There are many signs that parents can look for that may indicate a need for an occupational therapy referral. Two main questions to ask yourself are: “Does my child have difficulties with day-to-day activities at home, school, or in the community?” and “Is my child experiencing challenges that do not affect typically developing children?” If you answered yes to the above questions, an occupational therapist may be able to help your child.
Occupational therapy is a treatment that supports a child and their family when they experience specific difficulties in the areas outlined below.
Developmental Delay
Developmental delay means that a child is behind in developing skills that are common during a particular age or during a particular time period. A developmental delay, however, is more than being a little behind other children in a skill; it is being behind in a combination of skills or not meeting developmental milestones. These are examples of developmental delays:
- Not reaching developmental milestones of sitting, crawling, and walking
- Not learning at an age-appropriate level
- Not developing age-appropriate play and social skills
Fine Motor Skills
Fine motor skills are small movements made with fingers, toes, wrists, lips, and tongue, like holding a small object or picking up a spoon. If your child is struggling with fine motor skills, they may have difficulty with one of these actions:
- Manipulating toys and puzzles
- Holding a pencil
- Using silverware or straws at an age-appropriate time
- Using scissors
- Using zippers, buttons, shoelaces
- Coloring, drawing, tracing, prewriting shapes
- Poor handwriting, letter/number formation
- Not developing a hand dominance at an age-appropriate time
- Avoiding tasks and games that require fine motor skills
Movement, Strength and Balance Development (Gross Motor Skills)
Gross motor skills help us move and coordinate our arms, legs, and other body parts. These skills involve larger muscles that help us control our bodies. A child who is behind in movement, strength, and/or balance may appear clumsy or uncoordinated. They may also have difficulty with these things:
- Going up and downstairs at an age-appropriate time
- Coordinating both sides of the body
- Understanding the concept of right and left
- Poor ball skills
- Poor balance
- Becoming fearful of feet leaving the ground
- Doesn’t cross the midline of his or her body during play and school tasks
- Avoids tasks and games that require gross motor skills
Visual Processing
Visual processing is the process we use to make sense of what we see. It is a process in our brain that interprets visual information. If your child has difficulty with one of these things, they may have difficulty with visual processing:
- Difficulty with the spacing and sizes of letters
- Difficulty with recognizing letters
- Difficulty with copying shapes or letters
- Difficulty with visual tracking and crossing midline
- Difficulty finding objects among other objects
- Difficulty with copying from the board or another paper
- Difficulty with the concept of right and left
You might notice that your child may lose his or her place when reading or copying from the board or may have poor eye contact.
Oral Motor/Oral Sensory
Oral motor or oral sensory skills are those that control muscle movements in the face and oral areas, such as the lips, jaw, tongue, and soft palate. Delayed oral motor and sensory skills can show in one or more of these ways:
- Excessive drool
- Chews food in the front of the mouth, rather than on the molars
- Difficulty using a cup at an age-appropriate time
- Difficulty with drinking from a straw at an age-appropriate time
- Lengthy bottle or breastfeedings
- Tiredness after eating
- Baby loses excessive liquid from his or her lips when bottle or breastfeeding
- Child loses excessive liquid or food from his or her mouth when drinking or chewing
- Child appears to be excessively picky when eating, only eating certain types or textures of food
- Child excessively mouths toys or objects beyond an age-appropriate time
Sensory Processing
Sensory processing refers to the way the brain receives information that we receive through our senses, like sound and smell. Your child may be oversensitive to things around them and show the following symptoms:
- Overly sensitive or heightened reactivity to sound, touch, or movement
- Under-responsive to certain sensations (e.g., high pain tolerance, doesn’t notice cuts/bruises)
- Constantly moving, jumping, crashing, bumping
- Easily distracted by visual or auditory stimuli
- Emotionally reactive
- Difficulty coping with change
- Inability to calm self when upset
Social Interaction Skills
Social interaction skills are skills that help us have relationships and understand those around us. They help us bond with other people in our life. Your child may have delayed social skills if they show some of the following things:
- Difficulty interacting socially and engaging with family and peers
- Difficulty adapting to new environments
- Delayed language skills
- Overly focused on one subject (e.g., space, universe, dinosaurs, trains)
- Can’t cope in the school environment
Learning Challenges
Learning challenges or learning disabilities are another form of developmental delay. If your child is challenged by one of the following, you may want to consult an occupational therapist:
- Unable to concentrate and focus at school
- Easily distracted
- Difficulty following instructions and completing work
- Tires easily with school work
- Poor impulse control
- Hyperactivity or low energy
- Not keeping up with workload at school
- Difficulty learning new material
- Makes letter or number reversals after age seven
Play Skills
Play skills are skills that can help a child make sense of the world around them. A child can gain self-confidence, learn problem-solving, and develop social skills through play. Your child may be developmentally delayed if they show one of the following symptoms:
- Needs adult guidance to initiate play
- Difficulty with imitative play
- Wanders aimlessly without purposeful play
- Moves quickly from one activity to the next
- Does not explore toys appropriately
- Participates in repetitive play for hours (e.g., lining up toys)
- Does not join in with peers/siblings when playing
- Does not understand concepts of sharing and turn-taking
Remember that all children are unique and develop these skills at their own pace.
However, if you think your child may be struggling with some of the skill areas above, you may contact us for a consultation.