes I ask that myself … what is it?’ (Participant 04). Most participants associated the role with motor skills: ‘It was more so … fine motor type skills … those type of skills with handwriting’ (Participant 02). Whereas some participants recognised that occupational therapists addressed sensory processing, cognitive functioning, and emotional regulation, such as ‘depending on their focus, it can be emotion regulation’ (Participant 01), this understanding was limited.

Conversely, participants expressed dissatisfaction in the way that occupational therapists overlooked the challenges they manage daily: ‘They [occupational therapist] just weren't considering my time, and … the situation that was happening’ (Participant 03). Moreover, participants felt that occupational therapists were not considerate of teachers' lesson plans: ‘[The occupational therapist] was changing a lot of things that I'd put in place for that lesson, which was a bit tricky … [it] wasn't the aim of the lesson’ (Participant 02). As a result, some viewed occupational therapy as an additional burden rather than support: ‘There's quite a few teachers that I feel are so overburdened with what they're doing and fixed on end goal that they may even see it [occupational therapy] as a bit of extra work’ (Participant 01).

Talk to me: Clear, concise, and frequent

This subtheme speaks to the way in which teachers find communication with occupational therapists both effective and ineffective, highlighting the need for more aligned methods. Participants strongly preferred direct communication with occupational therapists, rather than through principals or parents: ‘If [the occupational therapist] communicate[s] anything to the school, they send it to the principal … it doesn't even come to me’ (Participant 06).

Most participants indicated that email is the most effective and manageable communication method given their heavy workloads. They appreciate follow‐up emails with recommendations and progress updates, as they can review and respond at their convenience: ‘I think it [preferred communication method] would be email, and that simply again, [is due to] time constraints’. (Participant 01).

Whereas phone calls and Zoom meetings were reported to be valued when seeking an immediate response, face‐to‐face communication was ‘far more impacting’ (Participant 04), but often impractical due to classroom constraints: ‘How many hours am I going to have in a day away from kids to have that conversation let alone [occupational therapists] might have four other clients they've got to go talk to’ (Participant 07).

Additionally, participants emphasised the need for concise communication, whether written or spoken: ‘I personally like face‐to‐face, quick conversation, because obviously, when you're teaching the class, you've got to be with them’ (Participant 05). Long reports and conversations are impractical and ‘overwhelming’ (Participant 02) due to limited time outside of face‐to‐face teaching hours. However, participants reported that occupational therapists often send extensive reports or attempt to communicate during class time, adding to these challenges.

3.2.2. Bridging the resource gap

The second theme presents the resource misalignment between teachers and occupational therapists which impacts their ability to intertwine their practices effectively. Teachers want to ‘[work] as a team as opposed to separate[ly]’ (Participant 04), but current systems lack the policies, physical supports, and educational opportunities needed to foster effective collaboration.

School rules

This subtheme addresses the misalignments between school structures and the integration of occupational therapy, which limit collaborative opportunities. Teachers noted a lack of clear school policy on how collaboration should occur, leading to inconsistent practices. While some participants preferred occupational therapy sessions in the classroom for better opportunities to collaborate: ‘I think encouraging that [occupational therapists coming into the classroom more frequently] would allow the teacher and occupational therapist space to kind of work together within one setting’. (Participant 01), others preferred sessions outside of the classroom for the sake of the students: ‘… concentration and the ability to work with someone when there's a whole class around them … it proves challenging’ (Participant 07). The absence of such guidance compels teachers to adapt to the occupational therapist's preferences rather than what best suited the classroom. To address this, participants expressed that having occupational therapists employed within the school would facilitate better opportunities to align their practices:

Working with an [occupational therapist] on hand, being able to book in an appointment; it has been fantastic!...I've had [occupational therapists] come in for an observation on students that are external to the school … completely different experience … very difficult. (Participant 02)

Other participants also described the challenge of managing time for collaboration with visiting health professionals, feeling overwhelmed by this: ‘There's a lot of teachers that are really burnt out and the workload‐ you never obviously tick everything off your to do list. There's always something happening’ (Participant 05).

Without adequate time built into their schedules for collaboration, participants noted often doing so outside of working hours. They stressed the need for less face‐to‐face learning time to accommodate for this: ‘Teachers definitely need more non‐face‐to‐face time … the teaching job is so admin heavy now that unfortunately, teachers do it in their own time’ (Participant 05).

