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The Role of the School-Based Occupational Therapist in Moral Education
Deidra S. Holland
Abstract
The following article addresses the potential for school-based occupational therapists in the United States and Canada to contribute to the moral development of elementary school students, a critical aspect of child development. School-based occupational therapists in the U.S. and Canada provide clinical services that facilitate the inclusion of students with special needs into mainstream educational settings. The potential also exists for this educational-clinical discipline to enhance the moral education of children who have special needs. To the extent that any curriculum promotes moral education, every child, regardless of disability, must have access to that curriculum in order to benefit from the moral educational component. While the contributions of school-based occupational therapists in improving access to the curriculum are clear, the potential for these educator-clinicians to integrate moral education into their repertoire of activities remains less so. This manuscript highlights how school-based occupational therapists in North America are uniquely positioned to enhance the moral education of children with special needs through the innovative pedagogy and clinical activities they engage in as part of a typical school-based practice.
Introduction
Recently there has been increasing interest among educators, policy makers, school administrators, and the public regarding moral development in educational settings (Crawford, 2001; Governali, 1995; Meier, 2003; Veugelers, 2003). This interest stems from the perceived need for educational settings to address aspects of human development beyond the acquisition of academic skills alone (Damon, 1988). The enhancement of moral development through specific pedagogical methods is referred to as moral education. Because moral education necessitates experiential learning and other pedagogical methods that are often different from those employed in the development of academic skills, flexibility and coordination among all school personnel becomes imperative if this complementary educational process is to be successfully implemented.
School personnel who constitute "related services," such as speech language pathologists, physical therapists, and occupational therapists, are educator-clinicians who have significant potential to complement the classroom instruction of teachers and contribute to the moral education of elementary school students. Each of the disciplines included within related services can contribute to aspects of children's moral development through the pedagogical methods and interactive styles unique to that professional discipline. This manuscript describes the nature and purpose of moral education and highlights how school based occupational therapists can make significant and unique contributions to the moral development of the children it serves in the schools.
What is Moral Education?
Moral education refers to a variety of theories and approaches aimed at facilitating, or enhancing, the process of moral development. Moral development, like cognitive or physical development, is dependent upon life experience (Durkheim et al, 1986; Kohlberg, 1981 & 1984; Piaget, 1965). While theorists disagree over what specific kinds of life experiences are most relevant for moral development, they tend to agree on the general notion that moral development is a critical aspect of human growth and is dependent upon both individual insights as well as social interactions. Despite theoretical arguments, it is understood that the child who is exposed to various types of learning experiences in the home and in the community will have the opportunity to distinguish right from wrong at progressively abstract and complex levels (Shaffer, 2002).
Moral education refers to the pedagogic methods aimed at promoting this process of moral development. While often misperceived as a process of teaching some specific doctrine or religious content, moral education actually refers to any method of addressing or enhancing the psychosocial process of children's moral and ethical development within an educational setting. This educational setting may be public or private, secular or religious, traditional or alternative, culturally homogenous or diverse.
Given that moral development is a progressive learning process, and given that it depends upon individual as well as social experiences, educational settings become critical agents for the facilitation and promotion of this human quality. Experiential learning, group exercises, and didactic content all serve to promote moral awareness and moral development, and together constitute a moral educational process.
The Potential for the School-Based Occupational Therapist to Contribute to Moral Education
The school-based occupational therapist is uniquely positioned to enhance certain aspects of moral development and contribute to distinctive facets of moral education. Because occupational therapists address cognitive, motor, and psychosocial (i.e. behavioral) realms of functioning (Johnson, 1996) (see Figure 1), the school-based occupational therapist is in the position to evaluate and promote these interacting functional domains as they relate to the moral development of the child.
Moral education should not refer to a specific curriculum per se, but instead to a general promotion of the moral development of the child through the provision of various learning experiences, pedagogic methods, and reflective opportunities. Moral education is best conceived as a process of facilitating moral development, rather than mastery of a specific content area. While there are some circles in which a "Values Certification" model is promoted, emphasizing specific personal qualities like "punctuality" or "integrity" as end points of moral education (Kohn, 1997), such approaches often defeat the deeper purpose of moral education, which is to foster independent reflection and the confidence to act in accord with what one believes to be pro-social values. In a very real sense, then, moral education can be promoted in the course of any curricular activity or content area, since it is a process of encouraging insight, awareness, and pro-social action regardless of context.
