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Does my child need occupational therapy?

Occupational therapy (OT) for young children is typically recommended when there are concerns or delays in the development of certain skills. A child might need occupational therapy if they have a Developmental delay, Fine and Gross motor skills challenge, Autism, Neurological disorder, Sensory processing issue, and Behavioural challenges. The decision to pursue OT is often based on an evaluation of the child's developmental, sensory, motor, and cognitive abilities.

Here are some common reasons why a child might need occupational therapy at different age levels:



An OT with a child




















Occupational Therapy for 2-Year-Olds:


  1. Motor Skill Development: Occupational therapy can help if a child is experiencing delays in achieving age-appropriate motor milestones, such as crawling, walking, or using hands for play and exploration.

  2. Sensory Processing Issues: Children who show signs of sensitivity or aversion to sensory stimuli, such as textures, sounds, or lights, may benefit from sensory integration activities provided by an occupational therapist.

  3. Feeding Difficulties: If a child is experiencing challenges with feeding, such as difficulty transitioning to solid foods, aversions to certain textures, or oral-motor difficulties, occupational therapy can be beneficial.

  4. Behavioral Concerns: Occupational therapists can work with parents and caregivers to address behavioral challenges, such as difficulties with transitions, sensory meltdowns, or self-regulation issues.

  5. Speech and Language Development: If a child is exhibiting delays in speech and language development, occupational therapists may work on activities that support oral-motor skills, communication, and interaction.


A small kid playing with toys

A general checklist of developmental milestones for a 2-year-old that may help you identify if your child might benefit from occupational therapy (OT).

Here's a checklist to consider:


  1. Fine & Gross Motor Skills:

  • Can your child use a spoon and fork?

  • Is your child able to stack blocks or other small objects?

  • Can your child walk steadily and without falling?

  1. Sensory Processing:

  • Does your child react appropriately to sensory stimuli (lights, sounds, textures)?

  • Is your child sensitive or avoidant to certain sensory experiences?

  1. Social and Emotional Development:

  • Does your child show interest in playing with other children?

  • Is your child able to make eye contact and respond to their name?

  1. Communication Skills:

  • Is your child using a variety of words to communicate?

  • Can your child follow simple instructions?

Occupational Therapy for 3-Year-Olds:


  1. Fine and Gross Motor Delays: Children may be referred for occupational therapy if they exhibit delays in the development of fine motor skills (e.g., holding a pencil, using scissors), hand-eye coordination, or manipulation of objects or gross motor skills (e.g., balance, coordination).

  2. Sensory Processing Challenges: Occupational therapists can address sensory processing issues that may impact a child's ability to focus, self-regulate, or engage in daily activities.

  3. Self-Care Skills: OT can assist in developing independence in self-care activities such as dressing, grooming, and toileting.

  4. Social and Play Skills: If a 3-year-old is struggling with social interactions, making friends, or engaging in age-appropriate play, occupational therapy can provide support in developing these skills.

  5. Behavioral Challenges: Occupational therapists can work with parents and caregivers to address behavioral concerns, including difficulties with transitions, self-regulation, and coping strategies.

An infographic on Sensory Regulation

A general checklist for developmental milestones in a 3-year-old that might help identify the need for occupational therapy:


  1. Fine & Gross Motor Skills:

  • Is your child able to hold a crayon or pencil with a somewhat mature grip?

  • Can your child run, jump, and climb with coordination?

  • Is your child able to throw and catch a ball with some accuracy?

  1. Self-Help Skills:

  • Can your child dress and undress themselves to some extent?

  • Can your child use the toilet with minimal assistance?

  1. Communication Skills:

  • Is your child using sentences and a growing vocabulary?

  • Can your child follow two or three-step instructions?

  • Does your child attempt to engage in conversations with others?

  1. Play Skills:

  • Does your child engage in imaginative or pretend play?

  • Can your child play cooperatively with other children?

  1. Attention and Concentration:

  • Does your child show an increasing ability to focus on tasks?

  • Can your child complete simple puzzles or games that require attention?



Occupational Therapy for 4-Year-Olds:


  1. Fine Motor and Handwriting Skills: If a 4-year-old is struggling with pre-writing skills and handwriting readiness, occupational therapy can provide activities and exercises to enhance hand strength, grip, and control.

