What Is Occupational Therapy for Children? A UK Parent's Guide (2026)

What Is Occupational Therapy?

The word "occupation" in occupational therapy does not mean a job. For children, their "occupations" are the activities that fill their day — playing, learning, eating, dressing, socialising, and all the other things that make up childhood. When a child finds these activities difficult because of physical, sensory, or developmental challenges, an occupational therapist can help.

Paediatric occupational therapists are trained to understand how children develop and what can go wrong along the way. They look at the whole child — their body, their senses, their environment, and the demands being placed on them — and work out practical ways to help them participate more fully in daily life.

Occupational therapists are registered with the Health and Care Professions Council (HCPC) and hold a degree or postgraduate qualification in occupational therapy. Many paediatric OTs also have additional specialist training in areas like sensory integration or handwriting.

What Does a Paediatric OT Actually Help With?

Paediatric OT covers a wide range of areas. Here are the most common ones:

Fine motor skills

These are the small, precise movements of the hands and fingers. Fine motor difficulties can affect:

• Handwriting — letter formation, pencil grip, writing speed, legibility
• Using scissors
• Doing up buttons, zips, and laces
• Using cutlery
• Building with small pieces (Lego, puzzles)
• Drawing and colouring

Gross motor skills

These are the larger movements involving the whole body. Difficulties here might look like:

• Clumsiness or frequent tripping and bumping into things
• Difficulty with balance — riding a bike, standing on one foot
• Poor coordination — catching a ball, skipping, climbing
• Low muscle tone (hypotonia) — appearing "floppy," tiring easily, slouching
• Difficulty sitting still in a chair at school

Sensory processing

This is one of the biggest areas of paediatric OT, and one that many parents have not heard of until their child is flagged. Sensory processing is how the brain takes in, organises, and responds to information from the senses. Most people think of five senses, but there are actually at least seven that matter here:

• Sight (visual)
• Sound (auditory)
• Touch (tactile)
• Taste (gustatory)
• Smell (olfactory)
• Movement and balance (vestibular) — your sense of where your body is in space and whether you are moving
• Body awareness (proprioception) — your sense of how much force your muscles are using and where your limbs are without looking at them

Children can be over-sensitive (hypersensitive) or under-sensitive (hyposensitive) to any of these senses — or a mixture of both. This can show up in many ways:

• Covering ears in noisy environments or becoming distressed by certain sounds
• Refusing certain clothing because of how it feels (labels, seams, textures)
• Very restricted eating — only accepting certain textures or colours of food
• Seeking intense movement — constantly spinning, jumping, crashing into things
• Avoiding messy play, sand, paint, or certain textures
• Appearing not to notice pain or temperature
• Difficulty concentrating in a busy, noisy classroom
• Becoming overwhelmed or having meltdowns in sensory-rich environments like supermarkets

Sensory processing difficulties are very common in autistic children, but they can also occur on their own or alongside other conditions like ADHD, dyspraxia (developmental coordination disorder), or anxiety.

For more detail on sensory processing, see our guide to sensory processing difficulties in children.

Daily living skills (self-care)

Some children need support to develop independence with everyday tasks:

• Getting dressed and undressed
• Using the toilet independently
• Eating and drinking (including using cutlery and managing different textures)
• Washing, teeth brushing, hair brushing
• Organising belongings — packing a school bag, keeping track of things

Attention and self-regulation

OTs also help children who struggle to:

• Sit still and focus during lessons
• Manage transitions between activities
• Regulate their emotions and energy levels
• Follow multi-step instructions

When Might Your Child Need an OT?

You might consider an OT assessment if your child:

• Is significantly behind their peers with handwriting or other fine motor tasks
• Is noticeably clumsy or uncoordinated for their age
• Has intense reactions to sensory input — sounds, textures, tastes, movement
• Struggles with self-care tasks that other children their age manage independently
• Finds it very difficult to sit still, pay attention, or cope in a classroom environment
• Has been diagnosed with (or is being assessed for) autism, ADHD, dyspraxia, or developmental delay
• Has low muscle tone or seems to tire very easily
• Is a very restricted eater and you suspect it may be sensory-related

What Happens in an OT Assessment?

The first appointment is usually an assessment, which will typically involve:

• A detailed discussion with you — about your child's history, daily routines, what they find easy and hard, and your concerns
• Observation of your child — the OT will watch how they move, play, and interact with materials
• Standardised assessments — formal tests to measure things like fine motor skills, visual motor integration, grip strength, and sensory processing. Common tools include the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2), the Beery VMI, and the Sensory Processing Measure (SPM)
• Functional tasks — the OT may ask your child to complete real-life tasks like writing, cutting, dressing, or catching a ball

For younger children, assessment may use play-based observation. Ask the service how it will adapt communication, pace and environment, and tell the therapist about anything likely to cause distress.

