NESCA just announced that it has expanded its Occupational Therapy (OT) services to include Direct Sensory-/Motor-based OT for its existing and new clients.
As you may know, NESCA already offers educational OT assessments and consultation along with Executive Functioning (EF) and Real-life Skills Coaching, mainly for those students in grades 6 and up. Now, NESCA broadens the range of students it can provide with OT, feeding, speech, language and social skills.
To introduce NESCA families and community members to the new team and its services, NESCA’s Sophie Bellenis, OTD, OTR/L, sat down for an interview with Julie Robinson, OT, to learn more.
What is the main focus of the new OT services that we are adding here at NESCA?
We are so excited to be on board and collaborating with the existing clinical team at NESCA to bring these new services to our community. The main focus of the new OT services is to provide instruction and practice, through teletherapy, and when appropriate at the home or in the community, in order to promote the best functionality kids can achieve on a daily basis. Where academic-based occupational therapy is focused on accessing the curriculum and receiving services while at school, Direct Sensory-/Motor-based OT services really look at giving our clients those wrap-around services outside of school to help with sensory processing, self-regulation, attention/following directions, fine and gross motor skill development, social pragmatics, managing routines, feeding and independence in carrying out daily activities, such as dressing, hygiene and sleep.
Who is a candidate for these new OT services?
We work with children of all ages, but our team typically works with children who are in the fifth grade or below. Many of the skills we are working on are skills that should be targeted and developed early on. Ideally, we are working with children from a young age or as soon as the challenges noted above come to light. Children with motor delays or sensory processing disorders, delays with play skills, and/or feeding difficulties are appropriate for these services.
How does the process of getting OT services start?
We usually start with an OT assessment that is focused on function. Insurance typically covers a 45-minute in-office screening. We would typically conduct a phone intake with the family, then look at the child’s skills using standardized tests for motor/sensory performance. With COVID-19, we are gathering sensory information from The Sensory Processing Measure and assessing other skill levels through interviews and checklists from parents, as well as 1:1 observation either virtually or in-person, as determined through the phone intake.
After an initial assessment is conducted, we work with families on a once or twice weekly basis. Each OT session is 45 minutes long and generally either begins or ends with a conversation with parents.
How do the services work?
We would typically provide services in-person inside the OT clinic at NESCA. Due to COVID-19, we are primarily providing services through telehealth, on a HIPAA-compliant virtual platform on a weekly basis. Sessions are 45 minutes each, with parents involved in part of each session to facilitate engagement of the child, to be coached by the clinician and for education about activities to incorporate in the days before the next session for follow through.
A small number of patients are being seen outdoors at their home or in the community, mainly when online engagement is too challenging, and when it can fit accordingly into clinician schedules. All patients are being seen individually for their services.
How do you set goals for the children you work with?
We get some of our background information for goal-setting from the assessment, but much of the real information on goals, strengths and weaknesses is revealed through observation during our sessions.
From the initial evaluation, we develop a brief report identifying the areas that we need to work on and collaborate with the parents to help achieve those goals and potentially target other areas that arise through ongoing observation and informal assessment during sessions and in parent consults.
When can families expect to see progress with goals being achieved?
We like to see our established goals being achieved in a three to six month time period. While every child is different, many kids go on to work with us for approximately 12 to 18 months, focusing on various goals throughout that period.
What are the related services that have just been introduced at NESCA?
Along with our new occupational therapy services, we are also now providing assessment and treatment of a variety of Speech & Language disorders, including dysphagia, childhood apraxia of speech, phonology/articulation disorder, receptive and expressive language disorder, social pragmatic communication disorder, autism spectrum disorder and language-based learning disabilities.
In addition, our therapists work with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake, and reducing avoidance behaviors during mealtimes. Our feeding therapists work with families to make mealtimes easier and more enjoyable for everyone using a systematic desensitization approach to increase sensory comfort with foods. We also employ the TR-eat®—Transdisciplinary Effective Assessment and Treatment—method for highly challenging feeding and eating issues.
Does NESCA accept insurance for its new services?
Direct Sensory-/Motor-based OT at NESCA (not academically-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.
To learn more about NESCA’s Occupational Therapy and Related Services, please click here.
About the Interviewer
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.