What is Occupational Therapy?

Pediatric occupational therapists work to improve the function and independence of children and teens with disabilities, injuries, or illnesses. They provide therapeutic interventions that help develop their fine motor skills, visual motor and visual perceptual skills, work on increasing independence for self-care skills and improve sensory processing skills. Through play, children develop age appropriate skills while also building up their confidence and self-esteem.

When to Get an Assessment

One of the first things I tell parents I talk to is to go with their gut. Parents know their children better than anyone and if you feel like something isn’t right or you see your child struggling, reach out and see if your child should be evaluated. Some of the many reasons parents or teachers seek out evaluations are the following:

a child has developmental delays and is not reaching milestones as expected
a child presents with sensory processing difficulties such as increased energy, difficulty with focus and attention, tactile defensiveness, picky eating and difficulty with self-regulation.
a child seems overly sensitive to clothing and different textures
delayed fine motor skills
a child is having handwriting challenges in school
a child is clumsy tripping and falling more often than what is considered normal
a child is low-tone and has difficulty sitting up for long periods of time, leans on other people or asks to sit in your lap during circle time
a child has difficulty with routines and transitions and experiences increased meltdowns during these times

Newborn to 6 Months

child will open and close fists
child brings hand to mouth
child will hold a toy in their hands
child uses arms to purposely swing at toys
child brings hand to mouth consistently
child pushes up onto elbows/forearms when on their tummy

6 to 12 Months

child uses consistent and purposeful reach
child moves an object between hands
child begins to finger feed when eating large foods
child will lean on hands during supported sitting
child begins to use finger to poke objects
child will use purposeful grasp and release patterns when putting objects in a container
child will use a raking grasp to pick up smaller objects
child develops a pincer grasp to pick up small objects/cereal
child begins to imitate tool use; for example, hair brushing, brushing teeth, etc.
child uses hands to push, pull, squeeze, rotate toys
child removes socks

1 to 2 Years

child begins to feed self using hands or age appropriate utensils
child points to people and objects using their pointer finger
child completes simple shape puzzles
child brings hands to midline for functional use
child holds crayons with a fisted grasp
child can stack 2-6 blocks

2 to 3 Years

child feeds self using utensils and begins to drink from an open cup with minimal spillage
child can screw and unscrew lids on containers
child can string a series of larger beads
child imitates vertical and horizontal lines and a circle
child holds a writing instrument using fingers and their thumb with a pronated wrist
child begins to use scissors to snip into paper
child can stack up to 8 blocks
child can put together 4-12 piece interlocking puzzles

3 to 4 Years

child independently feeds self using utensils and drinks from an open cup with little spillage
child strings small beads
child can manipulate snaps, begins to assist with zippering and begins to manipulate larger buttons with assistance
child can fold/crease a piece of paper
child can imitate a cross with bisecting lines
child can draw a person with two body parts
child holds writing instruments with thumb and fingers
child can cut a piece of a paper in half
child can cut on a thick, straight line
child can stack up to 10 blocks
child can imitate simple block designs (train, bridge and wall)
child can put together 24 piece interlocking puzzles

4 to 5 Years

child independently feeds self with utensils and drinks from an open cup with no spillage
child imitate blocks designs with 4-6 blocks
child manipulates buttons
child can lace sewing cards/boards
child can manipulate all types of fasteners
child can imitate diagonal lines, a square, triangle and an “X”
child can draw a person with at least 3 body parts
child can cut out simple shapes (circle, triangle and square)
child can put together 48 piece interlocking puzzles

5 to 6 Years

child can build complex designs with Legos and other types of manipulative building toys
child can copy uppercase letters
child can write their name
child can draw a person with all body parts and draw more complex pictures
child can cut out more complex shapes and pictures
child can dress themselves independently, including smaller buttons, snaps and initiating the catch of a zipper
child can put together 100 piece interlocking puzzles