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 4 weeks 9 hours 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 3 weeks 6 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 4 weeks 5 days 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 weeks 1 day 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 11 weeks 3 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 11 weeks 1 day 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 12 weeks 1 day 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 11 weeks 6 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 15 weeks 6 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 15 weeks 5 days 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 24 weeks 2 days 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 23 weeks 6 days 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 25 weeks 1 day 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 24 weeks 5 days 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 25 weeks 2 days 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 25 weeks 1 day 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 26 weeks 6 days 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 27 weeks 1 day 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 27 weeks 3 hours ago

Occupational therapy is explained in the article above.

Leigh24 wrote 29 weeks 22 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 29 weeks 7 hours 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 35 weeks 10 hours 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 35 weeks 2 hours 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 38 weeks 1 day 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 38 weeks 4 hours 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 51 weeks 7 hours 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 51 weeks 3 hours ago

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

Anonymous wrote 1 year 2 weeks 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 1 year 2 weeks 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 1 year 8 weeks 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 1 year 8 weeks 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: www.dore.co.za

Concerned Parent wrote 1 year 10 weeks 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 1 year 11 weeks 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 1 year 10 weeks 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 1 year 13 weeks 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 1 year 13 weeks 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 1 year 15 weeks 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 1 year 15 weeks 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 1 year 16 weeks 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 1 year 16 weeks 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 1 year 18 weeks 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 1 year 25 weeks 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 1 year 25 weeks ago

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

Anonymous wrote 1 year 29 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 29 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 29 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 29 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 32 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 36 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 35 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!

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