What do occupational therapists do with children from birth to 3 years of age?

We work with families to assist children to learn functional skills. These include the ability to pay attention; remain calm; teach them self-care skills, such as learning to feed themselves, brushing hair, brushing teeth, dressing, and eventually bathing; encourage development of eye-hand skills, oral skills for eating; coordination of the whole body; feeling comfortable with the positioning and movement of their body during daily activities such as play. We work with families to help children learn cooperative behavior, and work with learning problems.

Tips for parents from OT
The following is a list of suggestions to facilitate your child’s development. Remember, play is the way children learn almost everything., including language, social skills, motor skills. They repeat the activities they see their family doing. They learn about the physical properties of all their toys including size, weight, texture, visual perception, and how things fit together. They develop all of the senses and all of their muscles while playing.

If your child is allergic to any of the items suggested, then an item of similar texture may be substituted.

Feeding

As soon as your baby is able to feed himself finger foods, let him be in control of putting all of these foods into his mouth himself. Parents supply small pieces of soft food that are easy to chew. Let the baby explore the food at his own pace.

Let your baby get messy when learning to use a spoon. It is natural and necessary to get food on hands, arms and face, so that she can learn more about textures, tastes, and smells. Exploring in this manner will actually heighten his interest in new foods.

Twelve to 15 months: If you want to interest your baby in spoon feeding, ask her to feed you a few bites of pudding with a spoon.

When children are learning to use a spoon, use foods that stick to the spoon, such as pudding, or mashed potatoes.

Introduce strained vegetables to your baby before introducing fruit. If sweet fruits are introduced first, the baby may not be as interested in vegetables.

Children form all of their opinions about what tastes good in the first two years of life. Be sure to expose your baby to a wide variety of healthy foods during this time.

Some toddlers over-stuff their mouths, then have trouble swallowing. If your child does this, put small amounts of food on her plate, a little at a time.

If your child is unstable in the high chair, it will be more difficult to chew and swallow, and to learn to use a spoon. Try placing rolled towels in the chair on both sides of your child to make the chair “hug” him. This will increase sitting balance.

Children benefit from foot support when trying to feed themselves. If your child’s feet do not reach the footrest of the highchair, try taping a shoebox on it. This will allow her to reach the foot support to stabilize posture/feet.

Grooming/Hygiene

Allow child to comb /brush hair.

Practice playing in water with supervision and exploring toothbrush/toothpaste (with supervision so as not to swallow) in preparation for brushing teeth.

If your child’s mouth is sensitive when trying to brush teeth, encourage your child to try wiping the mouth with a warm washcloth and to keep doing it before brushing teeth.

Allow your child to play in water with supervision and rub face and hands in preparation for hand washing.

Birth to 2 Months:
-doesn’t blink
-does not grasp objects placed near palm

3 Months
-does not follow an object with her eyes
-hands remain closed almost all of the time
-frequently resists being held
-becomes upset when moved, as when being picked up, laid down, or handed
from one familiar person to another

4 Months
-does not swipe at or reach for objects
-does not bring hands or objects to his mouth
-frequently irritable for no apparent reason
-does not place both hands on her bottle while fed

5 months
-does not hold his own bottle
-doesn’t smile at his image in a mirror

6 Months
-involuntarily drops objects after only a few moments
-does not actively grasp large finger foods such as teething cookies when they are
placed on the highchair tray
-is excessively and consistently upset by leaving the home

7 months
-does not transfer an object from one hand to the other

10 months
-not beginning to pick up small objects
-does not poke with index finger
-is not accepting a variety of food textures
-is excessively upset by being dressed, diapered, bathed, or having hair groomed

12 months
-isn’t able to pick up a cheerio or other small object with tip of the thumb and
the tip of the index finger
-is not sleeping through the night most of the time
-is not interested in exploring toys made for one year-olds
-is excessively upset by sound of siren, barking dog, vacuum cleaner, or other
familiar loud noise

15 months
-cannot put a one-inch object into a container with a slightly bigger opening
-cannot stack two cubes
-cannot put a round form into a round shape on a puzzle

18 months
-cannot point to a few of the following body parts: eyes, nose, mouth, hair,
tummy, legs, feet, and hands
-cannot turn pages of a cardboard book, or regular small book two or three pages
at a time.
-cannot stack four blocks

