Evidence-Based OT Interventions for Children with Developmental Delays

Evidence-Based OT Interventions for Children with Developmental Delays

Children with developmental delays can require occupational therapy (OT) interventions.

According to the Centers for Disease Control, 1 in 6 children in the United States have a developmental delay. Developmental delays can adversely affect a child's ability to naturally acquire the skills needed to engage in functional activities. Children with developmental delays can require occupational therapy (OT) interventions to engage in one or multiple meaningful activities. These meaningful activities can include challenges with:

  • Leisure activities
  • Activities of daily living
  • Social activities
  • Educational activities
  • Pre-vocational and vocational activities

Recommended course: Evidenced-Based Pediatric Yoga Tools for Children with Developmental Disorders, Autism Spectrum Disorder, and Sensory Modulation Dysfunction

Community-based services for children with developmental delays

The service environment determines the scope of OT services. Community-based occupational therapy services address the broader implications on occupational performance resulting from developmental delays.

Occupational therapists are essential to early intervention services for children birth to 3. The CDC states, "Early intervention services can change a child's developmental path and improve outcomes for children, families, and communities." Early intervention (EI) services support both the child and their families and caregivers.

EI can be essential for children with developmental delays. Since developmental skills are like building blocks, EI allows families to work with specialists such as OTs to improve the foundational skills needed for participation in daily activities.

Sensory processing differences

Sensory processing refers to how the nervous system receives, organizes, and responds to sensory input from the environment. Children with developmental disorders can exhibit atypical responses to sensory stimuli, leading to challenges in regulating their behavior and emotions. Sensory processing differences can adversely affect engagement in self-care activities such as feeding, dressing, bathing, toileting, etc.

A 2021 study with limited participants found that in the early intervention population, tactile play with a non-food item can increase the oral acceptance of non-preferred, wet-food items with similar consistency. The tactile play helped the child become desensitized to the aversive sensation, which carried over into eating food of a similar consistency.

In the same birth to three age group, another study found Qigong Sensory Training (QST) to be an effective evidence-based practice for this age group. QST is an infant massage protocol that was developed for children with autism based on Chinese medicine.

Additional research showed that the use of weighted vests had conflicting evidence for efficacy. Therapeutic brushing only had anecdotal evidence for efficacy in early intervention.

School-based services

The Individuals with Disabilities Education Act (IDEA) is a federal law that mandates special education and related services to eligible children with disabilities. It ensures that students with developmental and other disabilities receive an appropriate education that prepares them for pre-vocational, vocational, and independent living skills.

In the academic setting, a 504 plan or an Individualized Education Program (IEP) will contain recommendations made by the school-based occupational therapist agreed upon by the whole team. These two legal documents ensure that students with developmental delays receive a free and appropriate education (FAPE).

Recommended course: Developmental and Sensory Motor Strategies in School Based Programs

Fine motor interventions for children with developmental delays

A child with impaired fine motor coordination or decreased fine motor strength may have difficulty with classroom tasks such as coloring, handwriting, and cutting. These students may benefit from fine motor tools and adaptations until their skills improve or as a permanent solution. Such tools include:

  • Pencil grips for a more functional writing grasp.
  • Broken pencils and crayons to encourage a more efficient 3-point grasp.
  • Adapted scissors, such as auto open or electric scissors, for cutting tasks.
  • Talk-to-text programs, typing, or using a scribe allow children to convey thoughts without worrying about the mechanics of handwriting.

Cognitive delays in children with developmental delays

The following accommodations may be helpful for children with cognitive delays.

  • Schools can implement individualized picture schedules to help the child understand their schedule.
  • Timers can assist with time management and attention.
  • Teachers can use visual cue cards to assist with sequencing tasks.

Addressing the diverse needs of children with developmental delays requires a multifaceted approach, encompassing OT interventions tailored to various aspects of their daily lives, from sensory processing differences to fine motor skills and cognitive challenges. By implementing early intervention services and leveraging supportive environments such as schools and communities, OTs can empower both children and their families to navigate developmental hurdles and foster meaningful participation in activities essential for growth and development.


This article was written by Tasha Holmes, MOT, OTR/L, BCP

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