Before the appointment, ask what written output is included, who will receive it and whether recommendations will state the assessed need, functional goal, provision, responsible person, frequency, review and safety controls. A report can be relevant evidence, but it does not itself determine an EHCP decision.

What Do OT Sessions Look Like?

OT sessions for children are hands-on, active, and often quite fun from the child's perspective. Here is what you might expect:

• Sessions are usually 45 to 60 minutes
• They are highly practical — the OT uses activities and games targeted at your child's specific goals
• For sensory processing — sessions might involve swinging, climbing, playing with different textures, using weighted items, or doing movement activities. This is especially true in clinics set up for Ayres Sensory Integration (more on this below)
• For motor skills — activities might include cutting, threading beads, handwriting practice with specific grips, ball skills, or obstacle courses
• For self-care — the OT might practise dressing techniques, develop visual schedules, or work on cutlery use
• Parents are usually involved — the OT will teach you strategies to use at home, and home practice is important
• The OT will set measurable goals — for example, "write first name legibly using a tripod grip" or "tolerate hair washing without distress"

What Is Ayres Sensory Integration (ASI)?

Ayres Sensory Integration is a structured OT approach developed by Dr A. Jean Ayres and delivered by practitioners with specific training. Evidence is mixed and condition-specific; it should not be presented as the universal “gold standard” for sensory difficulties. Goals, baseline function, progress reviews and stopping criteria should be agreed before treatment.

ASI therapy takes place in a specially equipped room (a sensory gym) with equipment like:

• Platform swings and bolster swings
• Climbing walls and ladders
• Crash mats and ball pits
• Textured surfaces and tactile materials
• Weighted and compression items

The therapist may use this equipment in guided, play-based activities linked to agreed functional goals. The proposed benefit, possible adverse responses and progress measures should be explained for the individual child rather than assumed from the equipment itself.

Important: ASI is a specific approach and not every OT offers it. Ask what training the practitioner has completed, how the proposed intervention follows current RCOT guidance, what functional outcome is being targeted, how progress and adverse effects will be measured, and when the approach will be changed or stopped.

NHS vs Private Occupational Therapy

NHS and private services differ by locality and provider. Payment route does not establish quality, speed, scope or whether a particular intervention is appropriate. Use the live service information and ask the same questions of either route.

Kent NHS route

The current Kent Community Health referral page says routes and criteria vary by locality. Most children's OT referrals must be made by an education or health professional; the page also describes a parent/carer route for south-east Kent. Its separate sensory-processing pathway begins with public resources and recording meaningful participation goals. Check those pages for the current route rather than relying on a quoted wait.

Private route

Before paying, confirm the therapist's HCPC registration, relevant paediatric experience, scope of assessment, proposed method, appointment and report fees, cancellation terms, timescale, information sharing, complaints process and professional indemnity cover. Ask whether the report format will answer the question you need addressed. Availability and fees must be checked directly with the provider.

How to Find a Paediatric Occupational Therapist

For NHS services

• Read the current Kent Community Health access criteria and referral page
• For localities requiring a professional referral, discuss the functional difficulty with the child's nursery, school or health team
• For the published south-east Kent route, follow the current parent/carer instructions on the referral page

For private therapists

• SENDPath Kent OT Directory — our curated list of paediatric occupational therapists in Kent
• RCOT Find an OT — the Royal College of Occupational Therapists directory
• Sensory Integration Education — to find ASI-trained therapists

What to look for in a private OT

• HCPC registration — this is a legal requirement. Check the HCPC register online
• RCOT membership — not compulsory but shows commitment to professional standards
• Paediatric experience — make sure they work regularly with children, not just adults
• Specialist training — if sensory processing is a concern, ask about ASI or sensory integration training
• Safeguarding checks — ask what DBS and safeguarding arrangements apply to the proposed work and setting
• Insurance — ask for current professional indemnity details
• Experience with your child's needs — ask about their experience with autism, ADHD, dyspraxia, or whatever is relevant

Occupational Therapy and EHCPs

If your child has significant occupational therapy needs, OT can be written into their Education, Health and Care Plan (EHCP). This is important because:

• Where OT provision educates or trains, section 21(5) of the Children and Families Act 2014 treats it as special educational provision for Section F, which the local authority must secure
• Health provision that does not educate or train belongs in Section G; under section 42, the responsible commissioning body must arrange it. Classification depends on the purpose of the provision, not the therapist's employer
• The provision must be specific and quantified — for example, "1 hour of direct occupational therapy per week, delivered by an HCPC-registered occupational therapist with sensory integration training"
• Vague wording like "OT support as required" is not acceptable and you should challenge it

An OT report can be relevant evidence where it addresses a disputed functional need or provision gap, but no report guarantees an EHCP decision or appeal outcome. The decision-maker considers the evidence as a whole. See our EHCP application guide for step-by-step information.

