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Helping Little Hands Reach Big Milestones: Occupational Therapy and Developmental Disabilities

therapist and child working together on fine motor skills

Article Summary:

Occupational therapy (OT) is essential for helping children with developmental disorders reach their full potential and live more independently. By addressing these children's unique challenges, occupational therapists develop individualized strategies that enhance their motor, cognitive, social, and emotional abilities, improving a child's ability to perform daily tasks, fostering personal growth and self-confidence. As a holistic and evidence-based approach, OT is an essential resource for families navigating developmental disorders, promoting the wellbeing and success of affected children.

Understanding Developmental Disorders

A developmental disorder is a condition that usually shows up in childhood and can affect the way a person thinks, acts, feels, moves, or talks. These disorders make it hard or impossible for children to reach milestones at the right time for their age. This can significantly affect their ability to function and interact with their environment. It's essential to find and treat developmental disorders in children as soon as possible because early help can greatly improve their chances of overcoming problems and reaching their full potential.

Group of children tending to a vegetable garden

Causes of Developmental Disorders

Numerous factors, including genetic predispositions, neurological disorders, and environmental factors, can contribute to developmental disorders. Some common causes include:

  1. Genetic abnormalities, such as Down syndrome or fragile X syndrome, can lead to developmental disorders in children.

  2. Due to insufficient time for proper development in the womb, premature babies born before 37 weeks of gestation are more likely to experience developmental disorders.

  3. Exposure to environmental factors such as pollutants and toxins, such as lead or alcohol, during pregnancy can adversely affect a child's development.

  4. Pregnancy-related infections: If the mother contracts certain infections like rubella or cytomegalovirus during pregnancy, it can lead to developmental disorders.

  5. Neurological disorders: Conditions like cerebral palsy or fetal alcohol spectrum disorder can lead to developmental disorders.

Types of Developmental Disorders

Developmental disorders can be categorized based on which parts of development they affect most (Developmental Disabilities, 2022). These categories include:

  1. Motor Development Disorders: These disorders affect the development of fine and gross motor skills. Examples include cerebral palsy, developmental coordination disorder, and motor skill disorders.

  2. Cognitive Development Disorders: These problems affect a child's cognition, including learning, remembering, and solving problems. Intellectual disability and specific learning disabilities like dyslexia, dyscalculia, and dysgraphia fall under this category.

  3. Social and Emotional Development Disorders: Children with these disorders have trouble getting along with others, making friends, understanding emotions, and controlling their feelings. Autism spectrum disorder (ASD) and attachment disorders are examples.

  4. Communication and Language Development Disorders: These disorders affect a person's ability to understand and use language effectively. Some examples include speech and language problems like stuttering and expressive and receptive language disorders.

  5. Sensory and Sensory Integration Disorders: These disorders involve challenges in processing and integrating sensory information from the environment. Sensory processing disorder is an example of this category.

Children in wheelchairs playing lacrosse

Some developmental disorders' complexity and overlapping nature make them difficult to treat for several reasons. One challenge lies in obtaining an accurate diagnosis, as multiple areas of a child's development may be affected, making it harder to pinpoint the exact nature and extent of the issues. When disorders overlap, determining the most practical combination of treatments and therapies that address all the affected areas simultaneously can be difficult and sometimes impossible.

Determining how to allocate resources also poses a challenge for families and professionals when multiple developmental disorders exist. Planning and prioritizing available therapy time, money, and effort to address the various needs and challenges of the child can be a complex and demanding process. Despite these challenges, it is essential to approach the treatment of overlapping developmental disorders with a comprehensive and tailored strategy that addresses each child's unique needs.

Assessment and Evaluation in Occupational Therapy

Standardized Assessments and Observational Techniques

A crucial aspect of occupational therapy for children with developmental disabilities is conducting thorough assessments and evaluations to understand each child's unique needs, strengths, and challenges. Occupational therapists often use a combination of standardized assessments and observational techniques to gather essential information about the child's abilities and areas of difficulty.

Standardized assessments use tests and tools to measure specific skills or functions, such as fine motor skills, gross motor skills, sensory processing, cognitive abilities, and social-emotional development. These assessments provide quantifiable information that helps occupational therapists compare a child's performance to age-appropriate norms and identify areas where they may be experiencing disorders. Some commonly used standardized assessments include (Insight Psychological, 2022):

  • Wechsler Preschool and Primary Scale of Intelligence (WPPSI): This assessment tool is designed for children aged 2.5 to 7 years and evaluates cognitive abilities, including verbal and non-verbal intelligence.

  • Vineland Adaptive Behavior Scales (Vineland-3): This assessment tool measures adaptive behaviours in children and adults with developmental disabilities. It evaluates communication, daily living skills, socialization, and motor skills.

  • Peabody Developmental Motor Scales (PDMS): This assessment tool evaluates fine and gross motor skills in children from birth through 5 years of age.

Observations are essential in complementing standardized assessments for several reasons. While standardized assessments provide objective data and allow for comparisons to normative samples, they may not capture a holistic and complete picture of a child's abilities and challenges in their natural environment.

A young boy who has a developmental disability sitting in a wheelchair. He is holding onto a soccer ball with an occupational therapist at his side.

Observations provide insight into a child's behaviour, skills, and challenges within their natural settings, such as home, school, or community environments, helping professionals better tailor interventions to meet their needs in real-life situations. Observations also allow professionals to simultaneously consider multiple aspects of a child's development that may not be apparent through standardized assessments alone and play a crucial role in obtaining a more comprehensive and accurate understanding of a child's development and functioning.

Identifying Individual Needs and Challenges

After conducting assessments and observations, occupational therapists analyze the data to identify the child's needs and challenges. They look at things like the severity of the disorder, the child's interests and motivations, and their overall goals for improvement. This comprehensive understanding of the child's abilities and areas of difficulty forms the foundation for developing a tailored intervention plan.

