Paediatric Occupational Therapy under the NDIS – A Guide for Families

Reading time: 11 minutes  |  Updated: April 2026  |  Written by: TEAH Allied Health Team

If your child has recently been diagnosed with a disability or developmental delay, or if you are navigating the NDIS for the first time on their behalf, you may have heard that occupational therapy is one of the most important early supports you can access. But what does paediatric OT actually involve? What will the therapist do with your child, what can you realistically expect from it, and how does NDIS funding make it possible?

This guide is written for families — not clinicians. It explains what paediatric occupational therapy is, what areas it addresses, what to expect from assessments and therapy sessions, how NDIS funding works for children, and how to choose the right OT for your child’s needs.

What Is Paediatric Occupational Therapy?

Occupational therapy for children focuses on helping children participate in the “occupations” that make up their daily lives. For children, those occupations are play, learning, self-care, and social participation — the activities through which children develop, grow, and engage with their world.

A paediatric OT assesses how a child’s disability or developmental difference is affecting their ability to participate in these activities, identifies the specific skills or environmental factors creating barriers, and develops a therapeutic program to address those barriers — building skills, providing adaptive strategies, and recommending the environmental modifications and equipment that will support participation.

Unlike adult OT — which is often focused on maintaining or recovering function — paediatric OT is largely about building function during a critical developmental window. The brain’s neuroplasticity in early childhood means that skill-building interventions have a far greater potential impact in early years than at any other time of life. This is why early intervention is so important, and why families are encouraged to access OT as soon as a developmental concern is identified — not to wait for a definitive diagnosis.

Which Children Benefit from Paediatric OT?

Paediatric OT is relevant for a broad range of children with developmental differences, disabilities, and health conditions. Under the NDIS, children from age 7 (and through the NDIS Early Childhood approach, from birth to age 9) can access OT where their disability or developmental delay meets eligibility criteria.

What Areas Does Paediatric OT Address?

Sensory processing

Many children with developmental conditions experience differences in how they process sensory information — the degree to which they notice and respond to touch, sound, movement, taste, smell, and visual input. Sensory processing difficulties can affect almost every area of daily life: getting dressed in the morning, tolerating certain foods, sitting in a busy classroom, or participating in group play.

A paediatric OT assesses a child’s sensory processing profile using tools such as the Sensory Processing Measure — 2nd Edition (SPM-2) or the Sensory Profile 2, and develops a personalised sensory diet — a daily program of sensory activities designed to help the child maintain an optimal level of alertness and regulation throughout the day.

Fine motor skills

Fine motor skills — the small, precise movements of the hands and fingers — underpin a huge range of childhood activities: holding a pencil, using scissors, doing up buttons, using cutlery, managing a keyboard, or assembling a puzzle. Children who struggle with fine motor skills often find schoolwork physically exhausting, have messy or effortful handwriting, and may avoid activities that highlight their difficulties.

Paediatric OT addresses fine motor development through targeted play activities, therapeutic putty and grip exercises, handwriting programs (such as Handwriting Without Tears), and adaptive equipment where needed.

Gross motor skills and coordination

Gross motor skills — whole-body movements involving balance, coordination, strength, and body awareness — affect a child’s ability to participate in physical education, sport, playground activities, and daily physical tasks like climbing stairs or riding a bike. Developmental coordination disorder (DCD), sometimes called dyspraxia, is one of the most common reasons children are referred to OT for gross motor concerns.

Self-care and daily living skills

Getting dressed, managing personal hygiene, preparing simple food, and managing belongings are the daily living skills that support a child’s independence and participation at home and school. OT supports children to develop these skills through task analysis, graded practice, adaptive equipment, and visual supports.

Play skills

Play is a child’s primary occupation — it is how children learn, develop social skills, build creativity, and process their experiences. For children with disabilities, access to meaningful play can be significantly limited by motor, sensory, cognitive, or social differences. Paediatric OT supports the development of play skills in a broad sense — from simple cause-and-effect play in infancy through to complex cooperative and imaginative play in school-age children.

Social participation

For children with ASD, social anxiety, or significant sensory processing differences, participating in social environments — classrooms, playgrounds, birthday parties — can be genuinely difficult. OT can support social participation by developing the sensory and regulatory skills that allow the child to be more comfortable in social settings, building social interaction skills through structured group programs, and working with parents and teachers on environmental and routine modifications that reduce barriers.

School participation and learning support

School is one of the most complex environments a child with a disability must navigate — it involves sustained attention, fine motor demands, sensory management, social complexity, and executive function challenges all at once. Paediatric OTs conduct school-based assessments, work collaboratively with teachers, and develop tailored plans that support the child’s participation and learning within the school environment. Common school OT goals include handwriting and written output, attention and regulation in the classroom, managing transitions, and participating in physical education.

Assistive technology for children

AT for children covers a wide range of tools: communication devices and AAC apps, adapted grip equipment, seating and postural support, keyboard and mouse alternatives, screen readers, and sensory equipment. A paediatric OT with AT experience assesses which tools would best support the child’s participation, conducts trials, and writes the NDIS AT prescription that unlocks Capital Supports funding.