All hands on deck

This subtheme portrays the lack of physical supports, such as teacher aides, available to assist with collaboration between teachers and occupational therapists. Whereas participants reported experiencing increased complex behaviours in mainstream schools: ‘It's a lot more common these days for students with additional needs in the classroom … it's getting more and more’ (Participant 02), they currently face a shortage of support staff. One participant described that even with classroom support, management of the classroom is challenging: ‘I've got [one] support four days a week … but even then, there's only two people to twenty two [students] and my job is to still teach the class and manage some pretty complex behaviours’ (Participant 07). This shortage makes it difficult for participants to find time to collaborate with occupational therapists and implement suggested strategies effectively. One participant explained the difficulty: ‘Yes, there might be aides in a classroom, but they are needed … it can be harder to facilitate regular breaks [as an intervention for one student] without taking the whole class out’ (Participant 05). Additionally, the shortage of teaching staff and growing administrative burdens further complicated the situation:

In the ideal world, the best thing would be that that classroom teacher is released by another educator to have time to talk [with the occupational therapist] about that particular child's needs there and then, but I think in the context of the busyness of the classroom, it's just not sustainable. (Participant 04)

Teach me, teach you

This subtheme describes participants' requests for more educational opportunities regarding collaboration with occupational therapists and allied health professionals. Participants expressed the need for increased knowledge about occupational therapy, noting that this is absent in tertiary education: ‘[University] doesn't teach you any of this. It really needs to be mentioned [about] occupational therapists and allied health and that they can impact even teaching, because often they're separated; the two end goals’ (Participant 01). Multiple participants also noted the desire for more professional development opportunities to support them in collaboration: ‘I think definitely professional development and looking at … what does an [occupational therapist] do? How can we use those skills in schools?’ (Participant 04).

Additionally, participants wanted more training on disability and diversity in childhood to better manage their classroom and address complex behaviours more effectively. ‘Even with the neurodiversity, all of the learning [would be helpful]’ (Participant 01).

4. DISCUSSION

The purpose of this study was to explore the perspectives of Victorian primary school teachers on collaborating with occupational therapists. Whereas participants' perspectives varied, the findings revealed that collaboration barriers largely stem from misalignment between the professions, captured in the theme ‘We need to have everyone working on the same page’. Unlike previous literature, this study emphasises how misalignment impacts collaboration. Despite occupational therapists and teachers sharing the goal of supporting students, they may view this process through different lenses. This aligns with research suggesting that collaboration is shaped not only by interpersonal dynamics but also by broader professional differences and service delivery models, with tensions often emerging from the contrasting frames of reference of education and health (Jeremy, Spandagou, & Hinitt, 2025; Wintle et al., 2017).

A common finding was teachers' limited understanding of the occupational therapy role within schools, aligning with the subtheme Defining dynamics and clarifying contributions. This gap in knowledge is crucial to address, as the Interprofessional Education Collaborative (2023) highlights role understanding as a core competency for effective collaboration. Participants in the study often expressed uncertainty about how to describe occupational therapists' roles, a finding consistent with international research highlighting similar gaps in knowledge (Benevides et al., 2022; Benson, 2013; Harutyunyan & Sadlo, 2019; Jeremy et al., 2024c; Scannell et al., 2023). However, this lack of understanding could be attributed to the absence of explicit documentation and guidelines on the role of occupational therapists in schools. The novelty of occupational therapy in schools may also explain slow educational adaptation. Older teachers may lack prior exposure to occupational therapists, whereas newer graduates still face gaps in their tertiary education. This mismatch is further reflected in evidence showing that teachers often rate themselves as more collaborative than occupational therapists, suggesting possible discrepancies in perceptions of collaboration quality between professions (Jeremy, Hinitt, & Spandagou, 2025).

