Experiences of Teachers and Occupational Therapists in Identifying Activity Problems Among Primary School Students With Developmental Difficulties in Indonesia: A Focus Group Interview.

All 15 participants worked on Java island, Indonesia's most developed region, so the findings may not transfer to other parts of the country with fewer resources. Thirteen of the 15 participants worked in private schools, which the authors acknowledge likely have greater access to structured processes, therapy centres, and professional support than public schools; the described identification pathway may not exist in the majority of Indonesian schools. The data are self-reported professional perspectives, not direct clinical assessments of the students; some examples may have involved children with temporary challenges rather than developmental difficulties. The mixed-profession focus group design may have steered the conversation toward a harmonious collaborative narrative, potentially masking real tensions between teachers and OTs. The research team all had occupational therapy backgrounds, which the authors acknowledge may have introduced a clinical OT lens into the interpretation of the data. Participant experience ranged from 3 to 27 years (median 8), and the authors note that more experienced participants may have been more confident and less uncertain than less experienced ones.

No funding was received for this manuscript. The authors declare no conflicts of interest.

Do not read the structured, multi-step identification and support process described here as evidence that it works or as a model you can adopt in any Indonesian school. This is a qualitative account from 15 participants, 13 of whom worked in private schools on Java island, and the authors themselves state the findings may represent a 'best-case scenario' specific to better-resourced environments. In a public school with no OT, no therapy centre, and no principal referral pathway, the process described simply does not exist.