It is important to note that there exists a tragic trend in disability history that involves the conflation of "disability" with "moral corruption" (Gallagher, 1985, p. 30). This historical social construction was and is created through the association of disability with personal failure (Elmslie, 1911). It is imperative that this social perspective on disability continue to be identified, challenged, and deconstructed, even in its most subtle forms. But, at the same time, the spurious historical error of conflating disability with immorality must not now result in children with disabilities being denied access to moral education, particularly while students without disabilities are increasingly encouraged to participate in such opportunities. What is being proposed here is not in any way a return to, or continuation of, the conflation of disability and moral weakness. It is, instead, a recognition of the importance of moral development for all children, and a proposal for one method of promoting that development for children with special needs so that these children's moral education is not neglected in favor of special education.
There is a great deal of potential for the school-based occupational therapist to become engaged in moral education. Many students with special needs require added attention in order to learn concepts important to moral development, as with academic development. For example, Abrahamsen and Sprouse (1995) found that when children with and without learning disabilities were read a series of fables, the children with learning disabilities had more difficulty and required more guidance selecting the correct moral associated with the story. This suggests that some students are likely to benefit from added attention and learning opportunities regarding moral reasoning and problem solving. The school-based occupational therapist is well suited to provide this attention and these learning opportunities.
What follow are specific functional domains frequently addressed by school-based occupational therapists that have particular relevance for moral education. The purpose here is to illustrate how the school-based occupational therapist might make a unique contribution to the moral education of the children they serve, and clarify the specific realms in which this might take place.
Attention
Attentional skills constitute a frequent focus of the school-based occupational therapist and also have relevance for moral development and moral education. Teachers consistently remark that many of their children have difficulty sustaining attention to task, thus adversely affecting their (and the rest of the class') ability to learn. Frequently, this shortened attention span is due to the child's difficulty understanding the material being presented, since limited comprehension is associated with a worsening of attention across settings. In the school setting, the occupational therapist often addresses these attentional deficits through the therapeutic process known as Activity Analysis (the breaking down of an activity into its component parts) (Lamport, Coffey & Hersch, 1996). Through this process it is possible to determine exactly where the child is experiencing difficulty. Once this is known, the activity can be modified as needed (shortened, broken-down, or compensatory strategies developed) (Johnson, 1996).
The implications that attentional deficits have for academic performance are relatively obvious, but there are also important implications that attention has for moral development and moral education. Because attentional problems frequently lead to functional problems, the child with attentional difficulties can experience limited success and heightened frustration in certain content areas. This chronic lack of success can lead to poor morale, negative thinking, and hopelessness (Bloomquist, 1996, p. 15). These internal conditions, in turn, are risk factors for the development of disruptive behavior disorders (Cara and MacRae, 1998, p. 164), disorders which might, themselves, be framed as a lack of moral awareness and choice, and place the child at risk for further marginalization from the "moral community" of the classroom. The school-based occupational therapist's efforts to address attentional difficulties, therefore, not only represent a significant portion of any school-based occupational therapist's time, but also constitute a preventative intervention with implications for the child's moral development and inclusion in the moral community of the classroom.
Self-Efficacy
Self-efficacy refers to a person's belief in his or her ability to accomplish some identifiable goal or outcome (Bandura, 1994). Moral behavior, like other realms of action, depends upon the individual's belief that he or she has the abilities necessary to perform that action (Kohn, 1997). Lacking the requisite self-efficacy will result in avoidance of challenging routes of action, including challenging moral action.
School-based occupational therapists contribute to the development of self-efficacy primarily through two methods: (1) by identifying and encouraging areas of strength in children who may have multiple and frustrating areas of weakness and (2) by adapting and modifying activities so that these children are more likely to experience success (Johnson, 1996). This is frequently accomplished through qualitative and quantitative assessment, and subsequently drawing the child's attention to those areas of relative strength and how they might be most effectively utilized in the school setting. This process of identifying and promoting the child's relative strengths enhances self-efficacy and self-confidence (Parham & Mailloux, 1996, p 343), which can then be generalized to the non-academic realm of moral action and altruistic behavior. This generalization can be encouraged by the school-based occupational therapist through explicit examples, role-playing, and encouragement of any examples of such behavior the child is able to report (Cara & MacRae, 1998). The school-based occupational therapist is in a position to extrapolate the same methods used for increasing self-efficacy for academic performance to moral and altruistic behavior, thereby contributing to the collective moral educational mission.
