Infant and Toddler Occupational Therapy
About OT for Infants and Toddlers
Occupational therapy can support people across their lifespan including during infancy and toddlerhood. During this time, the primary goal of occupational therapy is to support the “occupations” of infants and toddlers, including play, sleep, feeding, dressing, toilet readiness, and education.
Whether your child needs additional support in meeting their milestones, your child has a specific medical diagnosis, or, as a parent, you would like guidance on how to become proactive with your child’s development, Occupational Therapy can help.
The Assessment
You can expect your occupational therapist to complete a thorough, play-based screening of your child’s developmental milestones. Developmental milestones are age-specific tasks and functional skills (Alghamdi et al., 2023), including gross motor, fine motor, visual motor, feeding, and sensory processing abilities. Examples of developmental milestones your therapist will be assessing include:
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Tummy time
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Playing with hands in the middle of their body
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Head control
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Sitting
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Crawling
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Standing
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Walking
Our assessment can include, but is not limited to, clinical observation, parent questionnaires, and standardized assessments. The main goal of the assessment is for our team to establish a sense of your goals and the direction of treatment and intervention.
Other Common Concerns for Infants and Toddlers
Infant Feeding
Feeding is essential and one of the most important occupations for a child. Here at Shoreline Therapy, we follow the most recent evidence-based approach of responsive feeding. Responsive feeding has been defined as, “Feeding practices that encourage the child to eat autonomously and in response to physiological and developmental needs, which may encourage self‐regulation in eating and support cognitive, emotional, and social development” (Pérez-Escamilla et al., 2021).
Whether you require support with breast/chestfeeding, bottle feeding, transitioning to solids, or improving established mealtimes, occupational therapy can provide strategies and guidance to help create a positive and connected experience for your infant or toddler. Please refer to the pediatric feeding services page for more details.
Sensory Processing
Sometimes new or particular activities for infants and toddlers can be overwhelming or challenging to navigate. An occupational therapist can support your understanding of how your infant or toddler is experiencing and processing the world and help your family find ways to make activities more engaging and manageable.
Examples of when to seek out support include when your little one:
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finds bath time distressing,
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appears sensitive to lights and/or sounds,
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appears fussier during moments of touch such as diaper changes, and/or
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becomes fussy during changes in position such as being picked up or spun in a circle.
Torticollis and Head Shape Management
Torticollis is a musculoskeletal disorder that typically forms at birth or in the first few months of life. The infant typically presents with a posture where their head is tilted towards one side of the body and rotated towards the opposite side of the body (Rodríguez-Huguet et al., 2024).
In some cases, torticollis can lead to changes in a child’s head shape. For example, a parent may notice a part of the child’s head flattening on the portion that is in contact with a hard surface (e.g., cribs, swings, car seats). This is referred to as positional plagiocephaly (Van Vlimmeren et al., 2007). This may be accompanied by bulking of the opposite side of the head that is not in contact with these surfaces. Over time, these shape changes could lead to physical asymmetries and changes in activity levels in the child (Blanco-Diaz et al., 2023). Reduction or changes in activity levels may delay participation in developmental milestones.
Occupational therapy can support your family when torticollis and/or positional plagiocephaly prevent your child from participating in their occupations. Some clues that torticollis or positional plagiocephaly is affecting your child’s daily participation include when your child:
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prefers to use one side of their body,
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may consistently have their head tilted during play or other tasks,
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prefers to breastfeed or bottle-feed on one side or in one particular position,
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is demonstrating a preference for looking to one side,
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appears to be sleeping with a consistent head position, leading to flattening on that side of the head,
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has a difference in appearance between the two sides of their face, and/or
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demonstrates unexplained stress when placed in different positions.
Occupational therapy can support your family in learning how to identify when your child is using compensatory strategies, how to use repositioning strategies to reduce pressure on flattening areas, and ways to promote the incorporation of both sides of the body during play and other daily tasks.
Information and Resources
CDC Developmental Milestones
https://www.cdc.gov/ncbddd/actearly/milestones/index.html
Pathways.org
Free app and website to track development
Torticollis and Positional Plagiocephaly
https://pathways.org/positional-plagiocephaly-positional-torticollis/
References on This Page
Alghamdi, H. M., Altirkistani, B. A., Baatya, R. A., Marghalani, Y. O., & Alshaikh, N. M. (2023). Bridging the gap: Parents’ knowledge of childhood developmental milestones and the early identification of children with developmental delay. Cureus, 15(11) doi:https://doi.org/10.7759/cureus.48232
Blanco-Diaz, M., Marcos-Alvarez, M., Escobio-Prieto, I., De la Fuente-Costa, M., Perez Dominguez, B., Pinero-Pinto, E., & Rodriguez-Rodriguez, A. (2023). Effectiveness of conservative treatments in positional plagiocephaly in infants: A systematic review. Children, 10(7), 1184. doi:https://doi.org/10.3390/children10071184
Pérez-Escamilla, R., Jimenez, E. Y., & Dewey, K. G. (2021). Responsive feeding recommendations: Harmonizing integration into dietary guidelines for infants and young children. Current Developments in Nutrition, 5(6), nzab076. https://doi.org/10.1093/cdn/nzab076
Rodríguez-Huguet, M., Rodríguez-Almagro, D., Rosety-Rodríguez, M. Á., Maria Jesus Vinolo-Gil, Ayala-Martínez, C., & Góngora-Rodríguez, J. (2024). Effectiveness of the treatment of physiotherapy in the congenital muscular torticollis: A systematic review. Children, 11(1), 8. doi:https://doi.org/10.3390/children11010008
Van Vlimmeren, L. A., Van Der Graaf, Y., Boere-Boonekamp, M. M., L’Hoir, M. P., Helders, P. J. M., & Engelbert, R. H. H. (2007). Risk Factors for deformational plagiocephaly at birth and at 7 weeks of age: A prospective cohort study. Pediatrics, 119(2), e408–e418. https://doi.org/10.1542/peds.2006-2012