Shenandoah University alumni siblings Sarah Limoges ’25, OTD, and Matthew Thompson ’17, ’19, MSOT, recently turned their shared Shenandoah occupational therapy training into Pathway Pioneers, a Clarke County, Virginia-based business that provides pediatric occupational therapy in the home and inclusive activities for neurodiverse children throughout the region. 

Both have separate jobs in the occupational therapy field – Thompson works for Frederick County Public Schools while Limoges is employed at a clinic and is an adjunct OT professor at Shenandoah – but they could see the need for something more within the pediatric community in the region they’ve always called home. “We want to really see our community thriving,” Limoges said. 

A different OT experience

As the Pathway Pioneers website states: “Our treatment model goes beyond the clinic walls — we work with children in natural, real-world environments such as parks, farms, client homes, community spaces, and even doctor or dentist offices. These settings are intentionally chosen to support meaningful skill development and generalization into everyday life.”

Raised in a Clarke County household with a mother who was a special education teacher for more than 20 years and who, at one point, also ran a home daycare that included children with special needs, the siblings grew up understanding the deep importance of inclusion for children. 

That’s why Pathway Pioneers, established in 2025, isn’t the typical occupational therapy provider. “We like to take it to the next level,” Thompson said, noting that the business’s name truly reflects its goals – it is pioneering pathways for children and families. “There’s more that OTs can do,” Limoges said. 

Their work with Pathway Pioneers covers everything from teaching feeding skills to helping children learn how to play on a playground. Thompson and Limoges model behavior in environments where the skills are used. They may eat with their young client at home or teach them self-care skills there, or play with them on the playground, Limoges said. 

Bringing children together

Along with providing individual services, the pair has also developed an inclusive co-op, where a group of children can learn social skills while having fun. Additionally, it offers the Free 2 Be Me inclusive 4-H club; a Rhythm and Rhyme group, which utilizes singing, dancing and art; small social groups where children build skills together through shared activities; summer camps; and even holiday parties.  

When it comes to teaching social skills, the siblings offer gentle, neuroaffirming guidance, providing examples like, “I like to say it this way.” 

Ultimately, their goal as occupational therapists is to make sure that children can do what they need to do and what they want to do in their daily lives, Thompson said. In the best moments, Limoges added, it feels like they’re helping to positively change the trajectory of a child’s life. It feels great, Thompson said, when parents note how much more their children can do after taking part in occupational therapy. 

Limoges recalled the effect on one child, who participated in a summer camp in which Pathway Pioneers was involved. The child’s mother asked if the child was just hanging out with adults, which is what she expected. Limoges said they could happily report that no, instead the child interacted quite happily with the other children.

A new program on the way

Thompson said he and Limoges are getting set to launch a new program soon – the Inclusive Leadership Neurodiversity Program – which will teach neurotypical young people to be good buddies/friends with neurodiverse students.