PAEDIATRIC OCCUPATIONAL THERAPY
Occupational therapy for school-age children
FIRST Occupational Therapy works with children and young people aged 5 to 18 across Canberra and surrounds, and by telehealth Australia-wide, on the everyday things that school and home ask of them: handwriting and written output, reading and spelling, getting organised, getting dressed, and getting through the day.
WHAT IS OCCUPATIONAL THERAPY?
The things a child needs to do, wants to do, and is expected to do
Occupational therapy is a broad profession that supports people across the lifespan to take part in the activities that make up daily life. For a school-age child those activities are looking after themselves (dressing, eating, sleep and rest), the practical tasks of home life, play and leisure, school and learning, and friendships. The Integrated Hourglass, the clinical framework behind every assessment and program at FIRST Occupational Therapy, calls these the performance areas: they are where difficulty shows up in daily life, and taking part in them is what the work is for.
An occupational therapist starts from what a child is trying to do and works backwards to what is making it hard. Sometimes the answer sits in the hands, sometimes in the eyes, and sometimes in a nervous system that has been running hot since the first bell. The aim is not a better score on a test. It is a child who can get their ideas onto the page, find their way through the morning routine, join in at lunchtime, and still have something left at three o'clock.
WHEN PARENTS GET IN TOUCH
Things you may have noticed
Families come to FIRST Occupational Therapy for a wide range of reasons. These are the ones we hear most often, in the words parents tend to use.
WRITING AND THE PENCIL
Handwriting that is slow, effortful or hard to read. A child who avoids writing tasks or whose ideas are far ahead of anything that reaches the page. Complaints that their hand hurts.
READING AND SPELLING
Reading that has not moved in a year. Spelling that stays unpredictable however much it is practised. A child who reads aloud accurately and takes almost nothing in.
THE SCHOOL DAY
Homework that takes three times as long as the teacher says it should. A bag that is never packed. Instructions that need repeating. A report that says capable but inconsistent.
AFTER SCHOOL
A child who holds it together all day and comes apart at the front door. Exhaustion that does not match the day they have actually had.
THE BODY
Clumsiness, or steady avoidance of sport and playground equipment. Difficulty with cutlery, laces, buttons, or learning to ride a bike.
BEING IN THE WORLD
Noise, tags, seams, crowds or lighting that are more than a child can bear. Or a child who seeks constant movement and cannot settle without it.
BEFORE YOU READ TOO MUCH INTO A LIST
None of these on its own means a child needs occupational therapy. Children develop at different rates, and plenty of them do some of this at some point. What matters is whether it is getting in the way of school, home or friendships, and whether it has stopped shifting on its own. If you are not sure, a phone call costs nothing and will usually tell you either way.
AREAS OF PRACTICE
What occupational therapy can help with
Every program is built from what the assessment finds and from the goals you and your child set. The areas below are organised the way the Integrated Hourglass organises them: the thinking skills that learning depends on, the foundations beneath them, and the everyday life they serve. Handwriting draws on the first two at once, which is why it comes first.
WHERE THE TWO STREAMS MEET
Handwriting and written output
Letter formation, pencil grasp, legibility, speed and endurance, and the point at which handwriting stops costing so much attention that there is none left over for the writing itself. The hand and eye are working below; language is working above.
THINKING AND LEARNING
Language and literacy
Oral language, vocabulary, phonemic awareness, phonics, decoding and spelling, and the links between them and handwriting. This is the ground the Groundwork Handwriting System is built on, and the area James also teaches to educators.
Attention, processing and memory
Attention, processing speed, and the memory strategies a child uses to hold on to what they are learning long enough to use it.
Executive function and organisation
Working memory, holding back a first impulse, changing tack when a plan is not working, starting a task, checking work, and the self-management that becomes steadily more important through high school.
Confidence, motivation and self-management
A child's sense of being capable, of having some say in what they do, and of being connected to the people around them: the ground that effort and persistence grow from.
THE BODY AND THE NERVOUS SYSTEM
Perceptual-motor skills
Gross motor and fine motor skills, visual-motor integration (making the hand do what the eye intends), visual perception, and the eye movements that reading and copying depend on.
Sensory-motor integration
Posture and core stability, using both sides of the body together, knowing where the body is in space, and motor planning: working out how to do a new movement and getting it done.
Sensory processing
How a child takes in and organises touch, movement and balance, body position, the signals from inside the body, sound, sight, smell and taste, and what helps when a classroom or a shopping centre is too much.
Regulation
Recognising when a child is over- or under-aroused, what tips them, and building the co-regulation, strategies and environmental changes that keep them in a state where learning is possible. Regulation enables learning, and learning refines regulation.
EVERYDAY LIFE
School participation
Copying from the board, working within a time limit, managing materials, moving between activities, and taking part in the parts of the day that are not lessons.
Self-care, home life, play and friendships
Dressing, mealtimes, sleep routines and personal hygiene; the practical tasks of home life; and the play, leisure and friendships that most of the rest of it exists to serve.
WHO WE WORK WITH
School-age children and young people, 5 to 18
FIRST Occupational Therapy works with children presenting with literacy and learning difficulties, sensory processing differences, ADHD, autism, developmental coordination disorder and related neurodevelopmental profiles. Co-occurring profiles are the norm rather than the exception, and the assessment is designed to pick them up rather than work around them.
A diagnosis is not required. Plenty of families arrive without one, and some finish without one, because a label is not the thing that makes a program work.
GETTING STARTED
You do not need a referral
You do not need a referral to see an occupational therapist privately. Many families arrive with one from a GP, paediatrician, psychologist or the school, and many arrive with nothing more than a growing sense that something is not right. Either way the first step is the same: a conversation with James about what you are seeing.
See what happens next, from the first call to the first session →