When one of our children kept experiencing frequent, long-lasting meltdowns about the smallest things, my husband and I weren’t sure what to do. We could see that our kid needed more support around frustration tolerance and emotional regulation, but nothing we tried seemed to make a difference. A friend suggested occupational therapy as an option to explore, and after several weeks of sessions, we finally started to notice a difference in behavior—and we felt more equipped to handle it going forward. Here’s what to know about occupational therapy (OT) and how it can help families and children alike.
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What is pediatric occupational therapy?
A common misconception about pediatric occupational therapy is that it’s only for children who need help with fine motor skills or those who have a developmental disability, injury, or disease. However, these services are actually much broader and include support for children from birth to young adulthood.
“Occupational therapy helps people who are experiencing some barrier to participating in their daily activities engage in their lives in meaningful, purposeful ways,” said occupational therapist Larissa Geleris. “In terms of children, this might include Down’s syndrome, cerebral palsy, sensory processing disorder, autism, or ADHD.”
The goal is to help kids learn a wide range of developmental skills, such as gross motor coordination, visual-perceptual skills, social skills, sensory regulation skills, and cognitive and problem-solving skills, explained Brian Comly, an occupational therapist with 14 years of experience. In general, pediatric occupational therapists work with kids from birth to age 21, but the most common age range is 2-12 according to Samantha Kaufman, MOT, OTR/L, and Clinical Director of Occupational Therapy at DotCom Therapy.
Where are occupational therapy sessions typically held?
Occupational therapists can work with children in many different settings, but the most common ones are schools, hospitals, clinics, and the child’s home, said Marielle Marquez, a pediatric occupational therapist based in Los Angeles. Additionally, some sessions may occur through state-based early intervention programs or virtually through teletherapy.
“OT services are offered in a few different ways,” said Geleris. “In the U.S., early intervention services are offered, free of charge, for children under 3 who qualify, but eligibility requirements may vary depending on location. School-based services are offered when the child is experiencing barriers to participating in their academic life. There are medical- or hospital-based services for medical barriers, or private clinics that often provide sensory integration-based services.”
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Do you need a referral from your pediatrician?
Many occupational therapists recommend that parents first talk to their child’s pediatrician about potential services. Geleris suggested keeping a running list of concerns or challenges you’ve noticed, such as difficulty with transitions, feeding challenges, unusually long meltdowns, or rigidity around routines, so you can speak to your kid’s doctor about your specific concerns. If for some reason you’re unable to get a referral, private therapy clinics are an option, but insurance may not cover services.
How much does it cost, and does insurance typically cover it?
The short answer: It depends. Occupational therapy services are usually covered to some degree, but caregivers should always call their medical insurance company to find out more details, as well as to ask if a formal referral is needed. Unsurprisingly, out-of-pocket costs for occupational therapy in the U.S. may be much more expensive depending on the type of service and provider. However, you’ll want to get a ballpark so you can try to budget accordingly, use HSA or FSA funds, or explore other options.
What happens during an occupational therapy consultation?
According to Kaufman, pediatric occupational therapy consultations often involve interviewing the child’s caregiver to better understand the child’s baseline. “Then, the OT will observe the child during play or [while] participating in a developmentally appropriate activity such as feeding or handwriting,” she continued. “Additionally, the consult may involve completing a standardized assessment to determine what the child is and is not able to do. This helps the OT to determine and set the right goals and outcomes.”
What do children learn during occupational therapy sessions?
The short answer: It depends on what the child needs. Occupational therapy can help support sensory integration, fine motor skill development, independence in self-care, and skills with feeding, said Marquez. For older children, that may include self-regulation strategies or coping tools that may help the entire family unit during moments of overstimulation.
“Children who go through OT services often experience improved regulation skills, such as fewer meltdowns, increased flexibility with changes in routine, and independence in self-care skills,” said Geleris. “Most importantly is an increased sense of self-confidence and self-worth. You’ll notice an increased pride in themselves, and more ‘Watch this, mom!’ moments.”
Source: Paige Cody | Unsplash
How long does it take to see progress?
While every kid’s situation is unique, occupational therapy sessions can serve as both a short- and long-term solution—with consistent support from caregivers and family members at home. Sometimes that looks like a single consultation to develop an at-home program, or it could involve ongoing sessions for months or years. It’s critical to remember that success also looks different for each kid, and knowing OT is “working” may take some time.
When should parents explore additional support outside of OT services?
Occupational therapy offers many ways to help children, but there are a few areas where parents should consider additional services. “For example, if a child is having speech and language difficulties, then that child would benefit from working with a speech-language pathologist,” explained Comly. “If they are having trouble walking, going up stairs, or if they lose their balance often, then physical therapy. If a child is having significant mental health concerns, such as severe depression or anxiety, working with a psychologist and/or psychiatrist would be beneficial. Your pediatrician is a good resource to help navigate these different disciplines to provide the best fit for your child who may need some, none, or all of these services.”
What’s the #1 thing occupational therapists wish more parents knew?
“I always encourage parents to ask what their child is working on,” said Marquez. “A good therapist will make it look like they are just having fun but will be able to explain to the parents all the underlying skills they are addressing through playful activities. Ultimately, parents really need to buy into occupational therapy for it to be effective.”
