7 Signs Your Child Needs Occupational Therapy

All children develop at different rates, and no two children are alike—even among siblings and children who grow up in the same environment. 

If your child is delayed in reaching their physical milestones or if they look like they may be struggling with physical movement in general, seeking expert help from a pediatric occupational therapist is something to consider.

If you’re at a point in parenting where you’re wondering if your child may benefit from pediatric occupational therapy (also known as pediatric OT), we’re here to help. Knowing how to recognize the signs a child may need pediatric OT is the first step toward getting them the professional assistance they need to develop and thrive.

In this guide, we break down:

• What pediatric occupational therapy (OT) for kids is

• How pediatric occupational therapy can help children

• The 7 signs your child may need pediatric occupational therapy

• How long a child may need pediatric occupational therapy

• How to get started with pediatric OT

What is occupational therapy for kids? 

“Occupational therapy for kids really focuses on helping kids participate in their everyday, daily activities,” says Lindsey Wood, MOT, OTR/L, and founder and CEO of Eat. Play. Love. Occupational Therapy Inc. 

For kids, these everyday activities include things like:

• Playing

• Learning

• Regulating their minds, bodies, and emotions

• Learning or gaining independence with self-care

• Interacting with others

When it comes to defining pediatric occupational therapy, it helps to remember that an occupation is anything that occupies your time, and so when it comes to kids, Wood says it’s “essentially their job to play, learn, interact socially, and regulate.”

After an evaluation session with your child, their pediatric occupational therapist will create a customized care plan that includes the short-term and long-term goals for your child. They will track progress over time and see if your child is moving toward or meeting their individualized goals.

When children go to pediatric OT sessions, it may look a lot like playing games, going through obstacle courses, pretend play, and fun movement. In reality, their therapist has created an enriching environment filled with child-centered activities that are helping them learn valuable skills like physical movement, self-regulation, and self-care. “Everything we do in therapy is very intentional at addressing the underlying skills that we’re supporting,” Wood says.

How can occupational therapy help children?

The goals for your child will be outlined in the care plan their therapist creates for them. Your child may go to OT for one specific reason or with one goal in mind, but they’ll learn other valuable skills along the way as well. 

Pediatric occupational therapy can help children:

• Learn the physical skills they need to work toward or meet physical milestones

• Boost their gross motor skills and fine motor skills 

• Support their sensory systems

• Work on their emotional regulation

• Build their self-care skills

• Improve their relationships with others

Pediatric OT is tailored to each child’s needs, so your child’s therapist will meet them where they’re at and change and adapt their activities on the fly as needed, Wood says. 

Why would a child need occupational therapy?

If you’ve been thinking about whether your child could benefit from pediatric OT, there are a few things to look out for that could signal they could use the additional support of a therapist. Here, Bindi Gudhka, MA, OTR/L, SWC, and founder of Play Connections, shares the 7 signs your child may need occupational therapy. 

1. Your child experiences sensory processing challenges.

When it comes to sensory processing challenges, these children may be constantly moving, climbing on furniture, not following directions, or have a hard time transitioning from one activity to another, Gudhka says. 

Oftentimes, these sensory processing challenges are discovered once a child starts school or daycare and their teachers notice. There’s a lot of stimuli in a school environment, as well as more tactile, hands-on experiences like going outside to the playground, playing in a sandbox or sensory bin, painting with fingers or hands, and doing crafting activities—all of which may bring sensory processing issues to the surface.

2. Your child has attention or cognitive awareness issues.

Similar to the sensory processing challenges, school or daycare may be the first place you discover your child may have attention or cognitive awareness issues. In this case, Gudhka says their teacher may notice that they’re not able to sit during circle time like other kids, or they may not be able to follow along with someone reading a book or singing a song during class.

3. Your child is having difficulty with their social participation or play skills. 

Social participation in young children is often centered around play, so recognizing when their play skills may need some additional support could be another sign. 

