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What does a pediatric occupational

therapist do?

An occupational therapist is someone who specializes in working with individuals who are experiencing a condition that is limiting their ability to independently complete the tasks of everyday living. 

 

In pediatrics, occupational therapists use their expertise to help children gain the functional skills they need for independence in play, learning, motor skill development, self-care (feeding/dressing), and socialization within their home, school, and community environments.

An occupational therapist will first need to do a thorough evaluation of your child’s functioning through a parent interview, reviewing any pertinent medical records, and engaging with your child in a variety of fun play activities, to determine areas of strengths and weaknesses.

Together with the parent, an occupational therapist will be able to recommend a plan of treatment for occupational therapy or make

recommendations that will be beneficial in helping your child reach new goals. Most often, you will see occupational therapists having fun with a child using play, toys, a variety of gymnasium equipment and crafts, as their tools for treatment. Children usually enjoy their time with an occupational therapist, making it one of the activities they look forward to during the week.

Dr. Hubert's Philosophy and Techniques:

I believe that the emotional life of a child is critical in promoting developmental progress. When a child is in a calm, regulated state and engaged in meaningful activities and relationships, learning can occur. It is for this reason that I strive to develop a trusting relationship with the child and modify the treatment plan based on his or her unique interests. I work actively with parents to help them understand their child’s way of communicating so they can feel more connected and empowered to support their child’s needs.

I have advanced training in infant and child development, sensory integration, DIR/floortime, feeding and swallowing, and parenting. I use evidence based theories and models to inform my work, some of which include; developmental psychology, attachment theory, 

neurobiology, sensory integration, DIR/floortime, yoga and mindfulness. The treatments are conducted in the comfort of your own home in a fun and nurturing manner. Each treatment plan is individualized and based on the child’s motivations, individual differences and the family’s goals, rather than on the diagnosis alone.

Should I get my child assessed or wait and see?

If you are concerned about your child’s development in any way you should get your child assessed by a trained professional. Studies show that early identification and intervention are the best way to ensure the most effective progress for your child. Your pediatrician is a good place to start.

Pediatrician - Discuss your concerns with your pediatrician and mutually decide what the appropriate next steps would be. If a plan to “wait and see” is suggested and you still feel concerned or anxious, I suggest you let your pediatrician know that you would like the reassurance of an evaluation instead of waiting. Your pediatrician should be able to refer you to the appropriate specialist that is best suited to evaluate your child. Best practices suggest always getting an evaluation if there is concern about development rather than waiting.

Regional Center - These are non-profit organizations set up in regions around the state. They provide services and support for those with developmental disabilities and their families. If your child is between the ages of 0-35 months and you are concerned about their physical skills, cognitive skills, language skills, social-emotional skills, self-care skills(feeding, dressing), or their reactions to sensations, you can call your local regional center directly and request an evaluation to determine if your child meets requirements for eligibility under “Early Start Program” or your state’s “Prevention Program”. You do not need your doctor to call nor do you need a doctor’s prescription for this evaluation. There is no charge for the initial evaluation.

Local School - If your child is 35 months or older and you have concerns about their development, you can request they be evaluated by your home district school, special education division. There is no charge for the initial evaluation.

Major Universities with a pediatric evaluation clinc, or a children's hospital - Being evaluated at a children’s hospital or university center has many advantages including multidisciplinary teams with specialty training and often times, access to research trials. Calling one of these centers and speaking with an intake coordinator would be a good place to start. Often, however, many of these centers have long waitlists so it would be prudent to add your name to the list if you want to move forward with this option. If the waitlist seems too long to wait, you can pursue other options for evaluation while you maintain your place on the waitlist.

Private clinics and solo practioners- There are many private therapy clinics and solo practitioners specializing in pediatric evaluation and treatment. You can ask trusted friends and professionals for recommendations.  It is very important to inquire whether the practitioner is

legally authorized to diagnose the condition, if you are seeking an evaluation for diagnostic purposes. Not all professionals are authorized to diagnose, however many are able to perform valuable evaluations and provide you with important information about your child’s functioning and treatment needs without making a diagnosis. Whomever you chose  should have the appropriate professional credentials required by the state, and have ample experience in assessment and treatment of children with the condition for which you are seeking help.

It is always a good practice to inquire about your health insurance benefits for pediatric services  before calling one of these options so that you can inform the intake coordinator and know what you are covered for and the exclusions. Many private professionals do not take insurance but will provide you with a superbill to submit to your insurance for reimbursement. It is imperative you know your benefits and exclusions for the services before the appointment if you expect to get reimbursed.

Your infant may benefit from an OT consultation if you notice:

 

  • Your infant seems hard to settle and is most often fussy

  • Cries after meals

  • Does not ever seem to get into a rhythm for sleep and wakes easily to the slightest noise or movement

  • Does not like to be held or cuddled or is only calm and happy when held

  • Is having difficulty with breast or bottle feeding (especially if a lactation consultant has already seen your child and progress is not        

       as expected)

  • Is over the age of 5 months and is not interested in starting solids or gags or vomits at presentation of new foods

  • Does not look at you or seems to look past you

  • Is older than 6 weeks and does not smile or coo

  • Seems to be slower to progress than other infants with holding his head up on his own, rolling, sitting or crawling

  • Does not reach out or hold onto toys and is 3 months of age

  • Resists tummy time

  • Seems overly sensitive to noise, touch or light

  • Seems under responsive to your voice or does seem to notice noises in the environment

  • When reading about development or comparing your infant to others of a similar age, he does not seem to be doing things that he should be doing at this age (recognizing that all children develop differently, he seems behind)

  • As a parent, you feel overwhelmed when trying to meet the demands of caring for your infant

Your preschool or elementary age child may benefit from an OT consultation if:

 

  • Seems over or under responsive to stimulation in the environment

  • Avoids or craves touching messy things

  • Avoids or has constant craving of movement, bouncing, spinning or swinging

  • Vigorously protests: certain clothing, haircuts, nail trimming, bathing, teeth brushing

  • Seems to bump into objects, falls a lot or seems unsteady or clumsy

  • Does not respect other people’s space

  • Does not seem to read social cues from peers

  • Has frequent and intense temper tantrums that are often inconsolable or can include self-injurious behavior

  • Often “gets with the program” a few minutes behind the group and then misses play opportunities

  • Demonstrates repetitive behaviors or has restricted interests

  • Does not stay calm and engaged other than when his routine is predictable

  • Is having more difficulty than his peers separating from caregivers

  • Is getting in trouble at school

  • Is having difficulty manipulating toys, using feeding utensils or has difficulty with coloring or handwriting

  • Is having trouble completing tasks at home or school

  • Is getting in arguments with friends or is having a hard time making or maintaining friendships

  • Has been diagnosed with a developmental delay or neuromotor disorder or condition that affects development

  • Seems delayed compared to his peers

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