It seems like more people have heard of occupational therapy (OT) by now, but what exactly is it? We do so much more than work on handwriting and fine motor skills.

This beginner’s guide to OT will help you understand what an occupational therapist is and what to expect in different settings.

You’ll also learn what to look for in a good occupational therapist and a surprising reason you don’t need OT.

The more you know, the more you can get exactly what you need.

Let’s get started!

What are Occupations?

An occupational therapist helps you improve your ability to perform occupations.

Duh, right?

But when you learn what an occupation is, it’ll all make sense…

Simply put, occupations are the things that occupy your time.

What do kids need or want to do? (This is not a trick question).

Children need to sleep, eat, drink, play, learn to use the toilet, get dressed and undressed, go to school, make friends, etc, etc. The list is endless. These are all occupations.

The whole point of occupational therapy is to help people do things that really matter to them.

Now that you know WHAT it is, find out your options of WHERE to get it:

NICU (neonatal intensive care unit)

If your child was born early, experienced a difficult birth, or was born with a variety of health problems, he could end up in the NICU.

PROS

• Parents learn how to feed and take care of their baby

• Minimize effects of medical conditions

CONS

• May not have many options of which NICU to go to

Hospital 

If your child is in the hospital, he probably has something serious going on like a head injury, stroke, burn, genetic disorder, or cancer.

Occupational therapists in hospitals help your child work on things like eating and using their hands to do everyday activities.

They might also make splints for your child to protect their hands.

PROS

• Your family gets expert help managing difficult situations

CONS

• May not have many options of which hospital to go to

Early intervention

Early intervention programs are publically funded and available for children under three. The whole point is to catch delays early or prevent them from happening in kids who are at risk for developing delays.

Early intervention is about taking advantage of the child’s early years - when their brain and muscles are most easily impacted.

The focus is on helping parents learn because children are with their caregivers so much.

The child gets services in their natural environment which means your child can get therapy in their homes, in daycares, at their neighborhood park, etc.

“Natural environment” also means therapy involves using what you already have in your house.

Depending on your needs, you might see a therapist once a week, every other week, or once a month.

Common reasons kids need early intervention occupational therapy :

• Premature/multiple births

• Late milestones (rolling, sitting, walking, talking, eating solids)

• Vision or hearing problems

• Stroke/brain injury

• Cerebral palsy

• Plagiocephaly and/or torticollis

• Limb deformities

• Brachial plexus injury

• Viral diseases

• Epilepsy

• Neonatal withdrawal symptoms

• Low/high tone (rigid or floppy baby)

• Down syndrome

• Autism

… and so much more!

Interested in learning more?

Read more about your state’s early intervention program here.

PROS

• Kids make good progress when parents understand what to do

• Free for people with Medicaid / sliding scale for families with private insurance or paying out of pocket

• Can help get your child evaluated by the schools soon after their third birthday

CONS

• Different rules and qualifications in every state

• Ends when child turns 3

• Can have long waitlists for evaluations and/or starting therapy

School

To get occupational therapy in the schools, the child must be having difficulties with something related to school.

He could work on things like paying attention in class, managing his homework better, managing his clothes when going to the restroom, being more independent in the cafeteria, etc.

PROS

• Your child is already at school (no driving for the caregivers)

• Your child will be in school for a long time, so what he learns in school OT can possibly help him in school for years to come

• Funded by the schools (no cost to parents)

CONS

• Goals are limited to school function

• OTs may have a lot of kids to see in many schools, so your kid might get as much one-on-one attention as you’d like

• Parents may have less of an idea of what is going on

Clinic (aka “outpatient pediatric clinic”)

Children of all ages can go to clinics, but you can expect children in most clinics to be around 2-8 years old.

Children with sensory processing differences (including autism) often go to clinics.

Make sure to look at what your child needs to do or wants to do that is impacted by his sensory processing challenges.

Depending on your needs and the therapist's recommendations, expect to come to the clinic about once or twice per week for 30-60 minute sessions.

PROS

• Can work on a wide range of goals (depending on insurance approval)

• Clinics usually have a lot of equipment/supplies/toys/space

• There are usually several clinics to choose from near major cities.

CONS

• A clinic you like might be a far drive

• Parents and therapists might not have much time to talk in between sessions

• Can have long waitlist

Some clinics also offer intensive occupational therapy. Usually, these clinics are highly specialized with programs to go target just what your child needs.

For intensive therapy, expect your child to have therapy 1-3 hours per day, 3-5 days per week, for 3-6 weeks (depending on your child’s needs and therapist recommendations).

PROS

• Your child can make a lot of progress quickly

• Usually involves some parent coaching as part of the program

CONS

• Could have long waitlists

• Parents may have to take off work to participate.

• Can be expensive

Home Health

Home health occupational therapy is usually recommended when it is medically necessary for your child to stay home.

Reasons your child might need home health (not complete list): 

• Uses a gastric tube

• Is on a ventilator

• Has a tracheostomy

• Uses an apnea monitor

What does your child need to do in these situations? Younger kids can work on getting around the house or eating. Maybe he’s an older kid and he needs to manage his own health devices.

PROS

• Convenient

• Your child learns using their own stuff in their own home

CONS

• Some insurances require this service to be a medical necessity. If not covered, your child would have to get therapy in a hospital or clinic

• If the therapist brings a “bag of tricks” but takes the toys away when they leave, your child may not make as much progress as possible.

What makes a good OT (in any setting)

No matter where your child gets occupational therapy, a good therapist makes all the difference.

A good OT will look at your child’s strengths and interests as well as struggles.

She looks beyond your child’s physical skills. She helps him develop the mental, emotional, and social skills needed to live a happy life.

She thinks about how your child’s environment can be used to set him up for success.

A good occupational therapist works with you to find solutions that work for your family.

A surprising reason you DON’T need OT:

You don’t necessarily need OT if your child has a diagnosis like autism or Down syndrome, etc. Those things are part of their being. Those diagnoses don’t automatically mean they will be in therapy for the rest of their lives.

Remember, keep the “occupation” in occupational therapy.

Whenever you are thinking of goals, think about how you’d like your child’s daily life to improve.

Hopefully, you now have a better understanding of what occupational therapy is and which setting could work for you.

Do you think your child would benefit from virtual occupational therapy?

If so,