Occupational therapy in schools: an analysis of Argentine written productions (1985-2015)

Abstract

This essay aims to identify and disseminate written works on occupational therapy in schools, presented at the Argentine Congresses of Occupational Therapy from 1985 to 2015. Throughout the text, the issue of national knowledge production in the school area is addressed as a current problem in our country. Written works on occupational therapy and schools present in the proceedings of national congresses are a documentary source of historical relevance that contribute to knowledge about the professional role and dispel the established idea of a lack of information on the subject. It is therefore urgent to understand from early training that our work in schools is an activity that is situated in its own cultural matrix and that the work of the occupational therapist in schools in Argentina has been based on practical experience, and that from this it was amalgamated with conceptual frameworks that shaped a plurality of interventions in the school context.

Keywords:
Occupational Therapy; Schools; Education; Education Mainstreaming

Resumen

El presente ensayo tiene por objetivo conocer y difundir las producciones escritas sobre terapia ocupacional en escuelas, presentadas en los congresos Argentinos de Terapia Ocupacional en el periodo 1985-2015. A lo largo del escrito se aborda la cuestión de la producción nacional de conocimiento sobre el área escolar como un problema actual en nuestro país. Las producciones escritas sobre terapia ocupacional y escuelas presentes en las memorias de los congresos nacionales son una fuente documental de relevancia histórica que contribuyen al conocimiento sobre el rol profesional y permite desechar la idea instalada sobre la escasez de información sobre el tema. Se torna urgente, entonces, comprender desde la temprana formación que nuestro trabajo en escuelas es una actividad que se sitúa en una matriz cultural propia y que la actuación del terapista ocupacional en escuelas de Argentina se ha sustentado sobre la base de la experiencia práctica, y que a partir de ella se fue amalgamando con marcos conceptuales que dieron forma a una pluralidad de intervenciones en el contexto escolar.

Palabras clave:
Terapia Ocupacional; Escuelas; Educación; Integración Escolar

Resumo

O presente ensaio tem por objetivo conhecer e divulgar as produções escritas sobre terapia ocupacional em escolas, apresentadas nos congressos argentinos de terapia ocupacional no período de 1985-2015. Ao longo do texto, aborda-se a questão da produção nacional de conhecimento sobre a área escolar como um problema atual no nosso país. As produções escritas sobre terapia ocupacional e escolas presentes nas memórias dos congressos nacionais são uma fonte documental de relevância histórica que contribui para o conhecimento sobre o papel profissional e permite descartar a ideia instalada sobre a escassez de informações sobre o tema. Torna-se urgente, então, compreender desde a formação inicial que nosso trabalho nas escolas é uma atividade que se situa em uma matriz cultural própria e que a atuação do terapeuta ocupacional nas escolas da Argentina tem sido baseada na experiência prática, e que a partir daí foi amalgamado com quadros conceituais que deram forma a uma pluralidade de intervenções no contexto escolar.

Palavras-chave:
Terapia Ocupacional; Escolas; Educação; Inclusão Escolar

Introduction

Writing about the early days of the discipline in Argentine schools has been a personal challenge and at the same time the result of a collective feeling that has its roots in the questions raised during the First Meeting of Occupational Therapists in Schools, organized by the Argentine Association of Occupational Therapists (AATO) in 2017. One of the problems pointed out and reflected in the summary document of that activity is related to the scarce circulation of knowledge on the subject and its impact on the professional role due to a lack of knowledge of the background. Based on these reflections, we wonder about the first experiences of occupational therapists in schools, about the history that we do not know, and about the invisible practices. These questions are the driving force behind this writing, the purpose of which is to learn about and disseminate national productions on from 1985 to 2015 and which, in our opinion, contribute to the knowledge of the occupational therapy in schools, presented at national congresses (NC) in the period professional role and lay the “[…] foundations necessary for growth and contributions to our professional identity” in schools (Narváez & Itovich, 2019, p. 62).

