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School-based Occupational Therapy at Home

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach

While school districts and government officials work to plan for the current “new normal,” no concrete decisions have been made about the delivery of special education and provider services. As parents take on the huge task of educating within the home, it is important to consider how we can bolster some of the skills that are continuously targeted in the school setting. As an occupational therapist, I have provided direct services and worked with teachers who are adeptly teaching a class of 20, while simultaneously making sure that their two students with OT needs are being provided appropriate accommodations and motor practice. Here are some activities that can be done in the home to keep the development and learning going!

If your child’s occupational therapy (OT) evaluation mentions difficulty with fine motor coordination, consider incorporating these activities into your day.

  • Sort marbles, pompom or coins. Using fingers to pinch and pick up small objects helps to build strength and solidify grasp and grip patterns. Increase the difficulty of this activity by having kids push pompom and marbles through small holes or manipulate coins through slits in a tub or box.
  • Play with playdough or putty. Make shapes using cookie cutters, push beads into putty and pull them all out, roll playdough into a snake and use different pinches to create patterns from head to tail. Pinches to consider include: thumb and index finger, thumb and index+middle finger and thumb against the side of the index finger (lateral pinch).
  • String beads, cheerios or pasta with holes. This activity promotes bilateral coordination, fine motor control and grasp patterns. Scaffold this activity by starting with threading on pipe cleaners, moving to dry spaghetti and finally working to thread onto string.
  • Practice using tweezers to pick up small objects.

If your child’s OT evaluation mentions difficulty with visual perception or visual motor integration, try these!

  • Puzzles! Doing a puzzle requires multiple visual perceptual skills, as well as the fine motor precision to fit pieces together.
  • Word searches. Word searches require horizontal and vertical tracking, letter discrimination and visual figure ground ability. Consider scaffolding this activity by finding word searches that only have horizontal words, have both horizontal and vertical, or have horizontal, vertical and diagonal words.
  • Sorting activities. Objects can be sorted by color, shape, size, texture and a plethora of other characteristics. Consider using objects found in the home, such as pens, buttons, silverware or simply items in a junk drawer for sorting activities.
  • Mazes, Hidden Pictures and Spot the Difference activities can all be found online.
  • Copying activities. Draw pictures using horizontal, vertical and diagonal lines, circles, squares, triangles and crosses and have your child try to copy them exactly. This activity works on visual motor integration specifically.

If your child’s OT evaluation mentions difficulty with endurance, postural stability or core strength, try these!

  • Draw or play while lying on the ground. Tummy time is often thought of as an activity to help our newborns, but lying on your tummy and using the muscles needed to keep the upper body and head stable can be beneficial for building strength in most of our kids.
  • Yoga! Incorporate an online video or movement break into your daily routine.
  • Pretend to be different animals! Walk like a bear, slither like a snake, hop like a frog or trot like a horse. Mimicking these animals is a great activity to do while listening to music and uses all different muscles.

While it can be difficult to target our children’s specific needs without direct access to therapists and our usual resources, building in small activities throughout the day can help to maintain strength, skill development and the foundational abilities needed for academic growth.


About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. 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. Dr. 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, Dr. 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.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email or call 617-658-9800.


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 or call 617-658-9800.