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When Your Child Needs Occupational Therapy

Hearing that your child might benefit from occupational therapy is not easy, but it might be exactly what they need
By Laura Twiggs

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The World Federation of Occupational Therapists defines occupational therapy as “a profession concerned with promoting health and wellbeing through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by enabling people to do things that will enhance their ability to participate, or by modifying the environment to better support participation.”
According to the Occupational Therapy Association of South Africa (OTASA), occupational therapy deals with fine-motor skills, visual-perceptual skills, cognitive skills and sensory-processing deficits. OTASA advocates that: “Occupational therapists use scientifically chosen, meaningful activities to assist diverse clients with a range of problems to maximise their functioning. This empowers them to be as independent as possible and to experience dignity and quality of life.”
Some of the misunderstandings around occupational therapy come from confusion around the word “occupation”. Why would a child need it, when they don’t have an occupation, as we understand it in the adult sense? However, “occupation” is meant in its broadest sense.
“The very word ‘occupation’ means an activity that occupies our time. A child in school has the occupation of learning. An adult may need to learn how to write after a traumatic injury. A senior may want to continue driving safely in order to stay active in their community. All of these things are occupations, and participating in them is vital to maintaining overall health and wellness,” explains The American Occupational Therapy Association (AOTA).
It took one meeting with an occupational therapist to change the way Jane* viewed not only the field of occupational therapy but, more importantly, her son and his individual needs. “My husband and I discussed at length what the teacher had told me about our son’s struggles in the classroom and eventually we decided it would be worse not to do anything. We owed it to Callum* to at least investigate it,” she says. “And once I got over myself, I was surprisingly impressed.”
Holistic Approach
What impressed Jane was the way the occupational therapist viewed Callum as a total entity, taking into account a variety of factors, including the way he played and what he liked to do, how he functioned at school, how he went about his daily activities and tasks, as well as the issues of posture, balance, motor skills and visual perception.
A year later, Jane says that occupational therapy is the best thing that could have happened to Callum. “I was so concerned about the stigma and worried about him being singled out, but he loves it,” she says. “He’s a different little boy. His confidence has increased so much and he has blossomed in every conceivable way.”
*Names have been changed.
Children who may benefit from occupational therapy …
  • Were injured at birth or were born with birth defects
  • Have sensory processing/integrative disorders
  • Have suffered traumatic injuries (brain or spinal cord)
  • Have learning problems
  • Have autism
  • Suffer from pervasive developmental disorders
  • Have suffered from juvenile rheumatoid arthritis
  • Suffer from mental health or behavioural problems
  • Have broken bones or other orthopaedic injuries
  • Have experienced developmental delays
  • Have post-surgical conditions
  • Have suffered burns
  • Have spina bifida (split spine)
  • Have had traumatic amputations
  • Have cancer
  • Have suffered severe hand injuries
  • Are sufferers of multiple sclerosis, cerebral palsy, and other chronic illnesses.
Adapted from the American Occupational Therapy Association (AOTA)
OT should be considered if a child exhibits any of the following …
  • He/she does not use his/her hands simultaneously and for different actions
  • He/she cannot cut along a line at age four
  • He/she cannot cut out a circle at age five
  • He/she is always full of glue or paint but doesn’t know how it happened
  • He/she has difficulty moving to music
  • He/she has difficulty writing letters when he/she learns to write in Grade R.

Contact the Occupational Therapy Association of South Africa (OTASA): Tel: 012 362 5457; email;


Leigh24 wrote 2 weeks 8 hours ago

My daughter has recently started Grade R at a new school as we have relocated. On the first day of school I told the teacher my daughter is afraid of a swing; she immediately told me to take her to an OT. Exactly a week later she said OT is a must as my child now doesn’t want to enter the playground but when we fetched her from school that same afternoon, she was swinging on the rope ladder. She has now told me that my daughter is struggling to complete her work and that she is slow and she does not grasp tasks. But when my child gets home at 6pm she is able to do the work on her own without my help. I have received a message every week referring me to an OT. I spoke my daughter's paediatrician, who said the decision is premature and that we should at least wait three months. The teacher has gone behind my back to the paediatrician after I informed her of this. Please advise if I should really be taking my child to an OT. She was top of her class last year at her previous school and gets awards currently for getting all her work right.

admin wrote 1 week 6 days ago

It seems that you need to resolve this issue at the school level. Perhaps call a meeting with the teacher and school principal to determine the most appropriate way forward, whcih should always be in the best interests of your child.

