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Areas of Concern

Occupational Therapists work with children and young people who have a range of difficulties and diagnoses that impact their ability to perform daily tasks. Some common difficulties include the following:

Motor difficulties

  • Gross motor skills- Such as walking and running, catching and throwing. 

  • Fine motor skills- Such as using cutlery, using a toothbrush, or constructing legos/puzzles. 

  • Muscle tone and strength- This can cause children to fatigue quickly, increase flexibility therefore increasing risk of injury and negatively affect their development of motor skills.

  • Posture- This can include difficulty maintaining sitting posture when sitting at a desk which can have a negative affect on their ability to participate in classroom activities therefore impacting their learning.

  • Coordination- This may impact a child's confidence in, and ability to participate in physical activities as they may take more time and require more effort than their peers when completing physical/motor tasks.

  •  Motor planning and sequencing- This includes difficulty executing actions/movements in an activity. Children may have difficulty following multiple step physical tasks, or have difficulty starting or completing tasks

Kid Playing with Wooden Toys

Sensory processing difficulties

Sensory processing difficulties typically affect every other area of functioning and are an underlying factor impacting the development of a child’s motor, cognitive and social skills.

Sensory processing is the child’s ability to interpret and organise information from the senses (see, hear, touch, smell, taste, balance, movement) about their body and environment.


Difficulty with sensory processing means that the child has difficulties regulating their response to information received about their environment and body. A child may be highly sensitive to sound, sight or touch, whereas others are almost numb. For example, a child may become easily frustrated in a loud environment or, on the other hand, they may not notice when they are called by name.

Cognitive difficulties

Arousal level and attention skills- This refers to a child's level of alertness and responsiveness as well as their ability to maintain focused on tasks. 

Initiation and planning of activities- Some children may have trouble completing every step of a task and abandon the task halfway through. Other children may know what they want to do but struggle to identify the first steps of that task.

Problem solving- This is the ability to identify and work through the possible solutions to a challenge, i.e. what it is, what strategies could be used to overcome it and the actions used to complete the strategies.

Safety awareness- This is a child's ability to identify risky situations and identify the steps needed to keep themselves safe, i.e. looking both ways before crossing the road.


Psychosocial difficulties 

This includes social interactions, self-esteem and motivation difficulties

A child may have difficulties in engaging in everyday social interactions that involve aspects such as sharing and turn taking, responding to verbal/non-verbal cues appropriately, being aware of the personal space of others.


Difficulties in these areas can lead to lowered self-esteem in social situations and an avoidance of social interaction. 

Handwriting difficulties

Handwriting is a complex process involving coordinating the eyes, arms, hands, pencil grip, letter formation and body posture. The components listed below are considered when planning interventions focused on improving handwriting skills.

  • Grip

  • Posture

  • Hand muscle strength and endurance

  • Speed/legibility

  • Coordination

  • Motor control

School readiness

All of the concerns listed above can have an impact on a child's ability to transition smoothly to school. The following list includes some of the skills that children may need to develop to assist with transitioning between the home and school environments.

  • Following routines i.e. Brushing teeth, getting dressed, going to school

  • Scissor skills- cutting out shapes and along lines

  • Handwriting- copying shapes, writing numbers, writing name

  • Independent self-help skills for dressing, eating, managing their lunchbox, toileting, and personal hygiene

  • Managing emotions such as  anger or frustration

  • Following instructions in a structured environment and understanding rules

  • Playing and interacting cooperatively with other children

  • Ability to communicate with other children and the teacher

  • Problem solving for tasks and social interactions

Reasons for children having the above difficulties include but are not limited to the following list:

  • Autism Spectrum Disorder (ASD)

  • Attention Deficit/Hyperactivity Disorder (ADHD)

  • Syndromes, such as Down’s Syndrome and Fragile X syndrome

  • Sensory Processing Disorder

  • Cerebral Palsy

  • Developmental delay/ Intellectual disabilities

  • Dyspraxia

  • Vision Impairment

  • Attachment Disorder

  • Anxiety

  • Childhood trauma

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