Frequently Asked Questions

Children are ready for our group therapy services when they can:

-Demonstrate body and safety awareness to participate (at their own level) in group activities with an adult nearby but NOT within arm’s reach at all times.

-Stay within eyesight of the group in a wild nature environment without attempting to elope or run away.

-Communicate their needs to the therapist and others (using an adaptive device, pictures, facial expressions, gestures, or verbal words).

If your child cannot do these things yet, we’d love to work with them in individual sessions to get them ready for participation in a group in the future.

Our application process allows you to submit an application for all locations and times that would work for your family. After the application deadline, our therapists review applications as a team. We form groups based on ages and needs of children who applied for each available group.

After review of applications, you will be notified if your child is offered a spot in a group. You will then have 48 hours to pay your deposit to confirm your child’s spot. If you do not reply, we will move to the next child on the waitlist. We generally have about 10-15 applications for 4 spots in each group. If your child is not placed, they will remain on the waitlist for upcoming openings in groups.

Your OT will contact you via email one week prior to the group’s start date to send you our Welcome Packet with all the information you’ll need. Your child’s goals will be established after the 1st or 2nd group. Group activities will address goals and you’ll receive a written progress report on goals at the end of each semester.

Due to the therapeutic nature of our services and HIPAA privacy laws, we cannot offer trial visits. Our application process has been carefully crafted to assess goodness-of-fit before your child joins a group.

We review all applications to make sure the children’s needs are balanced to be a "good fit" in a group together. We've found in our experience that a variety of different diagnoses work best in a group- rather than grouping kids based on diagnosis. Diversity of strengths and challenges is essential in a group OT model. The OT plans the group’s activities specifically to address the needs of the children in the group.

Children receiving OT may have diagnoses of ADHD, Autism, Sensory Processing Disorder, Anxiety, motor skill challenges, or have no diagnosis at all but just need work on developmental skills. We do require that children are able to function with a 1:2 adult-to-child ratio to be in the group. They must be able to stay with the group in the woods and maintain personal safety with an adult nearby but NOT always within arm’s reach. Children receiving group OT are also expected to maintain behavior that does not endanger the safety or compromise the therapy of other children in the group.

Group therapy IS different than individual services since it is not 1:1 with the OT. One of the reasons we staff our groups with an OT and an assistant (or 2) is so that the OT can get focused time with each child as needed to work on their goals during the group. The longer meeting time also helps with this. We make sure kids don't feel left out by keeping kids engaged throughout the session- so for example, if the OT is working with one child during an activity, the assistant may be helping other kids or leading/supervising some exploration or group game. Also, we tend to do focused work on 1 main goal per child at a time, focusing on the family's main concerns.

Nope! We prepare and play outdoors in all kinds of weather. In the case of rain, we would only cancel if the weather conditions posed a hazard to the children (for example, strong winds, or hail). Groups are cancelled for poor air quality during fire season or if the temperature is below 20 with wind chill during Wisconsin winter.

Our program is intended for children who are ready for a group therapy model, so we generally don’t allow parents to join our group services. (Individual OT sessions may be a good option if your child is not ready for group quite yet.) The philosophy of our groups is to be child-led and encourage children’s independence. We intentionally staff with a very high adult-to-child ratio to provide support for children in our groups. We’ve found that having more adults present really impacts all the children’s tendencies to play independently. Another reason for this policy is that it provides consistency in service provision across all families within our group therapy model.

Due to our group model and the importance of consistent attendance for group therapy, we do not reimburse for missed visits. We do not meet on holidays or holiday weekends and arrange the group calendar to closely match local school district holidays.

We hold our groups rain or shine. During fire season in California, we cancel groups if air quality is in the orange range based on the reading on AirNow.gov for the park location. During winter in Wisconsin, we cancel groups if the temperature is below 20 with wind chill. If a group is canceled by OKOT, a make-up visit will be scheduled on the next date on the session calendar.

Item descriptionThe first consult call is when the formal goal will be set as a collaborative effort between yourself and the therapist. They will have the information you provided in the application, combined with their experience of the first few sessions with your child, and together you will discuss what to focus on initially. The reason for setting 1 treatment goal is to ensure we are focusing treatment on the specific most important desired outcome for your child and family. The therapist will plan treatment sessions keeping your child’s goal in mind and will address your child’s goal every session throughout the group’s activities. It will then be reviewed in the January consult call and adjustments made/new goal set accordingly. Our therapists are always looking holistically at your child’s participation in the group and considering all the developmental and contextual factors that may be strengths and challenges for them overall. Your therapist may comment on these strengths and challenges in session notes and progress reports, in addition to reporting progress on your child’s 1 treatment goal.

Individual services start with an OT assessment to establish goals with you for your child. All individual services are offered in semester-long packages (fall and winter/spring). Each semester package includes weekly visits, monthly parent consultation calls, and progress report at the end of the semester.

