What is Pediatric Occupational Therapy? Pediatric OT Scenarios 


Occupational therapy is a form of physical and mental rehabilitation that focuses on performing activities required in daily life. In the case of pediatric occupational therapy, this generally focuses on getting children to engage in play, school, and peer interactions. Pediatric occupational therapy helps children develop skills including vision, perception, coordination, strength, sensory processing, writing, emotional management, and social interaction. 


The overall goal of occupational therapy is to improve a child’s ability to effectively interact with and learn from the environment in order to develop skills necessary for daily function.  Often this simply looks like play to a bystander, but play is the way children learn! An occupational therapist can use many fun materials or even games to encourage development of new skills in a fun and creative way.  


What Specific Areas Can OT Address? 


Occupational therapy can help children with many different aspects of life. For example, it can help children with using appropriate social skills and regulating emotions. Being able to dress oneself and having the appropriate self care fine motor skills to use utensils, pencils, button a button or zip up a zipper, are all areas of focus in occupational therapy.  Many children have difficulty with knowing left from right, which can affect the ability to orient clothing for dressing, scan to read a book or know how to tie shoes. Occupational therapy can address this left/right awareness or “laterality” in daily activities.   

Sensory integration is another area that occupational therapy can address.  Improved sensory integration is often achieved by expanding the variety of textures and tastes in a child’s diet and improving tolerance to various clothing textures. An OT could help develop a sensory “diet” with the goal to improve attention or transitions between tasks that are necessary in the school setting. 

Many times kids will present with difficulty with visual perception and ocular motor skills.  OT can provide exercises and activities to improve these skills which can affect school and homework activities as well as participation in many sporting activities.  OT can also address gross motor skills, motor planning and executive function.  

There are times children exhibit symptoms of retained primitive reflexes in their function. Primitive reflexes are involuntary motions that often help to protect infants. Typically these are integrated into more mature and voluntary responses; however, if not integrated, these reflexive patterns can create functional concerns. Retained reflexes can look like difficulty paying attention, anxiety, impaired fine or gross motor coordination, difficulty with balance or reading, difficulty with left-right awareness or a multitude of other concerns.  Occupational therapy can provide guidance to integrate primitive reflexes.  With this developmental foundation, children can improve the skills needed to make daily function more efficient.  

There are times that the most effective way for a child to complete a task is to utilize adaptive equipment.  Some examples of adaptive equipment are adapted eating utensils or pencil grips, slant boards, wheelchairs or crutches, and splints.  An OT will also often recommend sensory equipment for the home or school setting as well.  


Does My Child Need Occupational Therapy? 

Occupational therapy can be helpful for a wide variety of challenges that children face, and can help children improve skills related to school, play, and daily life in general. Occupational may be helpful for your child if they are dealing with any of the following:


  • Sensory integration difficulties or limited emotional management
  • Limited diet and food sensitivity
  • Weak and uncoordinated movements
  • Poor handwriting
  • Difficulty focusing in school
  • Difficulty reading
  • Difficulty tying shoes, buttoning, and dressing
  • Spasms/Muscle Cramps/Spasticity
  • Needing specialty equipment (writing, eating, sensory tools, etc.)


Feel free to get in touch with us to learn more about how our team of expert occupational therapists can help your child reach their maximum potential. 


Common Scenarios and Case Studies of Pediatric Occupational Therapy 

Niagara Therapy’s team of occupational therapists has helped many children over the years. We’ve outlined some common scenarios to help give you a better understanding of what occupational therapy looks like in the real world. 

Scenario 1

JH is a 6 year old girl who has a difficult time playing on the playground.  Her teacher noticed that she falls frequently and seems clumsy.  She loves the social aspect of tee ball, but has a hard time connecting the bat to the ball.  


She was referred to occupational therapy, and we noted that she had difficulty with visual perception, using both hands together, and had a hard time crossing midline in activity. Each of these areas is vital when trying to swing a bat or catch a ball. She also had some retained primitive reflexes that have affected development of these skills.  

We determined that occupational therapy intervention would be helpful for JH. Treatment would focus on improving visual perception, bimanual use, midline crossing, and primitive reflex integration.  


Scenario 2 

PR is really struggling with handwriting and copying his assignments from the board at school. His OT found that he has hand weakness and poor fine motor skills as well as limited core strength affecting sitting posture and balance.  He also demonstrates difficulty with visual perception and ocular motor skills which contribute to the challenge of handwriting.  

We determined that occupational therapy services would help to improve core strength, fine motor skills, and address visual concerns. By regularly completing tasks or exercises as recommended by an OT, PR should gain skills to improve his abilities in these areas, and his parents and teachers should see improvements in school work.  

Scenario 3

HC is an 8 year old who cannot tie his shoes or button a shirt. He also requires some assistance to put on his clothing and has trouble crossing midline in activity. In OT, he demonstrates impaired hand strength and fine motor skills as well as some retained primitive reflexes.  

We determined that occupational therapy can help him learn left/right and spatial awareness to

improve his ability to orient clothing.  He is also given exercises and activities to do at home to improve strength and fine motor skills that would allow him to more easily tie a shoe or button a button. Reflex integration can also develop underlying skills to help to make these tasks easier.

Scenario 4

YG sustained a concussion, has been experiencing headaches, and has difficulty organizing schoolwork or cleaning her room.  When evaluated in OT she was found to have ocular motor and visual perceptual impairments that are contributing to headaches and difficulty with reading.  


We determined that occupational therapy can help to improve visual deficits and address executive function.  

Scenario 5 

KL is unable to tolerate wearing various textures of clothing and is a very picky eater.  This has made getting ready for school and mealtimes very frustrating for everyone in the house.


Our occupational therapist had KL’s caregiver complete a sensory profile to evaluate the various areas of sensory processing in order to determine how those sensory abilities affect daily function. The OT also observed and interacted with the child to determine how to plan the best intervention for KL. We evaluated sensory preferences and assisted in exploring strategies to make these areas less stressful for both the child and parent.   

What Do All of These Children Have in Common? 

Each of these children has some observable functional difficulties with underlying causes that can be addressed in occupational therapy! As you can see, OT addresses a variety of areas. Undeveloped or underdeveloped skills can make everyday tasks challenging.  Determining and addressing these areas is crucial for improved function. An occupational therapist will look at the big picture to help determine what skills may need improved to ultimately affect function.  

Pediatric Occupational Therapy with Niagara Therapy 

Your kids are important to us at Niagara Therapy, and we love to get to know them and their interests in order to help them enjoy every moment and be as independent as possible every day.  We utilize tools and techniques that are not available anywhere else in the region. Interactive Metronome and Brain beats are computerized programs that can help improve coordination and attention as well as auditory processing.  The Neuro Sensoriomotor Integrator or NSI is a fun & interactive technological tool we can use to improve letter and number recognition as well as ocular motor and visual perceptual skills.  Our therapists use various programs to improve body awareness, visual perception, handwriting, emotional regulation and explore new foods.  


We offer speech, physical and occupational therapies at Niagara Therapy and use a team approach driven by your goals.  We offer sessions between 7 AM and 7 PM and focus on only one client at each session.  If your child is experiencing difficulties with independent function or meeting developmental milestones, call us at 814-464-0627.  

Let us know what’s on your mind!