Occupational Therapy

Occupational Therapy for toddlers

A clear guide to how toddlers grow through play, the four developmental domains an Occupational Therapist watches, and the signs a session at home or in clinic can help.

Occupational Therapy for toddlers
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If you are watching your toddler play and quietly wondering whether they are doing all the things they should be at this age, you are not alone. Play is how toddlers learn to feel, think, move and use their hands. An Occupational Therapist looks at the same play you watch every day, but with a developmental lens. This is what they see.

01 . Why play matters

Why play is the work of toddlerhood

For a toddler, play is not a break from learning. It is the learning. Between roughly one and three years of age, children move from being carried through the world to running through it on their own two feet, and play is how they make sense of the change.

When a toddler stacks blocks, posts shapes into a sorter, scribbles on paper, or runs after a ball, they are not just passing time. They are practising the skills they will use at preschool, at school, and in everyday life. Play builds the brain. It also builds the body and the relationships around the child.

> “Play is the highest expression of human development in childhood, for it alone is the free expression of what is in a child’s soul.” – Friedrich Froebel, founder of kindergarten.

Free play matters most. It is the play the child leads. The parent follows, comments, joins in when invited, and resists the urge to take over. Free play gives toddlers room to imagine, to make mistakes, to repeat the same activity over and over until they have mastered it, and to feel proud of what they have built. Structured drills at this age are usually unnecessary and often counter-productive.

02 . How an Occupational Therapist watches play

How an Occupational Therapist watches a toddler play

When an Occupational Therapist sits on the floor with a toddler and a basket of toys, they are doing several things at once. They are joining the play, because rapport matters. They are also watching, because play reveals development.

A paediatric Occupational Therapist looks for patterns: how the toddler grips an object, how they shift their weight, how they react when a tower of blocks falls, how they ask for help, how they handle being asked to wait. Each of these moments is a small clue about how the toddler is growing.

This kind of observation is different from a checklist at a preschool visit. The Occupational Therapist is not ticking boxes. They are watching the whole child in their preferred environment, and noting the strengths to build on as much as the gaps to address. A good paediatric session looks, to a parent, like nothing more than play. That is the point.

For the parent-facing milestones an Occupational Therapist works from, raisingchildren.net.au, the Australian parenting resource, maintains a clear toddler developmental guide covering the one to three year window.

03 . The four domains

The four developmental domains play supports

When an Occupational Therapist talks about toddler development, the conversation usually maps to four overlapping domains. Each one shows up in everyday play, and each one is a window into how a child is growing.

Emotions

Toddlers learn what emotions mean by feeling them and naming them with the adults around them. Through play, a toddler experiences empathy when a doll falls and they reach to comfort it, pride when they finish a puzzle, and frustration when the tower will not balance. These are the building blocks of self-regulation, which is the skill of managing big feelings as the child grows.

Thinking

Toddler thinking is concrete, hands-on and fast-moving. Play with puzzles, shape-sorters, matching games and stacking blocks teaches problem-solving, cause-and-effect, sequencing and early planning. When a toddler tries the same shape in three different holes before finding the right one, they are running an experiment. Repeating an activity is not a sign of getting stuck. It is the toddler consolidating the skill. For a deeper look at how playdough supports this kind of thinking, see our guide on playing with playdough.

Movement

Between one and three years of age, toddlers move from crawling and being carried to walking, running, climbing, throwing, kicking and jumping. Play that involves dancing to music, kicking a ball, climbing on safe equipment and running freely in the park develops muscle strength, balance and coordination. Gross-motor play is also where toddlers learn to read other people’s bodies: when to follow, when to wait, when to take a turn. See our guide on motor skills development in children for the milestone detail.

Dexterity

Dexterity is the careful work of the hands and fingers. Toddlers build dexterity through finger painting, threading beads, using playdough, building with Lego Duplo, picking up small foods at mealtimes, and starting to dress themselves. Dexterity is the foundation for self-care skills like brushing teeth and using a spoon, and later for school skills like holding a pencil and using scissors. For an everyday family activity that builds it, see play with your food.

A good paediatric Occupational Therapy session looks, to a parent, like nothing more than play. That is the point.

