What do parents of preschoolers expect to hear when they get that first call from a concerned teacher? “Your child doesn’t listen. Your child has a biting problem. Your child calls everyone stupid.” and much more, but when Ms. Nour was pulled aside by her son’s pre-K teacher, the issue was different: Her son couldn’t write.

He could hold a pencil, but not correctly. His letters were barely distinguishable. Straight lines and simple shapes were impossible. The teacher urged Ms. Nour to get her four-year-old son some extra help. She told her to seek help from an Occupational Therapist.

So, what is “Occupational Therapy”?

Occupational therapy (OT) helps people who struggle to complete everyday tasks (activities of daily living). For kids, that includes playing, learning, and performing well at school.

Occupational therapy is a treatment that helps to improve fine and gross motor skills. It can help kids who struggle with self-regulation and sensory processing as well.

Occupational therapy is adapted to a child’s specific needs. Before it begins, an occupational therapist (an OT) inspects a child’s strengths and challenges, then creates a plan of activities for the child to work on.

Pediatric occupational therapy aims to help children become independent in areas of life appropriate for their age. Signs that your child might need occupational therapy include:

Difficulty achieving age-appropriate developmental milestones:

If a child has difficulties developing common skills during a particular age or a specific period.

For example:

• Not reaching developmental milestones of neck holding, sitting, crawling, and walking on time.
• Not learning at an age-appropriate level.
• Not developing age-appropriate play and social skills
• Not pointing or communicating age appropriately.

Inappropriate Social Interaction:

Your child may show delayed social skills if you observe some of the following traits:

• Avoiding appropriate eye contact while talking.
• Difficulty interacting socially with family and peers.
• Difficulty interacting, engaging, and play with peers age appropriately.
• Difficulty adapting to new environments and large gatherings.
• Delayed communication or language skills.
• Can’t cope in the school environment.

Inadequate or Inappropriate Play Skills:

Play is an essential activity in children for developing age-appropriate skills and exploring the world around them.

Children can build their motor skills and cognitive skills, learn problem-solving, and develop social skills through play.

It’s recommended to consult an OT if you notice that your child:

• Does not explore toys appropriately.
• Engages in repetitive play for hours (e.g., lining up toys, flicking car wheels while watching them spin…).
• Prefers to play alone rather than with an adult or peer.
• Is constantly on the go without purposeful play.
• Has short attention span, moves quickly from one activity to the next.
• Shows difficulty in joining with peers/siblings when playing.
• Does not understand concepts of sharing and turn-taking.

Issues with gross motor and fine motor skills:

Gross Motor (physical) skills involve the large (core) muscles of the body to perform everyday functions like standing, walking, running, and sitting upright. It includes eye-hand coordination skills such as ball skills (throwing, catching, kicking) as well. A child having low body tone and strength and/or balance difficulties may appear uncoordinated or clumsy. They may have difficulty in these areas:

• Unable to roll, throw, catch or kick a ball age appropriately.
• Climbing up and downstairs at an age-appropriate time.
• Coordinating both sides of the body.
• Understanding the concept of right and left.
• Poor balance and coordination.
• Low muscle tone.
• Poor endurance gets tired easily (or avoids physical games and activities).

Fine motor skills include the hands’ muscles such as writing, cutting, holding a small object, picking up a spoon, and tying shoelaces.

If your child is struggling with fine motor skills, they may have trouble with:

• Developing a hand dominance at an age-appropriate time.
• Using both hands appropriately.
• Manipulating toys and puzzles.
• Holding a pencil or writing tool or using scissors.
• Poor pencil grip, poor handwriting (letter/number formation).
• Coloring, drawing, tracing, prewriting shapes.
• Using zippers, buttons, shoelaces.
• Avoiding tasks and games that require fine motor skills.

Sensory Processing Disorders:

A child with sensory processing concerns may have difficulty using senses (vision, sound, touch, smell, taste, body awareness, balance, and body position in space).

Suppose you have noticed the sensory issues and think your child’s sensory behaviors interfere with their ability to focus or complete day-to-day activities. You might need to consult a pediatric occupational therapist.

An occupational therapist can help you identify the sensory issues and propose strategies to help the child. An OT might also design a sensory diet. This carefully designed program is a series of physical activities to give each child the right amount of sensory input they need.

Learning challenges:

Learning challenges are another type of developmental delay. If your child is challenged by one of the following, you may want to consult an occupational therapist if your child:

• Can’t concentrate and focus at school.
• Distracts easily.
• Fails to follow instructions and complete work.
• Tires quickly with school work.
• Exhibits poor impulse control.
• Shows hyperactivity or low energy.
• Fails to keep up with workload at school.
• Displays difficulty learning new material.
• Makes letter or number reversals after age seven.

Occupational therapy can help kids with various needs to improve their cognitive, physical, sensory, and motor skills and enhance their self-esteem and sense of accomplishment.