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 2 years 42 weeks ago

My son is five and has delayed speech. He says a lot of words but cannot put together a sentence. He sees a speech therapist and though I see  improvement every day, I'm worried about his education. He needs to start Grade R next year but I know he is not ready. Are there schools that cater for kids like him? Everything else is developing normally, according to me and his therapist.

Tamlyn wrote 2 years 42 weeks ago

There are schools that will be able to assist. Please have a look at our Dealing with Difference resource, where we have a number of special needs schools listed. 

annonymous wrote 2 years 46 weeks ago

Good day 

I have a 10 year old boy and I have been in and out of school because of his behaviour. I don't know where he gets it from and his teachers also told me that he is diruptive and jokey in class, and he does not finish his tasks or school work. They also say that he speak back at times. However, academically he is doing great. On my side, as a parent, I find it very difficult to get through to him when I ask him why is he doing what the teachers say he is doing. One of the teachers said something that disturbed me - she said I should consider taking him to a boarding school. He can't follow instructions; he just does not get the word NO when he is told. 

Should I take him to the OT? Help is urgently needed; I am a single parent who is trying so hard for her child, any assistance will help...

Tamlyn wrote 2 years 46 weeks ago

Hi there. We would suggest speaking to an educational psychologist, who may be able to assist in identifying possible problems. You can have a look at our Health care practitioner resource, to find a therapist in your area: www.childmag.co.za/resources/healthcare-practitioners 

Sally mlambo wrote 3 years 18 hours ago

My daughter is 6 years old and in grade 1. She is struggling to write; she can't even write her name or surname but she can talk and name things and even count .Please advise if I need to take her to OT. 

Tamlyn wrote 2 years 52 weeks ago

We would suggest that you speak to your daughter's teacher or school to see what they recommend. Alternatively, an assessment by an occupational therapist may help in determining if there is a cause for concern, and what action to take. 

Anonymous wrote 3 years 3 weeks ago

My son just turned 5, and is in grade R. This is his first year in formal school and it has been just over two months. His teacher called us in and had some issues; she has informed us that he has difficulty sitting still in the class, and that he sometimes refuses to listen to instructions. He does have a problem pronouncing some words, but his speech is ok, and he has a very good memory. He knows the alphabet and is able to count to 20. He can colour and draw and is able to write his name. He can identify all the shapes and colours. Do you recommend that I take him for an assessment?

Tamlyn wrote 3 years 3 weeks ago

We would suggest that you speak to the school and find out what they recommend. An assessment could help identify if there are any problems, and it is often better to pick these up early. 

Cheryl wrote 3 years 4 weeks ago

My 10 year old grandson is battling to write and read in cursive.

He is ADHD and battles to complete any schoolwork. He disrupts class daily and is extremely short tempered. He uses 40mg Ritallin daily with an anti depressant and a Rispidor tab at night for mood swings. I  believe that he's being misdiagnosed and is suffering from ODD ( Defiant Oppostional Disorder). He can verbalise the schoolwork or orally understands, but battles to write it down on paper. Does he need occupational therapy?

Tamlyn wrote 3 years 4 weeks ago

We would suggest that you speak to his teachers and possibly the school counsellor and ask what they would suggest. You can also speak to an occupational therapist, and find out whether therapy would be able to help, or what alternatives could work. 

Anonymous wrote 3 years 5 weeks ago

My son is 7 and is struggling to recognize and understand the phonics sounds. He understands his mathematics well. He can express himself well. When he is at home he is bubbly, but he is very shy at school. He is unable to make friends at school. I am worried whether he will be able to read. What could the problem be and how can I help him?

Tamlyn wrote 3 years 5 weeks ago

We would suggest that you talk to your child's teacher, who may be able to give you a better understanding of how your son interacts at school. His teacher may also be able to tell you if someone like an occupational therapist could be of any assistance. 

Anonymous wrote 3 years 8 weeks ago

Hi. My daughter is 5 years old and in  Grade R. I was not referred by her teacher but decided to make an appointment at the O.T. anyway. She has been in this school for a year and a half. She is normal with her development, but she is extremely shy when it comes to her teachers; they usually have to take her aside to ask her questions about her work at school and they still struggle to hear her as she will whisper to them and she always seems anxious when they ask her to answer a question. She is not like this at home at all, or even on the playground with her school friends or home friends, or with adults we know. Just worried that it will effect her grades later on in school. Do you think that this OT appointment will benefit her in some way?

Tamlyn wrote 3 years 8 weeks ago

It may be best to speak to your daughter's teachers to see what they recommend. But OT can be very beneficial, and the therapist may also be able to suggest other avenues that could help. 

Anonymous wrote 3 years 28 weeks ago

My son is turning 6 in a few day's time. He is in Grade R but seems to be struggling at school. All the other kids are reading and writing but he still cannot.  Even when we do homework he battles to memorise anything; he can count to 20 but does not remember what the numbers look like. He battles with the alphabet - he cannot say it and does not remember it. He even battles to copy the numbers and letters if you write them down for him. Please advise whether I need to take him for an OT assessment? Or please provide me with any advice which may help. Thank you.

Tamlyn wrote 3 years 28 weeks ago

We would suggest that you speak to your child's teacher or school first, to see if they think your son needs further assistance. Following that, an OT assessment may also give you some insight or guidance. 

Anonymous wrote 3 years 36 weeks ago

What are the standard O.T. fees for an assessment?


Tamlyn wrote 3 years 36 weeks ago

You would need to get that information from your occupational therapist. Your medical aid may also be able to give you an indication of standard fees. 

Anonymous wrote 3 years 39 weeks ago

Hi there

My baby is now 18 months old. She had a difficult birth and is receiving physio to help with her milestones. She is an estimated 6 to 10 months behind in her development. What else can I do to help her to catch up? I feel helpless and want to do everything possible to get her up to date with her milestones.

Tamlyn wrote 3 years 38 weeks ago

We would suggest that you speak to your physio, a paediatrician or an OT to see if there is anything more you can do, either at home or through consulting a medical practitioner. If you attend any baby development classes, they may also be able to suggest some options available to you.

Anonymous wrote 3 years 45 weeks 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 3 years 45 weeks 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 3 years 45 weeks 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 3 years 45 weeks 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 3 years 45 weeks 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 3 years 45 weeks 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 3 years 45 weeks 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 3 years 45 weeks 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 3 years 45 weeks 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 3 years 45 weeks 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 3 years 48 weeks 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 3 years 48 weeks 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 3 years 51 weeks 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 3 years 51 weeks ago

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

Anonymous wrote 4 years 3 weeks 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 4 years 3 weeks 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 4 years 4 weeks 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 4 years 4 weeks 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 4 years 6 weeks 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 4 years 5 weeks 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 4 years 10 weeks 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 4 years 10 weeks ago

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

Anonymous wrote 4 years 22 weeks 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 4 years 22 weeks ago

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

Anonymous wrote 4 years 29 weeks 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 4 years 29 weeks 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 4 years 30 weeks 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 4 years 29 weeks 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 4 years 36 weeks 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 4 years 36 weeks 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!

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