The Occupational Outcome & Energy Scale (OESS)

At Empower Neurodiversity, I use a practice-developed framework called the Occupational Outcome & Energy Scale (OESS).

The OESS was created in response to a recurring theme in neurodivergent adults:

Success in occupation is not only about skill or motivation. Rather, it is deeply influenced by energy capacity, values alignment, and the cost of participation.

Why Energy?

• Many neurodivergent people experience:
• Fluctuating cognitive and sensory energy
• Burnout and post-exertional fatigue
• High effort associated with masking or social participation
• Executive functioning fatigue
• Mismatch between demands and internal capacity

Traditional outcome measures often focus on performance or satisfaction. The OESS additionally explores the energy cost of occupation, recognising that participation is only sustainable when it is energetically viable.

The Values Component

A core part of the OESS is its values alignment element.

Occupations are explored not only in terms of:

• Performance
• Frequency
• Energy demand

But also:

• Personal meaning
• Identity alignment
• Values congruence

This reflects the understanding that:

An occupation that aligns with personal values may feel energising, while one that conflicts with identity or requires masking may significantly drain energy, even if performed successfully.

By combining:

• Energy capacity
• Occupational engagement
• Personal values

the OESS supports more authentic, sustainable goal setting.

How It Is Used

The OESS is:

• A collaborative reflective tool
• Used to support shared understanding
• Designed to guide intervention planning
• Applied consistently within practice

It helps identify:

• High-cost occupations
• Values/energy mismatches
• Risk factors for burnout
• Opportunities for occupational adaptation
• Professional Transparency

The OESS is a practice-developed framework informed by established occupational therapy models and principles. 

It is not a standardised or validated outcome measure. It is used to enhance clinical reasoning, support collaboration, and ensure that interventions prioritise sustainable, values-aligned participation.