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Occupational Therapy
Explore explanations, everyday questions and next steps connected with occupational therapy.
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Signs & concerns
Observing hopping skills during a home visit
During a home visit, a frontline worker should observe whether a child can balance briefly on one foot, push off and land with control, and hop a few times on a preferred foot — skills that usually emerge between about 3 and 5 years. Watch how the child moves, note any persistent gap, clear left–right difference, or trouble across several motor areas, and gently encourage a general developmental screen. These are observations to monitor, never to diagnose at home.
Read the answer AnswerObserving jumping skills during a home visit
On a home visit, observe whether a child can bend the knees, push off and lift both feet off the ground together — emerging around 2 years and steadier by 2½–3 years. Watch jumping in place, forward and off a low step, balance on landing, and confidence to try. These are everyday observations to note and encourage, not to diagnose at home; a persistent gap, stiff or floppy tone, or lost skills merits a gentle developmental check.
Read the answer AnswerWhat to observe about lateral movement on a home visit
During a home visit, a frontline worker should observe how a child learning lateral (sideways) movement shifts weight between legs, cruises along furniture, keeps balance, and uses both sides of the body equally. These are signs to observe and note, not to diagnose. A delay, strong one-sidedness, or stiff/floppy tone should be gently flagged for a developmental check at a primary health centre.
Read the answer AnswerWhat to Observe in a Child Learning Line Tracing
On a home visit, observe how the child holds the crayon, whether marks stay roughly along the line, hand steadiness, eye-hand coordination, and willingness to try. Line tracing is an early fine-motor and visual-motor skill emerging around 2.5–4 years, so observe and note rather than label. A child who struggles well past age 4 or avoids all mark-making is best routed gently for a developmental check.
Read the answer AnswerObserving mobility during a home visit
During a home visit, a frontline worker should observe how a child moves naturally — rolling, sitting, crawling, pulling to stand and walking — judged against age, plus muscle tone, symmetry (both sides used equally) and confidence in exploring their home space. These are observations to note and route, never to diagnose. A pattern that persists, affects one side, or shows markedly stiff or floppy tone should prompt a prompt, gentle referral for a developmental check.
Read the answer AnswerObserving Motor Skills on a Home Visit
During a home visit, a frontline worker should observe a child's gross motor skills (head control, sitting, crawling, standing, walking) and fine motor skills (reaching, grasping, passing objects), checking that movement is symmetrical and tone is neither too stiff nor too floppy, and that skills are appearing roughly on time. These are observations to note and refer, not to diagnose at home — clear delays, one-sided movement, or unusual tone should be referred promptly to a PHC officer or developmental check.
Read the answer AnswerWhat to observe about a child's pencil grip on a home visit
On a home visit, a frontline worker should observe how a child holds the pencil (whole-fist grip in toddlers, refining to a fingertip tripod grip by 5–6 years), what they do with it (scribbling, copying lines and circles), hand preference, and the supporting skills of sitting balance and pincer grasp. These are observations to note and monitor by age, not to diagnose at home. Refer to the PHC medical officer or a developmental check if grip lags well behind age, if there is weakness or stiffness, or if the family is concerned.
Read the answer AnswerWhat to Observe About Fine Motor Skills on a Home Visit
During a home visit, a frontline worker should observe how a child uses hands and fingers in everyday play and feeding — reaching, grasping, releasing, transferring objects, pincer grip, stacking, scribbling and self-feeding — judged against age. These are observations to note and monitor, not to diagnose. Refer for a developmental check if hand skills lag across several visits, if tone is stiff or floppy, or if one hand is strongly favoured before 12 months.
Read the answer AnswerGross motor: what to observe on a home visit
On a home visit, a frontline worker should observe a child's gross motor skills — head control, sitting, crawling, standing, walking — alongside the *quality* of movement: muscle tone (too stiff or floppy), symmetry (using both sides), and balance. Watch for stalled or lost skills, strong one-sidedness, or several milestones delayed together. These are signs to record and refer to the PHC medical officer, never to diagnose at home. Judge preterm babies by corrected age.
Read the answer AnswerRoutine management: what to observe at a home visit
During a home visit, a frontline worker should observe how a child manages everyday routines (ICF d5) — following familiar steps for washing, dressing, mealtimes and tidying, coping with small changes, and how much prompting they still need compared with peers. The goal is to observe and note, not to diagnose at home. A persisting or widening gap, heavy reliance on prompting, or routines affected alongside speech, play or movement should be routed to a developmental screen.
Read the answer AnswerObserving running skills on a home visit
On a home visit, a frontline worker should observe how a child runs — balance, coordination of arms and legs, ability to start, stop and turn, and whether both legs are used evenly — not just whether they can run. Running usually emerges by 18–24 months and smooths by 3 years. These are observations to note and monitor, not diagnose at home; a persistent gap, clear asymmetry, loss of a skill, or stiffness should be gently flagged for a developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning scissor use?
During a home visit, a frontline worker should observe how a child holds and uses scissors — thumb-up grip, steady wrist, the two hands working together (one cutting, one holding and turning paper), hand strength, and attention to the task. Snipping usually begins around 2–3 years and cutting along a line by 4–5 years, so observations are judged against age. This is a strengths-first observation to note and encourage, not a home diagnosis. If a child past 4 cannot snip, shows one-sided weakness or strong avoidance, suggest a general developmental check.
