Occupational therapy focuses on the following areas of development. If you notice any differences in the following skills where function is affected, a referral to occupational therapy may be appropriate. It is important to note that these indicators are written from a strengths-based and supportive lens to recognise when a child might benefit from Occupational Therapy; NOT because they are "deficient" in any way, but to identify what support is needed to help them thrive in a given environment. The aim of therapy is not to get the child to conform, but to provide support and develop skills to allow them to thrive. 

 

 

Gross Motor (physical skills like running, jumping and co-ordination) 

 

• Clumsy or has difficulty with body awareness – often trips over, bumps into things, awkward movements 

• Appears to lose balance easily 

• Appears weaker than other children his/her age (floppy/lethargic) 

• Differences in ability to hop, jump, skip, run, throw or catch a ball compared with other children his/her age 

• Avoids or shies away from playgroup equipment 

• Slouches or finds it hard to keep self upright 

• Difficulty doing coordinated tasks such as jumping jacks 

• Likes to move around or fidget when sitting in a chair or on the floor 

 

Fine motor (table top skills, eg using pencils and scissors) 

 

• Switches hands to write or do fine motor tasks (*up to age 4 or 5 this is considered appropriate)

• Unusual pencil grip or difficulty maintaining a consistent pencil grasp ​

• Fatigue when writing or colouring

• Alternates hands when crossing the midline 

• Avoidance of table top activities such as drawing, colouring or writing

• Difficulty with drawing, copying shapes or colouring-in 

• Difficulty with manipulating small objects or using precise hand or finger movements 

• Can’t use both hands together with ease (bilateral movement) 

 

Sensory processing 

 

• Sensitivity to noise, textures, personal touch 

• Has challenges with self regulation, or may need more support than others in order to regulate, eg more movement, more time to transition before and after activities 

• Has big reactions to changes in routine, transitions, waiting in a line 

• Frequently touching or mouthing non-food objects such as pencils, clothing, fingers

• Under-responsive to the environment; does not seem to notice being touched, having food on their face etc 

• Seems unaware of own body or body position in space or may seek out sensory input such as running, crashing, deep hugs or spinning

 

Visual perception 

 

• Has trouble completing puzzles/block designs appropriate to child’s age 

• Difficulty copying shapes, numbers, letter formations 

• Difficulty sorting objects according to shape, size and colour 

• Has a hard time finding things eg. objects in a desk or drawer 

• Letter/number reversals 

• Difficulty identifying similarities and differences 

• Difficulty copying from the board or a book

• Difficulty with position concepts (in front of, behind, under...) 

 

Self-help skills (such as dressing, using cutlery) 

 

• Difficulty with dressing – sorting back from front, doing up fastenings 

• Difficulty with eating – picky eater, messy eater, spills often, difficulty managing cutlery 

• Toileting – difficulty knowing when to go, managing clothes, wiping self, opening/closing taps to wash hands 

 

Social/emotional 

 

• Gets easily distracted, finds it hard to concentrate, or may find it hard to shift attention from one thing to another 

• Has challenges participating in group or peer interactions, or interpreting cues from others

• Has trouble paying attention to complete a task 

• Difficulty settling or separating, often restless, or may become overwhelmed in social settings

• Has a hard time making friends, or lacks confidence around peers

 

Additionally, a referral to Occupational Therapy may be warranted if:

• A family, caregiver or teacher has concerns about a child's participation or wellbeing

• A child expresses frustration or dislike for tasks that may be routine for peers

• A child is not meeting developmental milestones to the point where functional independence is affected

• There is an interest in building the child's strengths to support the development of skills and participation 

• There has been a history of birth trauma, developmental differences, or co-occuring neurotypes (such as both autism and ADHD) that may affect overall function and participation