As Occupational Therapists [OT’s] our main focus in relation to children is their ability to master skills and develop from playful, safe toddlers into independent adults. The main skills we focus on to assist with development are:

  • Self care skills [feeding, dressing, grooming, etc]
  • Fine and Gross Motor Skills
  • Skills related to school performance [e.g. printing, cutting etc.]
  • Play and Leisure skills.

Of equal importance to a child’s development is the support and input provided by their family and the support they receive from their school.

Here I will focus mainly on children with Downs syndrome, however a lot of the interventions outlined can be transferable and the basic skills can be used for many children going through the developmental stage.


The importance of Occupational Therapy at this stage [6 months +]  in a child’s development cannot be overlooked in the facilitation oft motor milestones particularly for fine motor skills.

The OT will work with the child and their family at this stage to promote arm and hand movements that lay the foundation for later developing fine motor skills [writing]. The low muscle tone and loose ligaments at the joints associated with Downs syndrome are real challenges to early motor development and OT can help the child to meet those challenges.

Children beginning preschool normally have independent mobility and will be busy exploring their environment. Family support is essential at this stage in encouraging learning, feeding, dressing and social interaction and the promotion and development of communication skills. Refinement of gross motor skills is still an integral part of the process at this stage. OT input will include:

  • Facilitation of fine motor skills development. It is very important at this stage that children with Downs syndrome learn to ‘fine tune’ the movements in their hands that will allow them to do many things as they get older; However many at this stage need some OT intervention to assist the development of these movements. This will be done through play. At this stage children are inquisitive and start to open and close cupboards or boxes, pick up and release toys of various sizes and shapes, stack and build, manipulate buttons and handles, experiment with crayons etc. Children with downs syndrome particularly benefit from OT at this stage due to challenges they face such as low muscle tone, decreased strength and joint ligament laxity.
  • Promotion of independent living skills. Providing information and teaching families how to break down the skills practiced so expectations are realistic and appropriate. OT’s will also recommend correct positioning to reduce risk of injury and pain or any adaptations or equipment that might help the developing child become more independent. For example, a child may not have much success feeding themselves with “normal” cutlery or crockery. An OT can provide specially adapted crockery and cutlery to increase the child’s independence and increase confidence.

A child’s routine changes once they start school. OT’s can assist in managing the changes with the family, the school and the child. OT’s are there to provide families with information, techniques and strategies on how best to help the child in adapting to new and unusual situations. The OT could attend meetings with the family and the teachers to assist with planning the child’s new routines and look at ways to reduce negative change and promote the positive change.

Speech and communication are a primary focus at this stage in the developmental process, however OT still play an integral part by increasing and developing the child’s fine motor skills in the classroom. Many OT’s work in the school system and provide programs on how to learn skills such as; printing, handwriting, keyboarding, cutting etc. OT’s also look at positioning for optimal performance [e.g. desk and chair heights] and assist with program adaptations based on the child’s physical abilities. This program can be used at school and at home, or a separate program can be tailored for the child to continue to develop their skills at home with their family.

Many children with Downs syndrome are very motivated and like to do things for themselves, such as dress and feed themselves. A lot of these behaviors are learned through observing their parent or sibling complete the activity and participating in the learning process from a young age. Other children may be happy to let others do things for them, and may resist attempts to help themselves learn these skills. In these cases the OT would work with the parents to work out these challenges , while helping the child develop better motor skills and in doing do increasing their ability to help themselves.

OT’s also address any sensory needs the child may have. Sometimes a parent has concerns about things their child does that may relate to the child’s sensory development. For example, they may excessively put toys in their mouth, have poor awareness of their body in space, may be squeezing items too hard or dropping things a lot, or they may not be tolerant to certain routines such as washing or brushing their hair, they may also be sensitive to certain clothing materials. OT’s are able to provide suggestions and recommendations on how best to manage and possibly overcome some of these issues.

Summary: OT plays a major role in the development of a child with Downs syndrome. OT’s not only assist the child’s development and increase their independence, it also provides reassurance and support for families and teachers working with the children.

EVERYBODY is entitled to an assessment. If you feel your child may benefit from an OT assessment you can request a referral from your GP. If this helps even 1 person I will be a happy woman 🙂 Thanks for Reading.


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