  2. School Readiness: For children preparing for kindergarten, occupational therapy can focus on developing skills needed for successful participation in a classroom setting, including attention, concentration, and following directions.

  3. Sensory Integration: Children who demonstrate challenges in sensory processing, such as being overly sensitive or under-reactive to sensory stimuli, may benefit from occupational therapy to help regulate their responses and improve their ability to engage with the environment.

  4. Neurological or Developmental Conditions: Children with certain neurological or developmental conditions, such as autism spectrum disorder, ADHD, or developmental coordination disorder, may benefit from occupational therapy to address specific challenges associated with these conditions.

  5. Visual-Motor Integration: Some children may struggle with tasks that require coordination between visual perception and motor skills, such as copying shapes or letters. Occupational therapy can address visual-motor integration challenges.


An infographic on Visual Motor & Perceptual Skills

A general checklist for developmental milestones in a 4-year-old that might help identify the need for occupational therapy:


  1. Fine & Gross Motor Skills:

  • Can your child use scissors to cut along a straight line?

  • Is your child able to draw basic shapes and perhaps some letters or numbers?

  • Can your child hop on one foot and balance briefly?

  1. Self-Help Skills:

  • Can your child dress and undress independently, including buttons and zippers?

  • Is your child starting to manage basic hygiene tasks, like brushing teeth or combing hair?

  1. Social and Emotional Development:

  • Does your child engage in cooperative play with other children?

  • Can your child express a wide range of emotions and understand others' emotions?

  1. Communication Skills:

  • Is your child using clear and complex sentences to communicate?

  • Does your child ask and answer questions appropriately?

  1. Attention and Concentration:

  • Can your child focus on a task for an extended period and complete simple puzzles?

  • Is your child able to listen and follow more complex instructions?


Occupational Therapy for 5-Year-Olds:


  1. Attention and Concentration: Children who have difficulties sustaining attention, staying focused, or completing tasks may benefit from occupational therapy interventions to enhance attention and concentration skills.

  2. Emotional Regulation: Occupational therapists can work with children to develop strategies for emotional regulation, helping them manage and express their emotions appropriately.

  3. Organizational Skills: Occupational therapy can assist in developing organizational skills, which are essential for tasks such as keeping track of belongings, following routines, and managing personal space.

  4. Executive Functioning Skills: Developing executive functioning skills, such as planning, organizing, and problem-solving, can be an area of focus in occupational therapy for a 5-year-old.

  5. Visual Perception: Occupational therapists can address visual perception skills, including spatial awareness, visual discrimination, and figure-ground perception, which are crucial for various academic and daily living tasks.

A general checklist for developmental milestones in a 5-year-old that might help identify the need for occupational therapy:


  1. Fine & Gross Motor Skills:

  • Can your child use scissors to cut along more complex shapes?

  • Is your child able to draw recognizable objects and perhaps write some letters or numbers?

  • Is your child able to throw and catch a ball with greater accuracy?

  1. Self-Help Skills:

  • Can your child tie shoelaces or fasten buttons independently?

  • Is your child becoming more independent in personal hygiene tasks like bathing and dressing?

  • Can your child use utensils to eat with minimal assistance?

  1. Sensory Processing:

  • Does your child appropriately respond to various sensory stimuli in their environment?

  • Is your child still sensitive or under-responsive to certain sensory experiences?

  • Can your child adapt to changes in sensory input and maintain attention in various situations?

  1. Social and Emotional Development:

  • Does your child engage in more complex play with other children?

  • Can your child express themselves clearly and articulate their needs and feelings?

  • Is your child showing increased empathy and understanding of social norms?

  1. Communication Skills:

  • Is your child using more complex sentences and expressing thoughts coherently?

  • Can your child engage in conversations, ask questions, and provide relevant information?

  1. Play Skills:

  • Does your child engage in more elaborate imaginative play with detailed storylines?

  • Can your child follow and create more complex rules in games?

  • Is your child interested in a variety of creative activities, such as drawing, building, and crafting?



Children may require occupational therapy for a combination of these reasons, and early intervention can be crucial in addressing developmental concerns. If you have concerns about your child's development, then please consult with our occupational therapist for a comprehensive assessment.



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