Importance: This project highlighted the need to support children with adverse childhood experiences (ACEs) through the creation of educational resources for teachers and guardians to eliminate barriers hindering classroom performance. Objective: (1) Establish educational resources from an occupational therapy (OT) lens for guardians and teachers to address key barriers (2) Assess the usability, feasibility, and potential for future implementation of resources for OT-infused literacy program. Design: Applied research and mixed methods design Setting: OT-infused literacy program providing Tier 1 Rti services at inner city elementary school Participants: Resources were developed for guardians and teachers of the students involved in program. For outcome measures, 7 teachers completed the survey and 7 previous/current OT students and supervisors of OT-infused literacy program. Outcomes and Measures: Two separate surveys developed for teacher and OT perspectives regarding feasibility, usability, and future implementation of the resources. Surveys consisted of six questions using a 5-point Likert scale and two open-ended questions. Additionally, a 15 question semi-structured interview was performed with lead OT of program. Results: Teachers and OT students/supervisors rated resources as feasible, usable, and easy to implement in the future. Four themes were developed from the interview: (1) understandable, readable, and well-rounded; (2) provide clear framework for intervention planning; (3) support communication, collaboration, and education between care team; (4) challenges with implementation may arise if resources are not properly utilized or valued. Conclusion and Relevance: OT’s need to increase advocacy and support for guardians and teachers in school setting from OTs, especially for students with ACEs.

Plain-Language Summary When children experience ACEs and grow up in generational poverty they experience challenges impacting development that translate to classroom difficulty. This project partnered with a low-income, inner-city elementary school implementing an OT-infused literacy program led by master’s OT students. Educational resources were developed from an OT lens for guardians and teachers to address ten key domains impacting the success of students in the classroom with the hope to increase student performance. The ten domains included: behaviors, emotional regulation, sensory regulation, communication skills, social skills, time on task, fine motor skills, cutting skills, handwriting skills, and self-care skills. Two surveys and an interview showed the resources were usable, feasible, and would be easy to implement. In addition, the results indicated they would promote improved communication between OT’s, teachers, and guardians. The findings support the use of providing resources to teachers and guardians to improve the success of children from poverty.