Level Up OT – Rebuilding Confidence Through Play

Vision & Purpose

Level Up OT supports children and young people aged 7–14 who have been left behind after COVID-19—especially those with autism spectrum disorder (ASD), sensory processing differences, social anxiety or difficulties engaging in school or community life. Our purpose is to deliver functional, evidence-informed occupational therapy interventions using engaging media such as video games, tabletop role‑playing games and supported outdoor activities to build confidence, social participation and physical engagement.

We meet children where they are—digitally, socially and emotionally—and help them bridge back to real‑world interaction at their own pace.

Target Audience

  • Children and young people aged 7–14 with social withdrawal or school avoidance
  • Those with ASD, sensory integration difficulties or developmental coordination disorder (DCD)
  • Young people experiencing anxiety or low confidence post‑COVID
  • Children with difficulties in motor coordination or participation in physical activities
  • Families seeking flexible, engaging support outside traditional therapy rooms
  • Schools struggling to re‑engage neurodiverse pupils post‑pandemic

Strategic Goals

  • Increase engagement in social and physical activity using meaningful occupation
  • Improve self‑esteem and resilience through structured, supported challenges
  • Rebuild identity and belonging through creative group interaction (e.g., Dungeons & Dragons)
  • Support families with evidence‑based, low‑pressure interventions that generalise to home and school life
  • Reduce pressure on CAMHS and school‑based mental health teams by offering early intervention and participation‑focused support

Evidence Base

  • Video games: Research indicates that virtual reality and gaming platforms can improve social cognition in autistic young people (Parsons et al., 2012). Additional sources highlight therapeutic gaming as a tool to build engagement and emotional regulation.
  • Tabletop role‑playing games: Studies and media reports (e.g., University of South Australia, 2022; Forbes, 2024) show that Dungeons & Dragons fosters cooperation, communication and confidence, particularly for neurodivergent youth.
  • Outdoor activity: Occupational therapy frameworks such as the PEO model and MOHO support context‑based participation. Outdoor tasks improve proprioceptive feedback, resilience and physical literacy.
  • Policy alignment: RCOT’s Children and Young People Strategy and the NHS Long Term Plan emphasise early support for emotional well‑being, reducing CAMHS demand and improving access for neurodivergent youth.

Intervention Model

Phase 1 – Initial Engagement
Home‑based or online sessions focusing on rapport building through structured games. Gaming (e.g., Minecraft, co‑operative video games) is used to co‑regulate and introduce problem‑solving while developing the occupational profile alongside parents/carers.

Phase 2 – Group Connection & Challenge
The child joins small group RPG sessions (e.g., D&D) to develop collaborative storytelling, social thinking and flexible problem‑solving. As tolerated, physical tasks such as scavenger hunts, ball games or geocaching are introduced. Functional goals are set—for example, attending a local club, cycling with peers or navigating public space.

Phase 3 – Community Generalisation
Sessions move into the community (parks, cafes, climbing walls, etc.), focusing on real‑world application of learned social, sensory and physical strategies. Discharge planning is co‑created with family and school to ensure sustainability.

Professional Governance

All interventions fall within HCPC’s scope of practice for occupational therapists and adhere to:

  • RCOT standards promoting participation in meaningful activity.
  • HCPC guidance on evidence‑based practice, continuous development and service user engagement.
  • NHS standards for preventative, functional and child‑led support for mental health and participation.

Comprehensive risk assessments, consent and safeguarding policies align with NHS and private practice standards.

Training & Development

Completed training:

  • Sensory Integration Level 1
  • CO‑OP Approach (self‑directed modules)
  • Basic certification in postural management
  • Up‑to‑date safeguarding (NHS mandatory)
  • Clinical experience delivering therapy via video games (Minecraft, Roblox)

Planned training:

  • Dungeons & Dragons facilitation for mental health professionals
  • Advanced Sensory Integration Levels 2–3
  • Trauma‑informed practice in outdoor therapy
  • Youth Mental Health First Aid (MHFA)

10‑Step Evaluation Plan

  1. Define success: Establish measurable outcomes (attendance, participation, Goal Attainment Scaling, validated measures of social confidence or motor competence).
  2. Use standardised tools: Select assessment instruments (e.g., COPM, Strengths and Difficulties Questionnaire, Social Responsiveness Scale) for consistent use at intake and discharge.
  3. Collect baseline data: Gather initial measures from child and parents before intervention begins.
  4. Employ a simple design: Use pre‑ and post‑intervention comparisons or single‑case experimental designs to demonstrate change.
  5. Track attendance & engagement: Document session attendance, participation and drop‑outs; engagement is an outcome for avoidant children.
  6. Gather qualitative feedback: Regularly collect structured feedback from parents, children and teachers on confidence, enjoyment and carry‑over to daily life.
  7. Review and adjust: Conduct quarterly reviews of data to identify patterns and refine the programme.
  8. Benchmark externally: Compare outcomes to published norms or similar services to contextualise results.
  9. Compile annual reports: Summarise findings into clear reports for parents and referrers, highlighting functional improvements.
  10. Frame your messaging: Emphasise that gaming and outdoor play are therapeutic means to improved participation and well‑being rather than ends in themselves.