Historical Background

In Argentina, Resolution 240/87 of the Ministry of Education and Justice of the Nation creates the position of occupational therapist (OT) in special education schools. Among its paragraphs are the definitions of the role and function of the professional as part of the interdisciplinary teams of these educational institutions:

Promote the development of the functional capacity of students in life activities, food, clothing, communication, transfers and transportation. Carry out the functional evaluation of students in order to determine their placement in pre-workshops and workshops. Carry out in Vocational Training schools the study of job offers according to the possibilities of the students, advice to the technicians and final evaluation for their job placement, together with the other members of the team (Argentina, 1987, p. 4).

This resolution is considered as “[…] the cornerstone in the definition of the role of the occupational therapist in schools as it is the first official document until the appearance of other regulatory frameworks” (Villagra et al., 2023). Since that resolution, and over the years, other regulations on the professional role and function have emerged in different jurisdictions of our country, such as Decree 2679/1993 of the Provincial Directorate of Education of Santa Fe (Argentina, 1993), Provision 15/2003 of the General Directorate of Culture and Education of the Province of Buenos Aires, Resolution 100/2015 of the General Council of Education of Entre Ríos and Resolution 1886/2011 of the Ministry of Education, Science and Technology of Tierra del Fuego.

It should be noted that not all school jurisdictions¹ in Argentina have these positions, since each jurisdiction, according to local needs and the availability of professional resources, is the one that establishes the incorporation of the occupational therapist in schools.

The existence of these positions in the educational system provides professionals with stable employment and the possibility of advancing in their teaching career, that is, through public competitions, they can access higher-ranking positions on equal terms with other education workers.

Spaces for the Circulation of Knowledge

The first Argentine congress on occupational therapy marked the resurgence of collective projects that were linked to the union organization and that in the years prior to the military dictatorship, had fought for the formation and production of local knowledge. With the coup d'état of 1976, this process of local theoretical development was cut short. Sbriller (1997, p. 29) speaks of a stage of preservation that began in the mid-1970s until 1985 and was characterized by “[…] a notable professional isolation related to numerical inferiority and the need for survival at times when meeting was not the most prudent thing to do”.

In this context, professional advances and the development of spaces for training, exchange and production of local knowledge that the discipline had been experiencing were interrupted. The return of democracy brought with it the reopening of civil organizations and the revitalization of collective projects such as the holding of the first national congress.

In this sense, the first Argentine congress on occupational therapy is considered an activity of high relevance and professional significance where the greatest production of knowledge of our discipline circulates locally and regionally. This activity is organized by associations and/or professional colleges² every two or three years and to date has eleven uninterrupted editions.

Where to Start this Search?

The conference proceedings are documents that compile what happened at each event, containing not only general data of the activity but also the summaries of the works that were presented there, becoming a tangible element to know, from a historical perspective, the way of conceiving and consequently intervening in an area of ​​professional practice. Access to this material was possible through the use of the National Production Index of occupational therapy³ (Nabergoi et al.,2023) that allowed us to identify the works on occupational therapy in schools and place them in the year in which they were presented.

For the period analyzed (1985-2015) we found through the cited Index a total of 19 titles of texts on occupational therapy in schools which were organized (Table 1) for a better understanding according to the following criteria: year of presentation at the congress, title, authors, type of work and amount.

Table 1
Works on occupational therapy in schools documented in the proceedings of the Argentine Congresses (1985-2015).

