The invisible and the non-routine: a meta-ethnography of intersectoral work in schools from the perspective of speech and language therapists and occupational therapists.

Effective intersectoral collaboration across health and education has been a policy priority for decades as a means of meeting the needs of children with neurodevelopmental disorders in school yet remains rare in practice. A meta-ethnography was undertaken to explore the experiences of occupational therapists (OTs) and speech and language therapists (SLTs) with the aim of contributing new insights into the nature of their collaborative work in schools, and how it may best be facilitated. Electronic and manual searches were conducted. Papers were double-screened and critically appraised. A line of argument analysis was undertaken. Fourteen papers were analyzed, reporting the experiences of 369 practitioners from schools across six countries. Five concepts were identified: (a) negotiating liminal professional spaces; (b) gaining entry; (c) collaborative endeavor; (d) collaborative inertia; and (e) collaborative conviction. We describe the complex, effortful, and relational nature of intersectoral collaboration. We propose a conceptualization of SLT and OT collaborative practice in schools as articulation work, with elements of boundary work, much of which is invisible and non-routine. We argue the need for collaborative leadership to promote knowledge and awareness of the role of SLTs and OTs in school, and to support the contextual integration of their relational work in this setting.