OT for kids: what occupational therapy can help with

Sometimes parents, caregivers and educators notice everyday differences in children that get in the way of their participation in everyday life. In this article, occupational therapist Ben Ho explains what types of things might be helped by occupational therapy, what OT is and how to take the next step to get the right support. 

Things you might have noticed 

Maybe you’ve noticed your pre-schooler avoiding buttons and zippers. Or your child's teacher mentions they're finding group tasks or concentrating for long periods exhausting.  

Maybe your teenager suddenly withdraws from social events. Or you might have seen sensory differences like covering ears in busy places, avoiding certain clothes or becoming overwhelmed by bright lights.  

Or perhaps they’ve mentioned that using cutlery or doing handwriting is uncomfortable. 

Feeling uncertain about next steps is very common 

Those moments can leave you unsure. You sense something is hard for them, but you don’t know who to ask or whether it is worth raising. It’s common to worry you are overreacting and wait and hope it will pass. 

My advice is simple: it’s always worth a conversation 

If something is happening regularly, troubling your child or getting in the way of daily life or school, it’s worth reaching out for support.  

Sometimes occupational therapy is the right starting point, or sometimes we’ll guide you to another MTHC service, like speech pathology or psychology. We can help you understand when support might be helpful and what to do next. 

What is occupational therapy for children? 

As an occupational therapist, my role is to support children to do the things they need to do, want to do and are expected to do. 

We look at how everyday differences are affecting your child and work with them to find ways to build practical skills to help them participate more confidently in life. 

The word "occupation" makes people think of jobs and careers. But in occupational therapy, also known as OT, occupation means everything that occupies a person's time. For children, that's things like getting dressed, eating breakfast, going to school, playing with friends, doing homework and everything in between. 

Whether it's learning to use a spoon, navigating a busy school day or enjoying a party without becoming overwhelmed, OT can help by building independence, skills and confidence. 

What can OT help kids with? 

Paediatric occupational therapy covers a broad range of areas, from early childhood through to adolescence. Here are some common signs that occupational therapy might help. 

1. Everyday routines feel like a battle. Getting dressed, managing mealtimes, using the bathroom or settling into sleep are the rhythms of daily life. If they consistently take a lot of time, effort or support, and it’s causing distress for your child or your family, that’s worth exploring. It may be that certain tasks are demanding in ways that aren't obvious from the outside.  
2. School feels consistently exhausting or difficult to get through. Maybe your child finds writing uncomfortable, finds it hard to stay focused or finds changing activities in the school day unsettling. Some children find the physical demands of writing tiring, or the pace and unpredictability of a school day draining. OT can help identify what's contributing and build supports to make their day easier and more enjoyable.
3. Certain environments feel overwhelming. If your child finds noisy, busy or unpredictable places like classrooms, shopping centres, restaurants or parties difficult to be in, or if certain textures, clothing or sounds cause real distress, sensory processing may be a factor. Some children also seek out intense sensory input rather than avoiding it. Both experiences are valid, and OT can help find ways to support participation without asking a child to just put up with what feels overwhelming.
4. Social situations feel confusing or uncomfortable. If your child finds it hard to join in with other children, feels unsure in group settings or finds social situations confusing or uncomfortable to read, OT can support skills and strategies that make connection and participation feel more within reach.
5. Everyday tasks feel physically hard or frustrating. If handwriting feels tiring or frustrating, or if tasks like using scissors, managing buttons or activities involving balance and coordination feel physically demanding, that's a sign to reach out for support. Some children find motor-based tasks so demanding that they stop engaging with them altogether. Targeted support can often help.

Our approach to occupational therapy 

We’re experienced paediatric clinicians delivering evidence-informed care within the MTHC network of health services.  

We use a neurodiversity‑affirming, individualised and strengths‑based approach that focuses on what matters to the child. 

• We respect how each child expresses themselves and aim to support participation, not erase differences. 
• We start with what the child wants and build skills around that motivation. 
• We use the child’s interests and strengths as the foundation for therapy. 

