Nashoba Pediatric Therapies

Nashoba Pediatric Therapies Caring for Kids and Families

Nashoba Pediatric Therapies provides pediatric occupational therapy services at our clinics in West Townsend and Shirley, MA.

We are "in network" with most insurance plans in Massachusetts and New Hampshire. At Nashoba Pediatric Therapies, we are able to provide your child with highly individualized services. We place a high value on parental input and encourage parents, siblings and other important people to take part in all aspects of your child's OT programming when appropriate. Our programming begins with a phone or

virtual intake meeting prior to your child's first visit. This allows parents to discuss concerns and ask questions at a time and place convenient for you. During your child's first visit, we will spend time getting to know each other in a playful and engaging manner. The occupational therapist will gain knowledge of your child's challenges while developing a friendly and meaningful rapport. After this initial visit, a comprehensive and individualized evaluation and treatment plan will be compiled and shared with parents. Follow-up visits will be planned to address parents concerns and findings discovered during the evaluation process. We accept most major insurance plans including:

Blue Cross Blue Shield of Mass
Anthem BCBS (New Hampshire)
Harvard Pilgrim Health Plan
Aetna
MassHealth
NH Medicaid
WellSense
New Hampshire Healthy Families
Allways Healthplan

Additionally, we can accept the following in many circumstances (please inquire to confirm):
Cigna
Health Plans Inc
United
TriCare

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05/09/2026

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We love this visual. A difficult day often reflects fluctuating capacity rather than unwillingness or loss of skill. Und...
05/09/2026

We love this visual. A difficult day often reflects fluctuating capacity rather than unwillingness or loss of skill. Understanding the “why” behind behavior can change how we support kids.

Imagine you're planning to make lasagna for supper, or something similarly complicated. You go to the store and buy all the ingredients, take the meat out of the freezer, and then you go to work.

But then work didn't go the way you expected. You were short-staffed, you spent all day on your feet, a coworker was rude to you, and you didn't have time to eat your lunch. When you get home, you're exhausted and starving. You now can't imagine spending an hour making lasagna and then cleaning up afterward. So.. you ACCOMMODATE yourself and order a pizza.

You didn't forget how to make lasagna. You still have all the ingredients for lasagna. You can make lasagna tomorrow. You might even technically WANT to make lasagna. You just don't have the capacity for it right now.

But you aren't lazy for not making lasagna. Nobody tells you that you are being manipulative or that you just need more discipline because you decided to order pizza. Adults extend themselves grace for exactly this kind of capacity shift all the time.

People's abilities don't have one steady baseline. They shift and change constantly, on multiple overlapping timescales, and the pattern is different for everyone.

This is called fluctuating capacity.

For some people, fluctuating capacity means they might handle a complex task one day and then struggle with basic self-care the next, or move between different levels of functioning within the same day, the same hour, even the same conversation.

Within a single day, capacity rises and falls based on accumulated demands, sensory input, food, hydration, transitions, and how much masking or effort someone has already done.

Day to day, sleep quality, what happened the day before, whether they are feeling well, where they are in their cycle, if applicable, and lingering effects from a big event can all change what is available.

Capacity depends on factors like sleep, sensory load, accumulated demands, illness, hormonal cycles, emotional state, environment, and how much the person has already had to mask or push through that day.

In kids, fluctuating capacity often looks like a child who can do something one moment and genuinely cannot do that same thing a short time later. The skill hasn't disappeared, but their access to it has.

A child who had a great Monday can be wiped out on Tuesday from the cost of that good day.

For kids, this could show up in various ways

✱ A kid who can write a full paragraph on Monday stares at a blank page on Wednesday and cannot get a single sentence out.

✱ A child who normally tolerates the tag in their shirt but then suddenly cannot bear it. Sensory thresholds can shift with capacity.

✱ A child who sometimes handles self-care tasks like brushing teeth, getting dressed, putting on shoes, but other times doesn't

✱ Language can also come and go. A kid who chats freely in the morning might give one-word answers by afternoon

These are all situations that involve the same kid, same skill, but different available capacity. Just like in the lasagna analogy.

When capacity fluctuates, you might notice skills requiring executive function, planning, sequencing, starting tasks, switching activities, are often times the first to go. Or, you might see emotional regulation drops, like crying or becoming frustrated more easily/quickly.

When adults don't recognize what's going on, this might feel confusing or frustrating. They might think the child is being lazy, or manipulative, or attention-seeking, or maybe it's a regression, or a behavior problem, or they're simply choosing not to what you want or expect.

But, it's none of those things.

They're still just a child doing the best they can with what they have in the moment, but in this moment, their nervous system has less to give, so skills are going offline.

We can't treat kids' best moments as their baseline. That is actually the ceiling, and the ceiling moves.

This!!!
04/22/2026

This!!!

04/15/2026
Throwback to our clinic director in action at Right Start Playgroup! Her fun and engaging style helps kids feel confiden...
04/08/2026

Throwback to our clinic director in action at Right Start Playgroup! Her fun and engaging style helps kids feel confident, comfortable, and supported while building important skills. 😊
(Photo courtesy of Ashby Free Public Library)

ASHBY — For those interested in learning new ways to enrich your child’s development, nurture curiosity, self-esteem, and independence, then the Right Start Playgroup could be of interest. Right Start Playgroup, designed with children fr…

Let's see what's going on at NPTOT...Making pizza!Pizza making in OT helps kids...🍕Explore new foods🍕Build focus and per...
03/31/2026

Let's see what's going on at NPTOT...

Making pizza!

Pizza making in OT helps kids...
🍕Explore new foods
🍕Build focus and persistence
🍕Interact with sensory textures
🍕Follow directions
🍕Encouraging confidence and self-efficacy

03/25/2026
03/21/2026

“Children cannot bounce off the walls if we take away the walls”

Erin K. Kenny, Forest Kindergartens: The Cedarsong Way

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03/21/2026

“A regulated adult is the most powerful intervention in the room.”

Not the behavior chart.
Not the clip system.
Not the consequence.

You.

Because when a learner is dysregulated, they are not asking for control, they are signaling a need for safety.

And safety isn’t created through raised voices, power struggles, or compliance demands.
It’s created through co-regulation.

✔️ A regulated tone
✔️ Predictable responses
✔️ Flexible expectations
✔️ Attunement over authority

Your nervous system sets the tone for the entire room.

So before we ask,
“How do we fix this behavior?”

We need to ask,
“Are we getting curious about the root cause of the behavior?”

Because dysregulation escalates dysregulation but regulation can interrupt it.

You are not just managing a classroom.
You are shaping an environment where nervous systems either feel safe… or don’t.

And that will always matter more than any intervention written on paper.





A little St. Patrick's Day fun with a purpose! We're working on:☘️Sensory exploration☘️Building comfort with different f...
03/20/2026

A little St. Patrick's Day fun with a purpose!

We're working on:
☘️Sensory exploration
☘️Building comfort with different foods, textures, and smells (picky eating)
☘️Task focus and persistence
☘️Attention & sequencing

All through an activity that feels like play 🌈

Address

2 Shaker Road
Shirley, MA
01464

Opening Hours

Monday 8am - 6pm
Tuesday 8am - 3pm
Wednesday 8am - 6pm
Thursday 8am - 6pm
Friday 8am - 3pm

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