Pediatric Occupational Therapy

The Department of Pediatric Occupational Therapy at Boston Children’s Hospital works with patients whose ability to participate in daily life is limited due to an injury, illness, or developmental issue. We help patients strengthen their existing skills and — when needed — learn how to work within their limitations so they can take part in activities at home, school, and in the community. 

To assure continuity of care, we offer both inpatient occupational therapy and outpatient occupational therapy.

Pediatric occupational therapy helps young patients — from infants to early adults — reach developmental milestones and gain independence in life.

For some patients, occupational therapy may focus on modifications at home or school that can help them get around with greater ease. If a patient has limited use of their hands or arms, an occupational therapist can help them develop fine motor skills. For patients with developmental or sensory issues, occupational therapy can help develop emotional regulation so they can participate in social situations more fully.

At Boston Children’s, we are experts in tailoring our services to each individual patient’s needs, age, and stage of development. We often incorporate play into our sessions to make therapy fun and engaging.

Our services help patients:

• Adapt to acute hand injuries
• Participate in sports, hobbies, and other activities
• Develop fine motor skills, such as handwriting
• Learn self-care skills
• Practice school-related tasks
• Prepare for surgery or recover from surgery

Customized orthotics

Orthotics (splints or braces) can help children with hand differences gain more stability and use of their hands. To best serve our patients’ unique needs, our skilled occupational therapists create customized orthotics for patients with congenital (present at birth) hand differences. We’ll work with your child and their medical team to create a customized brace of the size, form, and specialized materials that will serve them best.

Robotic therapy

We use robotic devices to help patients strengthen and train their hands and arms to move in controlled ways. This includes Tyromotion robotic and digital devices to engage children in virtual games designed to improve function.

Our staff is specially trained to help children with a variety of pediatric medical conditions that interfere with daily life, for instance:

• Orthopedic hand differences, such as polydactyly and symbrachydactyly
• Neurologic conditions, such as peripheral nerve injury, brachial plexus injury, and spinal cord injury
• Traumatic and sports-related injuries, such as tendon laceration, malunion fracture, finger amputation, and overuse injury
• Spasticity and movement disorders, such as cerebral palsy, hemiplegia, and stroke
• Neurodevelopmental conditions, such as genetic disorders, autism spectrum disorder, and fragile X syndrome
• Chronic pain
• Sensory processing difficulties, such as attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder
• Pre- and post-operative care for reconstructive surgery or muscle or tendon transfer surgery

We work as a team with you, your child, and the clinicians involved in their care. Our first step is getting to know your child, their condition, functional limitations, favorite activities, and goals. Using this information, we’ll develop a treatment plan best suited to your child.

If your child is hospitalized, inpatient occupational therapy can help them develop skills they need to function at home, school, and in the community.

In the hospital, our therapists work with patients who are:

• Recovering from surgery
• Hospitalized for a traumatic injury or illness
• In treatment for acute, chronic, or complex medical conditions
• At risk of developmental delay due to a long hospitalization
• Experiencing a change in hand or arm function
• Having trouble with activities of daily life

Inpatient therapies

Depending on your child and their needs, our inpatient services may include:

• Life skills such as dressing, self-feeding, grooming, and playing
• Skills for school and learning
• Range-of-motion and strengthening exercises
• Custom orthotic fabrication
• Sensory organizational skills and integration activities to help process sounds, sights, and other sensory inputs

Family education

Family caregivers play an essential role in their children’s treatment. You will be an important part of your child’s treatment sessions, and we will describe how occupational therapy can help your child.

Discharge

Our therapists often help decide when a patient is ready to leave the hospital, and if they may benefit from inpatient rehabilitation in another facility. If your child needs adaptive equipment, we will work with our Boston Children’s colleagues to ensure they have the equipment they need when they return home. If needed, we’ll also help arrange for your child to receive continued occupational therapy on an outpatient basis.

Outpatient occupational therapy has many of the same goals as inpatient therapy: to help your child participate in daily activities at home and in the community. To this end, our team will create a tailored treatment plan to help your child gain as much function as possible and learn to work with the skills and function they have.

Family education

Our therapists will show you how to help your child progress through their plan of care at home, with written instructions as needed.

Discharge

Once your child has met their goals for occupational therapy, we will discharge them from outpatient services. To maintain the gains from their occupational therapy, your child will likely need to continue with a home exercise program. We’ll provide information to help you continue health and wellness activities on your own and answer any questions you have.

Episodes of care

We provide therapy in episodes of care, periods of treatment organized around goals that you and your child help develop. When your child reaches their goals — whether in a matter of weeks or months — they’ll take a break so they can practice their new skills at home and in the community. Your child may return for another episode of care with new goals, or they may not need to return at all.

With hundreds of patients, we’ve found our episode-of-care model helps patients progress faster and achieve greater independence.