Read the answer AnswerObserving self-care on a home visit
On a home visit, observe how a child manages everyday self-care for their age — feeding, drinking, washing, dressing, toileting and signalling needs — and whether independence is growing over time. Watch how the child does these through natural routines, note family concerns and strengths, and route any persistent gap or delay across more than one area to a general developmental check. These are observations to track and refer early, never a diagnosis.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning self-care dexterity?
On a home visit, a frontline worker should observe how a child uses their hands for everyday self-care — pinching small objects, holding a spoon or cup, washing hands, undressing, and managing buttons by age. Watch grip, finger pinch, and both hands working together, and whether skills grow over months. Note stiff or floppy hands, strong early hand preference, or little progress, and refer onward. This is gentle observation to monitor — never a home diagnosis.
Read the answer AnswerObserving self-care skills during a home visit
During a home visit, a frontline worker should observe how a child manages age-appropriate self-care — eating, drinking, washing, dressing and toileting — and how much help a parent provides. Note whether the child attempts tasks, coordinates the movements, follows simple steps and improves over time. These are observations to record and discuss, not to diagnose at home. Difficulty across several areas, no progress over time, or skills well behind same-age children is the cue to route the family for a developmental check.
Read the answer AnswerObserving Sensory Responses on a Home Visit
During a home visit, a frontline worker should observe how a child naturally responds to sound, sight, touch, taste, smell and movement — turning to a voice, making eye contact, accepting touch, noticing objects. Watch for responses that are unusually strong, weak or absent across more than one sense, and whether they persist. This is observation and routing, not diagnosis; flag any consistent pattern or family worry for a developmental and hearing/vision check at the PHC.
Read the answer AnswerSensory avoidance: what to observe on a home visit
During a home visit, a frontline worker should observe how a child responds to everyday sensations — sounds, touch, food textures, lights and movement. Note covering ears, refusing certain clothes or foods, avoiding touch, or distress in busy spaces. These are patterns to observe and gently note, not to diagnose at home. Refer for a developmental check when avoidance is frequent, strong, spans several areas, or limits eating, play and family routines.
Read the answer AnswerWhat to Observe About Sensory Seeking at Home
During a home visit, a frontline worker should observe how a child seeks sensory input — spinning, jumping, crashing, touching everything, mouthing objects, or loving loud sounds — and whether this helps the child settle or disrupts feeding, sleep, safety and play. This is observing patterns to share, not diagnosing. If the seeking is intense, frequent, affects safety or daily routines, or comes with delays in speech or play, guide the family warmly to a developmental check.
Read the answer AnswerObserving sensory tolerance during a home visit
On a home visit, a frontline worker should observe how the child copes with everyday sensations — touch and texture, loud sounds, bright light, and movement. Note distress, withdrawal or craving patterns that disrupt feeding, sleep, play or family life across several weeks, and what helps the child settle. These are observations to record and route to a developmental check — never a home diagnosis.
Read the answer AnswerShape Drawing on a Home Visit: What to Observe
During a home visit, a frontline worker should observe how the child holds the crayon, whether they copy simple shapes appropriate to age (line by ~2, circle by ~3, cross by ~4, square by ~5), whether a preferred hand is emerging, and whether the child looks at and tries to copy a model with reasonable attention. These are fine-motor and visual-motor signs to observe and encourage, not diagnose. A clear, persistent gap from peers across several visits — especially with weak hand use or low interest in copying — should be routed to a general developmental check.
Read the answer AnswerWhat to Observe About Stair Climbing on a Home Visit
During a home visit, a frontline worker should observe how a child approaches stairs: crawling or creeping up, stepping with rail or hand support, balance and steadiness, leg symmetry, and confidence and interest in trying. Stair climbing emerges in stages between about 12 and 24 months, so the focus is on quality and progress, not diagnosis. Flag no attempt to climb with support by 18–20 months, marked asymmetry or stiffness, or loss of a skill to the PHC medical officer.
Read the answer AnswerObserving static balance on a home visit
On a home visit, a frontline worker should watch how steadily a child holds a still position — standing with feet together, balancing briefly on one foot (from about 3 years), and staying upright while reaching or playing. Note wobbling, constant grabbing for support, one side being clearly weaker, and stiff or floppy tone. These are observations to track, not diagnose; refer for a developmental check when a gap persists across visits, one side is consistently affected, or the family is worried.
Read the answer AnswerWhat to observe about a child learning task responsibility on a home visit
On a home visit, a frontline worker should observe how a child takes on, follows through and completes simple age-appropriate tasks — fetching items, tidying toys, basic self-care — noting willingness to start, how much help is needed, and whether they finish. These are everyday observations to note and encourage, not diagnose. A clear, persisting gap from same-age peers or no progress over months should be flagged gently and routed for a general developmental check.
Read the answer AnswerObserving Tiptoe Balance on a Home Visit
On a home visit, a frontline worker should observe — not test — a child learning tiptoe balance: whether they can rise onto their toes, hold steady briefly, use both legs evenly, and come down without falling. This gross-motor skill (ICF d4) develops gradually from around 2.5–3 years, so steady progress matters more than one attempt. Persistent asymmetry, constant toe-walking, very stiff or floppy tone, or balance well behind peers are reasons to encourage a gentle developmental check. Nothing observed at home is a diagnosis.
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