Occupational Therapy

Occupational Therapy

Pediatric Occupational Therapy assists children in the development of self-care, play, and work skills. Self-care skills include feeding, dressing, hygiene, and self-regulation.

Play includes goal-directed activities, crafts, games, and imaginative/symbolic activities. Work includes educational and pre-vocational activities.

In order for the child to adapt and continue to develop, sensory processing(response to tactile, auditory, vestibular, olfactory and gustatory) must be intact.


An infant conforming to being held and calming when swaddled demonstrates intact sensory processing.Coordination of sucking, swallowing and breathing should be well established by three months. Messyplay should by enjoyed by a toddler.Hand skills are complex and develop over a long period from infancy to early adolescence. Intact sensory feedback is vital to development of mature hand skills.

  • 4 months – infant’s hand should be open.
  • 5 months – reaching and grasping of toys begins.
  • 7 months – transfer of toys from hand to hand.
  • 10-12 months – neat pincer grasp/finger feeding small pieces of food.
  • 16-18 months – uses both hands in midline (one to hold, one to manipulate)/holds and drinks from a cup.
  • 20-30 months – imitates drawing simple strokes/undresses with assistance.
  • 36-48 months – uses adult-like grasp with writing tools/dresses and undresses independently including buttons.

Developmental Warning Signs


Sensory Processing Disorder
a child is difficult to calm; prefers to be left alone or becomes very aggressive with other children; eye contact is poor; upset with tactile play (may even gag when touching/smelling wet/messy items); becomes stiff and resistive to imposed movement; difficulty attending


Motor Difficulties
both hands or one hand remains clenched beyond 4-5 months of age; infant/toddler uses one hand exclusively or skills of one hand obviously higher developed than other; a child is difficult to dress because arms are stiff and resistive to movement; difficulty reaching and grasping toys


Visual motor/Visual Perceptual Difficulties
unable to complete the simple puzzle; poor handwriting (number/letter reversals; difficulty with spacing and alignment; does not use left to right progression when writing); difficulty with scanning and depth perception; difficulty drawing/copying shapes and letters.