04 . When to seek help

When a parent should consider an Occupational Therapy assessment

Most toddlers develop on a wide and wobbly curve. Worry is not a useful indicator on its own. Many parents worry about a child who is tracking perfectly well, and many parents miss early signs in a child who would benefit from support. What helps is paying attention to patterns over weeks, not single moments.

Some signs that a paediatric Occupational Therapy assessment may be worth booking:

  • The toddler is missing several developmental milestones in the same domain. For example, not walking by 18 months, or not using any words by two years of age.
  • Everyday self-care tasks are unusually difficult: feeding themselves, holding a cup, dressing with help, brushing teeth.
  • Childcare or family day care has raised concerns about how the child plays, joins in, or settles.
  • The toddler is highly distressed by ordinary sensory experiences (textures, noises, clothing tags) or seems to seek out intense sensory input constantly.
  • A General Practitioner, child and family health nurse, or paediatrician has suggested a referral.

For families with NDIS funding, paediatric Occupational Therapy is one of the most common supports under the Early Childhood Approach for children under nine. For families without NDIS funding, Medicare’s Chronic Disease Management items, private health extras, and self-funded sessions are all pathways. Our team can walk you through the funding options at the first appointment.

05 . How parents can support play at home

How parents can support toddler play at home

You do not need expensive equipment, a sensory room, or a structured curriculum. You need time, patience, and a willingness to follow your child’s lead.

A few simple principles support toddler development at home:

  • Let the toddler lead. When you sit on the floor and your toddler hands you a block, take it. Let them decide what the block is, where it goes, and when the game ends. Resist the urge to teach.
  • Name what is happening. “You are stacking. The red block is on top. It is wobbling. It fell.” This running narration builds vocabulary, sequencing and self-regulation language at the same time.
  • Offer a small choice. “Do you want the blocks or the puzzle?” Two options is enough. Choice builds agency without overwhelming.
  • Repeat what works. Toddlers learn through repetition. If they want to read the same book or stack the same blocks for the fifth day in a row, that is the skill consolidating.
  • Mix in big-body play. Climbing, running, jumping and chasing build the muscle strength and coordination that fine-motor skills sit on top of. A toddler who has not moved enough during the day will struggle with seated tasks.
  • Watch for stages, not ages. Children move through play stages in a fairly predictable order, even if the timing varies. For the detail, see our guide on the six stages of play.

Most of all, remember that the play itself is the intervention. You do not need to be an Occupational Therapist to support your toddler’s development. You need to be present.

Further reading

If you want to look at specific aspects of toddler development in more detail, these guides may help:

CLINICALLY REVIEWED BY

Sarah-Louise Higgins

BSc (hons) Occ Thy

HEAD OF CLINICAL DEVELOPMENT (PHYSICAL REHABILITATION),
OPTIMUM HEALTH SOLUTIONS

With over 10 years of clinical experience practicing in the United Kingdom and Australia, Sarah-Louise is an Occupational Therapist with a strong background in mental health, assistive technology, and home modifications.

Sarah-Louise Higgins
Common questions

Frequently asked questions

A paediatric Occupational Therapist watches how a toddler plays, identifies any developmental gaps across emotions, thinking, movement and dexterity, and works with parents on play-based activities that build the skills the toddler needs at home, in childcare and at preschool.
A paediatric Occupational Therapy assessment can be useful from around 12 months onwards if there are concerns about how the toddler is meeting milestones. The earlier a developmental gap is identified, the easier it usually is to address through play-based support at home and in clinic.
For most toddlers, free play that the child leads is one of the most valuable learning activities at this age. Structured drills are usually unnecessary. If a toddler is missing several milestones in the same domain, a paediatric Occupational Therapist can suggest specific play-based activities to target the gap.
Signs include missing several developmental milestones in the same domain, ongoing difficulty with everyday self-care tasks like feeding or dressing, concerns raised by childcare, distress with ordinary sensory experiences, or a referral suggestion from your General Practitioner, child and family health nurse, or paediatrician.
For children under nine, paediatric Occupational Therapy is commonly funded under the NDIS Early Childhood Approach. For children outside this age band or without NDIS funding, Medicare Chronic Disease Management items, private health extras, and self-funded sessions are available pathways. Our team can talk through the options.
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