Gudhka says some behaviors that could benefit from OT may include:

• A child who doesn’t play and who instead moves around a room from place to place with no engagement 

• A child who doesn’t interact with toys and instead only grabs or throws them

• A child who doesn’t know how to play in a meaningful, engaged way

There are different developmental stages of play, so things can progress and develop over time. Your child’s teachers are a great resource if you have any questions or concerns around their play skills.

4. Your child has delays in fine motor and/or gross motor skills. 

Pediatric occupational therapy can help children develop and improve their fine and gross motor skills. 

Fine motor skills are the movements that use the smaller muscles in the body, like the hands and fingers. According to the Cleveland Clinic, fine motor skills can include things like:

• Handwriting, coloring, or drawing

• Cutting with scissors

• Buttoning a button

• Tying shoes

• Holding and using utensils

If your child struggles with fine motor skills, they may avoid or struggle with activities like arts and crafts (such as coloring a picture or cutting out a shape with scissors), writing with a pencil, or getting dressed by themself (such as asking someone to button their shirt or tie their shoes for them).

Gross motor skills are the movements that use the large (gross) muscles in the body or the entire body, like the core, arms, and legs. According to the Cleveland Clinic, gross motor skills can include things like: 

• Walking

• Running

• Jumping

• Standing

• Sitting up

If your child struggles with gross motor skills, they may appear clumsy or show issues with balance, and they may avoid certain playtime activities like riding a tricycle or playing on a play structure. 

5. Your child shows major emotional dysregulation on a frequent, daily basis.

Emotional dysregulation can show up in children in different ways, and it may leave you feeling like you’re walking on eggshells all the time. Tantrums are the most obvious sign of emotional dysregulation, especially when tantrums happen frequently, it takes a long time to calm your child down, or tantrums lead to aggressive behavior (like biting, hitting, pushing, or kicking), Gudhka says.

“The minute parents start realizing that, wait, this feels harder than it should be, I think that's a sign because it shouldn't be that hard,” Gudhka says. “There might be an underlying reason why it feels that challenging.”

6. Your child struggles with self-care skills appropriate to their age.

Self-care skills like getting dressed are an important part of a child’s day-to-day life, and if they’re struggling with these types of skills, it can lead to tantrums and frustration. 

For example, Gudhka says by at least 3 years old a child should be able to do some simple self-care skills, such as taking off their clothes by themself and pulling their own pants up. If your child is struggling with a morning or evening routine and the self-care skills involved, pediatric OT could help them build their skills.

7. Your child has a certain condition or genetic syndrome that may benefit from occupational therapy.

According to the Cleveland Clinic, some conditions that benefit from pediatric OT include:

• Sensory processing disorder (SPD)

• Autism spectrum disorder (ASD)

• Attention-deficit/hyperactivity disorder (ADHD)

• Down syndrome

• Cerebral palsy

• Developmental delays

Gudhka adds that other children who may need pediatric OT include:

• Babies who were born prematurely or who spent time in the NICU

• Babies who experienced birth trauma 

• Children who had a G tube or an oral-nasal tube

Occupational therapy is one important piece in the treatment plans for children living with these conditions or genetic syndromes.

How long does a child need occupational therapy?

All children progress at their own individualized rate, so how long a child needs pediatric OT will depend on the skills they’re working on, the goals they’re aiming for, and on your child and their progression. The specific skills and goals for your child will be outlined in the personalized care plan their pediatric occupational therapist creates for them. Your child’s therapist will walk you through the care plan for your child and what kinds of goals they have set based on their evaluation. 

How to get started with pediatric occupational therapy

Pediatric occupational therapy can help children improve their physical, emotional, social, and self-care skills, making things easier for them and you as they learn valuable everyday skills.

Village can help you coordinate and find the care they need. Book a free consultation to learn how we can help you match with the best pediatric occupational therapist for your child.

References:

• Interview: Lindsey Wood, MOT, OTR/L, and founder and CEO of Eat. Play. Love. Occupational Therapy Inc.

• Interview: Bindi Gudhka, MA, OTR/L, SWC, and founder of Play Connections.

• Cleveland Clinic. Pediatric Occupational Therapy.

• Cleveland Clinic. Fine Motor Skills.

• Cleveland Clinic. Gross Motor Skills.