Anonymous wrote 7 weeks 6 days ago

My 9-year-old son has started Grade 4 this year and seems to be struggling to keep up with the rest of his class. He is not completing the assigned work in class and does not concentrate very well. Would he benefit from seeing an occupational therapist?

admin wrote 7 weeks 6 days ago

A good place to start is to discuss your child's struggles with his teacher, who in turn may be able to refer you to an OT or another professional. There could be any number of reasons for his current struggles, so an educational assessment by a relevant professional may be necessary. All the best.

Anonymous wrote 11 weeks 13 hours ago

My child is turning 3 years old next month and he tip toes with his right foot, he still can't speak properly, he says few words (like mommy, papa). He has not started making sentences. He does not like to play with other kids and never wants to share anything. He is, however, very independent, dresses himself, wants to bath himself, feeds himself, ties his shoelaces, can take pictures of himself with my cellphone, can switch the TV on and off. He also wears glasses and he was born 7 months premature. His teacher called me today to say that he must see a speech therapist and an occupational therapist. Any advice is welcomed.

admin wrote 10 weeks 6 days ago

We recommend that you take the advice of your child's teacher, as they are in a good position to assess typical problems that may require professional help. All the best.

Anonymous wrote 23 weeks 6 days ago

My daughter is 9 years old. She lacks concentration in school, she doesn't complete her sentences and mixes her words up when writing. At home she has short temper. Do you think she needs OT assessment?

admin wrote 23 weeks 6 days ago

We do recommend that you get her assessed, either by an OT or an educational psychologist.

Anonymous wrote 27 weeks 4 days ago

My son is 6 years old. His teacher called me in to say that she is concernd that he does not complete his written tasks given to him and thinks he is not concentrating on his tasks. Do you think he needs an OT?

admin wrote 27 weeks 12 hours ago

We recommend that you discuss this with his teacher, who should be in the best position to advise you about potential learning or behaviour problems that may need professional attention.

Amy wrote 33 weeks 1 day ago

My son is almost 4 years old. He can't keep still and is always moving around. He also has very defiant behaviour and terrible tantrums. I have put him into play school three weeks ago and his teacher says he can't keep still and does not listen to instructions. He is also refusing to go to the toilet at school and having accidents. I am aware that this sort of behaviour is common with preschoolers, however when I compare him to other kids in his class, I feel that he may have ADHD. Can someone please help me.

admin wrote 33 weeks 1 day ago

Have you considered taking your child to an OT for assessment? They may recommend other forms of therapy, but a specific diagnosis is always the best place to start so you can take the appropriate therapy route. You could contact Dore SA:

Concerned Parent wrote 35 weeks 5 days ago

Hi, I live in Goodwood and require a good OT for my 4 year old. We were advised that due to certain signs we need to consider seeing an OT who could do an assessment for us and advise accordingly. Can anyone assist me with the contact details of either a good OT or assessment centre?

Tanyavs wrote 36 weeks 13 hours ago

My son is turning 9 in November and is in Grade 3. He is really struggling at school, in the sense that he is very emotional when he has to do homework (tantrums, crying, etc). He is not a good reader at all, really struggles, even though we make him read as often as possible. I am starting to think that maybe I put him in school at a too young age? What can I do to help him, so that he will make it through Grade 3? I am very scared of Grade 4 and don't want things to get even more hectic for him!

admin wrote 35 weeks 1 day ago

We strongly recommend that you discuss these issues with your child's school, as they should be able to advise possible routes for therapy or remedial help for your child.

Ebrahim wrote 38 weeks 4 days ago

My son will turn six years old in September. He was a premature baby and started to walk when he was three years old. The problem is that he walks on his toes. How can you help me out?

admin wrote 38 weeks 4 days ago

Hi Ebrahim. We recommend that you take him to an OT, who will refer you to another professional if they cannot assist.

Anonymous wrote 40 weeks 18 hours ago

My daughter who is 5 turning 6 years old in September went for a school readiness test which was not successful and I was told she has concentration problems, numeracy and following instructions is difficult for her and that I should take her for occupational therapy. I'm worried this might be too late as she is supposed to start Grade 1 next year.

admin wrote 40 weeks 11 hours ago

We don't think it's ever too late to start OT. The sooner the better, if you have been so advised. All the best!

