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Occupational Therapy for Kids

One can argue that, for some children, receiving occupational therapy services as a child, may determine whether he/she will struggle or THRIVE through the entire school journey.

Let's Talk About It:

When Sarah was a baby, instead of crawling, she learned to make her way around by “bunny hopping.” She amused her family members by positioning herself cross-legged and POPPED up to inch forward. It was working for her, so her parents thought little about it.

Sarah made it to first grade before it became apparent to her teachers that she was trailing behind peers in all fine motor areas. They referred her to occupational therapy.

Thankfully, I had to opportunity to work with Sarah, strengthening her core, entire upper body, and hand musculature. We continued to employ a variety of OT interventions to get Sarah developmentally up to par. She was eventually excelling in school, sometimes even surpassing her classmates, as she found a fondness for art once she became stronger.

What Sarah’s parents didn’t realize was that Sarah was missing out on a crucial part of development. Crawling is a time when the right and left brain hemisphere learn to communicate efficiently for cross lateral movement. It’s when the hand arches become strengthened through weight bearing and is the precursor for a plethora of skills.

Early intervention is particularly important because weird quirks or minor delays not addressed right away, can persist through early and late childhood or even into one’s adult years. Often, these seemingly inconsequential problems may progress and become invasive to the child’s everyday life.

Occupational therapy enables individuals of any age or ability, to engage in the activities (occupations) that are important to them to live a meaningful life.

…but what about children?

Do Children Have Occupations?


From babyhood, the most important occupation for a child is one that we, many times, forget as adults: PLAY!

Play is how kids learn to interact with their environment and master new skills.

As children grow, their occupations expand, as well.

The child’s occupations include ADLs, Education, Sleep/Rest, and Social Participation along with Play.

In pediatric occupational therapy, OTs will actually utilize play as the mode to improve other occupational areas.

Play can be multifaceted in the skills that each activity requires, and therefore, one activity can work to strengthen multiple skills.

For example,

If a child is struggling to button his pants, (an ADL,) the OT might introduce a button sandwich game (Play) where the child buttons on different sandwich fillings.

This kind of game keeps a child motivated to repeat the buttoning motion multiple times.

With creativity, this activity can also challenge the child’s motor planning skills, memory, and visual discrimination.

With the bread on one side of the room and the fillings on the other, the therapist can provide verbal cues.

The therapist may say, “Crawl like a bear to get the mustard and pickles to button on your sandwich.”

What are the Goals in Occupational Therapy for Children?

Occupational therapy is always client centered.

When the client is a child, parents and teachers become valuable parts of the collaborative process as well. The can provide insight into the child's abilities, habits, routines, and be active in implementing OT suggested carryover activities to strengthen outcomes.

Other members of the treatment team might be a speech therapist, physical therapist, social worker, etc.

As a team, we communicate our observations and concerns. Then we each craft measurable goals, along with a treatment plan tailored carefully to the child.

The child’s goals, progress, and related information from all service providers is compiled into a comprehensive report.

For children ages 0-3, this report is known as an IFSP (Individualized Family Service Plan)

Children ages 3-18, have an IEP (Individualized Education Program).

The occupational therapist will address the OT goals using evidence-based practice models

He/she will also provide education, home exercise plans (HEP), and consultation to families, as needed.

How do I Know If My Child Needs OT?

  • Delayed or Skipped Milestones

  • He/she can’t keep up with peers during play or educational activities

  • Sensitivity or Lack of Sensitivity to Motion, Smell, Touch, Sound

  • Child is “clumsy” - Bumping into Objects or Others

  • Weakness in Core, Upper Body, or Hands

  • Easily Distracted (in either direction) Spacy or Hyper

  • Low Energy or High energy

  • Unable to Follow Directions

  • truggles to Manipulate Age Appropriate Toys

  • Inept at Dressing, Toileting, or Grooming

  • Illegible Handwriting

  • Fatigue During Writing or Coloring

  • No Hand Dominance

  • Drooling

  • Mouthing or Biting

  • Pressing Too Hard or Too Lightly on Pencil

**If any of these areas are being affected for your child, consult with an occupational therapist.

An OT will work to discover the underlying reason for the lapse in development, whether it’s a particular muscle group weakness, visual motor skill deficit, or a sensory processing issue, etc.

What Skills Do Pediatric Occupational Therapists Work On?

  • Body awareness

  • Moderating Tone – Low or High Tone

  • Visual Processing Skills

  • Fine Motor Skills

  • Sensory Processing

  • Object Manipulation

  • ADLs/Self-care

  • Play Skills

  • Social Skills

  • Muscle Strength in the Upper Body, Core, and Hands

What Childhood Diagnoses Can Benefit from OT?

  • Autism

  • Birth Defects or Injuries

  • Hand Injuries

  • Traumatic Brain Injuries

  • Stroke

  • Sensory Processing Disorders

  • Chronic Illnesses

  • Cerebral palsy

  • ADD

  • ADHD

  • Down Syndrome

In Conclusion

Never underestimate the impact early intervention occupational therapy can have on a child!

Children’s brains are malleable, and they are developing at such a rapid rate, making it the most crucial time to enter treatment as it is the most powerful.

With the right occupational therapist, the progress in early childhood can be astounding.

If you have an OT concern for a student or your own child, reach out to an OTR/L!!


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