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When should a parent pursue Occupational Therapy for their child?

Parents should consider seeking an evaluation with an Occupational Therapist if their child demonstrates any of the following:

Birth to 2 months:

  • Does not grasp objects placed near palm

3 months:

  • Does not follow an object with his eyes
  • Hands remain closed almost all of the time
  • Frequently resists being held
  • Becomes upset when moved, as when being picked up, laid down, or handed from one familiar person to another

4 months:

  • Does not swipe at or reach for objects
  • Does not bring hands or objects to his mouth
  • Frequently irritable for no apparent reason
  • Does not place both hands on his bottle while being fed

5 months:

  • Does not hold his own bottle
  • Doesn't smile at his image in a mirror

6 months:

  • Involuntarily drops objects after only a few minutes
  • Does not actively grasp large finger foods such as teething cookies when they are placed on the highchair tray
  • Is excessively and consistently upset by leaving the home

7 months:

  • Does not transfer an object from one hand to the other

10 months:

  • Not beginning to pick up small objects
  • Does not poke with index finger
  • Is not accepting a variety of food textures
  • Is excessively upset by being dressed, diapered, bathed, or having hair groomed

12 months:

  • Isn't able to pick up a Cheerio or other small object with the tip of the thumb and the tip of the index finger
  • Is not sleeping through the night most of the time
  • Is not interested in exploring toys made for one year olds
  • Is excessively upset by sounds of: siren, barking dog, vacuum cleaner, or other familiar loud noises
  • Cannot pass an object from one hand to the other
  • Cannot pick up small objects

15 months:

  • Cannot put a one inch object into a container with a slightly bigger opening
  • Cannot stack two cubes
  • Cannot put a round form into a round shape on a puzzle
  • Has a hard time picking up small objects

18 months:

  • Cannot point to a few of the following body parts: eyes, nose, mouth, hair, tummy, legs, feet, and hands
  • Cannot turn pages of a cardboard book, or regular small book two or three pages at a time
  • Cannot stack four cubes

24 months:

  • Play with toys only by tapping, shaking, or throwing
  • Cannot unscrew top of a one inch or two inch bottle
  • Cannot remove socks, untie shoes, or pull on pants without help
  • Cannot build tower of six blocks
  • Does not use utensils well

30 months:

  • Cannot imitate drawing a vertical line or a circular scribble on paper immediately after seeing an adult draw these lines
  • Cannot stack eight to ten cubes
  • Cannot imitate drawing a horizontal line immediately after seeing an adult draw a horizontal line

36 months:

  • Cannot remove / pull on clothing after fasteners have been undone
  • Does not imitate the actions of adults in the home
  • Does not pretend during play
  • Does not demonstrate grasp of crayon
  • Is not using utensils properly
  • Cannot complete 5-6 piece puzzle
  • Cannot build tower of 9 blocks

36-48 months (3-4 years):

  • Is not able to snip with scissors
  • Is not grasping and scribbling with marker
  • Unable to button or unbutton clothes
  • Unable to assist with zipping
  • Unable to copy simple shapes (circle, cross)

48-60 (4-5 years):

  • Is unable to put on socks
  • Is unable to pull pants on/off
  • Is unable to color in between lines
  • Is unable to cut simple shapes (circle, square)
  • Does not care for self at toilet (may need help after bowel movement)


Occupational Therapists provide therapy for the following:

  • Autism spectrum disorders
  • Developmental Coordination Disorder – a neurological disorder where the brain does not send accurate signals to the body with regards to movement and coordination.
  • Sensory Processing Disorder is characterized by the inability to organize sensations from the body and the environment causing much difficulty in areas of daily living.
  • Sensory-motor disorders: Dyspraxia- Tactile, Visual, Vestibular, and Proprioceptive; Postural Disorder- Oral Motor, Ocular Motor, Vestibular Motor, Proprioceptive Motor, Interoceptive Motor
  • Developmental disabilities
  • Fine motor and visual motor delays that directly affect academic performance such as: Self-care skills including feeding, dressing, and grooming
  • Hand strengthening and coordination skills required for activities such as cutting with scissors, coloring, and writing, buttoning, using feeding utensils, etc.
  • Sensory-motor processing and integration
  • Visual motor and handwriting skills