You can apply for an assessment spot and fill out the application here.

OT assessment is a process in which the therapist analyzes your child’s unique developmental profile & strengths, their daily life contexts, and factors that may be contributing to challenges they are experiencing.

Assessment is a critical part of the occupational therapy process to ensure effective therapy services. We work with parents to determine which assessments are appropriate and necessary to provide the information needed for the therapist to best address your child’s needs in therapy sessions. Not all children require formal standardized assessments. Therapist’s observations and interactions with your child are always part of the assessment process.

For current assessment pricing please refer to our individual services application.

If you have a current OT assessment completed within the past 6 months, we will give you a significant discount on assessment fees. We can review that assessment and use that to inform goal setting for treatment sessions.

Our therapists are trained to use clinical reasoning to select assessments specific to the needs of the child. We will work with you to decide which assessments are necessary. Depending upon your child's needs, we may conduct standardized assessments in the areas of gross motor, fine motor, visual motor, visual perceptual, executive functions, sensory processing, social-emotional, &/or social skills.

Individual services allow the therapist to provide more individualized support than a group, as the OT is 1:1 with the child and you (or another caregiver) in the session and can guide the session specific to your child’s needs. Individual services are a great fit if your child may not be ready to function with the 1:2 adult-to-child ratio and level of independence required for safety in our group sessions.

Individual assessments go more in-depth than our group assessment process. All children who are receiving OT will have specific treatment goals established after assessment. Individual services allow work on 3 or 4 goals at a time, while group therapy requires the therapist focus on only 1 goal at a time since there are 4-5 children receiving OT in each group.

Individual sessions include the child, parent or caregiver, and therapist. Siblings are welcome to join individual OT sessions at no cost, if the parent and therapist agree that sibling participation will benefit the child receiving therapy.

Individual sessions focus on addressing the specific needs of your child. Our therapy model at OKOT is all about PLAY and having fun outdoor adventures together. We meet at the trailhead, and hike to our play area to have a short check in, then make a plan together for the day.

All individual services are offered in semester-long packages that provide your child with weekly 50-minute OT visits, goal development and tracking, monthly 30-minute parent consult calls for you, and progress reporting at end of semester.

Fall semester runs September-December; Winter/Spring is January-May; Summer is June-August.

At the end of each semester, you and your therapist will discuss your child’s progress and the changes you’re seeing in your family, to decide together if continued services are necessary. An end-of-semester report will be provided that outlines progress made toward goals and further recommendations.

We typically work with children who may have diagnoses of ADHD, Autism Spectrum Disorder, Sensory Processing Disorder, Dyspraxia/Developmental Coordination Disorder (motor skill challenges), or mental health challenges (such as anxiety, low self-esteem, or behavior challenges). Some of the children we work with have no diagnosis at all but need therapy to be able to effectively participate in their daily life activities of childhood.

At OKOT, we value parents and caregivers as the most important influences in your child’s growth and progress. (Other people are with your child much more frequently in daily life than your OT is!) For this reason, we always attempt to include you to help support carryover of skills to the home and other community settings where you or caregivers are with your child in daily life.

When children have challenging behaviors that arise during sessions, it is an excellent opportunity to work together to use a relationship-based approach to help you (or other caregivers) learn effective ways to respond to challenging behaviors in daily life situations.

Just like we can’t control nature, we can’t always control what happens to us in daily life! Nature-based therapy sessions provide a “real-life” environment that is wonderful for working on your child’s flexiblity, frustration tolerance, and relationship-building to support their future success at school, home, and in life.

We do not staff individual sessions with staff members other than the therapist. If you choose not to join the session for any reason, please always ensure that your therapist knows exactly where to find you in case of an emergency. For safety, we require that parents or caregivers stay ON-SITE at the park in an easily accessible location nearby (within earshot) during your child’s therapy session.

Yes. One of our core values at OKOT is connection & relationship-building. Having a sibling participate can be beneficial for some children. Let your therapist know if you would like your child’s sibling to join their sessions. You and your therapist can decide together if sibling participation will benefit your child’s OT services.

We meet in local parks or outdoor areas in Berkeley and Oakland. Please indicate your preference on your application.

During therapy outdoors, we use the natural environment around us as therapy equipment and may supplement with outdoor therapy swings, and everyday tools (ex. scissors, ropes, hammers, knives for cutting snacks or whittling) in our sessions.

Our Outdoor Kids individual sessions provide a safe space for children to explore their limits, challenge themselves and enjoy play in nature...with the just-right amount of support they may need to do these things successfully. Nature offers experiences that cannot be replicated in an indoor therapy clinic.

Nope! We prepare for the weather and play outdoors!

We only cancel services in the following conditions:

-Hazardous weather conditions (strong winds, hail, lightning).

