The short answer: if something in your child's daily life has been hard for a while, is not getting easier, and is shaping how your household runs — that is enough to ask about. You do not need a diagnosis, a referral, or a certainty that something is wrong.
Most parents I speak to have been wondering for months before they call. Almost none of them are wasting my time.
What occupational therapy actually looks at
A child's "occupations" are the things they do all day: eating, sleeping, dressing, playing, learning, and being with other people. Occupational therapy asks where those things have become hard, and why — then changes the skill, the activity, or the environment around it, usually some of each.
That's a wide brief, which is why "is this an OT thing?" is such a common question. It covers sensory processing, fine motor skills, self-regulation, daily routines, play and social participation, and feeding.
Signs by age
These are not a checklist and not a screening tool. They're the things that most often turn out to be worth a conversation.
Babies and toddlers, birth to three
- Feeding is consistently difficult — trouble with the transition to solids, gagging, or a very small range of accepted foods
- Strong reactions to being handled, dressed, bathed, or having their face or hair touched
- Very little interest in playing with objects, or in playing with you
- Not seeming to notice or respond to what's going on around them, or the reverse — overwhelmed by ordinary household noise and activity
- Movement milestones arriving noticeably late, or skipped
- Extreme difficulty settling, in a way that hasn't improved with time
Preschool, three to five
- Mealtimes are a daily battle, or the accepted food list keeps shrinking
- Getting dressed, brushing teeth, or leaving the house takes far more than it seems like it should
- Meltdowns that arrive faster and last longer than other children their age
- Avoiding crayons, scissors, playdough, or anything else that needs small hand movements
- Struggling to play alongside other children, or only able to play one specific way
- Clothing, seams, tags, or particular textures cause genuine distress
- Constantly crashing, climbing, and moving — or the opposite, avoiding movement and physical play
School age
- Handwriting is painful, slow, or exhausting out of proportion to everything else
- Managing belongings, sequences, and transitions is much harder than for their peers
- Holding it together at school and falling apart entirely at home
- Difficulty with self-care that other children their age have moved past — showering, hair, laces, cutlery
- Not able to join in with games and social routines, or finding them exhausting
- Sensory demands of school — the cafeteria, the hallway, the assembly hall — are shaping their day
Phase or pattern?
This is the real question behind most calls, so here's the rough test I'd use.
How long has it been going on? Weeks are usually a phase. Months of the same thing, unchanged, is a pattern.
Is it moving? Difficulties that are slowly improving usually keep improving. Ones that are static, or getting narrower and more entrenched, tend not to resolve on their own.
What is it costing? Not just your child — your whole household. If your family has quietly reorganized itself around avoiding a particular thing, that reorganization is itself information.
Is your child distressed? A child who is managing something in their own unusual way and is happy doing it may need nothing at all. A child who is upset, avoidant, or exhausted by daily life is a different situation.
When waiting is the right answer
Sometimes it is. Children develop unevenly and on their own schedules, and a great deal resolves without intervention. If something started recently, is already improving, follows an obvious disruption like a new sibling or a house move, or isn't bothering your child, waiting is entirely reasonable.
I'd rather tell you that in a first conversation that costs you nothing than take you on.
What to do next
If you're in Port Townsend or East Jefferson County, call or email me and we'll work out whether this is an OT thing, and whether I'm the right person for it. It costs nothing to ask, and if I'm not the right person I'll say so and point you somewhere better.
Further out on the Olympic Peninsula, remote sessions cover the same ground over video — worth asking about rather than assuming distance rules it out.
Elsewhere, your pediatrician is a reasonable starting point — and if your child is under three, your state's early intervention program can evaluate at no cost to you.
You can also read what OT helps with in more detail, or what actually happens if you start.