The clinic is led by Dr. Laura Nicholson, MD, MPH, a developmental pediatrician who has spent more than a decade building interdisciplinary evaluation services for children in Montana. Rocky Mountain College OTD faculty member Dr. Paula Kitzenberg, an occupational therapist who has been a central participant in MtDAC’s clinical team, will guide students through their role in the clinic. Nicholson’s work in developmental assessment dates back to 2010, when a group of Montana professionals identified a critical gap: children with complex, hard-to-diagnose developmental conditions had nowhere in the region to receive a full interdisciplinary evaluation. The result was a pair of state-funded evaluation clinics in Billings and Great Falls, run through Montana’s Developmental Disabilities program.
That funding disappeared in 2017, and with it, the clinics.
Nicholson “retired” in 2021, but the need for the service didn’t go away with her. She partnered with the MSUB Neurodiversity Center to launch the Montana Developmental Assessment Clinic and secured sponsorship from STEP to keep it running, this time with a narrower and more urgent focus: autism and social communication disorders, among the most difficult childhood diagnoses to identify and among the most time-sensitive, since early intervention significantly changes outcomes. MtDAC now serves children ages 18 months to 12 years old, evaluating roughly 100 children a year through a team-based model that combines general developmental assessment, speech and language evaluation, occupational therapy, medical evaluation, and a direct autism assessment (the ADOS).
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The full clinical team meets after each evaluation to align on diagnosis and recommendations before Nicholson delivers feedback directly to the family. The clinic is entering its fifth year, and Nicholson says state Developmental Disabilities funding for developmental assessments may eventually bring MtDAC into a broader public developmental assessment system. Rocky Mountain College OTD students will step directly into that clinical process. Under Kitzenberg’s supervision, students will conduct fine motor skill assessments and sensory evaluations, the specific pieces of the evaluation that fall under occupational therapy’s scope. Students then join the full clinical team discussion, where Nicholson requires them to present their findings and recommendations in language the entire interdisciplinary team, and eventually the family, can understand.
“They are an integral part of the assessment,” Nicholson said of the OTD students’ role. “These are our future local occupational therapists, so we are excited to participate in their education.”
Kitzenberg brings years of experience integrating OT students into MtDAC’s clinical model from her prior work in occupational therapy education before joining Rocky Mountain College’s faculty. That continuity means Rocky’s OTD students are stepping into an already-proven training structure. For Rocky Mountain College’s OTD program, the partnership delivers something rare in doctoral-level occupational therapy education: a fully functioning clinic, serving real clients with real diagnostic stakes, built directly into the program. Students won’t wait until fieldwork placements to apply their training. They’ll be collaborating on assessing, discussing, and presenting findings on live cases starting their first year.
The first MtDAC clinic session with Rocky Mountain College OTD students begins September 11. Rocky Mountain College’s Occupational Therapy Doctorate program prepares students for careers as licensed occupational therapists through a curriculum grounded in hands-on fieldwork, small cohort mentorship, and early, direct clinical experience. The program is based in Billings, Montana.
