Your child may benefit from pediatric occupational therapy services if you have noticed that he/she:
- Is late to reach developmental milestones (see chart below)
- Has difficulty interpreting sensory information correctly and either over-responds or under-responds to touch, smell, movement, sound, visual information etc.
- Has difficulty with age appropriate self-care skills such as feeding, dressing and toileting
- Has difficulty with changes in routine
- Has difficulty settling or calming
- Has difficulty learning new activities
- Is clumsy or poorly coordinated
- Has difficulty with fine motor skills required for such things as zippers, buttons, shoelaces, and for school related skills such as coloring, cutting, pasting, printing
- Has difficulty engaging in age appropriate play
| Age | Social/Emotional | Gross Motor | Fine Motor | Cognitive |
| By 3 months… | Begin to develop a social smile
Imitates some movements and facial expressions |
Raises head and chest when on tummy
Supports upper body with arms when on tummy
|
Opens and closes hands
Brings hands to mouth Grasps rattle or toy |
Unable to assess. |
| By 7 months… | Enjoys social interaction
Appears happy often |
Rolls front to back and back to front
Gets into sitting without assistance Crawls forward on belly |
Reaches with one hand
Transfers object from hand to hand Uses raking of the hand to grasp object Finger-feeds self |
Finds partially hidden object
Explores objects with hands and mouth |
| By 12 months… | Shy with strangers
Shows preference for certain people and toys Tests parent responses to behaviors Finger-feeds self |
Crawls on hands and knees
Pulls to stand Walks holding onto furniture Takes two or three steps without support |
Uses pincer grasp
Bangs two objects together Puts objects into container Releases objects voluntarily |
Explores objects in many ways (shaking, banging, throwing, dropping)
Finds hidden objects easily Begins to use objects correctly (brushing hair, drinking from cup) |
| By 18 months… | Separation anxiety increases
Begins to show defiant behavior |
Walks alone
Pulls toys while walking |
Turns over container to pour out contents
Spoons feeds Uses open and sippy cup |
Imitates housework |
| By 24 months.. | Imitates behaviors of others particularly adults and older children
Increasingly excited about company of other children Separation anxiety begins to fade |
Carries large toy or several toys while walking
Begins to run Kicks a ball Walks up and down stairs with support |
Scribbles
Builds tower of 4 or more blocks Demonstrates handedness |
Helps with undressing
Finds objects hidden under multiple covers Begins to sort by shapes and colors Begins to engage in parallel play Begins make believe play |
| By 35 months/
3 years… |
Imitates adults and playmates
Shows affection for playmates Can take turns in games Expresses a wide range of emotions Separates easily from parents |
Climbs well
Walks up and down stair alternating feet Runs easily Pedals a tricycle Bends over without falling |
Makes lines vertically, horizontally, and scribbles circles
Turns pages of a book one at a time Builds a 6 block tower Holds a crayon or pencil in writing position Turns rotating handles |
Makes mechanical toys work
Plays make-believe with dolls and animals Participates in cooperative play Completes inset puzzles with 3-4 pieces Undresses self Toilet training begins |
| By 48 months / 4 years… | Interested in new experiences
Plays “mom” or “dad” Dresses and Undresses Often cannot tell the difference between fantasy and reality |
Hops and stands on one foot
Goes up and down stairs without support Throws a ball overhead Catches a bounced ball most of the time |
Copies squares
Draws a person with 2-4 body parts Uses scissors Draws circles and squares Begins to copy capital letters |
Correctly names colors
Understands concept of counting Begins to understand time Understands the concept of “same” and “different” |
| By 60 months/ 5 years… | Wants to please friends
More likely to agree to rules Likes to sing, dance, act Aware of gender Able to distinguish fantasy from reality |
Stands on one foot for 10 seconds or longer
Hops Somersaults Swings Beginning to skip |
Copies triangle and other shapes
Draws a person with a body Prints uppercase letters Cuts on line consistently Uses fork and spoon Cares for own toileting needs |
Can count 10 or more objects
Knows about use of everyday items (food, money) |
| By 6 years…. | Needs to win and may change rules to suit
Increasingly aware that others have feelings Shows more interest in taking care of his or her self without help Cleans his or her room, including making the bed Likes board games, crafts and other constructive projects |
Can move in time with music or a beat
Very interested in climbing and balancing, takes risks Learns to skip with rope More in control of his or her body Bounces and catches tennis ball |
Holds a pencil with three fingers, movement from fingers
Copies a diamond Draws a person with detail Writes alphabet Ties shoelaces without help Eye-hand coordination significantly improves Masters buttons and fasteners Cuts with a knife |
Develops reasoning skills
Learn through language and logic/reasoning Child shows a strong desire to learn |
| By 7 years… | Desires to be perfect and is quite self-critical
Tends to complain; has strong emotional reactions Understands the difference between right and wrong Takes direction well |
Has good balance
Executes more complicated gymnastics such as a cartwheel Activities become more sport specific |
Proficient with paper and pencil tasks
Able to organize multi-step sequences |
Able to solve more complex problems
Individual learning style becomes more clear-cut Can solve simple math problems using objects |
What if my child is older?
Pediatric occupational therapists work with children of all ages, from birth until transitioning into adulthood. If your child is having difficulty completing everyday tasks, or is unable to keep up with their same-aged peers, an OT may be able to help. An occupational therapist will asses your child’s development by considering a variety of components: gross and fine motor skills, social and emotional development, cognitive skills and sensory regulation. These components work together to allow your child to partake in all their activities of daily living; including self-care, school, play and leisure activities.
To learn more about how pediatric occupational therapy may help your child, visit these links:
www.caot.ca – The Canadian Association of Occupational Therapists
http://www.spdfoundation.net – Sensory Processing Disorder Foundation