What Does a Paediatric Occupational Therapist Do?
Occupational therapy is one of the most misunderstood allied health professions. For adults, the name makes some sense (helping people return to work or daily function after illness or injury). For children, it is less obvious. This guide explains what a paediatric occupational therapist actually does, what conditions they work with, and how to know whether your child might benefit.
What is occupational therapy for children?
For children, "occupation" does not mean work; it means the everyday activities that matter to them and their families: getting dressed, writing, concentrating in class, playing with other children, managing sensory input, and navigating daily routines.
A paediatric occupational therapist (OT) assesses and supports children when difficulties in any of these areas are affecting their participation in life. The goal is not to fix a label or diagnose a condition; it is to understand a child's specific profile and provide practical strategies, reports, and intervention to help them engage more fully in the things that matter.
In Ireland, paediatric OTs are CORU-registered health professionals who work with children from infancy through adolescence across a wide range of needs.
What does a paediatric OT assess and treat?
Paediatric OTs work across a broad range of areas. Some of the most common include:
Sensory processing: How a child responds to sensory input: sound, texture, movement, light, taste. Children who are overly sensitive, under-responsive, or who seek sensory input in ways that affect daily life often benefit from OT assessment and sensory strategies tailored for home and school.
Fine motor skills and handwriting: Pencil grip, letter formation, handwriting speed, scissor skills, and the underlying hand strength and coordination that underpins written work at school. Handwriting difficulties are among the most common referral reasons for paediatric OT in Ireland.
Motor coordination and dyspraxia (DCD): Gross and fine motor coordination, balance, motor planning, and the executive functioning skills that help children organise themselves and manage physical tasks. Developmental Coordination Disorder (DCD) is a recognised condition that paediatric OTs assess using standardised tools.
Executive functioning and organisation: Attention, planning, task initiation, time management, and self-regulation. These are particularly relevant for children with ADHD or autism who find school routines and transitions challenging.
Autism-related support: Sensory and emotional regulation, daily living routines, meaningful participation, and transitions. OTs take a neuroaffirmative approach, working with a child's profile, not against it.
Self-care and activities of daily living: Dressing, feeding, toileting, and managing personal organisation, including areas where some children with developmental differences need structured support and practical strategies.
What does an OT assessment involve?
A paediatric OT assessment is not a medical examination. It is a structured clinical process that typically involves:
1. **A pre-assessment conversation with parents** to understand concerns, history, and what matters most to the family. 2. **Standardised and non-standardised assessment tools**: practical tasks, observations, and validated questionnaires that give the OT a picture of the child's strengths and difficulties. 3. **A written report** summarising findings, clinical impressions, and specific recommendations for home, school, and any further supports. 4. **A feedback session** with parents to explain the findings in plain language and agree next steps.
At Engage OT, assessments are delivered in person or online via Doxy.me, a secure GDPR-compliant video platform. The written report is delivered within one week of the assessment.
How do I know if my child needs an OT assessment?
There is no single checklist, but the following are common reasons parents in Ireland refer their child for OT:
School is reporting difficulties with handwriting, pencil grip, or organisation
Your child becomes distressed or overwhelmed in sensory environments (loud places, certain clothing textures, busy classrooms)
Motor milestones seem delayed or your child appears unusually clumsy
A teacher, SNA, or GP has suggested OT might help
Your child has an ASD, ADHD, or DCD diagnosis and you want a clearer picture of functional strengths and needs
You are preparing a reasonable accommodation application for Junior or Leaving Certificate
Your child is on the HSE waiting list and you would like support now
If you are unsure whether OT is the right route, Engage OT offers parent consultations specifically designed to talk through your concerns and agree on the most appropriate next step, without committing to a full assessment.
Do I need a GP referral for paediatric OT in Ireland?
No. In private practice, you can contact an OT directly and book an appointment without a GP referral or paediatrician letter. The access is immediate.
If you are seeking OT through the HSE, you may be referred by a GP, school, or public health nurse, or you may self-refer in some areas. However, given current HSE waiting times of two to four years, many families choose to access private OT directly rather than waiting for the public route.
Not sure where to start?
Book a Parent Consultation to discuss your concerns and agree on the best next step for your child. Or book an Initial Assessment directly if you know what you need.
Book an assessmentFrequently asked questions
What age can a child start occupational therapy?
Children of any age from infancy through adolescence can access paediatric OT. Engage OT works with children of all ages. There is no minimum age for an assessment.
Does my child need a diagnosis to see an OT?
No. A diagnosis is not required. Many families access OT to understand whether a diagnosis is appropriate, or to get practical support regardless of whether a formal diagnosis exists.
How long does an OT assessment take?
A full initial assessment appointment typically takes 1.5 hours. The written report is delivered within one week. The process also includes a pre-assessment parent consultation and a post-assessment feedback call.
Is paediatric OT available online in Ireland?
Yes. Online OT sessions are delivered via secure, GDPR-compliant video platforms. At Engage OT, sessions are delivered via Doxy.me (no download or account needed, accessible from any browser). In-person sessions are also available.
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