What to Expect — Assessment and Therapy Sessions

The initial OT assessment

Your child’s first contact with the OT will typically involve a structured assessment. For younger children, this is usually play-based and takes place in your home, your child’s childcare or school environment, or an OT clinic with appropriate sensory and play equipment. The assessment typically includes:

• A detailed interview with you about your child’s history, daily routines, strengths, and difficulties
• Standardised assessment tools appropriate to your child’s age and the areas being assessed
• Direct observation of your child performing relevant tasks and play activities
• If relevant, observation in the school or childcare environment
• Review of any existing reports (paediatrician, speech pathologist, psychologist, school reports)

Following the assessment, you will receive a written report summarising findings, the child’s strengths and areas of difficulty, and the OT’s recommendations for therapy and supports. For NDIS purposes, this assessment report is often used as supporting evidence in plan reviews.

What ongoing therapy sessions look like

Once the assessment is complete, the OT will develop a therapy plan with specific goals, a recommended frequency of sessions, and the approaches they will use. For most children, therapy sessions are between 45 and 60 minutes. You should expect to:

• Be involved in sessions — particularly for younger children and early intervention, parents and carers are an essential part of the therapy process
• Receive home activities between sessions — strategies and activities to practise at home are how the greatest gains are achieved; OT once or twice a week makes limited impact without follow-through between appointments
• See gradual, measurable progress toward specific goals — ask your OT how they are tracking progress and what outcome measures they are using
• Review and update goals regularly — children develop quickly, and goals that were relevant six months ago may have been achieved (or may need to change direction)

OT for School-Age Children — What It Looks Like

The transition to school brings a significant shift in what paediatric OT prioritises. School-age children (5–12 years) face a range of occupational demands that often bring previously unrecognised difficulties to light for the first time — handwriting, seated attention, peer relationships, and the executive function demands of managing a school day.

Handwriting and written output

Handwriting difficulties are one of the most common reasons school-age children are referred to OT. Poor pencil grip, letter reversals, inconsistent sizing, slow writing speed, and painful or effortful writing all affect a child’s ability to participate in classroom learning and complete assessments. OT addresses handwriting through structured programs, fine motor skill building, sensory strategies for the writing environment, and — where handwriting is unlikely to become functional — transition to keyboard or alternative output methods.

Attention and classroom participation

Children with sensory processing differences often struggle to maintain attention in the sensory-rich environment of a classroom — fluorescent lights, background noise, uncomfortable seating, and the proximity of other children can create significant sensory overload. OT supports attention and classroom participation through sensory strategies (movement breaks, seating modifications, noise-cancelling headphones), environmental modifications, and communication with teachers about the child’s needs.

Transition management

Transitions — from home to school, between subjects, from inside to outside — are often the most difficult parts of a school day for children with ASD, ADHD, or sensory processing differences. OT works with children and their school to develop transition supports: visual schedules, preparation strategies, sensory regulation tools, and teacher communication approaches that make transitions more predictable and manageable.

School-based OT — where does it happen?

NDIS-funded OT can be delivered in the school environment — during class time, at recess, or after school — as well as in the home and clinic. Delivery within the school is often the most effective approach because the OT can observe the specific challenges the child faces in their actual school setting, collaborate directly with teachers, and implement strategies in real time. TEAH’s OTs will discuss the most appropriate therapy environment for your child’s needs at intake.

Early Intervention — Why Earlier Is Better

The evidence for early intervention in childhood disability is overwhelming: the earlier developmental support begins, the greater the impact. This is because the developing brain in infancy and early childhood has extraordinary neuroplasticity — the capacity to form new neural connections in response to experience. Therapeutic intervention during this window can redirect developmental trajectories in ways that become progressively harder to achieve as the brain matures.

For NDIS purposes, the Early Childhood Approach (ECA) supports children under 9 with developmental delays or disabilities — including children who do not yet have a formal diagnosis. The ECA connects children and families with early intervention services, including OT, without requiring a full NDIS plan in the first instance. Families can access ECA-funded supports by contacting the NDIS directly or through a partner in the community.

What early intervention OT looks like (ages 0–5)

For very young children, OT early intervention is typically delivered in the home and in natural environments like childcare — the places where the child actually lives and plays. The focus at this age is on:

• Supporting the development of foundational sensory, motor, and cognitive skills
• Coaching parents in strategies to embed therapeutic support into everyday routines — bath time, mealtimes, dressing, play
• Identifying and addressing sensory regulation needs before they escalate into significant behavioural challenges
• Supporting feeding skill development where eating difficulties are present
• Providing parents with information about their child’s developmental profile and what to expect

How the NDIS Funds Paediatric OT

NDIS Early Childhood Approach (children under 9)

Children under 9 with developmental delay or disability can access the NDIS Early Childhood Approach (ECA). Under the ECA, a partner organisation (usually an early childhood intervention provider) conducts an initial assessment and connects the child with appropriate early intervention services — including OT — funded through the NDIS. The ECA does not require the child to have a formal NDIS plan in the first instance, making it a faster pathway to support for young children.

