FREQUENTLY ASKED QUESTIONS

1. What is Occupational Therapy, and who can it help?

Occupational Therapy (OT) helps children to participate in meaningful activities of daily living (ADLs). Occupational Therapists (OTs) and Certified Occupational Therapy Assistants (COTAs) use interventions that promote health, well-being, and the client's ability to participate successfully. OT can address developmental motor delays (fine motor, gross motor, visual motor), sensory processing difficulties, cognitive challenges (including executive functioning skills of attention, planning, organization), emotional regulation, and mental health for children and adolescents of all abilities. These underlying skills are critical for success and independence with daily activities such as dressing, bathing, grooming, feeding, toileting, functional communication, and play!

2. Do you accept insurance?

Yes, we are an in-network provider with Kaiser Permanente, Kaiser Quest, Ohana Health Plan, AlohaCare, HMAA, and United Healthcare. For these insurances, we will bill on your behalf. For other insurances, we are an out-of-network provider.

Out-of-Network: Payment is due at the time of service with packages and payment plans available. We accept credit card, check, HSA, FSA, and cash payments. We can then create a Superbill (detailed receipt) of services rendered for you to submit to insurance for possible reimbursement. We advise all future clients to check with their individual insurance providers to see what services may be covered. To determine if your insurance company will cover out-of-network services, you can call member services of your insurance carrier and ask the following questions:

A. What are my out-of-network healthcare benefits for pediatric occupational therapy services in an outpatient setting? Examples listed below.
• OT evaluation CPT codes 97167:
• Treatment CPT codes 97530 & 97533:
B. Is pre-authorization and/or a referral required before I see an Occupational Therapist? (if applicable)
C. Co-payment? (if applicable)

D. Deductible? (if applicable)
E. Today’s accumulation for deductible? (if applicable)
F. Does my child have an out of pocket maximum that I pay per calendar year?
G. Does my insurance plan cover only a limited number of sessions for each calendar year?

3. How are your OT sessions different than clinic-based therapy?

Pediatric clinics are able to provide lots of equipment and toys in a controlled setting. This is wonderful for some children, but it can be overstimulating for others. We provide services in the client's natural setting; this could be their home and/or a nature-based setting close by. This provides parents the opportunity to easily replicate & practice activities they've learned during the OT session. A full 60-120 minutes will be provided, including a review of activities & specific recommendations after each session. This is also different from clinic-based OT, where sessions are typically limited to 45-50 minutes. Finally, our Occupational Therapy services are 100% holistic in that the whole family can and is encouraged to be involved. We believe that a child's family is an integral component to their growth and development, and we love having parents & siblings join in on sessions!

4. What are the benefits of Nature-Based therapy?

An integrative review of the benefits of nature-based therapy found evidence of physiological, psychological, social, vocational and quality of life benefits from participation in nature-based therapies.
Physiological: Decreased heart rate, blood pressure, and salivary cortisol levels. Increased parasympathetic nervous system (our rest & digest system) activity.
Psychological: Decreased stress and increased relaxation. Decreased depression, anxiety, tension, pain & fatigue. Enhanced self-esteem, positive identity, confidence, emotional stability, motivation, self-reflection, and a sense of achievement and responsibility. Attainment of a general sense of happiness and joy and positive changes in behavior towards self & others.
Social: Promotes social wellbeing and relationship development. Enhances sense of community & connectedness.
Vocational: Increase in skills and knowledge. Can develop new interests & hobbies.
Quality of life: Increased life satisfaction, well-being and spirituality. Facilitates immersive attention and positive stimulation for healing and change (Bonham-Corcoran et al., 2022).

5. What are the benefits of yoga for kids?

The practice of yoga for children, neurodiverse brains and other diverse needs, teaches many skills including motor coordination, balance, focus, and strength, but perhaps one of the most important elements of yoga for children is teaching them coping skills and how to respond to stress, tension, worry, anxiety and depression. Teaching children specific breathing strategies, yoga poses and somatic movement to support them in activating the parasympathetic nervous system (ventral vagal - social engagement system), which is responsible for rest, relaxation and digestion, supports them in reducing anxiety, releasing difficult emotions and tension in the body, developing healthier sleep patterns, improving digestion and optimal functioning in the body and improving mood and behavior (Shawnee, 2023).

6. What does it mean to be Neurodiversity-Affirming?

The concept of neurodiversity acknowledges and embraces neurological differences, i.e., variations in the way in which individuals interpret, process, and learn information. Neurodiversity can be broken down into two subgroups of individuals: those who are neurotypical and those who are neurodivergent.

Neurotypical describes individuals who think and process information in ways “typical” for their culture. Neurodivergent refers to individuals whose brain functioning differs from what is considered “typical.” This encompasses people with a range of conditions including:

Autism
Attention Deficit Hyperactivity Disorder
Dyslexia
Tourette’s
Dyspraxia
Other neurological conditions

A Neurodiversity-Affirming Approach

In contrast to a deficits-based model which focuses on “fixing” the impairments associated with neurodevelopmental conditions, a neurodiversity-affirming approach acknowledges that all neurotypes have unique strengths, interests, and support needs. Moreover, this approach highlights the role of the environment and societal barriers in further exacerbating challenges faced by neurodivergent individuals.

Traditional therapeutic approaches to working with neurodivergent individuals have focused on encouraging individuals to mask neurodivergent traits such as reducing stimming behaviors or forcing eye contact and mimicking neurotypical styles of communication. However, emerging evidence suggests that these practices can lead to shame, anxiety, depression, and reduced self-worth (Sedgewick et al., 2021). Rather than perpetuating the idea that neurodivergent individuals need to mask certain characteristics, neurodiversity-affirming practice seeks to understand and inform individuals about differences and provide adaptations and supports that affirm neurodivergent identities. Subsequently, this can lead to self-advocacy regarding accommodations within the classroom or workplace and help cultivate a sense of self-esteem (Hughes, 2023).

7. Do you have supportive options other than private services?

Yes, we offer group Keiki Mindful Movement classes seasonally throughout for all age groups, including toddler & caregiver classes. Follow us on social media @malamayoganaturetherapy or contact us to sign up for our email list for recent updates. We also offer coaching calls for caregivers to be collaborative problem solvers for the home and school environments, including support with Individualized Education Programs (IEPs). Please note that an evaluation may be recommended and required to offer specific guidance.

References:

Bonham-Corcoran, M., Armstrong, A., O’Briain, A., Cassidy, A. and Turner, N. (2022), "The benefits of nature-based therapy for the individual and the environment: an integrative review", Irish Journal of Occupational Therapy, Vol. 50 No. 1, pp. 16-27. https://doi.org/10.1108/IJOT-06-2021-0015

Hughes, M. (2023, January 17). A Neurodiversity-Affirming Approach: What is it and How Can it Support Your Child(ren)? Your Mind Matters Psychological Services. https://yourmindmatters.net.au/a-neurodiversity-affirming-approach-what-is-it-and-how-can-it-support-your-children/#:~:text=Neurodiversity%2DAffirming%20Therapy,%2C%20school%2C%20and%20play%20environments

Sedgewick, F., Hull, L., & Ellis, H. (2021). Autism and masking: How and why people do it, and the impact it can have. Jessica Kingsley Publishers.

Shawnee (2023). Why Yoga & Somatic Practices? Asanas for Autism and Special Needs. https://www.asanasforautismandspecialneeds.com/whyyoga

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