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OT for Our Littlest Clients

OT for Our Littlest Clients
Elisabeth Bahr, OTD, MS, OT/L
June 7, 2023

A mother and young child sitting with a therapist

Early intervention (EI) offers a remarkable practice area for occupational therapy practitioners (OTPs) to aid families and young kids in their home environment.

Unlike traditional medical settings, which emphasize insurance-based reimbursement and productivity requirements, EI prioritizes the well-being of the child and family.

The Centers for Disease Control and Prevention (CDC) defines EI as “the services and supports available to babies and young children with developmental delays and disabilities and their families… [which] can significantly impact a child’s ability to learn new skills, overcome challenges, and increase success in school and life.” (Centers for Disease Control and Prevention, 2022)

EI services are obtainable nationwide to help infants and toddlers who have developmental issues or are at risk of developing them. Eligibility criteria vary from state to state. A team of professionals—OTPs, speech-language pathologists, physical therapists, special education teachers, and social workers—can support a family with EI services.

OTPs play a crucial role in the EI team. They help the child and family develop skills in a typical sequence, protect the child from sensory or movement experiences that detract from typical development, and promote appropriate challenges and experiences to develop skills.

Family-Centered Care Model in EI

Family-centered care is a standard practice in pediatrics and encourages parent participation through education, training, and coaching (Popova et al., 2022).

This approach may involve:

  • Sharing specific information related to the child’s developmental delay
  • Teaching caregivers about general developmental processes, task adaptations, & environmental modifications
  • Ensuring communication that is flexible and encompasses collaboration, problem-solving, & teaching advocacy expertise

Parents benefit from involvement during EI sessions. Coaching can help them become more confident with their child. Using a collaborative model helps parents generalize new skills and strategies outside of therapy sessions and into their everyday lives.

Activities OTPs Address in Early Intervention

OTPs promote early childhood development by encouraging participation in areas of occupation (Stoffel & Schleis, 2014). This might include:

ADLs (activities of daily living):

  • Feeding: Supporting children in developing self-feeding skills, recommending specific utensils and cups, & addressing sensory-related eating challenges
  • Dressing: Assisting with fine motor skills needed for buttoning or zipping clothes & recommending adaptive clothing
  • Self-care: Teaching strategies for toilet training, handwashing, bathing, & grooming

IADLs (instrumental activities of daily living):

  • Chores: Encouraging age-appropriate tasks like stirring ingredients, setting the table, guiding children in organizing toys, or simple cleaning
  • Grocery shopping and community events: Teaching self-regulation strategies for busy places such as birthday parties, parks, grocery stores, & playgrounds
  • Transportation: Helping parents brainstorm ideas for safe and seamless community access, such as making a busy bag for the car or holding hands when walking

Rest & sleep:

  • Establishing consistent bedtime routines & naps 
  • Creating a sleep-friendly environment & implementing sensory strategies
  • Addressing sleep challenges (e.g., sleep disruptions, difficulty falling asleep)


  • Encouraging exploration through developmentally appropriate toys & games
  • Facilitating social play with siblings & parents
  • Supporting imaginative play to enhance cognitive development & creativity
  • Recommending toys, games, & strategies to promote skill development


  • Collaborating with pre-K & daycare centers to address classroom challenges
  • Developing skills necessary for school tasks like holding a crayon & drawing shapes

Social Participation:

  • Enhancing social skills through sibling play or playdates
  • Teaching children & caregivers to recognize & express emotions
  • Supporting the development of self-regulation & coping strategies for challenging social situations & behaviors

OTPs can help children achieve success in their early development and support caregivers in their roles by emphasizing family-centered care and collaboration. 


Course From OccupationalTherapy.com: OT Services For Our Littlest Clients: Three Key Concepts Presented By Brittney Franklin MS, OTR/L


Centers for Disease Control and Prevention (CDC). (2022, August 9). What is "early intervention"? https://www.cdc.gov/ncbddd/actearly/parents/states.html#textlinks

Popova, E. S., O’Brien, J. C., & Taylor, R. R. (2022). Communicating with intention: Therapist and parent perspectives of family-centered care in early intervention. American Journal of Occupational Therapy, 76(5), 7605205130. https://doi.org/10.5014/ajot.2022.049131

Stoffel, A., & Schleis, R. (2014). Frequently asked questions (FAQ): What is the role of occupational therapy in early intervention? The American Occupational Therapy Association. 

elisabeth bahr

Elisabeth Bahr, OTD, MS, OT/L

Liz Bahr is an occupational therapist, writer, professor, and yoga therapist. She is a neurodiverse-affirming, neurodivergent OTP committed to creating a more inclusive and equitable world for all. She graduated from Boston University's Occupational Therapy Post-Professional Doctorate and New York University, Master of Science programs. She is currently a Master of Creative Writing student at Harvard Extension.

In her clinical practice, she focuses on merging creativity and occupation to improve the quality of life for adolescents and young adults. She has undergone additional training in ADHD and uses this knowledge to help her clients develop strategies and reach their goals. She is also a certified yoga therapist and uses yoga to help her clients improve their physical and mental health.

Liz is a sought-after speaker and writer on occupational therapy, ADHD, and creativity. She has presented at conferences and workshops nationwide, and her work has been featured in national publications. She is passionate about sharing her knowledge and experiences with others to help them live their best lives.

You can find her on LinkedIn or at her wellness practice, pegasuswellness.co. She also writes for Continued.com.

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