Year	Title	Authors	Type of work	Amount
1985	T1. Inclusion of occupational therapy in regular school cabinets	Ivanovich de Acevedo (1985)	Experience report	1
	T2. Occupational therapy in an SE	Acosta (1985)	Experience report	1
1988.	T3. Occupational therapy in the US: a new proposal	Tellechea & Martijena (1988)	Experience report	1
1995	T4. Special Education. Occupational therapy	Candioti & Corti (1998)	Experience report	1
	T5. The role of occupational therapy in SE	Battaini (1988a)	Experience report	1
	T6. Professional training in SE	Díaz (1988)	Experience report	1
	T7. Education. occupational therapy	Battaini (1988b)	Experience report	1
2007	T8. The occupational therapist as a group teacher in special education	Campisi (2016)	Experience report	1
	T9. Study of good teaching practices for job integration through work internships	Di Clemente & Fernández (2007)	Research work	1
2011	T10. Opening Paths. Occupational therapy intervention in the Basic Secondary Schools of the Common School	Abregú (2011)	Experience report	1
2015	T11. Occupational therapy in Special Education in Tierra del Fuego	Herrera (2015)	Experience report	1
	T12. Our journey from occupational therapy in Special Education institutions in the Province of Entre Ríos.	Coronel et al. (2015)	Experience report	1
	T13. Experience of occupational therapy in comprehensive education. Telling us our own story.	Encina & Herrera Suárez (2015)	Experience report	1
	T14. The complex framework of Comprehensive Education and the proposals of our discipline	Céspedes et al. (2015)	Experience report	1
	T15. Education. Socio-historical view of special education and occupational therapy.	Martínez et al. (2015)	Research work	1
	T16. Functional profiles in schoolchildren from regular schools. Contributions to the promotion of participation in school occupations.	Boggio & Marengo (2015)	Research work	1
	T17. Social participation of children with disabilities in special and regular schools	Luther et al. (2015)	Research work	1
	T18. Leading the game, an experience in a special school. Occupational therapy. A different project.	Bruno et al. (2015)	Experience report	1
	T19. Professionalizing practices: views and experiences from occupational therapy.	Díaz & Lerner Matus (2015)	Experience report	1
				Total: 19

• Source: Own elaboration (2024).

This ordering gives us a temporal reading of the texts and the modality in which they were presented.

Among the texts found, we identified two presentation formats: experience reports, which total 15 texts, and research works, with 4 texts.

The experience reports mostly describe the role and professional interventions in state special schools in different jurisdictions of the country, with the exception of two texts that describe regular schools.

At the first national congress, the author Acosta (1985) documented the first work experience of an occupational therapist in a special school in the province of Formosa in 1974. Likewise, Ivanovich de Acevedo (1985) writes about her participation in an interdisciplinary team in a common school in the province of Chubut. Both experiences set a precedent for the incorporation of occupational therapists in schools prior to Resolution 240/87 and agree with what Sbriller (1997) pointed out about the development of the discipline and the increase in professional demand for other fields and areas of practice such as special education from 1965 onwards.

In relation to the professional role, we identify the influence of the rehabilitative medical model as a common feature of practices at that time and in accordance with the definition of disability “[…] any restriction or absence due to a deficiency, of the ability to carry out an activity in the manner or within a range that is considered normal for a human being” (Organización Mundial de la Salud, 1980).

According to this conception of disability, interventions focus on the prevention and/or rehabilitation of dysfunctions that affect the development and interfere with the learning of the student with a disability, which in the case of these schools, consisted of training for a job as a way of social integration.

Likewise, the narratives describe the way in which their authors build a place within interdisciplinary teams, the construction of links with other members of the school community, the work of orientation for teachers and families, the use of activity as a therapeutic means.

In summary, during this period, professional interventions in schools are consistent with the rehabilitative medical model that conceives the deficit as an attribute of the person and therefore prevention and rehabilitation configure the treatment of the student with a disability in pursuit of his adaptation and normalization to the social environment.

In this historical context, occupational therapy, due to its professional responsibilities, was outlined as a discipline related to the educational purposes of special education.

Until the 2007 congress, the works document various interventions in favor of the social and labor integration of the student with a disability and among the strategies used for this purpose, vocational guidance, evaluation of jobs and monitoring of the student in the incorporation into work internships within or outside educational institutions stand out.

Since the 2011 Congress, the work will reflect a change in the understanding of disability, introduced by the social model. This new conception is based on the Convention on the Rights of Persons with Disabilities and translates into the passage from the rehabilitation model (focused on the deficit) to a human rights model (focused on the barriers).

This is where occupational therapy in the region manages to align itself with contemporary proposals, by beginning to focus on people and their relationship with a social, political and economic environment: where occupations gain strength and a new epistemology emerges, which takes up the sense and meaning that occupations they do or do not have for the person themselves (Fernández Moreno & García Ruíz, 2016, p. 167).

The so-called rights perspective on disability appears as a common mark in all the works of the 2015 congress (Herrera, 2015; Encina & Herrera Suárez, 2015; Bruno et al., 2015; Díaz & Lerner Matus, 2015). Some of them analyze precisely the changes produced by the Convention and its impact on occupational therapy interventions in special education.

