Occupational Therapy

According to the American Association of Occupational Therapy, Inc. (AOTA), occupational therapy helps people across the lifespan take part in the things they both want and need to do through the therapeutic use of commonplace activities (occupations). For example, helping children with disabilities to participate fully in school and social situations/settings is a common occupational therapy (OT) goal.1

Many people are familiar with occupational therapy as a service that can help children develop better handwriting, support students who experience sensory processing difficulties or support a medical patient with an injury to learn to use new adaptive equipment. However, occupational therapy is a tremendously broad field and a profession critical to helping any person achieve function, meaning and success in all activities across their day and life.

Occupational therapists are trained to look at any individual’s performance in a given situation and tease apart the interaction between the person, the environment around them and the specific activity (e.g., group of tasks) that the person is engaged in. For each of these domains (person-environment-activity/occupation), changes can be made that can substantially impact the individual’s successful performance. Occupational therapists are able to evaluate when skill-building, adaptive tools, environmental modifications or subtle changes to the expectations for an activity are needed and appropriate.

NESCA is pleased to offer occupational therapy services specifically designed to help children, adolescents and young adults have success in any environment or activity where they want to perform better—at home, in school, during leisure, in the community and during the transition to adulthood.

NESCA's Educational Occupational Therapy Services

Educational Occupational Therapy

NESCA provides educational occupational therapy (OT) assessments, consultation and real-life skills coaching services for children, adolescents and young adults. In addition to office-based services, NESCA is pleased to offer services in the home and/or the community.

Through evaluation, observation and assessment, skills that are lacking and negatively impacting an individual’s ability to function successfully and navigate through everyday life are identified. Concrete goals are determined. Occupational therapy intervention aims to develop concrete skills to address the identified deficits.

Educational OT assessment/consultation (Primarily for K-21 students)

NESCA’s OTs assess whether there is something in a person’s physiology that may impact how they function at school. Our OTs will determine which functional supports would best serve students ages K-21 through consultations, observations and various treatments. In-depth evaluations are performed to identify skills that need to be developed for a student to access the curriculum, meet academic expectations and complete all activities required throughout the day (including non-academic periods such as lunch, recess, transitioning from class to class, etc.). Our OTs explore an individual’s visual motor integration, visual perception, fine motor, postural stability and actual function based on in-depth observation. For example, visual-motor deficits may have a negative impact on reading, mathematics and test-taking and can be addressed through OT interventions.

Importantly, NESCA OTs are able to evaluate and support students during times of transition (from one school year to the next or one school to another) and to help identify the services that a student will need to be successful throughout that transition.

Based on the recommendations in the student’s evaluation, participation in team meetings and consultations to schools are provided to encourage appropriate school-based supports, services and accommodations be put in place to aid in the success of the individual in the educational setting or wherever their educational program occurs.

Functional assessment of home- and community-based skills (Primarily for 5th grade and older students)

NESCA’s experienced OTs assess an individual to identify skills and services necessary for their functional success with home- and community-based activities and tasks.

Observations and assessments in a wide range of everyday areas take place to determine an individual’s strengths and deficits in social communication, navigation, executive functioning, self-advocacy, self-determination, problem solving, stamina and use of technology in real-world environments, for example.

While our assessments incorporate a sensory element, more individualized and specific information on an individual’s sensory profile will be determined through ongoing observation.

Real-life skills coaching, executive function coaching, and transition consultation (Any age)

NESCA’s real-life skills coaching focuses on developing essential adaptive and practical independent living skills in real-world environments. Real-life skills coaching is provided by NESCA OTs as well as NESCA Transition Specialists (who have backgrounds in vocational and college counseling).

Specific, individualized goals are established for continued learning, vocation and community life. Our OTs help clients build skills to assist with Activities of Daily Living (ADLs)—everyday, basic tasks that allow a person to both function and thrive—and Instrumental Activities of Daily Living (IADLs)—more complex tasks that allow a person to live and thrive independently. Our transition specialists help build skills to address transitions specifically to employment or post-secondary learning environments.

