An OT evaluation helps identify your child’s strengths and areas where they may need support in play, learning, and daily activities.
An occupational therapy evaluation (OT evaluation) happens during your child’s first occupational therapy visit. This evaluation helps the therapist assess your child’s ability and skills to perform tasks and skills like those of others their age. The occupational therapist will watch how your child moves, plays, and learns. They may ask questions or use simple tools to understand your child’s abilities.
This helps the occupational therapist understand your child’s strengths and where they may need support. The evaluation will consider your child’s age, development, and medical needs. After the evaluation, the therapist will make a plan of care for your child.
An occupational therapy evaluation is usually performed during the first session and may be repeated every so often during treatment to measure progress.
What to expect during an OT evaluation
An OT evaluation happens at your child’s first therapy session. Evaluation sessions usually take 30 – 60 minutes. Your child should wear comfortable clothing that lets them move easily. You may be asked to stay with your child during the evaluation.
During the evaluation, the therapist may:
Ask questions about your child’s activities, interests, self-care skills, pain, or changes in function
Watch your child complete tasks or activities
Use simple tools or tests to assess skills
Compare your child’s skills to those of other children their age
They will use the assessment to make an occupational therapy plan that fits your child’s needs.
Skills assessed during an OT evaluation
An OT evaluation measures different areas of function and everyday activities that help your child play, learn, and take care of themselves.
Fine motor skills
Fine motor skills use the smaller muscles of the hands to do tasks such as picking up objects, coloring, using scissors, and handwriting. To assess these skills, the therapist may:
Watch your child do tasks that use their hands and fingers, like putting beads on a string, picking up objects, or drawing.
Complete standardized tests that measure fine motor skills
Have your child hold and squeeze a dynamometer, a tool used to measure grip strength
Gross motor skills
Gross motor skills use large muscles in the arms, legs, and body for coordinated movement and body control. The therapist may:
Have your child do movement activities such as throw and catch a ball, use an arm bike, or reach for objects
Ask your child to hold certain positions to look at their posture or balance
Visual skills
Visual skills include how your child uses what they see to move and do tasks. The therapist may:
Watch to see how your child follows or tracks objects with their eyes
Measure visual motor skills (hand-eye coordination) with standardized tests
Assess how your child uses visual cues to help them move and do activities
Musculoskeletal function
The therapist may measure how well your child’s muscles and joints work. This may include:
Upper body (arm) strength
Movement around a joint (range of motion)
How much tension is in the muscle (muscle tone)
Activity tolerance
Activity tolerance measures how much energy your child has for daily activities. The therapist may:
Ask if your child needs rest breaks or extra naps, if they can do activities without stopping, or if they limit certain activities because of feeling tired
Use a questionnaire or checklist to learn about your child’s activities and routines
Complete tests to measure your child’s endurance or how well your child recovers from physical activity
Sensory processing
Sensory functions include how your child responds to sensory input, such as sounds, lights, touch, taste, and temperature. The therapist may:
Assess how your child reacts to sounds, textures, or movement
Observe your child during play to see if they seek or avoid certain types of sensory input
Ask about sensory behaviors at home, school, or in the hospital
Functional cognition
Functional cognition is the ability to use thinking, attention, and problem-solving skills to learn and do tasks for self-care, school, and play. The therapist may:
Ask how well your child follows directions, solves problems, or completes tasks without reminders
Have your child do an activity like playing a game, solving a puzzle, or following a recipe
Use age-appropriate tests that measure thinking and learning
Age-based OT evaluation
Occupational therapy evaluations look different at each stage of development. As your child grows, the therapist focuses on age-appropriate skills needed for play, learning, and independence.
OT assessment for children ages 0-3 years
OT for infants and toddlers focuses on developmental milestones and play-based activities. An assessment may include:
Caregiver interview about sleep, play, feeding, and routines
Developmental activities such as grasping, rolling, sitting, crawling, and walking
Play-based activities to see how your child responds to people and different sensory input
A screening test or standardized assessment to assess your child's skills and development
OT assessment for preschool-age children
For children ages 3-5, an OT assessment might include tasks and activities related to play, learning, and self-care. This may include age-appropriate skills, such as:
Fine motor skills: coloring, stacking objects, and using eating utensils
Gross motor skills: climbing, jumping, and running
Self-care skills: eating, dressing, brushing teeth, toileting, and washing hands
Play and social skills: taking turns, sharing, and interacting with others
Early learning skills: focusing, following simple directions, and doing puzzles
A screening test or standardized assessment to assess your child's skills and development
OT assessment for school-age children
For children ages 5-12, the therapist looks at skills needed for daily routines, school, and gaining independence. This may include:
Fine motor skills: holding a pencil, handwriting, and stacking objects
Gross motor skills: balance, coordination, physical activity, and sports skills
Self-care skills: eating, dressing, personal hygiene, and grooming
Social skills: taking turns, interacting with others, and knowing social cues
Learning and school skills: focusing, following directions, time management, planning, and problem-solving
OT assessment for teens
For teens, an OT evaluation focuses on school success, independence, and preparing for adulthood. More attention may be given to specific skills needed to care for themselves independently, such as preparing meals, managing routines, and preparing for college or independent living. An OT assessment for teens may look at driving readiness and job readiness, depending on your child’s age, needs, and goals.
What to expect after an OT evaluation
After the evaluation, the occupational therapist will review your child’s results with you. The therapist can let you know your child’s strengths, the areas that therapy will focus on, and how you can help your child between sessions.
Questions to ask your care team
Why does my child need an OT evaluation?
What happens during the evaluation?
Can I stay with my child during the evaluation?
What should my child wear or bring to the session?
How will I receive the results?
How often will my child need occupational therapy?
What goals will occupational therapy focus on?
What can I do at home to help my child?
Will insurance cover the OT evaluation and therapy?
How often will my child’s skills be re-evaluated?
Key points about OT evaluation
An occupational therapy evaluation helps identify your child’s strengths and areas where they may need support in play, learning, and daily activities.
The evaluation is done during the first occupational therapy session and may be repeated later to measure progress.
The therapist may use a combination of observation, activities, tools, and structured tasks or assessments.
You and your child (if they are old enough) will answer questions about daily routines, activities, concerns, interests, and goals.
The skills assessed will depend on your child’s age, stage of development, and needs.
After the evaluation, the occupational therapist will review the results and develop a plan of care for your child.
Youth returning to school after cancer, sickle cell, or other illness may need support. Learn how a 504 Plan or Individualized Education Program (IEP) can help.
Children with serious illnesses may need physical therapy, occupational therapy, audiology, and speech-language therapy. Learn about rehabilitation services.