Standard NDIS plan (children 7–17)

TEAH works with NDIS participants from age 7. Children with an NDIS plan access OT through the Capacity Building — Improved Daily Living budget at the standard 2025–26 OT rate of $193.99 per hour. This budget funds all OT professional time — assessments, therapy sessions, report writing, and carer coaching.

How much IDL should a child’s NDIS plan include?

Capital Supports for paediatric AT

Where an OT recommends assistive technology — communication devices, adapted seating and postural supports, adaptive equipment, sensory tools, or mobility aids — the equipment is funded from Capital Supports — Assistive Technology. The OT’s assessment and AT prescription are funded from IDL; the device or equipment itself from Capital. Both budgets must be present in the child’s plan for the full process to proceed.

Getting enough IDL in your child’s plan

The most effective way to secure adequate IDL for your child’s therapy is to submit a comprehensive OT assessment report at your plan review that documents the child’s current functional profile, the therapy recommended, the frequency and duration proposed, and the goals the therapy aims to achieve. A report that says “the child would benefit from OT” is far less effective than one that specifies “fortnightly 1-hour OT sessions over 12 months targeting fine motor development and classroom participation, estimated cost $3,880 from IDL.”

Your Role as a Parent — How to Get the Most from Paediatric OT

Paediatric OT is not something that happens to your child for one hour a week and then stops. The greatest gains come when therapy principles are embedded into daily life — and that requires active, informed, engaged parents and carers.

Be present and participatory during sessions

Where possible, observe your child’s sessions. Ask the OT to explain what they are doing and why. Ask what you should be doing at home. The most effective paediatric OT involves parents as co-therapists — not waiting rooms.

Implement home programs consistently

Your OT will typically provide home activities or strategies between sessions. These are not optional extras — they are the primary mechanism through which gains are consolidated and generalised from the clinic to real life. Consistent home program implementation makes the difference between a child who progresses steadily and one who effectively plateaus between sessions.

Communicate openly with the OT

Tell the OT what is and is not working at home and at school. Share teacher feedback. Flag when your child has had a difficult week, when a new challenge has emerged, or when a previous goal has been achieved. The OT can only adjust the therapy plan based on information you provide — the more context they have, the better calibrated the intervention will be.

Ask for progress updates

Ask your OT how they are measuring progress — what standardised or observational measures they are using, what the goals are, and how you will know when a goal has been reached. Therapy should be measurable and time-limited, not open-ended attendance with no defined outcome.

Bring OT reports to school meetings

An OT report is one of the strongest forms of evidence you can bring to a school meeting about your child’s learning support needs. OT assessments and reports can inform adjustments, inclusive education planning, and access to additional school-based support. Ask your OT to write reports that are accessible to teachers as well as to the NDIS.

Choosing the Right OT for Your Child

Paediatric OT is a relationship — your child will spend significant time with this person, and the therapeutic alliance matters enormously to outcomes. Here is what to look for:

Experience with your child’s specific age and condition

A paediatric OT who primarily works with school-age children with handwriting difficulties may not have the same depth of experience as one who specialises in early intervention for children with ASD. Ask specifically about the OT’s experience with children in your child’s age group and with your child’s primary diagnosis or developmental profile.

A child-friendly, engaging approach

The best paediatric OTs are those who can engage children — particularly reluctant ones — through play, creativity, and genuine warmth. Your child will not engage meaningfully with a therapist they find boring, threatening, or confusing. Ask whether you can observe a session before committing, and trust your instinct about whether the OT’s style is a good fit for your child’s personality.

Willingness to work in your child’s natural environments

Particularly for early intervention and school-age children, OT delivered in the home, school, or childcare setting is significantly more effective than clinic-only delivery. The OT should be willing and able to visit your child’s school to observe and consult with teachers, and to conduct home visits to assess and support daily living skill development.

Clear goal-setting and progress tracking

A good paediatric OT sets specific, measurable goals at the start of therapy, reviews progress against those goals regularly, and updates the therapy plan as goals are achieved or new priorities emerge. Be cautious of OTs who cannot articulate specific goals or who do not use any form of outcome measurement.

NDIS report-writing experience

For NDIS-funded children, you need an OT who can write assessment reports and progress summaries that meet NDIA evidentiary standards. An OT who is clinically skilled but produces vague reports is a liability at plan review time. Ask whether the OT has experience producing reports for NDIS plan reviews and whether they can show you an example of the report format they use.

Frequently Asked Questions

Summary

Paediatric occupational therapy under the NDIS supports children with disabilities and developmental differences to participate meaningfully in the activities that matter most to them — play, learning, self-care, and social connection. It addresses sensory processing, fine and gross motor development, daily living skills, school participation, and assistive technology — all funded from Capacity Building — Improved Daily Living in your child’s NDIS plan.

The most important factors in effective paediatric OT are: starting early, choosing an OT with genuine paediatric experience and a child-friendly approach, maintaining consistent home programs between sessions, and being actively involved as a parent in the therapy process. The results — a child who can manage the demands of school, play, and daily life with greater confidence and independence — are worth the investment.

TEAH’s paediatric occupational therapists work with children across Darwin (NT), Perth (WA), Brisbane (QLD), and Victoria — in your home, at school, and in the community.