Background: The main activity children engage with is learning through play or formal
education. The aim of this systematic review is to analyze the role of occupational therapy in the
school setting for children with additional support needs or disabilities. (2) Method: We conducted
a systematic review using the preferred reporting items for systematic reviews and meta-analyses
(PRISMA) guidelines. This systematic review was registered in PROSPERO (CDR42022314271).
The search was performed in the following databases: ERIC, Dialnet Plus, PubMed, OTseeker,
Cochrane, Scopus, CINAHL, and PsycINFO. (3) Results: In total, 1954 studies were identified, from
which 18 articles were selected. These studies were heterogeneous and showed different types
of intervention of the occupational therapist in school environments. (4) Conclusions: The main
conclusions highlighted the effectiveness of the occupational therapist within the school environment,
the importance of an interdisciplinary team to cover the special needs students within the school
and the need for intrinsic motivation for an active and inclusive participation of the students with
special needs. However, there is a need for more homogeneous studies with a larger sample size that
specifically focus on the school context and include the involvement of occupational therapists in
order to replicate the findings obtained.