Durban Anonymous wrote 41 weeks 4 days ago

My son is 7 and at a special needs school in Pretoria. He lives with his mum. Access and information have been hard as is standard in most divorce cases. This week I met with his teacher and part-time school OT for the first time. It was a shock to hear a description of his mental disability in such real terms. He is undiagnosed, has a history of seizures and shows many of the sympoms of autism, but as I discovered his mental age is more likely between 2-3 years, specifically not having met many of the fine motor skills milestones. How do I get him the help he needs?

admin wrote 41 weeks 4 days ago

We recommend that you ask your child's OT for further help or ask the school for their advice about professional help.

Denise M wrote 43 weeks 4 days ago

Hi Nicky J, I am in a similar situation as you with my 7 year old in Grade 2. His teacher claims that he is not coping in class, yet his accademic results reflect maximum scores. We are now bing refered to an OT. I am really not sure what to make of this situation. Did you have the OT assessment? If so, what was the results? Thanks.

Nicky J wrote 50 weeks 4 days ago

My daughter is 7 years old and in Grade 2. She had a very difficult year in Grade 1 academically. We were prepared for her to repeat the year but at the end of the last term, her teacher confirmed that she had met all the requirements to move over to Grade 2, but also warned us that she will probably struggle in Grade 2, even repeat the year. After the first term report in Grade 2, we are so worried about her as she is battling so much. Her Maths was said to be at an elementary level and her literacy is also not up to scratch. We had her assessed for ADHD last year but nothing came of it. I'm at my wits end as I'm really worried about her. Would you suggest we see an OT to do an assessment? Could she possibly have a learning disorder? I just want to have some sort of "closure" as to why she's not coping.

admin wrote 50 weeks 4 days ago

Hi Nicky. Yes, we recommend that you visit an OT or even an educational psychologist. All the best.

Anonymous wrote 1 year 2 weeks ago

My five-year-old son is highly intelligent. He reads way beyond his level and has a great memory. He is socially interactive and not autistic. He can write his letters A-Z and numbers 0-10. He has to use a pencil gripper to write them. He is in preK and it was suggested that he attend OT. I am not sure he needs it just for writing? Please advise. Thanks. 

admin wrote 1 year 2 weeks ago

Lots of children see an OT to help them with their writing, so if your child's school has advised this, it's probably a good idea.

NID wrote 1 year 2 weeks ago

I have a two-year-old boy in my preschool class that has me baffled. Excessive drooling. Very physical -- tends to hit, kick, pull hair, throw sand at other children unprovoked. Constantly running and falling when he gets going too fast, which is most of the time. Never successfully plays with another child for any length of time. Ends up hurting them in some way. Don't know if OT would be an appropriate path to suggest to his parents?

admin wrote 1 year 2 weeks ago

If you don't think OT is the appropriate path, perhaps a psychologist is the right course of action in this case.

Concerned Dad wrote 1 year 5 weeks ago

My Gabby will be 4 in March. She has been diagnosed ADHD and besides the tons of energy and limited speech, she is a normal toddler. Until recently she was on a trial dose of Ritalin, which slowed her down, but with no focus or attention and she was vey emotional. She is currently on Risperdal for just over a week and we are patiently waiting for any type of change. She has weekly speech therapy and we are currently trying to get OT for her, but her assessment didn't last 20 minutes as she could not focus or keep still. She can count to 13, name her colours and shapes but not on demand, only if she has the time, which is never. Sound familiar?

Anonymous wrote 1 year 8 weeks ago

My son is turning 4 in August, and he attends crèche. His teacher has suggested OT, because he's very busy, he does not sit down in class, interrupts when it’s story time, can’t identify shapes, he has not started talking, he still struggles with going to the toilet. His paediatrician did not see anything wrong with him. He can count from 1 to 10, recognises sounds, especially the national anthem. Please advise what should I do.

admin wrote 1 year 8 weeks ago

Hi. We think you should probably follow the recommendation of your son's teacher and take him to an OT. Ask your child's school for a recommended OT or search our health care practitioners resource for one nearest you. All the best!

Anonymous wrote 1 year 18 weeks ago

My 5 year old has trouble remembering his letters or sounds. He has been in preschool since 18 months of age. His preschool teachers and now kindergarten teacher are concerned about him. We had him tested a year ago, but nothing significant was noted. ADHD has been suggested. He has good motor skills and has met all of the milestones early for his age. I am looking at taking him to OT.

admin wrote 1 year 18 weeks ago

You can contact the national organisation listed in the article or find an OT in our health care practitioners resource.

