P4C in Practice

Practice is Different in Partnering for Change

The Partnering for Change (P4C) model uses a tiered approach; all children in the school are initially supported, with more intensive services being offered to the children most in need. Services are provided in many different ways that contrast substantially with traditional models of school-based OT service. As a result, children do not have to wait to access the P4C service.

  • P4C OTs follow a work load, not a case load, model that facilitates inclusion of all children in the school.
  • P4C OTs are responsive to the needs of both children and educators.
  • P4C OTs consider a broader range of issues that may be impacting the child including self-care, written productivity, self-regulation, socialization, leisure and community participation.
  • P4C OTs spend the whole day in one school so time is not lost for travel.

Lunch and Learn

The P4C OT offers an experiential “lunch and learn” for educators as soon as she or he starts in a school to share the P4C OT’s areas of expertise and to describe the change in role from the direct one-to-one intervention model. P4C OTs provide examples of some of the very practical and useful suggestions that can be implemented immediately in the classroom.

The P4C OT engages in school activities and spends time in the classrooms to get a feel for each school’s culture, classroom activities, educators’ style and curriculum expectations. This enables the P4C OT to introduce strategies that complement the educator’s teaching style and learning needs and allows the P4C OT to identify “teaching moments” that facilitate uptake and transfer of new knowledge by the educator. The P4C OT also learns from observing each educator as they manage their classroom.

The P4C OT engages in classroom activities such as:

  • offering to plan and bring activities to a classroom centre (e.g. pre-printing, printing, drawing, fine motor) and to work with all students as they rotate through that centre.
  • offering and demonstrating tips/strategies that the educator can immediately use in the classroom as a whole, or with specific students with special needs.
  • teaching a lesson to the whole class to model strategies for the teacher.
  • observing children’s responses and difficulties while the educator teaches the class.
  • providing materials to support the implementation of a tip or strategy. For example, the P4C OT may glue adapted lined paper into notebooks or build a holder for an alphabet strip to be placed vertically on a desk.
  • working with children in a group or individually, according to the needs of the child, educator and class.

Core Attributes of the P4C Model

Occupational therapy services delivered in the P4C model are based on a tiered approach and differ significantly from the type of service that OTs have previously provided. There are “core” or essential attributes that distinguish the P4C model of service from other school-based OT models of service. Essential attributes of the P4C service align with the principles of the model: to build capacity through collaboration and coaching in context.

The attributes that were identified during this project are presented and grouped according to the principles of the P4C model.

Core Attributes of a P4C Occupational Therapist
In the P4C model, the occupational therapist:
Builds Capacity
Supports educators in designing educational activities consistent with universal design approaches.
Supports educators in differentiating instruction.
Builds the educator’s capacity to identify children with atypical development that may be indicative of a health condition.
Facilitates the educator’s capacity to generalize successful strategies and implement accommodations.
Supports families in the implementation of successful strategies at home, at school, and in the community.
Through Collaboration
Uses a collaborative approach to communication and problem-solving, demonstrating respect for the expertise of the educator.
Demonstrates an understanding of the school and classroom culture.
And Coaching
Explicitly communicates the rationale for utilizing trialed strategies to build the capacity of the educator.
Models techniques to try when teaching a skill within the classroom.
Coaches the educator to support the implementation of strategies within the classroom.
Follows-up with educators regarding strategies previously trialed.
In Context
Spends time at the school each week.
Modifies the environment in line with universal design principles to benefit all learners.
Uses regular curriculum activities (e.g. journaling, circle time, construction centre) for screening / dynamic assessment / differentiation / intervention.
Uses Dynamic Performance Analysis as their primary assessment method.
Delivers intervention in context (e.g. classroom, playground, gym).

The P4C OT is available on a regular basis at the school and is often invited to in-school team meetings. This enables collaboration between educators and the P4C OT for children requiring additional support to participate successfully.

The P4C OT observes children who are having difficulty in “real time” and in context. He or she informs educators and parents of concerns, obtains health care consent and can immediately support the child and educator during the therapist’s regular time at the school. The child does not have to be put on a wait list for service and can be seen in a timely fashion. If there is a P4C OT in a school, there should be no waitlists.