The social model of disability implies a positive view of the person, focused on what happens to them, on their strengths and capabilities. This model is a significant advance, surpassing the psychometric medical model. It focuses on the social and school context and on the design of supports that allow transforming environments into accessible ones (Campisi, 2016, p. 84).

Under this conception, the interventions are reconfigured, critical reflections appear in the texts on the practices in this new school setting that challenge the professional role and its contributions in favor of social groups in situations of violation of their rights. Likewise, the narratives of the texts reveal interventions focused on the student's environments, on the barriers that hinder participation in school activities.

Concepts such as subject of law, citizenship, social participation, educational inclusion are part of these narratives and are consistent with the educational policy frameworks that support the so-called comprehensive education that “[…] expresses the responsibility of educating adolescents and young people with disabilities supporting a rights-based approach, the recognition of them as full subjects in the exercise of their citizenship, protagonists of their lives and their times” (Argentina, 2022, p. 13).

The Occupational Therapist in Regular Schools

As we pointed out in the introduction, among the experience stories collected, we found two that place the work of the occupational therapist in regular schools (Ivanovich de Acevedo, 1985; Abregú, 2011); this fact merits a separate section given that our presence in these schools is an exception, due to the lack of official positions in them.

These experiences are not only an important precedent for those who today provide their services in institutions of this type but they also contribute to debate and reflection on how to think about ourselves there.

Although the text by Ivanovich de Acevedo (1985) found in the proceedings of the first congress is a very brief summary, it provides us with valuable information about his work experience in the then called Center for Psychopedagogical Guidance and Social Assistance in Schools (COPASE in Spanish) dependent on the Provincial Council of Education of the Province of Chubut (Patagonia, Argentina).

The author describes the role of the occupational therapist within this team. Among his interventions, he highlights the direct work with the student through the use of activity as a means to achieve the expected maturational development, the evaluation and prevention of future learning problems, as well as the work of orientation to the family and the teaching staff.

The second text that documents the experience in a common school is by the author Abregú (2011), who describes her participation in the framework of the national program Institutional Improvement Plans (PMI in Spanish), a public policy focused on the prevention of school failure of adolescents and young people at the secondary level, implemented in Argentina between 2009 and 2011. The purpose of the so-called Improvement Plan was to promote actions aimed at accompanying the educational trajectories of adolescents and young people (Argentina, 2009) as a strategy to mitigate school repetition and dropping out and in favor of the permanence of young people in school.

The author describes the experience of working with adolescents from popular sectors, supported by current legal and reference frameworks that are in line with the so-called human rights perspective and the care policies that have transformed educational practices in the Argentine Educational System in the last twenty-five years.

In both texts, public policy operated as a gateway for the discipline to enter ordinary schools; although the experiences described are situated in different historical times and territories, the interventions in both cases are oriented to accompany and support the educational trajectories and participation of students in the educational levels that are now mandatory in our country.

About the Research Works

The research works on the area appear in the proceedings of the 2007 and 2015 conferences. In total, there are four works of this type in a period of thirty years. Although the number of investigations compared to other areas of professional practice is substantially lower, the achievement of this type of productions enriches the discipline, especially if we take into account the political, social and economic difficulties that condition the production of knowledge such as the limited, if not non-existent, paid access to research and to “[…] academic structures that barely assign exclusive dedication, and rarely grant the profile of teacher-researcher” (Testa, 2020, p. 1361) that materialize in some of the vicissitudes of a feminized profession as Nabergoi (2021) points out:

Finding time and space to think-dialogue-train-write in the midst of the daily hustle and bustle of clinical and teaching work, often precarious and multiple, and the numerous unpaid activities that imply the reproduction of life is, at the very least, a resilient act, an irruption that - when it finds conditions of possibility - makes its way by insisting on existing (Nabergoi, 2021, p. 5).

Based on the above, we understand that the appearance of these research works during the decade of the two thousand are the effect of historical and political conditions that have made their existence possible. During these years, the training of occupational therapists underwent modifications, going from a technical training to an academic profile, likewise the number of graduates increased exponentially as well as the study offers in different places of the country.

