5 Things to Try at Home Before an OT Evaluation
If you have been reading about the signs your child might need occupational therapy, you may have recognized a few of them. Maybe your child avoids crayons, melts down every time it is time to leave the park, or seems to bump into everything. You are paying attention, and that matters. Now you are probably wondering what to do next.
Here is something you can start this week. The five activities below are simple, playful, and use things you likely already have at home. They help every child, whether or not therapy is in the picture. And they tell you something either way: if your child takes off with them, wonderful. If they stay hard, you will have clear, specific observations to share with an occupational therapist.
Before You Start: Two Ground Rules
These activities work best when they feel like play, not homework. Keep the mood light, follow your child's lead, and stop while it is still fun.
Keep it short and playful. Ten minutes a day beats an hour on Sunday. Little bits of practice, most days, are what build skills.
Watch, do not test. You are not grading your child. You are simply noticing what comes easily, what takes effort, and what your child avoids.
1. Playdough and Tongs for Hand Strength
Set your child up at the kitchen table with a ball of playdough and a few small objects hidden inside it, like dry beans, buttons, or tiny plastic animals. Ask them to squeeze, roll, and pull the dough apart to find the hidden treasures. Then hand them kitchen tongs or salad tongs and have them move each treasure into a muffin tin, one per cup. You can turn it into a game by calling out colors or counting together as they go. For older kids, firm clay or therapy putty adds a bit more challenge.
What it builds
Squeezing and pulling strengthen the small muscles of the hand, and using tongs practices the same open and close motion your child needs for scissors. Stronger hands tire less during writing, coloring, and self care.
What to watch for
Your child tires quickly or shakes out their hands after just a few minutes
They use their whole fist or both hands for tasks that usually take one
They refuse to touch the playdough or get very upset when it sticks to their fingers
2. Stickers and Tweezers for Pincer Grasp
Give your child a sheet of small stickers and a piece of paper with a few circles or a simple curvy path drawn on it. Ask them to peel each sticker and place it inside a circle or along the line. Next, set out a bowl of cotton balls, pom poms, or cereal pieces with a pair of large plastic tweezers, and have them transfer the pieces into an ice cube tray. If the tweezers feel too hard at first, let them use their fingers and work up to the tool.
What it builds
Peeling stickers and using tweezers develop the pincer grasp, where the thumb and pointer finger work together to pick up and hold small things. This is the foundation for holding a pencil, buttoning a shirt, and opening snack packages.
What to watch for
Your child cannot get a fingernail under the edge of a sticker, even after several tries
They pick up small items with all their fingers or rake them toward their palm
They get frustrated very quickly and push the activity away every time
3. A Living Room Obstacle Course for Body Awareness
Use couch cushions, pillows, a blanket, and a couple of sturdy chairs to build a simple course. Your child might crawl under a blanket tunnel, climb over a pile of cushions, step from pillow to pillow like stepping stones, and finish with a jump onto a soft landing spot. Keep it to four or five stations and let your child help design it. Run through it together a few times, then try it backward or with a stuffed animal balanced on their back.
What it builds
Climbing, crawling, and balancing help children understand where their body is in space and how to plan a series of movements. That body awareness supports everything from sitting in a chair at school to keeping up on the playground.
What to watch for
Your child bumps into furniture or misjudges how far to step, even after practice
They seem fearful when their feet leave the ground or avoid climbing altogether
They have trouble remembering the order of the stations or copying a movement you show them
4. A Picture Routine Chart for Transitions
Pick one daily routine that tends to be hard, like getting ready in the morning or getting ready for bed. Take photos of your child doing each step, or draw simple pictures: clothes, toothbrush, shoes, backpack. Tape them in order on the fridge or a piece of cardboard, and let your child move a clothespin or check off each picture as they finish. Give a friendly heads up before each change, such as, "Two more minutes of play, then we look at the chart."
What it builds
Seeing what comes next makes the day feel predictable, which can make transitions much smoother. It also builds independence, since your child can check the chart instead of waiting for reminders.
What to watch for
Meltdowns at transitions stay just as intense, even with warnings and the chart
Your child has a hard time following the steps in order, even with pictures
Small changes to the routine lead to big distress that takes a long time to settle
5. Heavy Work for Calm
Heavy work simply means activities where your child pushes, pulls, or carries something with some weight to it. That effort gives the muscles and joints deep pressure input, which helps many children feel calmer and more organized in their bodies.
At home, have your child carry the laundry basket to the bedroom, push a box of books across the floor, help bring light grocery bags in from the car, or do wall push ups. Animal walks, like bear crawls and crab walks, count too. Try a few minutes of heavy work right before the parts of the day that tend to be hard, such as homework, a long car ride, or bedtime. Keep it playful by setting a silly goal, like moving all the stuffed animals to the other room.
What it builds
Heavy work helps the body regulate, so your child can settle, focus, and handle frustration a little more easily. It quietly builds strength and coordination along the way.
What to watch for
Your child constantly seeks out crashing, jumping, or squeezing and never seems to get enough
They avoid physical effort, tire very quickly, or seem floppy and low on energy
You see no change at all in how calm or focused they are after heavy work
Give It Three or Four Weeks
Pick two or three of these activities and weave them into your week. Over three or four weeks, you may notice your child sticking with the playdough a little longer, peeling stickers on the first try, moving through the obstacle course with more confidence, or getting through the morning routine with fewer tears. Those are real wins, and they are worth celebrating. Many children simply needed more practice and the right kind of play, and a few weeks of consistency is all it took.
If nothing changes, or things are getting harder, that is useful information too. It does not mean you did anything wrong. It means your child may benefit from a closer look, and an evaluation gives you answers instead of guesses. If you are curious about what an in-home evaluation looks like, we walk through the signs and the next steps, and you can also read how pediatric occupational therapy supports young children and their families.
Why We Do This at Home
At A Touch of Hope Occupational Therapy, we come to your family's home in Miami-Dade and Broward. That means therapy happens with the same toys, the same kitchen table, and the same routines your child already knows, so new skills carry over into everyday life instead of staying behind in a clinic. Our practice was founded by Hemdat Bar, M.S., OTR/L, and we build parent and caregiver coaching into our work so you always know what to practice between visits.
Questions? Just Ask
You do not have to figure this out alone. If you have tried these activities and still have questions, or you simply want a second set of eyes, we are happy to talk it through. Reach out through our website or call us at (786) 277-9497.
Ten minutes of the right kind of play, most days, changes more than you would think.