On the other hand, participants felt that occupational therapists often underestimate the demands on teachers, again reflecting the subtheme Defining dynamics and clarifying contributions. Literature supports this notion, describing how occupational therapists do not take teachers' time and workload into consideration when collaborating (Benevides et al., 2022). Occupational therapists may lack a strong grasp of the context of teaching, highlighting the need for mutual role understanding. Improved role understanding could lead to more effective use of each other's skills (Wintle et al., 2021), contributing to essential qualities of care and respect within teams (Wei et al., 2020). Wintle et al. (2017) further note that tensions may be exacerbated by professional socialisation, in which occupational therapists and teachers bring different expectations from their health or education frames of reference. These tensions can manifest when occupational therapists act as ‘experts’, undermining co‐equal collaboration, or when teachers make inappropriate referrals due to limited understanding of occupational therapy roles. Participants expressed a desire for more of these qualities in their experiences with occupational therapists. This requires occupational therapists to enter schools ready to learn about teachers' role demands while also supporting teachers' understanding of the occupational therapy role, thereby promoting mutual understandings. A deeper appreciation of each other's roles is crucial to collaboration, with literature describing mutual respect and interdependence as important (Jeremy et al., 2024c). The CIHC (2024) emphasises the importance of role clarification, suggesting that team members understand each other's knowledge, skills and expertise. Its competency framework provides a flexible guide for educators, practitioners, and organisations to strengthen team‐based, relationship‐focussed, and equity‐oriented care across diverse contexts, which is immensely important in education contexts.

Misaligned communication methods were also identified as a major barrier to collaboration, consistent with the subtheme Talk to me: Clear, concise and frequent. Interprofessional communication is a core component of the CIHC (2024) and Interprofessional Education Collaborative (2023) competency standards, further underscoring its importance in collaborative practice. Participants expressed a preference for direct, concise and frequent communication with occupational therapists, ideally through email due to time constraints. However, face‐to‐face communication was still preferred by several participants, though misaligned schedules and time constraints hinder this method of communication. Occupational therapists were noted to attempt communication during classroom hours or outside of teachers' working hours, further contributing to the misaligned methods. These findings reflect broader issues identified by Wintle et al. (2017), where poor communication, lack of relationship‐building, and differing views on inclusion can lead to one partner being left out of the loop, with recommendations not followed and working relationships weakened.

Current practices lack efficiency, as communication does not align with teachers' schedules. Other literature that confirmed this issue suggested that increasing occupational therapy presence in the classrooms could facilitate more opportunity to communicate (Benson, 2013; Hargreaves et al., 2012; Kennedy & Stewart, 2012; Meuser et al., 2022; Wilson & Harris, 2017). Furthermore, the CIHC (2024) recommends implementing structured procedures to improve the way that teams communicate. However, existing school structures and teacher workloads make this challenging, as demonstrated by another Australian study which concluded that for communication to improve, change is required at an organisational level (Kennedy & Stewart, 2012). A shift from itinerant to embedded models of service delivery may help address this, as embedded approaches have been shown to support more consistent communication, mutual professional development, and stronger collaboration (Jeremy, Spandagou, & Hinitt, 2025).

The second theme, Bridging the resource gap, also emerged as a core finding, demonstrating how resource constraints shape the conditions for collaboration. The lack of resources and support within schools was a core finding that impeded collaboration. According to the World Health Organisation (2010, p. 7), legislation that removes barriers from collaborative practice is essential, yet it remains a persistent challenge. Participants expressed frustration at the lack of time and resources available to support their growing role demands, echoing findings from other research that teachers need increased time and support to engage with occupational therapists and other allied health professionals (Edick et al., 2022; Meuser et al., 2022; Suc et al., 2017). The lack of time is not only a structural barrier but also a person‐level challenge, compounding individual stress and limiting opportunities for collaboration (Wintle et al., 2017).

The subtheme School rules reflected participants' perspectives with structural and policy constraints, which limited the integration of occupational therapy into schools. To address the misaligned practices between teachers and occupational therapists, other literature suggests employing occupational therapists internally within schools (Wilson & Harris, 2017). However, many Australian schools lack the funding or supporting legislation to do so (OTA, 2015). Only one participant from the study had experience with an internal occupational therapist and highlighted its benefits over those from external organisations. Participants also suggested increasing teaching support to reduce face‐to‐face teaching hours, allowing time for collaboration with occupational therapists. However, the ongoing teacher shortage in Australia (DETV, 2022) complicates efforts to hire more staff, making reduced teaching hours difficult to implement. Teacher burnout further reduced workforce appeal, a factor not yet highlighted in previous literature. Team cohesiveness is another important dimension of collaboration, and studies in health‐education teams have shown that cohesive teams are more effective and resilient in the face of such resource challenges (West et al., 2016).