The first research work found in the memoirs belongs to Di Clemente & Fernández (2007) who present the summary of a research on the labor integration of students with disabilities and the teaching strategies implemented in the labor training process.

Three more papers will be presented at the Entre Ríos conference: Boggio & Marengo (2015); Luther et al. (2015) and Martínez et al. (2015).

These research papers use qualitative methodologies and their objectives vary around different topics of interest for the educational field, such as the inclusion of students with disabilities, paradigm shifts in special education, the social and labor inclusion of students with disabilities, and school performance in first grade children.

The presence of these researches at the conferences reinforces our idea about a moment of consolidation of the discipline in the area that allowed us to overcome the focus on the professional role to focus on explaining phenomena that occur in schools.

Final Reflections

This essay arises from questions about the beginnings of occupational therapy in schools, documented in the proceedings of Argentine congresses over a period of thirty years. To this end, the National Production Index was a fundamental tool in locating those texts prior to the 2015 Congress that are not published and therefore difficult to find.

In this sense, we would like to praise the work carried out by the Argentine Association of Occupational Therapists in preserving national production not only through the aforementioned index but also through the library that safeguards the documentary heritage of the discipline in our country (Asociación Argentina de Terapistas Ocupacionales, 2017).

Access to the minutes and proceedings has allowed us, on the one hand, to (re)cognize an important local production on the work of occupational therapist in special education schools, documented in the format of experience reports and research papers.

We also propose, in line with many other voices in our local discipline, the relevance of making national production visible and adding value to it as an input for pre-professional training in the area.

It is therefore urgent to understand from early training that our work in schools is an activity that is situated in its own cultural matrix and that the work of the occupational therapist in schools in Argentina has been based on practical experience and that from this it was amalgamated with conceptual frameworks that gave shape to a plurality of interventions in the school context.

With the above we are in a position to affirm that there is sufficient documentary evidence on occupational therapy in schools that has circulated in one of the most relevant spaces for the discipline in our country, which are the national congresses.

Likewise, the material found allowed us to understand in a historical key the contextual conditions in which local knowledge is produced and its impact on the development of occupational therapy in schools, dismantling the false belief about the lack of local production that reinforces its invisibility and/or its overvaluation with foreign material disconnected from our educational system.

Finally, we want to highlight the importance of writing as an act of perpetuation of our work. As a shelter for experiences.

Writing as an act of generosity that allows us to share a glimpse of what we know and do not know; as a starting point for others to find in writing the spirit and courage to build a future in school work.

• 1
  Each of the 24 provinces that make up the Argentine national state are called a school jurisdiction.
• 2
  Professional organizations in Argentina are organized according to the legal frameworks in force for the constitution of such organizations in the national territory. Some provinces have professional associations (Santa Fe, Catamarca, La Rioja, Buenos Aires, Entre Ríos). Provincial associations and the National Association, which is the first professional organization that was created in 1969 by the first graduates. Currently, this association has branches in some provinces. In addition, in recent years, groups have been established in some provinces. In the case of professional associations, these are the ones that regulate professional registration, so in order to practice, the professional must become a member. Regarding associations and groups, membership in them is voluntary.
• 3
  The National Occupational Therapy Production Index is an instrument to facilitate the search for texts written by occupational therapists in Argentina. It was prepared by a group of professional members of the Asociación Argentina de Terapistas Ocupacionales (2023).
• How to cite: Villagra, A. B. (2024). Occupational therapy in schools: an analysis of Argentine written productions (1985-2015). Cadernos Brasileiros de Terapia Ocupacional, 32(spe), e3802. https://doi.org/10.1590/2526-8910.ctoEN392738022

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• Villagra, A. B., Venturini, Y., Beltrami, C., & Battilana, G. (2023). Terapia ocupacional en contextos educativos: guía para el trabajo. Buenos Aires: Asociación Argentina de Terapistas Ocupacionales.

Edited by

• Section editor
  Prof. Dr. Magno Nunes Farias

Publication Dates

• Publication in this collection
  06 Dec 2024
• Date of issue
  2024

History

• Received
  11 Mar 2024
• Accepted
  25 June 2024