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Occupational Therapy

Occupational therapy is a type of health care that helps individuals improve their ability to function and participate in everyday activities.

Your occupational therapy team may consist of an Occupational Therapist (OT), who will assess your child and set an intervention plan, and an Occupational Therapy Assistant (OTA), who helps carry out treatment under supervision of the OT.

Intervention focuses on skill development as well as on creating environments that promote best functioning. Intervention occurs in collaboration with the family and the whole service team.


Write-On Fine Motor Drop In starts in late January. Check out details and schedule.

What Do Occupational Therapy Services Involve?

Occupational therapy services may involve:

  • Assessment, treatment and consultation
  • Individual or group therapy combined with parent education and coaching 
  • Home programming and consultation to caregivers, professionals and supportive personnel who interact with the child 
  • Promotion of participation and functioning in the home and community environments
  • Activities of daily Living:
    • Motor Development: fine and gross motor skills, oral motor skills (eating and swallowing)
    • Self-help skills: dressing, bathing, personal care
    • Play skills
  • Recommendations for home modifications and vehicle modifications for wheelchair accessibility and effective functioning in all environments 
  • Support and training in use of adapted equipment (specialized seating, adaptive utensils, home and vehicle modifications)

2 children walking on a balance beam with an occupational therapist supervising them.


Typical Conditions Seen by ErinoakKids OTs

  • Cerebral Palsy
  • Acquired Brain Injury
  • Spina Bifida
  • Skeletal (bone) disorders (Achrondroplasia, Osteogenesis Imperfecta, Arthrogryphosis, Congenital or traumatic amputation)
  • Neuromuscular disorders (such as Duchenne Muscular Dystrophy, Becker and Limb Girdle Dystrophies, Spinal Muscular Atrophy)
  • Neural Tube deficits
  • Metabolic, mitochondrial disorders with neurological impairment
  • Medically fragile

Referral Process and Criteria

A referral is required to access Occupational Therapy services. Health professionals, families and clients can complete our online referral form. For more details, you can visit our Intake Services page.

Referral Criteria

Below are the criteria for Occupational Therapy services:

  • Children 0 – 19 years old with: 
    • a physical or developmental delay/disability
    • require therapy to improve optimum functioning in their environment
    • Does not include children with attention deficit hyperactivity disorder (ADHD) or learning disability (LD)
  • Must live in Peel, Halton or Dufferin

Children who are currently receiving speech and language services, Intensive Behavioural Intervention(IBI) services and/or Applied Behavioural Analysis (ABA) services through ErinoakKids or an ErinoakKids subcontractor may access OT services concurrent with their other service(s) as needed

Start A Referral

Referrals will be reviewed and services will be determined based on your child’s individual needs.

Online Referral Form

Intake Services Page

Typical Development and When to Call For Help

Developmental milestones are important age-specific skills that are used to help check on how your child is developing. 

Below we've listed some milestones that are commonly seen in most typically developing children and when to call for help if your child is not reaching certain milestones.

You are your child's best advocate. If you have any concerns about your child's development, don't hesitate to seek help from your pediatrician or contact our intake services for more information.

By 3 Months
Typical Development:
  • Lifts and holds head up while on tummy
  • Pushes up on arms while lying on tummy
  • Moves legs and arms away from surface when lying on back
When To Call For Help:
  • Not able to follow a moving object with eyes
  • Not able to grasp and  hold objects
  • Seems very stiff or very floppy
By 6 Months
Typical Development:
  • Uses hands to support self while sitting
  • Reaches for toys while on tummy
  • Reaches both hands to play with feet
When To Call For Help:
  • Not able to sit using hands for support
  • Poor head control and unable to lift head
  • Not able to get objects to mouth
  • Not able to reach for objects
By 9 Months
Typical Development:
  • Reaches for toys without falling
  • Turns head to look at and follow parent/objects
  • Sits independently
  • Can get into sitting position by themselves
  • Sits without support
  • Starting to crawl
When To Call For Help:
  • Needs assistance or uses hands to support sitting
  • Only uses one side of the body when moving
  • Consistently over or under-reaches for objects
  • Falls when reaching for toys
By 12 Months
Typical Development:
  • Able to grasp cheerio with finger and thumb
  • Points with finger
  • Bangs toys together
  • Holds crayon in a fist
  • Beginning to help with dressing
  • Bites through a soft cookie
  • Holds a cup independently
  • Drinks with some spillage
  • Begins to bring filled spoon to mouth
When To Call For Help:
  • Significant difficulty picking up and holding onto objects
  • Not able to turn head to follow parent/object
  • Play is limited to chewing and mouthing
  • Frequently chokes when eating or drinking
  • Favors one hand/arm
  • Does not use thumb when grasping objects
  • Hands are fisted most of the time
By 18 Months
Typical Development:
  • Walks alone
  • Helps with undressing
  • Can build a tower of two to four blocks
  • Can use a spoon and cup with help to feed self
  • Can turn two or three pages of a book at a time
  • Squats to pick up a toy
When To Call For Help:
  • Not able to pick up small objects between thumb and fingers
  • Only uses one hand to complete tasks
  • Has difficulty with chewing and swallowing
  • Not able to feed self with spoon or fork
  • Needs help to hold and drink from a cup
  • Has difficulty letting go of object from hands
By 24 Months
Typical Development:
  • Grasps small object  between thumb and fingers
  • Able to string large beads
  • Able to bring spoon/fork to mouth with little spillage
  • Able to drink from a cup
  • Helps with undressing
  • Plays appropriately with toys geared to child’s age
When To Call For Help:
  • Has significant difficulty picking up and grasping small objects
  • Explores objects with mouth most of the time
  • Frequently loses balance in sitting when using hands
  • Has significant difficulty playing with toys geared for his/her age e.g. can’t activate toys using fingers
  • Needs physical help to eat and drink
  • Requires wheelchair or mobility device
  • Requires orthotics/splints to manage arm/hand spasticity
By 3 Years
Typical Development:
  • Catches large balls and throws overhand
  • Alternates feet when climbing stairs 
  • Puts together simple puzzles
  • Able to grasp pencil between thumb and fingers
  • Able to pick up and carefully let go a small object
  • Able to use fork with little spillage
  • Able to put arms in sleeves of jacket
  • Undresses completely without assistance
When To Call For Help:
  • Needs special equipment  and/or significant assistance to complete self help activities  e.g. uses adapted cutlery to eat, needs bath chair to support sitting in tub
  • Needs specialized seating to support optimal positioning for play
  • Requires wheelchair or mobility device
  • Has significant difficulty playing with toys geared for his/her age
  • Requires orthotics/splints to manage arm/hand spasticity
  • Requires vehicle modification to support seating system
  • Has challenges with chewing and swallowing
By 6+ Years
Typical Development:
  • Can use utensils competently e.g. use a knife to cut and spread, cut a simple shape
  • Throws with accuracy
  • Kicks rolling ball
  • Uses playground equipment independently
  • Dresses and undresses independently
When To Call For Help:
  • Requires wheelchair or mobility device.
  • Has significant difficulty using utensils e.g. cutlery, scissors and requires adaptive equipment
  • Requires specialized equipment to complete personal care e.g. specialized seating or bath/shower chair
  • Requires full physical assistance of adult to transfer (moving from one position to another)
  • Requires home modification (such as ceiling track, grab bars in bathroom)
  • Requires orthotics/splints to manage arm/hand spasticity