Self-Awareness
A number of educators have emphasized the importance of self-awareness in moral development (Carr, 1991; Kohlberg, 1976). However, specific pedagogical methods for enhancing self-awareness are not often available. Occupational therapy, however, engages in a number of therapeutic activities that specifically promote self-awareness and can be readily generalized to the enhancement of moral reflection and action. For example, sensorimotor processing is a form of self-awareness that frequently warrants attention among the children served by school-based occupational therapists. The school-based occupational therapist frequently engages in sensorimotor exercises in order to promote attentional skills and associated cognitive performance in the young student, though often neglects the implications this intervention might have for the child's moral development. It has also been theorized, for example, that moral development depends on aspects of self-awareness that, indeed, include sensorimotor awareness of one's own physiological reactions to stress, environmental influences, and social exchanges. The school-based occupational therapist is well positioned to address, with the child, how improved sensorimotor awareness contributes to the ability to reflect upon ones' own psycho-motor reactions. The more sensorimotor awareness the child develops, the better positioned she is to reflect upon her responses to external events (Cronin, 1996; Fisher, Murray & Bundy, 1991; Parham & Mailloux, 1996.) This self-monitoring is one of the crucial steps to moral reflection, inhibition of potentially harmful impulses, and decisive moral actions. Through the application of pedagogical methods that enhance sensorimotor awareness, the school-based occupational therapist can uniquely contribute to the self-awareness and mindful reflection that is a necessary cornerstone to moral development.
Social Skills
Because school-based occupational therapists conduct much of their therapeutic work in a small group context (Cara & MacRae, 1998, p. 19), they are well positioned to address constructive social skills and other aspects of moral social behavior. These small group therapeutic opportunities allow for the encouragement of mutual respect among children, sharing, taking turns, and peer support (Howe & Schwartzberg, 1995). Of course, school-based occupational therapists find themselves promoting such social behavior whether or not they are aiming to specifically enhance moral development (Argabrite-Grove, 2002; Schoonover, 2002). Approaching such small group therapeutic settings with moral education as an additional consideration, however, allows school-based occupational therapists to consciously and deliberately promote such content as part of the moral educational mission shared by all of those engaged in the school setting. For example, spending added time encouraging the children to reflect upon their behaviors, particularly pro-social behaviors like sharing or helping, and discussing the advantages and challenges of such moral action, serves to make the small group therapy interaction one of academic development as well as an opportunity for enhancing moral awareness.
Case Example
The following is a concrete case example of the involvement of school-based occupational therapy in children's moral development. This case example was selected because the clinical activity involved, providing occupational therapy services to a school-based program for children with behavioral disorders, frequently necessitates interventions across the domains of attention, self-efficacy, self-awareness, and social skills, and constitutes common activities for school-based occupational therapists.
The school-based program for assisting children with behavioral disorders, referred to as Day Treatment, had an enrollment of 22 children ranging in ages from five to eleven years. These children were enrolled in the Day Treatment program because they exhibited persistent behavioral problems that posed an obstacle to educational goals in a regular classroom setting. These behavioral problems most often involved emotional lability (frequent tantrums), aggression (fighting), and/or inappropriate language (cursing). The primary goal of the Day Treatment program was to assist children with behavioral problems at the same time they were achieving academic goals. The role of the school-based occupational therapist in the Day Treatment program was to address clinical goals in areas such as handwriting, attention, on-task endurance, and adapting and maximizing environmental accommodations.
The school-based occupational therapist integrated moral educational goals into the Day Treatment program across the four functional domains of attention, self-efficacy, self-awareness, and social skills in the following ways:
Attention:
Based on the school based occupational therapist's Activity Analysis, various academic lessons were broken down into smaller, shorter segments to create shorter units that demanded less sustained attention. The goal was shifted from getting the activity completed in a specified period of time to focusing on the process of skill acquisition during the task. This shift in focus was made explicit to the child during the task.
After the task, a discussion was then initiated about how frustrating it can be to get distracted or to need more time to complete a task and how this frustration can sometimes lead to other feelings like anger. Differences in how the child felt when doing the task when completion was expected, versus doing a portion of the task when learning something from it was the goal, were discussed. The child was then encouraged to identify task demands that tend to result in frustration or anger, versus task demands that do not result in such feelings. Generalization of such reflective reactions to the mainstream classroom setting was promoted through collaboration with the teacher and encouraging the teacher to engage the entire classroom in such reflective exercises after facing challenging or potentially frustrating classroom exercises.
Self-Efficacy:
Students were introduced to the skills necessary for each segment of an activity. Those skills were mastered before moving on to the next segment. This allowed the student to experience success through repeated trials on smaller, discrete portions of an activity. Some of the children indicated they felt they were experiencing academic success for the first time by doing this exercise. A discussion was then initiated about how changing the nature of the task, or changing how many times one practices doing a task, can allow a person to be successful. Children were then encouraged to discuss how other tasks, tasks that they previously felt they had not mastered, might be changed so that they could be mastered. Again, the generalization of this reflective reaction to the regular classroom was encouraged by having the teacher engage in such reflective periods following challenging classroom tasks.