Here’s what it looks like in practice. 

Occupational therapy is not one size fits all.  

When I'm working on handwriting with a child, for example, I might take what we call a top-down approach and practise handwriting directly. Or I might take a bottom-up approach and build the foundational skills first: hand strength, endurance and fine motor coordination. Often it's both, running alongside each other. We always decide based on the child in front of us and never use a standard program. 

Using what the child cares about to build the skills they need. 

If a child wants to be a pilot, we'd practise handwriting with a cockpit checklist. Instead of worksheets, I'd draw a cockpit on my whiteboard with switches and dials and work through it together. It could lead to handwriting improvements, but more importantly, they'd be engaged and motivated to participate.  

A neurodiversity-affirming, collaborative OT example in practice. 

Sometimes a child is distressed from sensory overload, but the family want to be able to go to restaurants together. The noise and unpredictability of those environments can be difficult for their child. Once I've spoken with the child, they might be more interested in attending Friday morning assembly with their class than going to restaurants.  

So that would become our goal. We'd look carefully at what was making assembly hard. The noise and movement of a hall full of children could be overwhelming. By Friday morning, the child would already be exhausted from the week. Drop-off at the busy front gate could be stressful, with a lot of pressure to move quickly. 

By working through things piece by piece, we can find ways to adjust the environment to suit the child. We could find a quieter side entrance the family could use, where drop-off is calmer and less rushed. We could build in a movement break before assembly where the child can help their teacher set up the classroom, so they get some physical activity in before a long sit. At assembly, the child could use ear defenders to reduce the noise. We could also find a quiet space nearby where they could step out if needed, settle themselves and come back when they were ready. 

Over time, that child might be able to attend assembly more often, using the supports we’d put in place. The best part about it is that the goal came from the child. That's what we always aim for. We work in a way that respects and builds on how each child experiences the world, because the aim is never to change who they are. It's to help them take part more fully in the things that matter to them.  

The skills we'd build to get to assembly could be the same skills that eventually helped in restaurants, and in other situations the family hadn't thought to mention. That's how OT tends to work in many children. Progress in one area can flow through to others. 

If you're not sure where to start 

Always trust your instincts. You know your child better than anyone. You know if something is getting in the way of them being able to participate fully at home, at school or in the community. 

You can start by: 

• Finding reliable information. The Australian Government’s Raising Children Network is one I often recommend to parents and caregivers. It covers developmental milestones across all the areas OT works with, and flags when it might be worth getting some extra support. 
• Asking a medical professional. If your child is still at an age where you're seeing a maternal and child health nurse, bring it up at your next check-up. Your GP is also worth talking to. They can arrange a GP management plan, which provides Medicare rebates for OT sessions and can help with the cost of getting started.
• Contacting our clinic. You don't need a referral. Families are welcome to call or fill in our online enquiry form and someone from our team will get back to you. Sometimes after an initial conversation, we might suggest another MTHC service as the better starting point, like audiology or speech pathology. We'll always try to help you find the right support for your family, even if that's not with us. 

What to expect at a first appointment 

If you decide to try OT, the first appointment is about getting to know your child and understanding what's happening for your family. 

While I'm talking with you, I'll have activities set up relevant to what brought you in. If the concern is around handwriting, there might be activities on the table. I'll be observing how your child approaches tasks, what they find easy and what they find hard. I might collect a handwriting sample so we have a clear baseline to compare against in a few months' time. 

By the end of the session, I'll have a much clearer picture of where things are at. Together, we can start to map out what the goals are and what support might look like. 

Ready to take the next step? 

If you'd like to find out whether occupational therapy could support your child, please call the clinic on 03 9035 7199 or fill in our enquiry form. We'll get back to you and help guide you through the next steps. 

Ben Ho is an occupational therapist at MTHC Occupational Therapy, working with children and families to build the skills and confidence kids need to participate in everyday life.  

MTHC is where healthcare, education and research come together. We are a health service affiliated with the University of Melbourne, offering a range of services to support people across different needs and stages of life.

By Ben Ho