Examples of ADLs NESCA addresses are:

  • Self-care/hygiene
  • Dressing
  • Development of morning/evening routines

Examples of IADLs NESCA addresses are:

  • Executive functioning (organization and planning techniques)
  • *Travel training/community navigation
  • Grocery shopping
  • Managing finances
  • Meal planning and preparation
  • Fitness and nutrition

Examples of transition skills NESCA addresses are:

  • Self-advocacy
  • Participating in volunteer/community service work
  • Managing college application process
  • Building skills for navigating transition to a specific college campus
  • Finding volunteer, summer, part-time or full-time employment
  • Building soft skills for employment or technical skills for a specific job
  • Finding leisure and social activities to participate in within one’s community

*OTs are uniquely positioned to serve as travel trainers, helping individuals successfully and safely get from point A to point B. In this role, OTs assess, advise and train individuals to use transportation systems and services to get from home to work, school, stores or other destinations within the community and back home again.

**In addition, OTs are frequently trained to perform driving assessments that help individuals and families determine when someone is ready for driving, what kinds of assistive technology may be needed or if another mode of transportation would serve the individual better.

NESCA’s occupational therapists will determine the level of assessment/evaluation needed based on the availability and quality of previous assessments. Observation, which is part of the evaluation process, is often the most important and revealing assessment tool.

If you are interested in learning more about NESCA’s Educational Occupational Therapy, Real-life Skills Coaching Program and/or Transition Services, please contact us at 617-658-9800 or fill out our online Intake Form noting that you are interested in OT/Transition Services.

Families who are not sure which Occupational Therapy service is right for their child are encouraged to schedule a consultation. Our clinicians will review records in advance of the appointment, take a thorough history from parents/caretakers and guide families toward the evaluation or treatment process that will best-serve their child.


**While NESCA does not currently offer driving assessments, we can refer you to one of our partner organizations who has specific expertise in this domain.

1About Occupational Therapy (2019)

Retrieved from AOTA website https://www.aota.org/About-Occupational-Therapy.aspx

Thank you so much for the wonderful summary of the work you have done with [my son] in the past six sessions. He seems to have picked up a lot from you and many thanks for structuring the sessions beautifully and teaching him these vital skills.

Parent of a teen building personal finance skills with a NESCA Real-life Skills Coach

Thank you! You truly are his go to person, coach, comrade, and confidante. I am so proud of him and beyond grateful for your guidance and support. I have learned a tremendous amount from you!

Parent of a student with executive function challenges navigating remote learning with a Real-life Skills Coach

I am so grateful for all your support!! You are indeed an amazing person. You seem to have a magic wand because [my son] made tremendous progress since our first session. We are so lucky to work with you.

Parent of teen working with a NESCA Real-life Skills Coach over Zoom

Today was our final day with coaching. We went over what we have learned over the last couple of months, and planned to go to Friendly's for lunch. [My friend] and I planned out the time it would take to get there with an Uber, eat, and come back. The Uber who drove us there was driven by [driver name], who is a super nice guy who had driven us before. When we got to Friendly's, they were still serving breakfast, so I got an omelet and home fries. We also discussed how much to tip (20%), and then used that knowledge to pay for our meals. When we went back to the school, we were once again driven by [the same driver]. Overall, I had a great time, but it's unfortunate that our coach will not be coming back next week. I wish her the best of luck with whatever she does next.

Real-life Skills Coaching Student

Today I reviewed everything that I've learned about with my coach during my last six classes. [My friend] and I planned out to go to Friendly's. We planned to take an Uber there around 10:05-10:15 just in case it was late, arrive there around 10:30, order and eat and take an Uber back to the high school by 11:45. I practiced giving the waiter a tip and it worked out. I also took a driver's permit test and ended up getting so close to passing. I am really going to miss my coach, because she was a nice and helpful person.

Real-life Skills Coaching Student