OT for Autistic Children

Occupational therapy may help an autistic child where a functional difficulty affects everyday participation. Sensory differences can affect areas such as eating, dressing, learning and coping in busy environments, but the goals and approach should be individual.

An OT working with an autistic child might focus on:

• Sensory needs — assessing how sensory responses affect specific daily activities, then agreeing and reviewing individual strategies
• Environmental adjustments — trialling changes to the classroom or home environment against an agreed functional goal
• Self-care independence — breaking down tasks like dressing into manageable steps, sometimes using visual supports
• Fine motor skills — handwriting programmes, adapted equipment (pencil grips, sloped writing boards)
• Emotional regulation — strategies for managing overwhelm, transitions, and anxiety

A good OT will work with your child's sensory profile rather than against it. The goal is not to "normalise" your child's sensory responses, but to help them manage their environment and develop strategies that work for them.

Comparing Products While You Wait

The shopping links below are parent-curated categories, not products recommended by an occupational therapist, independently tested by SENDPath or suitable for every child. Start with the functional difficulty you are trying to address. Check the exact maker, model, intended age, materials, load or sizing limit, warnings and instructions; agree how you will observe benefit or harm and stop if it is not helping.

• Exercise or therapy putty category — verify the maker's intended age, material or allergy information, small-parts warning, resistance grade and cleaning instructions. Use only for an agreed activity with appropriate supervision. Compare therapy putty listings on Amazon →
• Wobble cushion category — verify the exact product's age, load limit, inflation, chair compatibility and supervision instructions. It should be trialled for a defined task, not assumed to improve attention. Compare wobble cushion listings on Amazon →
• Weighted lap-pad category — this is still a weighted product. RCOT advises individual risk assessment, consent, clear goals and review. Follow the exact manufacturer's instructions, use active supervision, keep the head and neck clear, never use it as restraint and make sure the child can remove it independently. Compare weighted lap-pad listings on Amazon →

For more safety checks, see our parent-curated guides to sensory toys, chew tools, weighted products, sensory lights and hearing protection and headphones. Amazon links are affiliate links: SENDPath may earn a small commission at no extra cost to you.

DLA and Funding for OT

DLA eligibility is not based on having OT involvement or on a diagnosis. For a child under 16 in England or Wales, it depends on the statutory care or mobility tests: the child must need much more looking after than a child of the same age without a disability, have qualifying walking difficulties, or meet another mobility rule. DLA helps with disability-related extra costs and is not restricted to paying for therapy. See the current GOV.UK DLA guide. The confirmed 2026–27 rates are:

• Care component: lowest rate £30.30/week, middle rate £76.70/week, highest rate £114.60/week
• Mobility component: lower rate £30.30/week, higher rate £80.00/week

Middle or highest-rate DLA care for the child is one Carer's Allowance condition. The carer must also meet all other rules, including at least 35 hours of care, the study rules and the current earnings test. The payment and earnings limit can change and Carer's Allowance can affect other benefits, so check the live GOV.UK Carer's Allowance guidance before acting.

Questions to Ask an Occupational Therapist

• What experience do you have working with children who have similar needs to mine?
• Are you trained in Ayres Sensory Integration? (if sensory processing is a concern)
• What assessments will you use?
• What will therapy sessions involve?
• How often do you recommend sessions?
• What can I do at home to support my child?
• Can you work with my child's school to recommend classroom adjustments?
• What written report is included, who will receive it, and will it answer the functional or EHCP question we need addressed?
• Are you HCPC registered?
• What are your fees?

Key Takeaways

Useful Resources

• Find an Occupational Therapist in Kent — our curated Kent directory
• Sensory Processing Difficulties in Children — our detailed guide
• EHCP Application Guide for Kent — step-by-step guide to applying for an EHCP
• EHCP Checklist — check your EHCP before you sign off
• Royal College of Occupational Therapists (RCOT)
• Sensory Integration Education — find ASI-trained therapists
• Kent SENDIASS — free, impartial advice for Kent families