Occupational Therapy

Pediatric Occupational Therapy helps children develop the skills they need for the occupations of daily life.

For a child, these occupations may include playing with friends or playing independently during screen-free quiet time, succeeding in school, participating on a sports team, eating, getting dressed, or regulating their emotions.

Our skilled therapists look at the whole child, identifying the underlying neurological, physical, or sensory barriers that may be hindering the child’s progress. Through play-based, evidence-driven interventions, we empower children to master new skills, build confidence, and navigate their world with greater ease and independence.

Our Approach

At The Children’s TLC, we believe that true progress begins beneath the surface. Our highly specialized occupational therapists are trained and hold Advanced Level Certifications in a variety of therapeutic frameworks and interventions, ensuring your child will make exceptional progress under our care.

When a child struggles with reading, handwriting, coordination, balance, sensory processing, or sitting still, we don’t just treat the symptoms; we look at the why behind them. We believe in strengthening a child’s neurological foundation first. Without a stable foundation of support, mastering higher level and complex academic and physical skills will feel like building a house on sand.

Signs Your Child May Benefit from Occupational Therapy

  • Feeding Challenges: Difficulty nursing, transitioning to solids, or extreme picky eating (avoiding specific textures).
  • Gross Motor Milestones: Delays in rolling, sitting up, crawling, walking, hopping, or standing on one foot.
  • Fine and Visual Motor Milestones: Difficulty with shape sorters, stacking blocks, using index finger and thumb to pick up small objects, etc.
  • Tummy Time Distress: Unusual or intense crying during floor play or an inability to support their own head.
  • Play Skills: Difficulty tracking toys with their eyes, lack of interest in exploring a variety of toys, etc.
  • Sensory Sensitivity: Overreacting to diaper changes, baths, loud noises, certain clothing fabrics, walking on grass barefoot, hands getting messing, being touched, etc.
  • Sensory Seeking: Is too rough with toys or others, or uses too much force on objects.
  • Sensory Modulation: Difficulty calming down or being unable to self-soothe when upset.
  • Fine Motor Struggles: Difficulty using crayons, stringing beads, completing simple puzzles, or using child safe scissors.
  • Visual Motor Struggles: Difficulty tracing, drawing shapes, coloring, writing name, or cutting.
  • Self-Care: Needing excessive help with big-kid tasks like dressing, zipping up a jacket, potty training, using utensils, etc.
  • Balance & Coordination: Appears clumsy for their age. Frequently trips, falls, or bumps into others.
  • Motor Planning: Difficulty figuring out how to climb new playground structures, completing hand or body motions to songs, etc.
  • Focus: Inability to sit still for a short story/game, or shifts rapidly from one activity to another.
  • Sensory Sensitivity: Covers ears for common sounds (toilets flushing, vacuums), avoids messy play like finger painting or sand.
  • Sensory Seeking: Constant crashing and bashing – intentionally running into walls, jumping, spinning without getting dizzy. Chews on shirts and non-food objects.
  • Sensory Modulation: Difficulty participating in messy play or sitting still at circle time.
  • Handwriting: Messy handwriting, difficulty forming letters or placing them on lines. Complaints of hand fatigue.
  • Gross Motor: Difficulty riding a bike, catching / kicking a ball, jumping rope or completing jumping jacks, completing hopscotch, participating in PE or various sports.
  • Organization: Struggles to follow multi-step instructions, complete school work, hand in homework on time, or keep track of school belongings.
  • Attention & Focus: Struggles to complete needed school or daily living tasks due to poor attention.
  • Academics: Struggles with specific subjects, i.e., reading, comprehension, spelling, math, etc. Requires assistance to complete homework. Has difficulty copying from the board or loses place frequently.
  • Social Emotional: Difficulty making and keeping friends, frequent melt-downs, or big reactions to small problems, poor self-confidence, etc.
  • Self-Care: Lacks independence with getting dressed, grooming and hygiene, preparing / cutting food, daily routines, etc.
  • Sensory: May be a picky- eater, easily over-whelmed, lose their place while reading, have difficulty filtering out background noise, become anxious over sounds or fire drills, in constant motion / fidgeting, or easily distracted, etc.
  • Sensory Modulation: Throws balls, writes, or colors too hard or too soft. Oftentimes breaks pencils / crayons due to heavy force.
  • Executive Functioning: Major struggles with time management, initiating and / or completing tasks, prioritizing tasks, attention, memory, logic and reasoning / problem solving, lack of impulse control, organization skills, etc.
  • Daily Living: Difficulty mastering and completing more complex grooming and hygiene routines, basic meal prep, simple money management, etc.
  • Posture & Strength: Lack of core strength and stability or slumping that affects their ability to sit upright and focus at a desk.
  • Sensory Processing: Feeling easily over-whelmed/overstimulated by crowded hallways, specific environments like cafeterias and gym, fluorescent lights, etc.
  • Recognizing Internal Cues: Decreased awareness of hunger, thirst, signs of anxiety, etc.
  • Social Awareness & Tuning: Missing non-verbal cues or aware of personal space boundaries
  • Driving & Pre-Driving Skills: Lacks the foundational skills needed for safe driving.