Anonymous wrote 1 year 22 weeks ago

Just wanted to know if I need to take my 9 month old to see an OT. He leopard crawls and he can't bring himself up to sit, but he sits well unaided.

admin wrote 1 year 22 weeks ago

If you feel that your child is developmentally behind, then it is advisable to consult an OT.

Phumela wrote 1 year 22 weeks ago

My daughter just turned one and recently started walking. I've noticed that when she walks her left arm is always at a right angle position. She also prefers to do things with her right hand and will only use her left if forced. She'll never hand me something with her left hand. If she's holding two objects and I want the object in the left hand, she'll put the object in the right hand down, tranfer the object in the left hand to the right hand and then hand it to me. So it almost seems like she doesn't want to stretch out her left arm. Should I take her to see an OT or physiotherapist?

admin wrote 1 year 22 weeks ago

Hi Phumela. Yes, we recommend that you take her to an OT. It may not be anything to worry about, but at least then your mind will be at ease. All the best.

Anonymous wrote 1 year 45 weeks ago

My son is 4 years old and he has a problem concentrating at anything at home and at school. He is always on time-out at school as he hurts other kids and he does not listen to anyone at all. The teacher suggests that we see an OT.

admin wrote 1 year 45 weeks ago

You may also want to consider seeing a child psychologist. You will find several listed in our health care practitioners resource:

Tumi Magazi wrote 1 year 48 weeks ago

My son is 3 years turning 4 in July. He is at crèche and his teacher recommended that he see an OT, because he is lagging compared to someone his age. Should I be worried for his future?

admin wrote 1 year 48 weeks ago

Hi Tumi. We recommend that you follow your child's teacher's advice and take him to a reputable OT. Hopefully this will give you the peace of mind you seek. All the best!

Anonymous wrote 2 years 5 days ago

Please help. I have twins who do not speak and they are turning three next month. They love building blocks, colouring in and playing with toys, but hardly say anything. They don't respond when we call them, but when they hear something on the TV, they come running.

admin wrote 2 years 5 days ago

Hi there. We recommend that you take your children to your paediatrician, who will do the basic milestone assessment tests to figure out what may be wrong. Your doctor will then refer you to a specialist if necessary.

cake wrote 2 years 11 weeks ago

My 2-year-old wants to eat ALL the time; she would rather eat than play or do anything else. She points to the fridge or pantry and has a fit if I don’t open them; she will then decide what she wants to eat. I don’t always give in, but to avoid a violent tantrum most times I do. She mostly acts this way around me and my husband and NOT my helper or mom. Any suggestions?

admin wrote 2 years 10 weeks ago

Read this article about taming tantrums:

Philile wrote 2 years 23 weeks ago

My son just turned 3. He does not chew and he has never chewed. He started saying words and a few sentences now. All my life I thought a child must be fluent in speech by the age of 3. His paediatritian does not see anything wrong with it and no-one knows why he is not chewing, as that is suppose to come naturally. He eats food very well, just not things like sweets, cakes, chocolates, etc that you must chew before you swallow. He is growing up very well, weighs 17kg and 1.3m tall. He does puzzles for 5-year-olds, counts from 1-40 and says his alphabet. Is there anything wrong with my boy, or that I should be corncerned about? Will he ever chew?

admin wrote 2 years 22 weeks ago

Hi Philile. We suggest that you get a second medical opinion if you are concerned. You may also want to consult with a dietician or an occupational therapist.

Anonymous wrote 2 years 26 weeks ago

My son turns 4 next month and currently attends play school. We were recently advised that he should attend an OT assessment as he was unable to draw his family members, albeit in stick format, was very reserved and scared to be left alone. He draws freely at home, knows planet names, knows a few lines of the national anthem, constructs sentences well, eats by himself, can construct puzzles and plays on the jungle gym. He is, however, shy and takes a while to get used to new faces, he is feisty and stubborn and always wants his way. Should we be concerned?

admin wrote 2 years 26 weeks ago

Hi. If you've been advised to consult an OT, we recommend that you do so to set your mind at ease. The OTASA should be able to advise you of an OT or you could browse our health care practitioners resource.

Vicky Williams wrote 2 years 29 weeks ago

My son was born with bilateral cataracts, he had the lens removal done before he turned 1 years old. Today he is 3, still not talking, walking or crawling at all. I am worried and need help with my little boy.

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