Watching your child grow and develop is one of life’s greatest joys, but it can also bring moments of concern when milestones seem delayed or development appears different from other children. If you’ve noticed your child struggling with daily activities like dressing, eating, playing, or interacting with others, you’re not alone. Research indicates that up to 15% of children under five experience delays in at least one developmental area, with 24% showing vulnerabilities by school entry. Understanding when to seek professional support through paediatric developmental assessments can make a profound difference in your child’s journey towards independence and confidence.
What Are the Key Developmental Milestones Parents Should Monitor?
Understanding typical developmental patterns helps parents recognise when their child may benefit from professional assessment. Child development progresses through predictable stages across physical, cognitive, language, social-emotional, and self-care domains.
Physical Development Milestones
Gross Motor Skills involve large muscle coordination and typically follow this progression:
- 6-9 months: Crawling movements emerge
- 8-10 months: Pulling to standing position
- 12-15 months: Independent walking
- 18-24 months: Running and jumping with both feet
Fine Motor Skills encompass precise hand movements:
- 12 months: Pincer grasp (thumb and forefinger coordination)
- 15-18 months: Stacking 2-3 blocks
- 24 months: Using utensils effectively
- 3-4 years: Copying simple shapes, using scissors
Cognitive and Language Development
Cognitive skills develop through exploration and problem-solving:
- 10-12 months: Understanding cause-and-effect relationships
- 18-24 months: Symbolic play begins
- 3-4 years: Complex pretend play and storytelling
Language milestones include:
- 3 months: Cooing and social vocalisation
- 12-15 months: First meaningful words
- 24 months: Combining two words
- 3-4 years: Sentence formation and conversation
Social-Emotional and Self-Care Skills
Social development encompasses:
- 6 weeks: Social smiling
- 12 months: Joint attention (following gaze)
- 18 months: Self-initiated calming strategies
- 3 years: Cooperative play with peers
Self-care abilities typically emerge:
- 15-18 months: Finger feeding
- 2-3 years: Toilet training readiness
- 3-4 years: Independent dressing (simple clothing)
- 4-5 years: Basic hygiene tasks
When Should Parents Consider a Paediatric Developmental Assessment?
Recognising red flags across different age groups helps determine when professional assessment becomes necessary. Early identification significantly improves outcomes, making timely referral crucial.
Infants (0-12 Months) – Warning Signs
Key concerns during infancy include:
- Inability to maintain head control by 6 months
- Absence of social smiling by 3 months
- Poor visual tracking (not following objects past midline)
- Persistent primitive reflexes beyond 6 months
- Extreme irritability during routine care activities
- Asymmetrical movement patterns
- Feeding difficulties or failure to thrive
Toddlers (1-3 Years) – Critical Indicators
Significant developmental concerns include:
- Fewer than 8 meaningful words by 18 months
- Inability to walk steadily by 18 months
- Limited shared attention or pointing to objects
- Regression in previously acquired skills
- Extreme sensory reactions (covering ears, avoiding textures)
- Minimal pretend play by 24 months
- Difficulty following simple instructions by 22 months
Preschoolers (3-5 Years) – School Readiness Concerns
Pre-academic readiness challenges may include:
- Inability to manage basic self-care tasks
- Inconsistent hand preference by age 4
- Poor scissor control or pencil grip
- Difficulty copying simple shapes
- Predominantly solitary or repetitive play
- Extreme anxiety in social settings
- Persistent clumsiness affecting daily activities
How Do Occupational Therapists Assess Child Development?
Paediatric occupational therapists use comprehensive, evidence-based approaches to evaluate children’s developmental progress and identify areas requiring support.
Standardised Assessment Tools
| Assessment Tool | Age Range | Areas Evaluated | Purpose |
|---|---|---|---|
| Bayley Scales of Infant Development (4th Edition) | 1-42 months | Cognitive, language, motor, social-emotional, adaptive | Identifies deviations from normative benchmarks |
| Bruininks-Oseretsky Test of Motor Proficiency | 4-21 years | Fine and gross motor competence | Quantifies motor skill development |
| Sensory Profile-2 | 3-17 years | Sensory processing patterns | Identifies sensory-related challenges |
| Peabody Developmental Motor Scales | 0-71 months | Fine and gross motor development | Measures motor skill acquisition |
Clinical Observation and Analysis
Beyond standardised testing, occupational therapists conduct detailed observations of:
- Play behaviour: How children engage with toys, peers, and environments
- Motor planning: Ability to sequence and execute complex movements
- Sensory processing: Responses to touch, sound, movement, and visual input
- Self-regulation: Emotional control and attention during activities
- Environmental interaction: How children navigate physical spaces
Family-Centred Assessment Approach
Comprehensive assessments include:
- Caregiver interviews: Understanding daily routines and concerns
- Home environment evaluation: Identifying supports and barriers
- Goal setting: Establishing family priorities and desired outcomes
- Cultural considerations: Respecting family values and practices
What Types of Interventions Do Occupational Therapists Provide?