Key Areas of Focus in Occupational Therapy

Sensory Integration is the brain’s ability to take in, organize, and interpret information from the world around us. Think of it as the brain’s traffic controller. When this sensory system works efficiently, a child can filter out the hum of a classroom light, stay balanced while sitting in a chair, and accurately judge how hard to grip a pencil, When the sensory system is disorganized, the world can feel overwhelming, unpredictable, or even painful, often leading to challenges in attention, emotional regulation, and social engagement.

While many clinics offer sensory play, our therapists are specifically trained in the Ayres Sensory Integration (ASI) framework. Our advanced-level training and uniquely built Ayres sensory integration gym allows us to move beyond simple coping strategies. We use purposeful, high-level sensory input and intervention planning to actually create new neural pathways and rewire the nervous system, helping your child to feel safe, organized, and successful.

Primitive Reflexes develop in utero and are the involuntary movements babies are born with to help them survive and develop in their first year of life. During the first year, as the infant matures and higher-level brain sophistication takes over, the primitive reflexes should become inhibited and postural reflexes develop in their place, allowing the infant to move within a gravity-based environment with good balance, posture, and voluntary movement. However when these reflexes remain retained, they act as neurological roadblocks.

A child with a retained reflex is constantly then fighting their own body’s involuntary responses and it may manifest as:

  • Difficulty with attention and concentration (often associated with ADD/ADHD)
  • Struggles with academic skills such as reading, writing, spelling, and math
  • Ocular motor challenges (e.g., tracking while reading or copying from the board)
  • Poor balance and coordination
  • Delays in cognitive processing (such as auditory processing or short-term memory difficulties)
  • Anxiety or mood swings
  • Bedwetting beyond typical developmental age
  • Social and communication challenges, such as poor eye contact or shyness
  • Physical health concerns like allergies, asthma, or digestive and immune issues
  • General developmental delays

There is strong evidence that shows that retained primitive reflexes is an underlying cause of many common learning problems and difficulties with coordination needed for success in sports performance.

At The Children’s TLC, our skilled occupational therapists hold advanced level training and certifications in Primitive Reflex Integration. Once the retained primitive reflexes are identified, occupational therapy interventions and treatment helps to integrate the primitive reflexes, allowing for appropriate postural reflexes to emerge, which further advances the maturation of the child’s central nervous system.

​Gross motor coordination is the ability to use the body’s large muscle groups in a controlled, efficient, and smooth manner. In a pediatric outpatient setting, occupational therapists look beyond simple muscle strength; we observe how a child integrates sensory information to plan and execute complex movements. This involves the big picture of physical interaction — how a child navigates their environment, maintains their balance while distracted, and transitions between different physical tasks without losing their footing or becoming overly fatigued.

​At the Children’s TLC, we focus on several foundational pillars of movement that serve as the building blocks for daily independence and confidence:

  • Postural Control & Core Stability: The ability to maintain an upright position against gravity, which is essential for sitting at a desk or standing in line.
  • ​Motor Planning (Praxis): The mental blueprint required to figure out how to climb a new play structure or navigate an obstacle course.
  • Bilateral Integration: Using both sides of the body together in a coordinated way, such as pumping legs on a swing or catching a large ball.
  • Balance & Vestibular Processing: Staying steady on uneven surfaces and understanding where the body is in space during movement.

We believe that therapy is most effective when it doesn’t feel like work. By incorporating meaningful, goal-directed play, we keep children engaged and motivated to push their physical limits.

​For a child who loves superheroes, we might design a Training Academy where they must climb a mountain (rock wall), leap over lava (foam blocks) and crawl through tunnels to save the day. For a child interested in nature, we might practice animal walks — like heavy bear crawls, crabwalks, or hopping like a frog—to build shoulder stability and leg power. By tying these movements to a child’s specific interests, we transform repetitive exercises into exciting challenges, helping them build the coordination needed to participate fully in sports, recess, and every adventure in between.