-Poor air quality due to forest fires in California (in the orange according to airnow.gov)

-Temperature below 15 degrees fahrenheit with wind chill in Wisconsin

Should a session be cancelled due to weather, a make-up date will be scheduled.

The effectiveness of our treatment model relies on the therapeutic value of longer sessions (greater than the 30-60 minutes typically allowed by insurance), a group model (usually not reimbursed by health insurance), and our outdoors-in-nature setting (also not recognized by our current health insurance model in the U.S.). In order to provide this high-caliber of care for our families, we do not bill insurance for our services and are not in-network with any health insurance. This allows us freedom to practice in optimal ways to serve your family, rather than being restricted to what insurance plans would approve. This often means your child will make faster progress and may be in services for a shorter period of time.

Yes. We have never turned away a child for lack of funding. In any given year, 10-20% of our children are receiving some form of scholarship. These spots are reserved for families who show extreme financial need. We submit all scholarship applications to a local philanthropic organization that supports funding for children to access occupational therapy services. Parents requesting scholarships will be required to fill out the application for the foundation and submit paperwork to demonstrate their financial need. Contact support@outdoorkidsot.com to inquire.

If your child has developmental disabilities, the Regional Center of the East Bay (RCEB) offers support and may help cover the cost of services like occupational therapy. Here’s a quick guide to getting started:

1. Check Eligibility: Review RCEB’s eligibility criteria for developmental disabilities, including autism, cerebral palsy, and more. For more information, visit https://rceb.org/clients/getting-started-with-us/.

2. Contact RCEB Intake: Call or email the RCEB intake department to begin the assessment process.

3. Complete an Intake Assessment: RCEB will assess your child’s needs to confirm eligibility.

4. Develop an Individualized Program Plan (IPP): If eligible, work with RCEB to create a plan detailing necessary services, including occupational therapy.

5. Arrange Financial Aid for Therapy: Discuss financial aid options with your RCEB case manager to help cover therapy costs.

6. Choose a Therapy Provider: With RCEB’s support, select an approved provider for your child’s needs.

For more information, visit https://rceb.org/

Since progress in therapy takes time, we enroll children in therapy for the full semester or school-year. Cancellations and withdrawals impact group dynamics and individual progress.

Our cancellation policy is as follows:

-Registrations for Outdoor Kids groups in California are for a full school year- September through May. We do not reimburse for missed sessions.

-Enrollment in individual sessions and Wisconsin groups are for a semester (Sept-Jan or Feb-May). Missed individual visits can be re-scheduled during make-up dates on the OKOT calendar. Missed visits are not refunded beyond make-up dates on the calendar.

-To provide group cohesion and consistency in individual services, we allow families to withdraw from group services only after the first semester of services ends in late January each year. The deadline for withdrawal requests is January 15. All requests must be made in writing via email to your therapist. We kindly request you notify your therapist at least 2-weeks prior to your child’s last visit so we can provide closure and a smooth transition for your child.

-For all withdrawals, a $200 withdrawal fee will apply. After the withdrawal fee has been subtracted, we will refund any funds received for remaining visits in the semester.

-If you withdrawal your child any other time during the school year, you will be billed for the remainder of that semester. Leaving in October? You will be billed for all sessions scheduled through Jan. Leaving in April? You will be billed for all sessions scheduled through the end of May.

Yes. To streamline administrative processes, we process these TWICE yearly- in January and June, and only do so at parent request. You can email Support@outdoorkids.com to make this request.

Since the start of our practice in 2016, families have found OKOT to be an inclusive and safe space for their children who are gender non-conforming / non-binary. We honor that gender non-conformity will have a unique presentation in each child.

Occupational therapists are specifically trained to support the holistic development of body, mind, and spirit of the whole child. One of our foundational values at OKOT is CONNECTION. Our work at OKOT is grounded in connection with families. We believe building relationships with each child and parent is critical to creating a safe, inclusive space for therapy.

After enrollment in services, our personalized assessment process will allow 1:1 discussion with your therapist about your child to individualize our approach to OT intervention based on your values, needs, & preferences. We want to ensure your child feels safe, supported, & accepted in our services.

While our groups and services are play-based, not “curriculum” based, we do teach social-emotional skills and self-regulation skills, always with a focus on inclusion, equity, & honoring neurodiversity. Our staff attends regular training for supporting diversity, equity, and inclusion, as well as training on current best practices for supporting children’s mental health, self-regulation, and relationship-based intervention.

We only hire experienced therapists at Outdoor Kids OT. All of our therapists are licensed and national board certified OT practitioners. You can read more about our therapists and their backgrounds here.

All of our therapists have been trained and certified in our ConTiGO (Connection & Transformation in the Great Outdoors) Approach. They also attend ongoing professional development in areas related to providing high-quality evidence-based therapy services in nature, including but not limited to: relationship-based behavioral management, facilitating play, nature connection mentoring, and sensory integration techniques.