As a major place of employment for occupational therapists within a rural community, school systems present the therapist with a foreign and oftentimes bureaucratic organizational form. The therapist is trained in the medical model of occupational therapy, and the transition to an educationally based care model is difficult and fraught with professional hazards. A survey assessing therapists' adjustment to the school environment and perceptions of the adequacy of their training was mailed to all 2,000 occupational therapists in Mississippi, Alabama, and Louisiana; 236 responded. The average respondent was 34 years old, female, and married; had a bachelor's degree; and had been a therapist for 10 years. About 79 percent were currently employed in a school system, and 31 percent lived in a rural area. Initial findings suggest that therapists felt a lack of ability to work autonomously with special needs children in the school system. Further, they felt they had limited or no exposure to the school environment during their on-campus education and were unprepared for the lack of professionalism there. About 53 percent of respondents intended to leave their current employment, and this intention was related to lower levels of job satisfaction, higher levels of education, absence of peers on-site, and fewer years as a practicing therapist. Feelings of preparedness to work in a school system and absence of peers on-site were related to perceptions of ability to work autonomously with children. (SV)