FAQs: Educational Occupational Therapy Services

Occupations are the everyday activities that people do as individuals, in families and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do (WFOT, 2019).

Occupational therapists (OTs) consider eight distinct areas of occupation: Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), Work, Play, Education, Social Participation, Rest/Sleep and Leisure. OTs work to increase participation in any or all of these areas.

While every area of occupation is hugely important, play is often considered the primary occupation of childhood. Pediatric OTs often focus on play as well as activities of daily living, education and social participation. Within the school context, occupational therapists work to help students access the curriculum by targeting specific skills to develop, modifying the environment and assessing the task or assignment.

An educational occupational therapy assessment looks at the specific fine motor, ocular motor, visual motor, visual perception and sensory skills necessary for learning. It takes into account foundational skills, such as postural stability, strength and integrated reflexes. This assessment determines how a child interprets data presented to them as well as how a child is able to display their knowledge in an academic setting.

A child may need an educational occupational therapy assessment for a variety of different reasons; these often depend on a child’s age and school stage. Some examples include:

Elementary

• Decreased endurance for writing activities – a child “gives up” easily or early
• Difficulty holding a pencil and creating accurate letters/coloring in the lines
• Inability to attend to information on the white board

Middle School/High School

• Decreased writing or typing speed/legibility
• Difficulty with geometry and alignment of math problems
• Difficulty using a graphic organizer or other visual supports

While handwriting instruction is a common intervention provided by occupational therapists, many of other foundational skills are considered during a comprehensive evaluation. If a child is overwhelmed by the visual, sensory or executive function demands at school, occupational therapy assessment and intervention may be beneficial.

This assessment includes review of historical records and work samples, a parent intake session, office-based assessment sessions and a parent feedback session.

A comprehensive review of historical records and current work samples generally takes 2-3 hours and includes a review of any relevant medical information, previous occupational therapy or physical therapy testing, a recent neuropsychological evaluation and current work samples. Work samples should include examples from multiple school-based activities, ex. writing, math sheets and drawing/coloring.

Office-based sessions will include both standardized assessment and unstructured activities that allow for clinical observation. This is conducted over two sessions that run from 1.5-2 hours each.

Finally, this assessment includes a comprehensive report that outlines a child’s function within all of the domains assessed and recommendations for accommodations or interventions.

Preparing a child for an occupational therapy evaluation really depends on their age and the type of evaluation they are receiving. Most young children tend to enjoy occupational therapy evaluations! While there is some seated work, there is also the opportunity to move their bodies and show off their skills. NESCA recommends telling children they will be working with an OT to see how their body moves, how their eyes move and see, and how they use their fingers. Finally, tell them to wear something comfortable that does not restrict their movement.

For older children receiving an Educational OT Assessment or a Functional Skills Assessment, the evaluation is focused on helping them realize their own skill levels, need for accommodation and ability to function within either the school or community environment. NESCA recommends telling them that the evaluation is to help figure out the best way for them to gain independence and further develop their skills.

While the educational assessment does not include an observation, this may be arranged for an additional fee. NESCA occupational therapists are available to observe a student either in the school setting or at home during homework completion.

An occupational therapy assessment is not a diagnostic evaluation and will not provide a specific diagnosis for your child. This assessment will highlight areas of strength, areas of weakness and specific environmental/task modifications necessary to make learning easier and/or more accessible for your child. This assessment evaluates multiple specific visual skills (figure ground, visual closure, form constancy, etc.) and motor skills (visual motor integration, hand-eye coordination, visual tracking, etc.) and relates them to the specific demands of the school environment and educational program.

A Functional Skills Assessment determines an adolescent’s current independent living skills in relation to the skills they may need to live independently. It focuses on the skills and services necessary for functional success with home and community-based activities and tasks. Examples of these tasks include personal hygiene, meal prep and cooking, grocery shopping, laundry, medication management, etc.

A Functional Skills Assessment is primarily recommended for students 6^th grade and older. As a child moves into adolescence, the need to develop specific independent living skills increases.  This assessment provides a roadmap for areas to focus on and skills to target.

A Functional Skills Assessment may take place in the NESCA office, at home and out in the community. To accurately assess these areas, adolescents are encouraged to show their skills in a comfortable and familiar environment.

A Functional Skills Assessment will provide a snapshot of an adolescent’s level of independence in conducting a wide range of everyday tasks, such as community navigation, household management skills and basic home/community safety. It assesses the ability to problem solve, use technology in real world situations and create/follow routines. This assessment will also provide information about which skills to prioritize for future independence and recommendations for how to develop areas of weakness.

Yes. Through the Real-life Skills Coaching program, NESCA will work one-on-one with adolescents and young adults to develop the skills necessary for increased independence. NESCA coaches are all either occupational therapists or transition specialists who work collaboratively to target skills that are both important to the individual and allow a person to live and thrive independently.

Our occupational therapists are happy to consult on any question regarding OT in the school/community setting. Consider coming in for a 1-hour consultation if:

• Your child is not making effective academic progress due to fine motor/visual/sensory needs
• Your child is often overwhelmed when trying to “keep up” with the speed of work in the classroom
• You are having difficulty interpreting a previous occupational therapy evaluation
• Your feel that a previous occupational therapy assessment does not seem to describe “your child”
• You have questions about occupational therapy and which evaluation may be beneficial for your family

An occupational therapy consultation session can help to interpret occupational therapy assessments or recommendations. NESCA OTs can also consult on recommended IEP goals, service delivery options and interventions, as well as provide recommendations for how to promote skill development at home.