Occupational Therapy Best Practices in U.S. Public Schools: Alignment with Federal Legislation and State Licensure

School-based occupational therapy practitioners must practice in alignment with federal legislation, state licensure requirements, and the Occupational Therapy Practice Framework and have adapted their practice for the U.S. public school system. The recent emergence of literature that advocates for and attempts to justify Ayres Sensory Integration® (ASI®) implementation in schools through Multi-Tiered Systems of Support is misaligned. There are potential licensure ramifications should school-based practitioners follow the recent Call to Action by ASI® advocates to implement direct, pull-out occupational therapy without meeting the due process requirement of the Individual with Disabilities Education Improvement Act, that is, obtaining parental consent prior to evaluation of student need. School-based occupational therapy practitioners choose occupation-based and activity-based interventions that allow adherence to the procedural, ethical, and legal mandates of the governing entities of this practice area to deliver positive proximal impacts for student participation at school.