Occupational Therapy

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When should a parent pursue Occupational Therapy for their child?

A child should be seen if...

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:

  1. Autism spectrum disorders
  2. Developmental Coordination Disorder – a neurological disorder where the brain does not send accurate signals to the body with regards to movement and coordination.
  3. 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.
  4. Sensory-motor disorders: Dyspraxia- Tactile, Visual, Vestibular, and Proprioceptive; Postural Disorder- Oral Motor, Ocular Motor, Vestibular Motor, Proprioceptive Motor, Interoceptive Motor
  5. ADD/ADHD
  6. Developmental disabilities
  7. Fine motor and visual motor delays that directly affect academic performance
  8. Self-care skills including feeding, dressing, and grooming
  9. Hand strengthening and coordination skills required for activities such as cutting with scissors, coloring, and writing, buttoning, using feeding utensils, etc.
  10. Sensory-motor processing and integration
  11. Visual motor and handwriting skills

Occupational Therapy works on fine motor skills such as the small muscles in the hand.  When there is not enough strength in the hand, a child may have difficulty writing or using scissors to cut.  They will also not be able to thread a needle or put beads on a string.  If these difficulties are not addressed, children will have trouble buttoning a shirt, zipping a jacket, and properly using utensils. 

Some fun techniques used by therapists to strengthen muscle control in the hands include: using tweezers to pick up small objects, picking up coins off the table, lacing, Lite Brite, and popping bubble wrap.