Self-Awareness:
The occupational therapist worked with the children to promote self-awareness in a number of ways. One method involved sitting quietly and focusing on relaxed breathing for a brief period. The children were encouraged to discuss how their breathing and body changes when they are frustrated, angry, or frightened, and these breathing and physical changes were practiced through pretend reactions. Subsequently, when an anger outburst or behavioral problem occurred in the class, a time-out was called and, following redirection of the student(s) expressing the anger or frustration, the entire class was asked to pause and reflect again on their breath, posture, and other physical states. In this way, over time, the children were encouraged to notice how emotional and cognitive states influence their physiological reactions, and how this chain of events can lead to behavioral reactions before one has fully calculated the impact or repercussions of those behavioral reactions. Reflection upon one's physical state, then, was used to enhance self-awareness in a concrete way, and encourage the children to realize how a lack of awareness can result in a chain of events that can result in behaviors with destructive or unintended results.
Social Skills:
Some occupational therapy lessons took place in small group settings. One of the students' favorite activities, the game UNO, allowed the opportunity to work on goals such as taking turns, controlling frustration, and showing respect to peers. When lapses in these social rules occurred, a pause in the game was called, and a discussion was initiated by the occupational therapist regarding what had happened, how the children felt when it happened, why it was problematic, and how it might be avoided. Time was taken after the game to review the discussions that took place and to draw conclusions from the children's comments.
This case example of integrating moral education into the repertoire of the school-based occupational therapist serving, in this instance, a Day Treatment program demonstrates the natural fluidity of this integration. The goals related to moral education were readily fused with clinical and educational goals, thereby promoting the skills children might employ to assess a situation and make decisions based on empathy, self-worth, and fairness. This case example serves as one instance in which the school-based occupational therapist was able to unite clinical goals with skills relevant to moral development in the best interest of the children involved.
Discussion
A number of considerations are necessary for school-based occupational therapists who intend to contribute to the moral education of the elementary school students with whom they work. The school-based occupational therapist in a public school setting, like the teacher or other public school personnel, must engage in moral education from a secular moral paradigm, not one drawn from any specific religious tradition. Moral education refers to a realm of psychological development, not religious instruction, and must not be confused with such.
Additionally, school-based occupational therapists will need to consider how to best integrate the promotion of moral development into the particular school setting in which they work, accommodating many organizational and administrative variables. Since the school-based occupational therapist's role in moral education is not yet a common element in the education and training of occupational therapists, each school-based occupational therapist him or herself will need to take the initiative to learn more regarding the significance of this area and how to best incorporate it into specific practice settings.
Likewise, because many school administrators and teachers do not fully understand what occupational therapy is, they will likely not fully appreciate the contributions school-based occupational therapy can make to the moral educational mission in the school setting. In order for school administrators and teachers to better understand the potential contribution of the school-based occupational therapist, and in order for the school-based occupational therapist to contribute most meaningfully to any moral educational goals, all of these professional educators will need to spend time discussing each others' perspectives, aims, and objectives so that a strong collaborative effort can be achieved. It remains critically important for school administrators and teachers to understand the unique contributions made by the school-based occupational therapist, particularly since there are basic elements of moral education (such as aspects of self-awareness that stem from sensorimotor experience) that the school-based occupational therapist may be best positioned to provide. School administrators and teachers need to consider the variety of school-based occupational therapy approaches detailed above and help promote access to school-based occupational therapy for those children with special needs.
Conclusion
School-based occupational therapy is well positioned to make substantial contributions to the moral education of elementary school children. These potential contributions, however, must be recognized and advocated by the school-based occupational therapist, and facilitated by teachers and school administrators. This will only occur if all parties recognize that many of the activities of the school-based occupational therapist already have a close relationship to some of the activities and goals of moral education. This manuscript detailed how school-based occupational therapists might make a contribution to moral educational initiatives through therapeutic activities that are already part of a school based occupational therapy repertoire. The moral education and moral development of children in public elementary school settings represents a growing focus among educators, and school based occupational therapists are particularly well positioned to contribute to this important mission.
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Contact for correspondence
Deidra S. Holland, M.S.O.T.R/L, Little Rock School District, Division of Exceptional Children And College of Education, University of Arkansas at Little Rock
Telephone (501) 772-1790
Email: dlanzisera@hotmail.com
Keywords
School-based occupational therapy; moral education
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