Occupational therapy interventions focus on enhancing participation in daily activities through skill-building, environmental modifications, and caregiver education.
Motor Skill Development Strategies
Task-Specific Training involves:
- Breaking down complex activities into manageable steps
- Practising functional movements in natural contexts
- Using adaptive equipment to promote independence
- Incorporating play-based learning activities
Sensory Integration Therapy addresses:
- Sensory processing challenges affecting daily function
- Self-regulation difficulties through controlled sensory experiences
- “Sensory diets” incorporating proprioceptive, vestibular, and tactile input
- Environmental modifications for sensory comfort
Educational and Social Support
School Readiness Programs focus on:
- Pre-writing skills and pencil control
- Attention and classroom behaviour
- Social interaction and peer relationships
- Independence in self-care tasks
Family Coaching includes:
- Embedding strategies into daily routines
- Teaching responsive interaction techniques
- Providing emotional support and resources
- Advocating for appropriate accommodations
How Can Families Access Occupational Therapy Services?
Understanding referral pathways and funding options helps families navigate the system effectively.
Referral Sources and Timing
Immediate referral is recommended for:
- Persistent developmental concerns despite support
- Significant delays in multiple developmental areas
- Regression in previously acquired skills
- Extreme behavioural responses to sensory input
- Inability to participate in age-appropriate activities
Referral sources include:
- General practitioners and paediatricians
- Maternal and child health nurses
- Early childhood educators
- Allied health professionals
- Direct family referrals (private services)
Funding and Service Options
Public Health Services provide:
- Hospital-based assessment and intervention
- Community health centre programs
- School-based support services
- Waitlists may apply for non-urgent referrals
Private Services offer:
- Shorter waiting periods
- Flexible scheduling options
- Home-based assessments and therapy
- Specialised programs for specific conditions
NDIS Funding supports:
- Children with permanent disabilities
- “Reasonable and necessary” support criteria
- Multidisciplinary team approaches
- Long-term intervention planning
Mobile and Telehealth Options
Modern service delivery includes:
- Mobile therapy services: Bringing assessment and intervention to homes and communities
- Telehealth consultations: Providing access to rural and remote areas
- Hybrid models: Combining in-person and virtual support
- Family training: Empowering caregivers with skills and strategies
Moving Forward: Supporting Your Child’s Development
Paediatric developmental assessments serve as valuable tools for understanding your child’s unique strengths and challenges. When developmental concerns persist or significantly impact daily functioning, occupational therapy assessment can provide clarity and direction.
Early intervention consistently demonstrates superior outcomes compared to delayed support. Children who receive timely, appropriate intervention show greater independence, improved social participation, and enhanced quality of life. The assessment process itself often provides reassurance for families, either confirming typical development or identifying specific strategies to support progress.
Remember that development occurs at varying rates, and every child follows their own unique path. Professional assessment helps distinguish between normal variation and patterns requiring intervention, ensuring your child receives appropriate support when needed.
The journey of child development involves celebrating achievements, addressing challenges, and fostering resilience. Occupational therapists work alongside families to enhance participation in meaningful activities, promoting confidence and independence across all areas of life.
At what age should I be concerned about my child’s development?
Concerns can arise at any age, but key periods include 6-9 months (motor milestones), 12-18 months (communication development), and 3-4 years (school readiness skills). Trust your instincts—if something feels different about your child’s development, seeking professional guidance is always appropriate.
How long does a paediatric developmental assessment take?
Comprehensive assessments typically require 1-2 sessions lasting 60-90 minutes each. This includes standardised testing, clinical observation, caregiver interviews, and report preparation. Some assessments may require additional sessions depending on the child’s needs and cooperation.
What should I expect during my child’s first occupational therapy assessment?
The assessment involves play-based activities, standardised tests, parent questionnaires, and observation of daily tasks. Your child will engage in age-appropriate activities while the therapist observes motor skills, sensory processing, and social interaction. The session is designed to be enjoyable and non-threatening.
Can occupational therapy help with behavioural issues in children?
Yes, occupational therapists address underlying factors contributing to challenging behaviours, including sensory processing difficulties, motor planning challenges, and self-regulation issues. By addressing these root causes, behavioural improvements often follow naturally.
How do I know if my child needs ongoing occupational therapy or just a one-time assessment?
The assessment results and your child’s response to initial strategies will guide recommendations. Some children benefit from short-term intervention (6-12 weeks), while others require longer-term support. The therapy team will regularly review progress and adjust recommendations accordingly.
