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, the assessment is largely play-based and should feel relaxed. The OT will usually put your child at ease very quickly — they are skilled at making it feel like a game.

After the assessment, you will receive a report outlining your child's strengths and difficulties, with recommendations for therapy, school strategies, and home activities. If you are going private, this report is a valuable document for EHCP applications.

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 specific, evidence-based approach to OT developed by Dr A. Jean Ayres. It is sometimes called "SI therapy" and is considered the gold standard for treating sensory processing difficulties.

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 uses these tools to create guided, playful activities that challenge the child's sensory systems in a controlled, supportive way. The aim is to help the brain get better at processing and organising sensory information.

Important: Not all OTs are trained in ASI. It requires specialist postgraduate training and certification. If sensory processing is a major concern for your child, ask whether the therapist has completed ASI training — and look for OTs who are registered with Sensory Integration Education (SIE) in the UK.

NHS vs Private Occupational Therapy

NHS occupational therapy

• Free — no cost to families
• Referral needed — usually from GP, paediatrician, health visitor, or school. Self-referral is possible in some areas
• Long waiting lists — 12 months or more in many areas, including Kent
• Limited scope — NHS services may offer a single assessment and advice session, then discharge. Ongoing therapy is often not available through the NHS unless it is in an EHCP
• May not cover sensory processing — some NHS OT services focus primarily on motor skills and do not offer sensory integration therapy

Private occupational therapy

• No waiting list — appointments usually available within days or weeks
• More frequent and flexible — weekly sessions if needed, at clinic, home, or school
• Full sensory assessment and ASI therapy available — if the therapist is trained
• Detailed written reports — essential for EHCP applications and tribunal evidence
• Cost — typically £70 to £130 per session, with initial assessments costing £200 to £450

How to Find a Paediatric Occupational Therapist

For NHS services

• Ask your GP or paediatrician for a referral
• Ask your child's school SENCO — they may be able to refer directly
• In Kent, children's OT services are provided through Kent Community Health NHS Foundation Trust

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
• DBS checked — essential for anyone working with children
• Insurance — professional indemnity insurance
• 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:

• When OT is in Section F of an EHCP (educational provision), the local authority has a legal duty to provide it
• OT that supports a child's ability to access education — such as help with handwriting, sitting in class, or managing sensory overload in school — should be in Section F, not Section G (health)
• 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

A private OT report is powerful evidence for an EHCP application. At the SEND Tribunal, 99% of parents who go to a hearing win (MOJ 2024/25 figures), and independent professional evidence is a major reason why. See our EHCP application guide for step-by-step advice.

OT for Autistic Children

Occupational therapy is one of the most helpful therapies for autistic children. Many autistic children experience sensory processing differences that significantly affect their daily life — from what they can eat and wear to how they cope in a classroom or a supermarket.

An OT working with an autistic child might focus on:

• Sensory regulation — creating a "sensory diet" (a personalised plan of sensory activities throughout the day) to help the child stay regulated
• Environmental adjustments — recommending changes to the classroom or home environment, such as noise-cancelling headphones, wobble cushions, fidget tools, or visual schedules
• 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.

DLA and Funding for OT

If your child has significant occupational therapy needs, they may qualify for Disability Living Allowance (DLA), which can help cover the cost of private therapy. The 2026-27 DLA 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

If you receive DLA at the middle or highest care rate, you may also be able to claim Carer's Allowance (£86.45/week, with an earnings limit of £204/week for 2026-27).

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?
• Can you provide a written report? (essential for EHCP evidence)
• 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