Fine motor skills are the foundation for a child’s ability to perform essential daily tasks, including activities like stinging beads, cutting, buttoning a shirt, and handwriting. At The Children’s TLC, when a child is struggling to complete tasks that require good fine motor skills, we look beyond the simple movement and deeply analyze the underlying neurological and muscular components that allow for precision.

Challenges with dexterity often manifest as avoidance of fine motor tasks, decreased attention, silly behavior, or frustration during table-top activities, or a preference for gross motor play where precision isn’t required.

Fine motor therapy often appears like play, but it is actually a series of highly structured and planned out interventions designed to look and feel like play all while improving hand strength and stability, finger isolation, in-hand manipulation, and bilateral coordination – make work FUN for the child!

A session might involve:

  • Manipulative Play: Using therapeutic putty to find hidden beads, which builds intrinsic hand strength.
  • ​Precision Tools: Utilizing tweezers or tongs to sort small objects, encouraging the pincer grasp necessary for holding a pencil.
  • ​Multi-Sensory Integration: Writing in sand or using vibrating pens to provide tactile feedback that helps the brain map the hand’s movements.
  • ​Graded Resistance: Engaging in activities like popping bubble wrap or using clothespins to calibrate the amount of force a child applies.

Handwriting is a complex brain-and-body workout that requires a child to coordinate their eyes, core strength, and tiny hand muscles all at once. In daily life, you might notice your child getting frustrated quickly, pressing so hard that the lead breaks, or complaining that their hand hurts after just a few minutes of homework. You might also see them slouching over the desk or struggling to keep their letters on the lines, which can make their writing look messy or disorganized despite their best efforts.

At The Children’s TLC, our occupational therapists don’t just practice tracing and writing letters. We look for the root cause of the struggle. Once identified, therapy might involve play-based activities to build hand strength, like using tweezers to pick up small beads or playing with resistance putty. We may also work on big muscle stability — since a steady hand starts with a strong shoulder and core — using activities like crawling through tunnels, animal crawls or wall push-ups will help them sit upright and write more comfortably.

​The goal of therapy is to make the physical act of writing feel automatic and easy. Our OTs use creative tools like weighted and vibrating pencils, raised-lined paper, and special grips to help the brain understand where the pencil and hand are while writing. By focusing on these foundations, the child can stop worrying about how to hold the pencil and start focusing on the fun part: sharing their ideas and stories with the world.

Emotional regulation is the ability to effectively manage and respond to an emotional experience. We all encounter moments of frustration, anxiety, or excitement, but these emotions can be especially complex for children with ADHD, Autism, SPD, or a history of trauma. Big feelings can become overwhelming or difficult to control, leading to meltdowns, withdrawal, or impulsive behaviors.

Our occupational therapists have advanced training in Emotional and Self-Regulation to help teach our children how to recognize these internal shifts, understand the physiological signals their bodies send — such as a racing heart, sweaty palms, or a clenched jaw — before an emotional spike occurs. By strengthening their brain’s control center and building this foundational self-awareness, our goal is to help every child develop the persistence and self-awareness they need to build lasting and healthy relationships.

Executive functioning is often described as the CEO of the brain. These are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. Just as a busy airport needs an air traffic control system to manage arrivals and departures, the brain needs executive functions to filter distractions, inhibit impulses, prioritize tasks, and set goals.

​Executive functioning is not a single skill, but a suite of interconnected abilities:

  • Working Memory: The ability to hold information in the mind, recall it, and use it (e.g., following multi-step directions).
  • ​Cognitive Flexibility: The ability to switch gears, adapt to changes, and think outside the box.
  • ​Inhibitory Control: The capacity to resist impulses, stay focused, and manage emotional responses.
  • ​Planning and Prioritization: Mapping out the steps needed to reach a goal and deciding what is most important.
  • Time Management: Estimating how much time one has, how to allocate it, and stay within deadlines.
  • ​Task Initiation: The ability to begin a project or chore without procrastinating.
  • ​Organization: Keeping track of information and physical belongings.
  • Processing Skills: The ability to interpret, organize, and utilize information to reach a logical conclusion.
  • Problem Solving: The ability to analyze a situation, apply logic, and flexibly shift strategies as needed.

At The Children’s TLC, we strengthen the brain’s foundation through our specialized neurosynchronization, rhythm, and timing programs to promote whole-brain learning and improve underlying cognitive processing skills. Simultaneously, we help our children develop practical compensatory strategies and environmental modifications that make immediate tasks more manageable. By combining neurological skill-building with real-world adaptations, we help each child improve planning, initiation, and emotional regulation for greater independence in all areas of life.

