ASI Update

Parents as partners and the role of the occupational therapist supporting the EHCP process

Ayres' Sensory Integration in Schools

In 2018, this ASI Wise presentation at the Royal College of Occupational Therapists Annual Conference examined the ethical tensions arising when occupational therapy assessment is used to inform provision within the Education, Health and Care Plan process in the UK and British-based education systems.

The EHCP process provides a legal framework for identifying and securing support for children and young people with special educational needs and disabilities. Within this context, occupational therapy assessment is increasingly used to provide evidence that informs decisions about provision, resources, and recommended support. This is particularly relevant when therapists draw on knowledge of sensory integration, participation, and functional needs to evidence the impact of difficulties on everyday school life.

Occupational therapists working across the NHS, education, social care, and independent practice are increasingly asked to prepare reports and offer guidance regarding provision, dosage, and resource allocation. This can create a significant ethical challenge where local provision is limited, family expectations are understandably high, and therapists may be positioned, implicitly or explicitly, as gatekeepers to access. The assessments selected, and the pathways available to support provision, can therefore have significant implications for both recommendation and outcome.

This presentation considered the ethical dilemmas faced by practising occupational therapists when balancing immediate resource constraints against the potential longer-term consequences of unmet need. These consequences may include reduced educational engagement and poorer outcomes where environmental, social, emotional, mental health, and sensory integration needs are insufficiently recognised or supported.

Presented as an ASI Wise paper, the session drew on a single case study to explore these issues and highlight the complexity of occupational therapy decision-making within legally framed, resource-constrained systems. The presentation also addressed broader questions relevant to Ayres’ Sensory Integration, ASI-informed assessment, sensory integration and processing, and the role of occupational therapists in advocating for participation-focused provision in education.