What Does a Paediatric Occupational Therapist Do?
- 3 hours ago
- 5 min read
By Georgina Ahrens, Occupational Therapist
Director, Kids World Paediatric Therapy
DIR®/Floortime Trainer | Profectum Foundation Associate Faculty
When parents first hear that their child may benefit from occupational therapy, one of the most common questions is: What does an occupational therapist actually do?
Occupational therapy is about helping people participate in the activities that are meaningful and important in their everyday lives. For children, these everyday “occupations” include playing, learning, getting dressed, eating, participating at preschool or school, developing relationships and becoming increasingly independent. This focus on participation in everyday life is central to occupational therapy practice.
A paediatric occupational therapist looks at the whole child — their strengths, individual differences, environment and the activities they need and want to participate in — to understand what may be helping or making participation more difficult.
Why Might a Child See an Occupational Therapist?
Children may come to occupational therapy for many different reasons.
Some children may find everyday activities more challenging because of differences in sensory processing, regulation, motor planning, coordination or executive functioning.
Others may need support with self-care, play, social participation, attention, independence or managing the demands of preschool or school.
Occupational therapy may support areas such as:
Sensory processing and regulation
Emotional regulation
Fine and gross motor skills
Motor planning and coordination
Executive functioning
Attention and participation
Dressing, toileting and other self-care activities
Play
Social participation and relationships
Independence and daily living skills
Participation at preschool or school
Confidence and self-advocacy
The focus will be different for every child because occupational therapy should respond to the individual child's strengths, needs and goals.
Understanding the “Why” Behind a Challenge
At Kids World, an important part of occupational therapy is understanding why a child may be finding something difficult.
For example, a child who has difficulty getting dressed may know how to put their clothes on but find certain fabrics or sensations uncomfortable. Another child may have difficulty remembering and organising the sequence of steps involved.
A child who struggles to participate in the classroom may be using considerable energy to manage noise, movement and other sensory information. Another may find it difficult to plan how to begin a task, shift their attention or understand what is expected.
What looks like the same difficulty from the outside can therefore have very different underlying reasons.
Understanding the “why” helps the occupational therapist determine what type of support may be meaningful for that individual child.
Looking at the Child, the Activity and the Environment
Occupational therapists don't only look at what a child can or cannot do.
We consider the interaction between the child, the activity and the environment.
Sometimes therapy focuses on developing a child's skills or capacities. At other times, changing the environment, adapting an activity or helping the adults around the child understand their individual needs may make the greatest difference.
For this reason, occupational therapy can involve much more than what happens during a therapy session.
An occupational therapist may work with parents and carers, collaborate with teachers or other professionals, observe a child at preschool or school, recommend changes to an activity or environment, or help develop practical strategies that can be used in everyday life.
Occupational Therapy Australia similarly describes contemporary paediatric OT as occupation-focused and concerned with supporting children's meaningful participation across their everyday routines and environments.
What Does Paediatric Occupational Therapy Look Like?
To a child, occupational therapy may look like play.
A session might involve movement, climbing, swinging, building, drawing, games, imaginative play, problem-solving, cooking or practising an everyday activity.
However, the occupational therapist is doing much more than simply choosing enjoyable activities.
The therapist is observing how the child responds, carefully considering the demands of the activity and adjusting the environment, challenge and level of support according to the child's individual developmental needs and therapy goals.
A movement activity, for example, might provide opportunities to support regulation, motor planning, coordination, problem-solving, communication and confidence at the same time.
Our Approach at Kids World
At Kids World, our occupational therapists use the DIR® model (Developmental, Individual-differences, Relationship-based) as part of our approach to understanding and supporting children.
All of our occupational therapists are DIR®/Floortime certified.
DIR® encourages us to consider a child's Functional Emotional Developmental Capacities (FEDCs), their individual sensory and motor processing differences, their interests and their relationships.
Rather than focusing only on teaching an isolated skill or changing a behaviour, we consider the developmental capacities and individual differences that may be influencing the child's ability to participate.
Relationships are also central to this approach. A child who feels connected, understood and supported is better able to engage, communicate, problem-solve and participate in experiences that support development.
Working With Parents and Carers
Parents and carers are an important part of occupational therapy.
Our goal is not for a child to develop skills that only appear in the therapy room.
We work with families to help them develop a deeper understanding of their child's individual strengths and needs and identify practical strategies that can be incorporated into everyday life.
This might involve discussing what we have observed during a session, helping a parent understand why a particular situation is difficult, adapting an activity or environment, or exploring different ways of supporting regulation and participation.
Over time, we want parents and carers to build their own knowledge, confidence and practical skills so they can support their child in the situations that matter in everyday family life.
Does My Child Need Occupational Therapy?
There isn't a single checklist that determines whether a child should see an occupational therapist.
It may be worth considering an occupational therapy assessment if differences in areas such as regulation, sensory processing, motor skills, self-care, executive functioning or participation are making everyday activities more difficult for your child.
An occupational therapy assessment can help identify your child's strengths, understand the factors that may be affecting their participation and determine whether occupational therapy or other supports may be helpful.
Most importantly, occupational therapy should not be about trying to make a child appear more like their peers. It should help us understand the individual child and support them to participate, develop skills, build independence and advocate for their needs in ways that are meaningful to them.
Paediatric Occupational Therapy at Kids World
Kids World Paediatric Therapy provides occupational therapy for children and young people aged 0–18 years from our clinics in Lane Cove, Sydney.
Our occupational therapists provide Individual Therapy, Social Setting Therapy, Occupational Therapy Assessments, Functional Capacity Assessments, school and preschool consultations and small-group Intensive Therapy Programs.
If you're wondering whether occupational therapy may be helpful for your child, our team can discuss your child's needs and the most appropriate next step.
Last reviewed: March 2026
Please note: This article provides general information and is not intended to replace individual assessment or advice from a qualified health professional. Every child is different, and recommendations should be considered in the context of their individual needs and circumstances.
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