Occupational therapy services can be delivered in a variety of ways depending on the child's strengths and areas of difficulty. Direct occupational therapy services consist of group or individual sessions provided in class or out of class (pull out) where the child's specific goals are addressed through hands on purposeful activity. Indirect services, such as consultation and/or monitoring are provided to those children who have achieved specific goals or who require more adaptation rather than remediation. Consultation is an ongoing communication between the therapist, parent, teacher and student where problem solving and trial of different adaptations and environmental changes are used to allow a student to function optimally in their educational environment without the need for direct services.