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Areas That Pediatric Occupational Therapists Treat

Occupational therapists are skilled at assessing a number of skills which include:  fine motor ability, sensory processing, coordination, motor planning, perception, functional visual skills, self-care, social skills, and other age appropriate skills. Developmental assessments are used to determine a child's skills in these areas in relation to their peers. This information is then used to devise individual treatment programs.

Fine Motor

  • Pencil grip
  • Handwriting adaptations
  • Pencil/crayon control in writing and drawing
  • Space & letter formation/orientation to lines
  • Hand/finger strength/stability
  • Wrist &/or forearm control
  • Postural/shoulder stability
  • Hand/finger speed & dexterity
  • Finger isolated movements
  • Tweezers, scissors, tool usage
  •  Determination of hand dominance
What to look out for in your child:
  • No interest in or avoidance of fine motor skills
  • Awkward or poor pencil grasp
  • When writing or coloring, lines are wavy
  • Poor scissors skills such difficulties staying on the line or jagged work.
  • Clumsy grasp & release skills, frequently dropping items
  • Difficulty holding small objects
  • Difficulties manipulating tools, pencils or scissors
  • Agonizing over completing mazes, dot-to-dots, etc.
  • Difficulty copying text from white board or blackboard
  • Difficulties with shoe tying, buttoning
  • Frequent switching of the hand used
Sensory Processing

  • Sensory diets are established at home and/or school based on the child's individual needs
  • Treatment is focused on the integration of the sensory systems including following areas: movement (vestibular), pull of gravity (vestibular), touch (tactile), mouth (oral motor), sight and sound.
  • Children are taught specific strategies for use in maintaining or regaining self-control
What to look out for in your child:
  • Over or under sensitivity to touch, movement, sights or sounds
  • Easily distracted from work or activities
  • Activity level is unusually high (always moving) or unusually low (lethargic, disinterested)
  • Impulsiveness, poor judgment
  • Clumsiness
  • Delays in language or motor skills
  • Emotionally reactive
  • Difficulties relating to peers or family
  • Difficulties with changes, wants items/routines to stay the same
  • Inability or difficulty in calming self
  • Academic Delays
Motor Planning/Coordination

  • Ball skills - throwing & catching, hitting ball
  • Balance: Balancing on one leg, hopping, walking on a balance beam
  • Coordination of body sides: difficulty skipping or dancing
  • Postural reactions to maintain balance on a moving surface
  • Laterality/Directionality
What to look out for in your child: 
  • Flinching when catching a ball or avoidance of playing catch
  • Clumsiness
  • Fearful of gross motor activities
  • Fearful of having their feet leave the ground
  • Difficulty coordinating body sides, moves awkwardly
  • Poor endurance
Visual Processing/Perception

  • Visual motor - the ability of the hand and eyes to smoothly work together to guide hand movements
  • Visual figure ground - being able to find "hidden" figures among a busy background
  • Visual memory - measuring the child's ability to remember previously shown shapes
  • Visual discrimination - finding similarities and differences among similar figures
  • Visual sequential memory - remembering a series of forms and choosing the series from among similar series
  • Visual constancy - the ability of the child to recognize a symbol as being the same in spite of being resized or rotated
  • Eye movements/Visual pursuits - the ability of the child to smoothly track with his eyes the movement of objects or symbols
  • Copying from far and near
  • Visual spatial relationships - being able to identify reversals of objects or shapes
  • Body awareness - familiarity with body parts and relation of self to environment
What to look out for in your child:
  • Difficulty in recognizing letters and with letter production
  • Reversals of letters or numbers, (such as b for d and p for q)
  • Inattention or distractibility to writing or reading tasks
  • Difficulty copying from a blackboard or white board
  • Poor at following instructions
  • Directionality confusion moving around environments
  • Difficulties understanding the layout of math problems and math worksheets which can interfere with learning of math concepts
  • When compared his or her peers, pictures drawn are immature and unrefined
  • Immature drawings of people compared to peers
  • Poor eye contact
  • Loses his place frequently or skips words while reading

  • Dressing skills -  (put on and take of) clothing, shoes & socks
  • Strategies and ideas for sequences/cues to use when dressing
  • Hygiene: basic grooming (hair and tooth brushing)
  • Eating; utensil grasp, bilateral coordination of knife and fork
What to look out for in your child:
  • Dressing: clothes put on backwards, shoes put on the wrong feet
  • Food is pushed off the edge of the plate
  • Food falls off of eating utensils
  • Messy eaters
Social Skills

  • Cooperative play/sharing skills
  • Development of leisure activities
  • Development of self-esteem
  • Attention
  • Listening skills
  • Following directions
What to look out for in your child: 
  • Poor body language
  • Withdrawal from social situations
  • Lack of group interaction (or avoidance of)
  • Lack of confidence in oneself
  • Poor eye contact

  © 2004 Carrie Lippincott, OTR/L

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