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 otasa@otasa.org.za; otasa.org.za


Anonymous wrote 1 week 1 day ago


My son is in Grade 2 and seems to have problems completing tasks in class. He is very clever but the minute the teacher gives him a task he does not complete it. I have just met with the teacher again and she advised that he just managed to pass this quarter but she is concerned and says that he may benefit from seeing someone and possibly looking at a tablet called "concerta". I am not very keen to use medication unless it's necessary and feel that I need to have my son assessed. I don't have much money and the school, although a public school, does not offer the service.

Any advice would be appreciated.


Tamlyn wrote 1 week 1 day ago

It would probably be advisable to have your son assessed, which would help you undertsand what options you have available going forward. Perhaps speak to your doctor first, to see if they could refer you to someone else. 

Anonymous wrote 1 week 1 day ago

My son is 3 and a half years old and always had delayed milestones. He hasn't started running yet and finds it hard going up and down stairs. He flaps his arms a lot and always leans on one side or lays down a lot. Can an OT help?

Tamlyn wrote 1 week 1 day ago

You would need to consult an occupational therapist, who would be able to tell you whether or not this is the correct course of action for your son. 

Xan3 wrote 1 week 2 days ago

Good day, my son will be turning 4 in December. He was born prematurely. He is currently in a creche and in a class where the majority children are 4 already. He is seeing a speech therapist as he is only starting to put 2 words together now. We have stopped with OT as we didn’t see any progress at all and also feel that speech thereapy and OT is a bit much for a 3 year old. Whilst he babbles and talks at home non-stop his teacher indicated that he doesn’t talk much at school and is very much in his own world when it comes to participating in class activities. Could this be due to the fact that everyone in his class is older than him? Or could it be another possible problem?

Tamlyn wrote 1 week 1 day ago

We're not able to make a medical recommendation, but there are a number of healthcare professionals that you could speak to, who would be able to advise you further. You could speak to the OT again, and find out when you would expect to see results. An Early Intervention Programme could also assess what''s wrong. Possibly consider visiting an ENT - maybe he has trouble hearing which could explain why he talks at home but is quiet outside of the home. 

Anonymous wrote 1 week 3 days ago

My child suffers from self confidence and certain motor skills. She's also been acting out over the past couple of weeks. She also has difficulty writing words on lines. Does she need OT or is there something else I should consider?

Tamlyn wrote 1 week 2 days ago

It would be best to discuss this with your daughter's teacher/s. They would probably be best suited to recommend a course of action. 

Anonymous wrote 1 week 5 days ago

Hi, my son is 8 years old and is in grade 2. He repeated grade one last year, and his teacher has called us in and explained to us that he is not concentrating in class. He sometimes writes his letters and numbers incorrectly, for example, he gets confused with the b's and d's and he writes the three upside down, but not all the time. Then on the other hand, he gets 10 spelling words on a Monday and he learns all of them and gets all right. Please help.

Tamlyn wrote 1 week 4 days ago

You may find that a therapist could help your son, but his teacher would probably be able to make the best recommendation. We would suggest that you first speak to his teacher, or other educators and specialists at his school. 

Anonymous wrote 4 weeks 1 day ago

My son's teacher has asked me to take him for an OT assesment. She says she finds him day dreaming in class and he doesn't concentrate. I find this hard to belive as if this was the case he would be performing badly in class, and recently he got a star child award for Maths. He reads well. His writing is a bit untidy but this is understandable as he is left handed. She is also concerned becase he takes a bit longer than the other kids to get dressed after his PE lesson. She also says he takes a bit longer to get going in class but once he does he performs well.

Tamlyn wrote 4 weeks 1 day ago

We can't say whether your child needs OT, but an assessment by an occupational therapist may help to determine if he does need therapy. The therapist may also be able to address any concerns you may have.

Anonymous wrote 7 weeks 5 days ago

It has been recommended that my child sees an OT and a speech therapist, however we cannot afford their prices. What does one do when they can't afford to see therapists but desperately want to help their child?

Tamlyn wrote 7 weeks 5 days ago

Perhaps try speaking to a family or parenting centre. In Cape Town we can recommend the Parent Centre or Tafelberg School. 

Anonymous wrote 11 weeks 2 days ago

My son has just turned 5 in Feb and he is in Grade R. I was informed by his teacher that he has difficulty in recalling his work, or memory recall. I did find that he tends to forget his work, like writing of numbers and alphabets. But orally he says it perfectly. Also when given problems to solve at school he gets them wrong but when I do the same at home with him, he gets it right. He seems to get stuff right at home but not at school. Do you think the OT can assist with his memory and concentration? He is not hyperactive in school. He draws and colours perfectly. I am so stressed out about his learning and not sure where to start assisting him.



Tamlyn wrote 11 weeks 2 days ago

An OT may be able to help, depending on what the problem is. We would suggest that you first speak to your son's teacher to establish where the potential problem may be, and to find out if you need to go to OT or other therapy. 

