When Should I Refer My Child for Occupational Therapy? A Checklist

As an Occupational Therapist in Malta, one of the most common things parents tell me is, “I wish I had come sooner.” Many parents notice their child is struggling but are unsure whether it warrants professional support. This checklist is designed to help you decide whether your child might benefit from an occupational therapy assessment.

Fine Motor and Handwriting

Consider an OT referral if your child:

• Avoids drawing, colouring, or writing activities
• Has an unusual or inefficient pencil grip
• Applies excessive pressure when writing or colours very lightly
• Produces illegible handwriting significantly below the level expected for their age
• Struggles to use scissors, do puzzles, or manipulate small objects
• Complains of hand pain or fatigue during writing tasks

Gross Motor Skills and Coordination

Consider an OT referral if your child:

• Is significantly more clumsy than peers
• Avoids physical activities or playground equipment
• Struggles to learn new motor tasks like riding a bike, swimming, or skipping
• Has poor posture — slumps at the desk or has difficulty sitting upright
• Cannot catch, throw, or kick a ball at an age-appropriate level

Sensory Processing

Consider an OT referral if your child:

• Overreacts to touch, noise, or light — covering ears, distress with clothing tags
• Seems to underreact to sensory input — does not notice pain or mess on their face
• Constantly seeks sensory input — spinning, crashing, chewing on objects
• Has extreme reactions to everyday experiences — haircuts, nail cutting, teeth brushing
• Is a very restrictive eater — limited to a small number of foods
• Becomes overwhelmed in busy environments like shopping centres or festas in Malta

Self-Care and Daily Living

Consider an OT referral if your child:

• Is significantly behind peers in dressing skills
• Struggles with personal hygiene tasks
• Cannot use cutlery age-appropriately
• Is not independent with self-care tasks other children their age manage

Attention, Organisation, and Behaviour

Consider an OT referral if your child:

• Cannot sit still or attend to age-appropriate tasks
• Has frequent meltdowns that seem out of proportion
• Is disorganised — losing belongings, forgetting instructions
• Has significant difficulty with transitions
• Struggles to play independently or engage in age-appropriate play

How Many Did You Tick?

There is no magic number. Even one or two persistent concerns can warrant an assessment if they are significantly affecting your child’s daily life. Trust your instincts — if something does not feel right, it is worth exploring.

What to Do Next

• Talk to your child’s teacher about whether they’ve noticed similar difficulties
• Speak to your paediatrician to rule out medical causes
• Contact an OT directly — in Malta, you can self-refer without needing a doctor’s referral

At WonderKids, we make the referral process simple. Call us at +356 77048650 or email info@wonderkids.mt. The best time to seek support is when you first notice a concern.