​Ocular motor skills refer to the brain’s ability to coordinate the small muscles of the eyes to look exactly where they need to go. When these skills are inefficient, the brain has to work significantly harder, often leading to mental fatigue, frustration, and academic or functional struggles.

​Three primary areas we address include:

  • Tracking (Pursuits): The ability to follow a moving target smoothly with the eyes without losing place or moving the head.
  • ​Convergence: The ability of the eyes to move inward together to focus on a near object (like a book or a tablet) and then move back out to see things far away.
  • ​Saccades: The ability to make quick, accurate jumps between two points, such as moving from one word to the next while reading or looking from a desk up to a whiteboard while copying.

​When these underlying skills are not strong, tasks that should be automatic become exhausting. Common areas of challenge include:

  • Reading & Learning: Losing one’s place while reading, skipping lines, or re-reading the same sentence because the eyes didn’t jump accurately.
  • ​Handwriting: Difficulty keeping letters on the line or copying information from one source to another because the eyes struggle to find the target quickly.
  • ​Coordination: Difficulty with ball sports or catching objects because the eyes cannot accurately track the speed and distance of the item.​
  • Physical Comfort: Frequent headaches, eye strain, or blurring of text after a short period of near-work.

​Our occupational therapy team has advanced training in treating ocular motor deficits. ​By strengthening the visual foundations, we reduce the hidden effort required for school and home tasks, allowing each child to focus their energy on learning and engagement rather than just trying to keep their eyes on the target.

Visual processing is much more than just seeing clearly. It is the complex process by which the brain organizes and interprets visual information to guide physical action. At The Children’s TLC, we look beyond basic eyesight to address how a child’s brain and body work together to navigate the world.

  • ​Visual Perceptual Skills: The brain work — interpreting shapes, sizes, and sequences to make sense of the environment, e.g., noticing differences between similar letters (like B and D), and remembering visual sequences.
  • Visual Motor Integration: The body work — coordinating those perceptions with hand and eye movements for tasks like handwriting, drawing, cutting, and sports.

​Standard developmental activities are often just the beginning. Our therapists utilize advanced, evidence-based frameworks at a neurological level to identify and treat the root cause of the visual processing delay rather than just the symptoms.

How We Elevate Progress:

  • Primitive Reflex Integration: Many visual-motor challenges are rooted in retained primitive reflexes. We assess and integrate these foundational patterns to unlock smoother eye-hand coordination.
  • ​Neuro-Developmental Foundations: We utilize specialized techniques to improve the brain’s timing and sequencing, which are essential for reading and fluid eye movements.
  • ​Multi-Sensory Integration: By engaging the vestibular and proprioceptive systems, we help children better map out visual space.
  • Executive Functioning: We teach strategies to improve visual attention and organization for complex academic tasks.

​Our goal is to bridge the gap between what a child sees and what they can achieve, providing them with the neurological tools they need to flourish in every environment.

​For a child, mastering daily tasks such as brushing teeth, washing hair, getting dressed and making a snack is about more than just meeting daily routines — it’s about developing a sense of autonomy and confidence. 

Through our advanced training in neuro-development and sensory integration, we don’t just practice the task. We address the underlying motor planning, sequencing, and sensory processing challenges that make these activities difficult.

​Mastering ADLs and higher-level IADLs not only builds independence, but also helps children transition from being cared for to becoming active contributors to their family’s rhythm. At The Children’s TLC, we break down daily activities into achievable steps and focus on building the skills necessary for independence. A few self-care and household participation routines that we address are:

  • Grooming Routines: Coordinating the movements for and tolerating hair brushing, tooth brushing, and washing their face.
  • ​Hygiene Habits: Developing the sequencing and sensory tolerance for bathing, nail clipping, and toileting.
  • ​Dressing: Improving the attention, sequential processing, and fine motor precision needed for buttons, zippers, laces, and managing clothing orientation.
  • ​Simple Meal Prep: Learning to plan and make a simple snack, spread toppings, pour liquids, and safely use kitchen tools.
  • ​Household Chores: Building the organizational skills to sort laundry, clear the table, or manage their own backpack.
  • ​Life Skills: Enhancing the executive functioning required for multi-step tasks, follow-through, and time management.

​Whether it’s mastering a morning routine or helping with dinner, our goal is to foster the competence your child needs to feel successful at home and beyond!