Anonymous wrote 12 weeks 5 days ago

Hi. My son is 5 turning 6 this year. Last year his teacher informed us that his speech wasn't on par with his classmates and she recommended a speech therapist. We went to see one and he started attending classes weekly. He showed a lot of improvement and loves attending the classes, always looking forward to them. He's in a new class now with a new teacher and she has raised a concern regarding his learning abilities and lack of understanding within the overall class environment. I think it goes back to his speech capabilities, which have improved dramatically since he started the speech classes. We're loving these new interactions but I don't understand how he could now need more added to that. We are not in a position to afford an OT with his speech and swimming classes already in his schedule. Overall I think he's a bright child; he's made friends at home, he can recite his cartoons, has no problem playing sport, dancing, navigating/gaming on a computer/tablet, his colouring is good and he can write his name and a few other letters. Maybe he is behind in some language aspects (which I suspect) because of the speech problems (we're bilingual as well) and can understand his teacher's concerns - perhaps he needs more attention in her daily activities but do we need to have see an OT?

Tamlyn wrote 12 weeks 4 days ago

We aren't able to say whether your son needs additional therapy, or whether OT would be able to assist him. We would suggest that you weigh your options by speaking to your teacher and your speech therapist about what would benefit your son the most. You can also ask for a consult from an occupational therapist, to establish if your son would benefit from this type of therapy. 

Anonymous wrote 14 weeks 1 day ago

My son is turning 7 in March. He started Grade 1 this year, in an Afrikaans school, and he does very well with math, but we are struggling with getting him to comprehend reading. We sound the words out to him and he cannot grasp them. Then we give him the word and when we start the sentence 2 minutes later he cannot remember the word once again. His teacher also says that he is having difficulty communicating with her and talking in front of the class. I worry because he has been brought up in a very bilingual house and we speak both English and Afrikaans simultaneously - maybe this is becoming a problem? Would he benefit from Occupational Therapy?

Tamlyn wrote 13 weeks 5 days ago

Living in a bilingual house shouldn't be a problem, and it doesn't sound like your son needs occupational therapy. You may find speech therapy helpful, but we would suggest that you speak with your son's teacher first, to try to determine what the problem could be and the best way forward. 

Anonymous wrote 18 weeks 3 days ago

My daughter is 5 years old. It seems she has a problem writing her name and it's her first year at school. I was already called in by her teacher. Please advise what steps should I take as I'm very worried.

admin wrote 18 weeks 2 days ago

Your teacher should be able to advise you, especially if occupational therapy is recommended.

Anonymous wrote 30 weeks 5 days ago

Hi, my son is 14 months old but he can't walk. Is this normal? My daughter started walking when she was 10 months old.

admin wrote 30 weeks 4 days ago

We recommend that you have a professional assessment done if you are concerned with any delayed developmental milestones.

Anonymous wrote 37 weeks 3 days ago

I have a sleep-in nanny and her son lives with her. He is 4 years old, but with the body and speech of a 2 year old. I am quite worried about his development. I have two sons of my own, one is 4 and the other is 2. When comparing him to the two of them, he is even lighter than my 2 year old! A clinic sister suggested we take him to an occupational therapist, but financially his mum cannot afford it. PLEASE HELP.

admin wrote 37 weeks 2 days ago

Perhaps you could help her to raise the necessary funds, unless you can find an OT who is willing to assess the child at a reduced rate. You could also enquire at a government hospital about free services.

Anonymous wrote 38 weeks 1 day ago

I have identical twin boys in Grade 1 this year. I have never had any problems with their behaviour or there school work in Grade R... but lately I have picked up at home they have no interest in anything, homework is driving me crazy, I feel horrible during homework because all I do is yell at them, and tell them that they should be able to do it by now. I cannot turn my back for one second because then they get side-tracked by the smallest thing. I feel that they have to be spoonfed, and what breaks my heart is their teacher has spoken to us almost everyday this third term. They do not listen in class and keep the other kids from working too. They refuse to do their assignments, they always have to go the bathroom when they get tasks to do, and the teacher has started to chase them out of the class. I am not happy with this as I feel she is breaking them down even further, but I also understand that she has other kids in the class too. They have a huge lack of concentration. WHAT SHOULD I DO?

admin wrote 37 weeks 4 days ago

You could request a meeting with the teacher and school principal to discuss these issues. They should also be able to recommend avenues to assist your children, possibly beginning with an educational assessment. It does sound like you need professional intervention of some kind.

patience wrote 44 weeks 6 days ago

My daughter is 6 years old. She talks a lot in class, but her marks are all above average. She has been assessed by an OT who has recommended therapy . The OT said she is easily distracted in class and in turn distracts others. She also colours and writes untidy. I am worried because I cannot afford ongoing therapy. Do you think it's something she will grow out of with time or should she at all costs go through the programme?

admin wrote 44 weeks 4 days ago

Unfortunately, we cannot give you professional advice. You can always get another assessment from a different OT if you are not satisfied. All the best!

