By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach, NESCA
Being an occupational therapist (OT) often means working in a profession that many people do not have extensive experience with or knowledge about. It can be hard to give one definition of this profession when OTs are at hospitals and schools, working on advocacy in DC, running mental health groups, and in some cases even responding to natural disasters. We are all around! Despite the broad range of settings, OTs are all guided by the Occupational Therapy Practice Framework: Domain and Process (AOTA, 2020), an ever-evolving framework that describes the central concepts, foundational views, and basic tenets of the profession. As an occupational therapist who has worked in schools with a huge focus on access to the curriculum, functional skill building, and increasing students’ overall participation, I frequently reference the document to ensure I am staying true to my profession and using my lens to help support clients’ goals in the most effective ways possible. As a member of the transition team here at NESCA, I have been fascinated by the natural fit between occupational therapy and transition assessment. Both of these require a holistic lens, consideration for the client as well as their environment, and an ability to focus on multiple different aspects of a person’s life simultaneously.
While occupation is sometimes considered a synonym for “job,” OTs focus on the broader definition of occupations as, “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, 2012). We consider nine separate “areas of occupation,” which include: Activities of Daily Living (bathing, showering toileting, etc.), Instrumental Activities of Daily Living (driving, financial management, meal preparation, etc.), Health Management (medication management, social and emotional health promotion, physical activity, etc.), Rest and Sleep, Education, Work, Play, Leisure, and Social Participation. We want to make sure that individuals have balance, are meeting their personal goals, and feel fulfilled by the activities of life. OTs both assess and provide direct intervention around all of these areas.
Similar to occupational therapy, transition assessment is complex and broad, and it is best thought of as an ongoing process incorporating a wide range of formal and informal assessment of a student’s strengths, interests, and preferences. When developing recommendations for transition assessments, we work in accordance with the federal law (as well as the Massachusetts Student-Driven Transition Model core areas of transition planning) to relate our findings to the demands of transition planning areas: Education/Training, Employment, Independent Living, and Community Participation. Each of these areas needs to be considered as a part of the transition planning process and plays a substantial role in putting together a comprehensive vision for a student.
As I compare the areas of occupation with the core areas of transition planning, I am struck by the similarities and constant overlap. There is an emphasis on functional independence, especially in daily living skills. There is the belief that connection and community are integral parts of life. There is also a need for purposeful activity, whether that be through work, continuing education, play, or all of the above. Each of the areas that OTs so passionately feel guide our work are areas that should be assessed and considered during transition assessment and planning. The lens through which OTs are taught to assess and evaluate clients lends itself perfectly to assessing students as they plan for their futures and transition out of high school. While there are many different ways that I could have applied my OT training, I am glad to be able to apply my expertise to transition assessment at NESCA as one of the ways we help youth and young adults achieve their goals and carry out fulfilling lives.
References
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), Article 7412410010. https://doi.org/10.5014/ajot.2020.74S2001
Massachusetts Department of Elementary and Secondary Education. (2021). Massachusetts student-driven transition model. Retrieved from https://www.doe.mass.edu/sped/secondary-transition/resources-materials.html.
World Federation of Occupational Therapy. (2012) Definition of occupational therapy. Retrieved from https://wfot.org/about/about-occupational-therapy
About the Author
Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Bellenis has extensive background with school-based occupational therapy services. She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.
Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.
Dr. Sophie Bellenis is Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy, including school-based service delivery. Dr. Bellenis has expertise in working with tweens, teens, and young adults with a wide range of social, emotional, and developmental needs. She joined NESCA full-time in the fall of 2019 in order to oversee the Real-life Skills Coaching program as well as to carry out transition assessment, occupational therapy assessment and treatment services. One of the keys to Dr. Bellenis’ success coaching students and young adults is her ability to form a meaningful relationship with each client and use that relationship to motivate lasting change.
Aubrey Matthews, OTD, OTR/L, is an occupational therapist who has focused most of her career on mental health and skill building for adolescents and young adults. She currently works full-time at a behavioral health hospital, splitting her time between the inpatient adolescent unit and the young adult intensive outpatient program. Aubrey tends to focus on building emotional regulation, executive function, and social skills through occupation-based strategies. Aubrey’s doctoral research at the MGH Institute of Health Professions focused on using LEGO therapy to build social skills at a pro-bono pediatric program, and she uses many of these creative strategies to increase client motivation and success.
Jasmine is an executive function coach, and a New York State Certified ENL and Special Education teacher. She earned her bachelor’s degree in Biological Sciences from Cornell University and her masters degree in TESOL from CUNY Hunter College. She has over 10 years of teaching experience across three countries, and has worked with students ranging in age from 7 years to adults.
Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD and related social, emotional and executive functioning challenges. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completing her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition-age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored to the client’s goals and interests.
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