Workload Model

(Lvl 5) (American Occupational Therapy Association et al., 2014)

• AOTA, APTA, and ASHA endorse a workload approach as a more effective way to deliver school-based therapy services while staying compliant with IDEA and improving student outcomes.

• Caseload model focuses on the number of students served, while the workload model considers the time needed for all responsibilities such as; collaboration, documentation, and indirect/direct services that a therapist does. 

• Workload model increases the ability to provide more comprehensive support, team-based interventions, which in turn promotes student success in a least restrictive environment. 

• Data driven to advocate for needed time to provide indirect services (teacher consultations, IEP meetings, professional development, duties, etc.) while providing effective interventions.

• Provides OTs diversity between the frequency/duration they see each client and the RTI time spent. 

(NCDPI, 2023)

• The workload calculator analyzes workload balances to improve efficiency. 

• Identify inefficiencies during work that might be causing OTs to work harder than necessary. 

• Data may be used for communication with administration, open opportunities for changes before the need to hire an additional occupational therapist.

This is a sample workload calculator, you can make a copy and utilize it in your practice.

(link to workload calculator)

(Lvl 3) (Seruya & Garfinkel, 2020) 

• Authors identified barriers to implementation of the workload model include challenges such as; lack of administrative support, high caseloads, and insufficient time or resources to make the transition.

• Despite evidence-based recommendations for more integrated services (push-in) in classrooms and natural settings, most occupational therapists still use pull-out models, which may limit collaboration and effectiveness.

• Practitioners require better tools, resources, and training in advocacy to successfully implement a workload model and push for policy changes.

(Lvl 4) (Corley et al., 2021) 

• The author's determined workload model allows for better implementation of best practices.

• OTs in a workload model engage more in teacher collaboration, family/caregiver training, and behavioral support.

• Providing services in a student’s natural environment (classroom) enhances participation and effectiveness.

• Many educators see OT as only focusing on fine motor skills rather than holistic student support.

• Transitioning from caseload to workload models can improve job satisfaction, reduce burnout, and enhance student outcomes.

• Occupational therapists should advocate for administrative support, policy changes, and professional learning communities (PLCs) to promote best practices.

(Lvl 4)(Seruya & Garfinkel, 2020)

• Elaborates the advocacy for a workload model in school-based occupational therapy to better address comprehensive responsibilities, including indirect services, collaboration, documentation, and participation in school-wide programs.

• Identifies barriers to adopting a workload approach, such as high caseloads, limited administrative support, scheduling conflicts, and lack of knowledge and advocacy skills.

• Many therapists reported continued use of nonintegrated pull-out interventions instead of integrated, contextually-based services, despite evidence of greater effectiveness.

• Therapists have a strong desire to adopt workload models but indicate unsuccessful advocacy at local levels, suggesting the need for stronger federal and state policy support.

• Links high caseload numbers directly to decreased job satisfaction among therapists, suggesting improvements in caseload management, salary, resources, and workload responsibilities could enhance overall satisfaction.

(Lvl 5) (Texas Association of School Boards [TASB], 2025)​

• Caseload analysis focuses solely on the number of students assigned to a special education provider, often neglecting the varying intensity and diversity of individual student needs.

• Workload analysis provides a comprehensive view by considering all responsibilities of special education providers, including direct instruction, assessment, intervention planning, collaboration with colleagues and families, and administrative tasks.

• Adopting a workload analysis approach allows for more tailored service delivery, ensuring that each student's unique needs are met effectively, leading to improved educational outcomes and more sustainable working conditions for educators.

(Lvl 5)(Ohio Department of Education, 2022)

• Ohio has already transitioned from caseload to a workload approach for special education providers.

• A workload calculator has helped Ohio districts manage provider responsibilities effectively.

• Regular workload assessments ensure ongoing alignment with student needs.

Legislative Findings  

(Lvl 5)(Oregon Department of Education, 2023)​

• In 2023, Oregon's House Bill 2618 mandated a study to identify optimal workload methodologies for school-based occupational therapists, physical therapists, and speech-language pathologists.​

• The Oregon Department of Education recommends adopting North Carolina's workload model to address practitioner workload concerns and enhance service delivery.​

• Surveys revealed that over 80% of practitioners felt their workload negatively impacted their ability to provide services, with only 38% planning to remain in the education field.​

• Over 92% of practitioners reported regularly working unpaid hours to meet their professional responsibilities.

• Practitioners identified inadequate staffing levels and high caseload demands as primary sources of stress and burnout.

• The study emphasized the importance of workload calculation tools that accurately reflect both direct and indirect service responsibilities.

• Recommended strategies include statewide adoption of workload analysis methods to improve staff retention and ensure high-quality student services.

Administrator's perspective

(Lvl 4)(Boileau, 2024)

• School-based occupational therapists experience high burnout and low job satisfaction due to excessive caseloads.

• The workload model, compensating OTs for all tasks performed, has potential benefits but is not widely adopted. ​

• School administrators value occupational therapy and recognize external factors and their own beliefs impacting OT service delivery. ​

• Three interrelated themes were identified: external factors, administrator beliefs/knowledge, and service delivery, with subthemes including finances, employment type, staffing, guidelines, valuing OTPs, and perceptions of the workload model. 

Occupational Therapist’s Perspective

(Lvl 4) (Garfinkel & Seruya, 2018)

• Occupational Therapist’s Perspective

• (Lvl 4) (Garfinkel & Seruya, 2018)

• Occupational therapists identified the 3:1 workload model (3 weeks direct intervention, 1 week indirect) as beneficial for managing workload.

• Occupational Therapists reported improved service quality and reduced burnout through the 3:1 model.

• Significant barriers to adopting the model include inadequate administrative support and lack of resources.

• Training and education for administrators and therapists were recommended for successful model implementation.

(Lvl 5) (MEOTA) 

• An infographic about common myths surrounding the workload model, and an explanation of the truths of how beneficial it can be when used. 

• Displays facts on how the workload model ensures a balanced approach

Link to Facts vs. Myths