Incorporating Occupational Therapy into Playtime

Table of Contents


Do you want to work on your child’s skills outside of therapy? This post will help you understand the skills we work on in occupational therapy (OT) as well as things you can include in your child’s play routines to encourage development of their skills!

Occupational therapists work on a variety of skills that include fine motor, visual motor, gross motor/coordination, sensory regulation, self regulation, and skills related to activities of daily life. Continue reading to learn more about each of these individual skills as well as different age-appropriate activities you can include in play to help your child progress outside of therapy!


Fine Motor Skills

Children’s fine motor skills begin to develop when a child is first born, then continue to develop over the span of their life. Fine motor skills refer to the precision, dexterity, and coordination of the hands and how children use their hands to manipulate objects and participate in all kinds of play, education, and daily living activities.

Visual Motor Skills

Similar to fine motor skills, visual motor skills begin to develop when children are first born and progress over time. Visual motor skills refer to a child’s ability to see and interpret the world around them and include visual tracking (following a moving object), visual scanning (spotting an object), and visual perception (seeing and interpreting).


Gross Motor/Coordination


Gross motor skills and the development of coordination begin to progress as soon as your child is able to move independently. Gross motor skills refer to the movement of larger muscles (legs, arms, body). Coordination refers to your child’s ability to control all body parts in a way that allows them to move smoothly and effectively.


Sensory Regulation

This skill encompasses a wide variety of subjects and allows your child to interact with the world around them in a constructive manner. If your child has difficulty with sensory regulation, you may notice that they are more or less affected by the world around them (lights, sounds, visuals, touch, etc.). You may notice that your child has difficulty at the grocery store, park, school, or even at home. Incorporating various sensory input into play can help your child feel more comfortable and learn to respond constructively to input that may be distracting, overwhelming/underwhelming, or that might be bothering them.

Self Regulation


You will not notice the development of your child’s self-regulation skills until they participate in more social interactions with yourself, peers, siblings, etc. Difficulty with self-regulation can be observed as emotional outbursts (tantrums, yelling), sleeping problems, or aggression as well as a variety of other reactions. Incorporating self-regulation skills into playtime will give your child a chance to practice skills learned in occupational therapy so they may use those skills in other environments.

Activities of Daily Life


These skills are the bread and butter of occupational therapy and your child’s life! They involve feeding at mealtime, bathing/showering, brushing teeth/hair, toileting, and other activities that your child participates in on a daily basis. Each of the other skills mentioned in this post help support your child’s ability to complete activities of daily life, and working on those skills at home will promote their overall independence.




Here are a few milestones regarding each skill mentioned above! Please take into consideration that each child develops at a different rate, and some children may reach milestones earlier or later in childhood. No matter your child’s abilities, playing at home can help them progress and develop in each skill mentioned! Take a look at this informative page on the SPT website, or continue reading for a condensed version!

Fine/Visual Motor Skills

Birth – 6 months

  • Brings objects to mouth
  • Plays with hands together at center
  • Transfers an object from hand to hand
  • Follows an object from side to side with their eyes/head

6 – 12 months

  • Reaches directly for toys
  • Releases a toy into a container purposefully
  • Grasps small objects with fingers

12 – 18 months

  • Scribbles with a crayon
  • Stacks blocks
  • Uses two hands in play (one supporting and one manipulating)

18 – 24 months

  • Completes a small puzzle
  • Begins to use simple tools (ex: a play hammer)
  • Holds crayons in fingertips and draws circular/straight strokes

24 – 36 months

  • Snips with scissors
  • Plays with toys with moving parts
  • Builds towers and lines objects up

3 – 4 years

  • Uses a precision grasp on a crayon/marker
  • Copies simple shapes/letters
  • Constructs simple 3-D shapes (ex: a bridge with blocks)

4 – 5 years

  • Completes puzzles up to 10 pieces
  • Uses scissors to cut simple shapes
  • Strings small beads
  • Copies their name

5 – 6 years

  • Completes puzzles up to 20 pieces
  • Holds and manipulates small objects with their fingers (without dropping them)
  • Uses both hands together in complementary movements

6 – 10 years

  • Motor planning develops further, allowing more complex activities to be completed (ex: larger puzzles, crafts, building complex structures)

Gross Motor Skills/Coordination

Birth – 6 months

  • Lifts head (3-4 months), then raises torso when lying on stomach (4-6 months)
  • Sits while propping with both hands
  • Rolls from belly to back and vise-versa

6 – 12 months

  • Sits independently
  • Plays in standing when leaning on supports
  • Walks with hands held (12 months)

