Does my child need an OT?

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


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




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: – The Canadian Association of Occupational Therapists – Sensory Processing Disorder Foundation

Call Now Button