Anonymous wrote 45 weeks 4 days ago

My boyfriend's son is 5 and lives with his gran. We have been informed by the gran that he has to have OT. Do the father and mother have to be informed by the crèche before proceeding with the therapy? Would the parents have to give consent before proceeding with the therapy and would they have to attend while being assessed? What is the proceedure before assessments and following thereafter if the gran refuses to get the parents involved?

admin wrote 45 weeks 2 days ago

We are not sure about the legalities around your questions and recommend that you seek professional counsel. You may be able to get social workers to advise you of parental rights and obligations.

Bernadette wrote 49 weeks 2 days ago

I am a single mother of two boys aged 2 and 5. I left when my youngest was 3 months old and since then they have only seen their father on three occasions. I have several concerns regarding my youngest and am worried that this could be the reason for these issues. He is incrediably active and constantly puts himself in harm's way and will repeat the exact same thing even after being repremanded. He does not seem to fear anything. He has burstd of anger that are difficult to control as he will hit, bite and scream untill he is over it. He doesn't talk at all and only has two words in his vocabulary. I have tried many different approaches to discipline, but none seem to work. He does not sit still for a time out. Can occupational theory help him in any way?

admin wrote 49 weeks 1 day ago

OT can help with a range of childhood developmental issues. However, your child needs a proper assessment to determine the best form of therapy, if this is required. 

Anonymous wrote 1 year 5 weeks ago

My daughter is 3 years old and her teacher recommends that we take her to an OT because she doesn't finish her tasks. But when she does things at home she finishes the tasks I give her. Should I take the teacher's advice and take her to the OT?

admin wrote 1 year 5 weeks ago

We don't think you have anything to lose by taking your child to an OT. They will be able to assess whether or not your child has any developmental problems, but do keep in mind that she is still very young. There may be many reasons why she doesn't finish her tasks at school but does at home. Good luck!

Anonymous wrote 1 year 6 weeks ago

My daughter is 5 turning 6. She is the most active little person you can get - she never stops. I have made it a rule that she doesn't eat sweets or any sugar whatsoever, but it is a problem as she gets hold of sugar some or other way. My concern is that her teacher mentioned in her report that she is a good student, but she does not complete her tasks and she has a short concentration span. Would you recommend I see an OT or could you give me activities I can do with her at home before going to an OT.

admin wrote 1 year 6 weeks ago

If your child's teacher recommends OT for your child, then we encourage you to follow that route. There may be any number of reasons that your child struggles with concentration. Here's a related article that may be of help: www.childmag.co.za/content/wandering-minds

Anonymous wrote 1 year 6 weeks ago

My daughter is 5 and turns 6 in November. Her teacher told us that she speaks well, but doesn't complete her work. She can't write the letters of the alphabet or identify the letterland phonics. The teacher also told us at last term's meeting that she doesn't walk properly on the stairs and that her physical development is not good. He said we must have my daughter assessed by an educational psychologist. We have decided to help her everyday and if there is no change in two months' time, we will have her assessed. Now I am wondering, shouldn't she be assessed by an OT rather than an educational psychologist? The teacher doesn't agree that we wait a bit. What do you think?

admin wrote 1 year 6 weeks ago

If you feel that your child would benefit from OT, then we encourage you to go that route. The OT should be able to determine if your child should also see an educational psychologist. If your child's teacher urges immediate action, we suggest you follow their advice.

Anonymous wrote 1 year 8 weeks ago

My daughter is 3 years old and has been at a playschool for over a year now. She could recite her alphabet when she was two and has an incredible memory. Her teachers say that her fine motor skills are above average. The problem is that she doesn't speak at school, but the minute we leave, she doesn't stop talking the rest of the day and can fully recount the entire day's activities. Socially she doesn't mix with the other children (she's in a slightly older class) - she is not unhappy at school, just plays alone. She is very particular about things and gets frustrated when the other children don't listen to the teacher or if they shout, she says it hurts her head. Her teachers say she needs help - advice welcome please. Thank you!

Anonymous wrote 1 year 8 weeks ago

Hi, my child is 6 and in Grade R. He has been referred to OT. It appears he cannot follow instructions in the class. He also cannot clean himself after he uses the toilet, although he is potty-trained. He is a normal child, but was a late-starter. He could only communicate at 5 years old.

I don't understand... what is OT?

admin wrote 1 year 8 weeks ago

Occupational therapy is explained in the article above.

Leigh24 wrote 1 year 10 weeks 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 year 10 weeks 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 1 year 16 weeks 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 1 year 16 weeks 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 1 year 19 weeks 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 1 year 19 weeks 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 1 year 32 weeks 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?

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