The subtheme All hands on deck further emphasises the shortage of physical and human resources, such as teacher aides and relief staff, which limited teachers' ability to collaborate with occupational therapists. Funding remains a key barrier. Policymakers should consider funding positions for occupational therapists within schools and developing collaborative frameworks tailored to Victoria's education system. Currently, financial incentives aimed at workforce retention and attraction are targeted towards secondary schools (State Government of Victoria, 2023b, 2026), offering little relief for primary school settings.

Participation in structured processes such as Student Support Group (SSG) meetings supports collaborative care and relationship‐focussed practice (CIHC, 2024), reinforcing the need for occupational therapists' involvement. However, time constraints and workforce shortages make consistent participation challenging.

Finally, the subtheme Teach me, teach you highlights teachers' desire for more professional learning and development opportunities to prepare them for interprofessional collaboration. Participants expressed a willingness to learn from occupational therapists but felt unprepared for collaboration due to limited training in their tertiary education. Participants also noted the lack of professional development opportunities related to interprofessional collaboration. This is supported by international research indicating that teachers and occupational therapists do not achieve adequate training on collaboration within schools but show improvements when such training is implemented (Edick et al., 2022; Friedman et al., 2022; Wilson & Harris, 2017).

Participants noted that limited interaction between each profession exacerbates a lack of knowledge about each other. Literature confirms that less interaction often results in weaker understandings (Arendse & Hess‐April, 2023; Meuser et al., 2022). Whereas interprofessional training and education could help bridge this gap (Friedman et al., 2022), immediate changes in tertiary education and professional development opportunities are needed. In the meantime, increased opportunities to interact and collaborate are crucial, though difficult to achieve given the current misalignments and lack of systemic support.

4.1. Limitations

Several limitations must be acknowledged pertinent to this study. The use of semi‐structured interviews may have introduced some limitations, as interviewer influence and probing could have shaped participant responses, and variability across interviews may have led to differences in the depth or emphasis placed on particular issues when discussing teacher perspectives of working with occupational therapists. The sample, limited to Melbourne, Geelong and surrounding areas, does not represent the broader Australian or Victorian teacher population. Moreover, whereas snowball sampling effectively recruited five participants, it further limited the sample's diversity. Although the findings align with existing literature, the diversity of educational settings across states and regions, especially in rural and Indigenous communities, limits generalisability to the wider Australian context. Additionally, social desirability bias may have influenced participants to emphasise positive experiences with occupational therapists, especially when interviewed by an occupational therapy student.

4.2. Implications for occupational therapy practice

The findings of this study highlight important implications for occupational therapy practice, education, and policy development in school settings. Whereas primary school teachers expressed a strong appreciation for collaboration with occupational therapists, challenges remain in aligning professional practices, communication styles, and expectations. Improving this alignment has the potential to significantly enhance outcomes for students, particularly those with diverse learning and participation needs.

For occupational therapists, it is essential to consider the workload, responsibilities, and time constraints of teachers when providing school‐based services. Occupational therapists should strive to develop recommendations that are functionally relevant, easily integrated into existing routines, and require minimal additional preparation or disruption to the classroom. Interventions that are embedded within everyday school activities support a participation‐based approach and can help foster student independence, regulation, and engagement in learning, which are core outcomes of occupational therapy in education.

Clear, concise, and proactive communication is also critical. Given teachers' limited availability, occupational therapists should prioritise timely, accessible communication methods (such as brief emails or pre‐scheduled meetings) while remaining respectful of teachers' preferences and workload (Benson et al., 2016). Occupational therapists must take initiative in clarifying their role and scope of practice in the school setting (Benson et al., 2016; Jeremy et al., 2024b). This includes educating teachers and school leaders about the breadth of occupational therapy support, beyond fine motor or sensory‐based strategies, to include self‐regulation, social participation, executive functioning, and classroom engagement (Bolton & Plattner, 2020). Such role clarification can reduce misunderstandings and facilitate more purposeful collaboration and shared goal setting. Stronger interpersonal relationships, built on mutual respect and understanding, are foundational to sustaining effective interdisciplinary practice.