24 months
-play with toys only by tapping, shaking, or throwing
-cannot unscrew top of a one-inch or two-inch bottle
-cannot remove socks, untied shoes, or pull-on pants without help

30 months
-cannot imitate drawing a vertical line or a circular scribble on paper immediately
after seeing an adult draw these lines
-cannot stack eight to ten cubes
-cannot imitate drawing a horizontal line immediately after seeing an adult draw
a horizontal line

36 months
-cannot remove all pull-on clothing after fasteners have been undone
-does not imitate the actions of adults in the home
-does not pretend during play

View Occupational Therapy Development Checklist

Dressing

• Children are able to take off their clothes before putting them on. Allow your child to assist in his/her dressing.
• Lay out clothes so that child can explore and “try on” various items. Allow the older child to pick out own clothes to wear.
• Play “dress up” Make dressing FUN!
• Lace an old shoe in preparation for eventual shoelace tying.
• Orient to identifying body parts by pointing and saying names of various parts of the body as you assist your child to dress or bathe.

Bathing

• Never leave a child unattended in the tub, or around water, even with just a little water in the tub.
• Place favorite waterproof toys/bubbles in water so child can explore under your supervision to get used to being in the water.
• Rub child with warm washcloth/towel to minimize fear/intolerance of water.
• Allow your child to play in a little tub of water on the floor under your supervision.

Sensory Learning

• Use bean bag chair during play, music, or reading tasks. This is for calming.
• Allow child to “sandwich” self using beanbag chair/cushions during story time, listening to music, etc. This will help with calming.
• Use headphones and calming music to cut down on auditory distractions.
• Use visor/hat to block visual glare, even indoors, if light is bothering her.
• A visor or hat can also be used to reduce visual distractions in the room if your child is easily distracted. Or try finding a place that is small and separated from the main part of the room as a place to do table activities.
• Encourage exploration of and participation in activities such as finger painting, use of shaving cream, play-doh/clay/putty, digging in dirt, and water, even if messy. This encourages exposure/tolerance to different textures.
• Provide slow rocking/soft lighting to calm or fast rocking to alert.
• Allow for crawling, hopping, and jumping activities to increase awareness of position of body in space.
• During transitions between different activities, gradually shift from activity of interest to the next necessary activity. Example: from playing to getting ready for bed.
• Sing a lullaby to child before bedtime.
• Clap hands/stomp feet to music.

Visual-Perceptual

• Match basic shapes (circle, square, triangle)
• Trace shapes in the sand, shaving cream, with fingerpaints, or on sandpaper.
• Try shape puzzles in preparation for sorting and matching skills.
• Tracking child’s favorite toy/flashlight on wall to improve visual scanning and crossing midline of body.
• Place items in the middle in front of child and allow his/her hand dominance to naturally develop.
• Encourage crossing midline of body with the hands by placement of toys of interest on opposite side to where child is playing so that she will rotate to get them.
• Encourage use of both hands during activities such as play-doh, carrying items, ball toss/catch, and self-care.
• Play pat-a-cake, “Simon Says,” imitating what you do, guiding younger children as needed.
• Rolling ball and toss/catch.

Using Hands and Developing Grasp

• Roll play-doh/clay/putty into a log or small balls with fingertips and squeeze. Child should be well-supervised to avoid swallowing.
• Fill coffee can with clothespins. Then, place clothespins around edge of can and remove again, as your child gets older.
• Pick up cheerios.
• Turn pages of a book.
• Squeeze soft sponge or ball.
• Practice unfastening zippers and unsnapping clothing.
• Press buttons on music box.
• Make a snowman with marshmallows and frostng.
• Build towers with blocks and construction toys (legos, plastic pop beads). Be cautious of size. Small items can cause choking hazard.
• Working on a vertical surface such as an easel or paper taped on the refrigerator or wall for drawing and painting helps to develop a mature grasp.
• Have the child imitate drawing a vertical straight line on a vertical surface like an easel or taped paper on wall.
• Attempt to draw a horizontal line on an upright surface when your child is able to draw a vertical line. Children develop grasp at their own rate. Do not force this.

Seating Suggestions

• Children can learn hand skills best if their feet are flat on the floor while sitting at a table to do activities. If your child’s feet don’t reach the floor, try putting an old phone book or other large book under her feet while she plays at the table.
• Decrease wiggling and sliding using a non-skid mat on seat of chair. These can be found at Wal-Mart, K-Mart, and some grocery stores.