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

Under the direction of Sophie Bellenis, OTD, OTR/L, Occupational Therapist, 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 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

NESCA's Direct Sensory-/Motor-based Occupational Therapy Services

Sensory-/Motor-based Occupational Therapy

Under the direction of Julie Robinson, OTR/L, Licensed Occupational Therapist, NESCA provides occupational direct sensory-/motor-based occupational therapy (OT) services for infants, toddlers, preschoolers, elementary school-aged children and adolescents. In addition to office/clinic-based services, NESCA is pleased to offer services at the home and/or the community. Due to COVID-19, we are currently conducting occupational therapy sessions via teletherapy or at the client’s home, but outside as weather permits.

Through initial assessment, ongoing observation during therapy sessions and ongoing consultation with parents and caregivers, NESCA’s OTs target areas of weakness that are impacting daily functioning in the home and community settings. We address difficulties with feeding, self-care and the ability to participate in routines at home, such as chores, bath time and family meals. We can also provide consultation regarding sensory diet needs to help children function more comfortably in group settings and out in the community by facilitating the development of coping skills, self-regulation, sensory processing, fine and gross motor skills and social pragmatics.

Direct Occupational Therapy Services: 

NESCA provides individual occupational therapy services focused on development of sensory processing and motor development, to facilitate independence with daily routines at home and in the community, which can translate to:

  • better self-regulation, sleep, behavioral control and frustration tolerance
  • increased comfort with sports and playground equipment
  • improved confidence with social interactions and peer interaction
  • Improved physical strength and coordination
  • better legibility of handwriting and improved ocular motor and visual perceptual skills
  • increased food intake as well as food repertoire and tolerance
  • improved tolerance for sensory stimuli and ability to function in group settings

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 or tasks
  • Messy eating or hygiene habits
  • Poor feeding
  • A child who seems fine at school all day, then falls apart upon returning home

Are OT services at NESCA covered by insurance? 

Direct Sensory-/Motor-based OT at NESCA (not educationally-focused), is covered by BCBS and Allways. Speech therapy at NESCA is covered by BCBS, Allways and Harvard Pilgrim.

NESCA can provide receipts for Direct Sensory-/Motor-based OT sessions for clients to attempt to submit to their insurance carrier, should they not have insurance through the above carriers. NESCA does not submit claims to any carrier other than those outlined above and cannot guarantee any reimbursement when claims are submitted to them by the client.

It is also worth noting that Educational OT assessment, consultation and treatment is less often, or less completely, covered by insurance because insurance carriers typically only cover treatments that are deemed “medically necessary.” However, this can be a vital service because students spend such a significant amount of their day and week in school programming.

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.

How are Sensory-/Motor-based OT services delivered?

Currently, many of our OT services are being delivered via telehealth due to COVID-19. Some services may be delivered outside of a client’s home or in the community as therapists’ schedules permit. As COVID restrictions lift and the environment begins to feel safer for in-person contact, the therapy department will move toward providing services in the office, as agreed upon by both clinicians and families.

If you are interested in learning more about NESCA’s Sensory-/Motor-based Occupational Therapy, please contact us at 617-658-9800 or fill out our online Intake Form noting that you are interested in Occupational Therapy Services.