Interventions: Targeted Skill Development

Fine Motor Skills

Fine motor skills are the coordination and control of small muscle movements, mainly in the hands and fingers. They are needed for everyday tasks like writing, drawing, using utensils, buttoning clothes, and manipulating small objects. Some common interventions include:

  • Finger games and activities, such as finger painting, playdough manipulation, and stringing beads, enhance finger dexterity and control.

  • Hand strengthening exercises, like squeezing stress balls or using hand grippers, build hand muscle strength.

  • Practicing pre-writing skills using tracing activities, colouring, and drawing shapes to develop precision and control in hand movements.

  • Using adapted tools, such as pencil grips or loop scissors, to support grip and make tasks more manageable.

  • Puzzles and sorting activities foster hand-eye coordination and spatial awareness.

A young boy with a developmental disability sitting in a bean bag chair. He is holding onto a book and reading it with his occupational therapist.

Gross Motor Skills

Gross motor skills involve coordinating and controlling large muscle movements, mainly in the arms, legs, and torso. These skills are essential for doing things that require balance, strength, and mobility. Gross motor skills enable a person to move around independently, maintain a stable posture while sitting and standing, prevent falls, and allow smooth transitions between positions. Examples of gross motor interventions include:

  • Balance activities, such as standing on one foot, walking on a balance beam, or using a therapy ball, improve stability and coordination.

  • Mobility activities, such as crawling, walking, running, or climbing, enhance movement and coordination.

  • Structured play, like throwing and catching a ball, jumping, or kicking, to develop motor skills while engaging in fun and age-appropriate games.

  • Group activities, such as dancing, yoga, or team sports, encourage social interaction and develop motor skills in a collaborative environment.

Cognitive Skills

Cognition involves mental processes that help children think, learn, understand, and interact with their surroundings. Attention, memory, perception, language, problem-solving, decision-making, and executive functions are all essential parts of cognition. Occupational therapists may use the following kinds of cognitive interventions with children who have developmental disabilities:

  • Attention and concentration activities, such as matching games, puzzles, or memory card games, enhance focus and sustained attention.

  • Memory exercises, like repeating sequences, storytelling, or using visual cues, improve short-term and long-term memory.

  • Problem-solving tasks, such as completing mazes, solving riddles, or engaging in strategy games, to develop logical thinking and reasoning skills.

  • Executive function activities, like planning and organizing tasks, setting goals or practicing time management, foster skills needed for daily routines and academic success.

  • Visual perceptual activities, such as sorting objects by size, shape, or colour, enhance the ability to interpret and make sense of visual information.

A young boy who is well supported in a manual wheelchair. He is holding onto a green block and manipulating it with his hands with his occupational therapist.

Social and Emotional Development

Social and emotional development is how individuals learn and improve at building relationships, controlling their emotions, and getting along with others in different social settings. To interact well with others in your social environment, you need to know how to read social cues, adjust to social norms, and respect the thoughts and feelings of others. Expressing and regulating emotions encompasses recognizing and understanding one's feelings and those of others. Some examples of these interventions include:

  • Social skills training: Teaching children essential social skills, such as making eye contact, taking turns, and sharing, through role-playing, modelling, and practice activities.

  • Emotion regulation strategies: Guiding children in recognizing and managing their emotions using techniques like deep breathing, progressive muscle relaxation, and visualization exercises.

  • Social stories: Creating personalized stories that depict social situations and appropriate responses, helping children understand and navigate social interactions more effectively.

  • Group activities: Engaging children in group games or projects that encourage cooperation, communication, and problem-solving, fostering the development of social skills and relationships.

  • Play-based therapy: Using play activities to address social and emotional development, such as practicing appropriate emotional responses, developing empathy, and building communication skills.


Occupational therapy is crucial in helping children with developmental disabilities become more independent and improve their overall functioning. Through tailored interventions, occupational therapists work on improving children's motor, cognitive, social, and emotional skills. These skill improvements contribute to better academic performance, effective communication, and healthy interpersonal relationships.

Resources for Children with Developmental Disabilities

  1. The Learning Disabilities Association of Canada (LDAC): LDAC is a national organization dedicated to supporting individuals with learning disabilities and their families. Their website provides resources for parents, including articles on various learning disabilities, tips for supporting academic success, and advocacy information. URL:

  2. NILD Canada: NILD (National Institute for Learning Development) Canada is an organization focused on providing educational therapy for individuals with learning difficulties. Their website offers resources for families, including information on learning disabilities, intervention strategies, and a directory of certified educational therapists across Canada. URL:

  3. ConnectABILITY: ConnectABILITY is a Canadian online community and resource hub for individuals with developmental disabilities and their families. The website provides a wealth of information, including articles, videos, and tools that cover various topics such as communication, life skills, behaviour, and social-emotional development. ConnectABILITY also offers a platform for connecting with other families, professionals, and support networks. URL:

  4. AIDE Canada: AIDE (Autism and Intellectual Disabilities Information and Education) Canada is a national project dedicated to providing information, resources, and support for individuals with autism and intellectual disabilities and their families. Their website offers an extensive library of resources, including articles, webinars, toolkits, and e-books, covering various topics related to autism, intellectual disabilities, and other developmental disorders. AIDE Canada also provides information on local support networks and services across the country. URL:

  5. The Canadian Association of Occupational Therapists (CAOT): CAOT is the professional organization for occupational therapists in Canada. Their website contains resources for families with children affected by developmental disorders, including articles, tips, and information on finding an occupational therapist. URL:

A drawing created using coloured pencil. It is a drawing of two people with a child in a wheelchair holding hands.



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