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Writer's pictureAmy Miller

Warning Signs That Your Child Might Need Occupational Therapy


children who need occupational therapy struggle with play

Occupational therapy is one of the broadest types of care available from Happy Hearts. This month we’ll dive into what an occupational therapist does and the warning signs that a child should be referred to an occupational therapist. These services are provided at no charge in the state of Pennsylvania for qualifying children from birth to age three through the early intervention program. If your child struggles with everyday activities, it’s important to get them a free evaluation so they can receive the assistance they need as soon as possible to help them live their lives to the fullest.


What is Occupational Therapy?


Occupational therapy is about helping people of all ages to be independent with everyday activities (also known as their occupation). A child's occupation is everything he or she does throughout the day. In our target age range of birth to three years, this includes: feeding, self-care, playing, engaging with others, and participating in the environment around them. Our goal is to help each child succeed in their daily routines.


Who Can Benefit From Occupational Therapy?


There are many reasons children may need occupational therapy. We help children with developmental disabilities, learning difficulties, sensory processing disorders, physical disabilities, autism, attention disorders, and many more.


Warning Signs That Your Child Should be Evaluated by a Occupational Therapist


Every child develops differently, and it can be hard to know what’s normal. But according to the CDC’s Developmental Milestones, you should be concerned if your child doesn’t achieve any of the following benchmarks:


By 2 months:

  • Child doesn’t calm down when spoken to or picked up

  • Child doesn’t look at your face

  • Child doesn’t seem happy to see you when you approach

  • Child doesn’t smile when you talk to or smile at them

By 4 months:

  • Child doesn’t smile to get your attention

  • Child doesn’t chuckle when you try to make them laugh

  • Child doesn’t look at you, move, or make sounds to keep your attention

  • Child doesn’t open mouth when he sees breast or bottle, even if hungry

By 6 months:

  • Child doesn’t seem to know people that should be familiar

  • Child doesn’t look at self in mirror

  • Child doesn’t laugh

  • Child doesn’t put things in their mouth

  • Child doesn’t grab toys they want

  • Child doesn’t close lips to show when they don’t want more food

By 9 months:

  • Child isn’t shy, clingy, or fearful around strangers

  • Child doesn’t have multiple facial expressions, such as happy, sad, angry, and surprised

  • Child doesn’t look when you call their name

  • Child doesn’t react when you leave (cry, reach for you, or change expression)

  • Child doesn’t smile or laugh when you play peek-a-boo

  • Child doesn’t lift arms to be picked up

By 12 months (1 year):

  • Child doesn’t play games with you, like pat-a-cake

  • Child doesn’t wave goodbye

  • Child won’t put something in a container, like a block in a cup

  • Child won’t look for a toy they see you hide

  • Child won’t drink from a cup without a lid when you hold it to their mouth

  • Child won’t pick up bits of food between their thumb and pointer finger

By 15 months:

  • Child doesn’t copy other children while playing

  • Child doesn’t show you objects they like

  • Child doesn’t clap when excited

  • Child doesn’t hug stuffed toys or dolls

  • Child doesn’t hug, cuddle, or kiss you

  • Child doesn’t point to ask for something or to get help

  • Child doesn’t use fingers to feed themselves

By 24 months (2 years):

  • Child doesn’t point to show you something interesting

  • Child doesn’t put hands out for your to wash them

  • Child doesn’t look at pages in a book when you read to them

  • Child doesn’t help you dress them by pushing their arms through sleeves or lifting their feet

  • Child won’t push a toy car or play with simple toys

  • Child does not scribble if you give them a pen or crayon

  • Child will not feed themself

  • Child cannot drink from a cup without a lid

  • Child will not try to use a spoon

By 30 months:

  • Child will not play next to or with other children

  • Child never says “Look at me!” to show you what they can do

  • Child does not follow simple routines when told, like helping to pick up toys

  • Child doesn’t use objects to pretend, like feeding a block to a doll as if it were food

  • Child cannot take off jacket or pants by themselves

  • Child doesn’t turn book pages when you read to them

By 36 months (3 years):

  • Child will not calm down within 10 minutes after you leave them

  • Child does not notice other children or join them to play

  • Child will not put on any clothes by themselves, like pants or a jacket

  • Child will not use a fork

What To Do If Your Child Exhibits These Warning Signs


If you recognize any of these warning signs in your child, it’s likely they'll qualify for free occupational therapy through the early intervention program. Early intervention helps children develop the skills they need to thrive throughout their lives, and trains and equips parents to be part of this important process. A doctor’s referral ISN'T necessary to seek early intervention services. If you’re located in Berks, Schuylkill, Lebanon, Tioga, or Wayne counties, please email JTofany@HappyHeartsLLC.com or call 570-573-3293 to schedule a no cost evaluation.


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