NESCA is pleased to offer occupational therapy (OT) 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 offers a range of educational OT services designed to assist students in maximizing their educational performance and readiness for transition to adulthood. NESCA also offers direct sensory- and motor-based therapy services to address a variety of functional needs.
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.
• Self-regulation – Self-regulation is the ability to recognize, acknowledge, adjust and control one’s emotions and behavior. Self-regulation skills help a child move through a day feeling in control, regulate their impulses and maintain focus.
• Sensory Processing – Sensory processing refers to the way that the nervous system receives and interprets information using the body’s senses, and organizes a response. Children may struggle with processing and integrating all of the information they receive from the environment around them.
• Gross Motor – Gross motor skills are movements and actions which involve use of the large muscles of the body in a coordinated way to complete activities, such as walking, running, stair climbing and maintaining seated posture.
• Fine Motor – Fine motor skills are the coordinative effort of the small muscles in the body, such as the arm, hand, finger and eye muscles. They involve precise movement, hand dominance, grasp patterns and synchronous movement.
• Visual Perception – Visual perception is the ability to see, organize and interpret the visual information that is being provided. It describes how a child is able to “make sense” of the visual world around them.
• Visual Motor Integration – Visual motor integration is the coordination of visual perception and motor skill. It allows a child to use their hands and body in a coordinated and efficient manner for functional and academic tasks.
• ADLs (Activities of Daily Living) – ADLs are the important tasks that we must do throughout the day to function. They include feeding, dressing, bathing and using the restroom.
• Digital Literacy – In today’s increasingly digital world, digital literacy skills refer to the ability to use and understand the hardware, software and the internet. They include functional motor skills needed to manipulate different devices, knowledge of software programs and how to create documents or presentations as well as the understanding of safety/privacy rules.
• Feeding Therapy – The TR-eat® (Transdisciplinary Effective Assessment and Treatment) method was created by Elizabeth Clawson, PhD and Carol Elliott, OTR/L as a model for a transdisciplinary and holistic approach for treating children with complex feeding problems. The TR-eat® model combines therapeutic skills and behavioral concepts to address even the most difficult feeding and eating issues. The child-led approach considers the environment, as well as social and medical aspects of every family’s life.
Who is this service appropriate for? When might a child need these kids of Occupational Therapy services?
We recommend assessment for children who are displaying any of the following challenges:
• A tendency to withdraw or shut down, or demonstration of heightened activity/anxiety level in groups
• Irritability, inflexibility or a tendency for meltdowns in school, at home or in the community
• Over-reaction to sounds, touch, tastes or visual stimuli
Aggression towards peers or adults, or poor tolerance for being in close proximity with others
• Low muscle tone, difficulty maintaining seated positions for extended time, fatigue from motor activity
• Delayed gross or fine motor milestones
• Awkward or clumsy movement; hesitancy to engage in playground or sports activity
• Frequent falls or poor safety awareness
• Difficulty following directions or learning new motor tasks without frustration
• Poor tolerance for transitions or changes in routine
• Lack of enjoyment with age-appropriate motor tasks
• Difficulty establishing rapport with peers; limited play skills or ability to self-entertain
• Difficulty managing routines, such as dressing, toileting, packing a backpack, completion of daily chores
• Messy eating or hygiene habits
• Poor feeding
• A child who seems fine at school all day, then falls apart upon returning home
A therapy-based assessment evaluates sensory and motor as the foundations for development across all settings in a child’s daily routine. It will evaluate baseline performance of gross motor, fine motor and visual motor skills, as well as sensory processing impairments that may have an impact on functional performance. It provides information that will inform goals of direct therapy services, in conjunction with caregivers and the student, to determine priorities and needs.
Insurance-based OT evaluations are medically based assessments, and only allow for 1 hour of time to complete a full assessment. Typical assessments with NESCA include a 45-minute screening of motor skills and sensory processing. The purpose of this is to determine if a child would benefit from direct weekly services, and to provide an overall picture of strengths and weaknesses that allow us to prioritize and devise goals for therapy. A brief screening report is provided as part of this process. We will work with you to find ways to incorporate more lengthy reports containing suggestions for both home and school if needed, on an hourly basis, but we are not able to bill insurance for lengthy reports, nor those that contain information regarding academic performance or needs.
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 OT Assessment, 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.
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 daily functioning more accessible and comfortable for your child at home or in the community.
NESCA provides insurance-based sensory- and motor-based occupational therapy (OT) services for infants, toddlers, preschoolers, elementary school-aged children and adolescents under the direction of Julie Robinson, OTR/L, Licensed Occupational Therapist. In addition to office/clinic-based services, NESCA is pleased to offer services at the home and/or the community on a weekly basis as well as via telehealth.