12 – 18 months

  • Squats when picking up items from the floor
  • Pushes/pulls large objects
  • Begins to run

18 – 24 months

  • Climbs on playground equipment or furniture
  • Kicks a ball forward
  • Throws a ball

24 – 36 months

  • Catches a large ball using their chest and arms
  • Begins to hop on one foot
  • Rides a tricycle

3 – 10 years (skills progress slowly and develop over time)

  • Jumps, climbs, runs
  • Throws a ball more accurately
  • Walks up and down stairs with alternating feet
  • Balances on one foot for longer periods of time
  • Runs with increasing speed and balance

Self Regulation/Sensory Regulation

Birth – 6 months

  • Quiets when picked up and shows pleasure when touched/handled
  • Relaxes, smiles, and vocalizes when held
  • Uses hands and mouth for sensory exploration

6 – 12 months

  • Self-soothes
  • Listens to speech, following 1-step directions
  • Finger-feeds self a variety of textured foods

12 – 18 months

  • Enjoys messy activities
  • Reacts to sensations such as temperature, taste, and wet

18 – 24 months

  • Enjoys solitary play for a short time
  • Regulates their attention

24 – 36 months

  • Enjoys interesting touch sensations/textures
  • Has some difficulty with transitioning between activities
  • Shows increasing self-awareness

Activities of Daily Life

1 year

  • Removes socks and hat
  • Assists in dressing
  • Shows distress when soiled
  • Uses a spoon to try and eat, messy

2 years

  • Removes shoes
  • Able to help more with dressing
  • Begins interest in potty training
  • Stabs food with a fork, uses a spoon without spilling
  • Interested in feeding themselves

3 years

  • Puts on t-shirt, shoes, socks with help
  • Buttons buttons and zips zippers (with help)
  • Often uses toilet on their own
  • Stabs food with a fork, uses a spoon without spilling
  • Begins eating by themselves

4 years

  • Laces shoes
  • Attaches and zip a zipper
  • Has few accidents, completes dressing after toileting

5 years

  • Dresses independently
  • Washes hands after using toilet

Toys/Play Activities

You may notice some of these play activities overlap and are in multiple categories. The wonderful part about OT is that each play activity can work on a variety of skills. This means that whatever you choose to introduce into playtime will help your child develop their skills! Please use discretion when choosing play activities, our goal is to utilize the just-right challenge. The just-right challenge uses play activities that are slightly difficult, but still fit within your child’s abilities. This means that the play activities you choose should be slightly difficult, but still fun, motivating, and encouraging. We want to allow your child to feel successful and have fun while working on their occupational therapy skills at home!


The play activities in this post are listed by skill, not by age. You know your child best and are aware of their capabilities, so just make sure to choose what activities suit your child. Have fun!


Fine Motor/Visual Motor Skills

These play activities will focus on your child using their hands and eyes together (eye-hand coordination) while challenging their manipulation, precision, and dexterity skills.

Gross Motor/Coordination

  • Throwing a ball
  • Kicking a ball
  • Playing at the playground (climbing, swinging, running around)

Sensory Regulation

Involving your child in creating sensory experiences can help promote their inner drive and encourage participation in activity! If you already see an occupational therapist, speak with them to identify the aspects of sensory regulation that your child has some difficulty with to make these activities effective and enjoyable for everyone!

Self Regulation


  • Board games with rules and social interactions such as turn-taking or communication (Guess Who, Yeti in my Spaghetti, etc.)
  • Reading books together
  • Playing at the playground (climbing, swinging, running around)
  • Incorporating music or preferred sounds into playtime
  • Incorporating preferred textures or touch into playtime
  • Incorporating coping/adaptive strategies learned from occupational therapy!

Activities of Daily Life

As mentioned previously in this post, all activities your child participates in can assist in developing skills related to activities of daily living. If you wish, you can also incorporate some ADL skills into play!

  • Opening latches
  • Playing with key toys – Link to it Here
  • Stringing beads (working on fine motor skills related to shoe-tying)
  • Pretend-play with food toys or play-doh


Fine Motor skills. The OT Toolbox. (2020, September 24).


Beck, C. (2023, October 19). Visual motor skills by age. The OT Toolbox.


O’Brien, J. C., & Miller-Kuhaneck, H. (2020). Assessment and Intervention of Social Participation and Social Skills. In Case-smith’s occupational therapy for children and adolescents (pp. 606–607). essay, Mosby.


Home Page. Your Kid’s Table. (2024, February 27).

By: Sydney Zoch
OTD, OTR/L Occupational Therapist

Learn More About Sydney Zoch!