At a broader level, these findings reinforce the need for systemic and policy‐level changes to enable more consistent and equitable collaboration (Jeremy, Hinitt, & Spandagou, 2025; Smilies et al., 2025). Policymakers should consider the development of collaborative frameworks that outline expectations for interprofessional work within school settings (Jeremy, Hinitt, & Spandagou, 2025). These frameworks could be co‐developed by occupational therapy and education professional bodies, to ensure contextual relevance and sector alignment. For example, the recent ‘Paediatrics occupational therapy capability framework’ clearly outlines required knowledge, skills and attitudes interprofessional practice (OTA, 2025); however, considering this study's findings, increased detail pertaining to educational contexts as a unique practice setting is warranted. Further, collaboration guidelines that reflect the various Australian education systems would support clarity in implementation across schools nation‐wide. Policies that enable time release for joint planning or shared professional development, as well as increased recruitment of allied health staff into schools, could provide structural support for collaborative practice. Additionally, funding models that allow for embedded, school‐based occupational therapy roles may facilitate stronger, more consistent partnerships with school staff.

Education also plays a pivotal role in bridging the gap between the professions. Pre‐service and in‐service training for both occupational therapists and teachers should include content on interdisciplinary practice, role understanding, and collaborative communication (O'Donoghue et al., 2021; Smiles et al., 2025). Interprofessional learning modules at the tertiary level, joint professional development opportunities, and mentoring programs may all contribute to greater understanding, improved communication, and shared expectations for practice (Friedman et al., 2022; Jeremy et al., 2024b; Scannell et al., 2023; Wilson & Harris, 2017). Professional associations can also contribute by developing resources, toolkits, or workshops to support members in working more effectively within school systems.

Importantly, these efforts should be student‐centred. The purpose of improving teacher‐occupational therapist collaboration is to ultimately enhance student outcomes, particularly for students with disability, developmental delay, or other participation and/or inclusion challenges. Effective collaboration ensures that supports are not only designed with therapeutic expertise but also delivered in ways that are feasible and meaningful within the classroom environment. This alignment can promote greater inclusion, improved learning engagement, and stronger developmental outcomes for students (Echsel et al., 2019) who might otherwise be missed or under‐supported by poorly coordinated services. When occupational therapy strategies are embedded into daily school routines and tailored to educational goals, students are more likely to access and sustain participation in key school occupations such as learning, social interaction, and play. Ultimately, meaningful collaboration contributes to students' sense of belonging, autonomy, and success in the school context, which are critical foundations for lifelong learning and wellbeing.

Future research should broaden the exploration of teacher perspectives to include diverse Australian contexts such as rural, remote, and Aboriginal and Torres Strait Islander communities, where access to occupational therapy and collaboration practices may differ. Replicating this qualitative study in these settings would support comparative analysis and greater contextual understanding.

Based on this study's findings, future research could refine the interview guide to include more targeted questions about specific collaborative practices (e.g., shared goal setting or communication strategies). Including occupational therapists with school‐based experience in future studies would provide a more balanced perspective on collaboration challenges and solutions. Studies involving both teachers and occupational therapists could also highlight points of misalignment and support the co‐design of practical, school‐based collaborative frameworks.

Finally, future research should explore the impact of improved collaboration on student outcomes, helping to build the case for policy change and increased investment in interprofessional practice in schools.

5. CONCLUSION

This study highlighted the current misalignment between teachers and occupational therapists in schools. Whereas both professions aim to support students, their lack of aligning practices and resources hinders effective collaboration. Addressing these barriers is essential in fostering a more cohesive relationship, essentially benefiting both students and professionals.

AUTHOR CONTRIBUTIONS

CM and EC were responsible for the conceptualisation of the study. AL completed participant recruitment and data collection. All authors were responsible for data analysis and contribution to writing and editing the final manuscript.

CONFLICT OF INTEREST STATEMENT

The authors have no conflict of interest to declare.

Lavery, A. , MacKinnon, C. , & Clark, E. (2026). Victorian primary school teachers' perspectives on collaboration with occupational therapists. Australian Occupational Therapy Journal, 73(2), e70087. 10.1111/1440-1630.70087

DATA AVAILABILITY STATEMENT

Research data are not shared.