Occupational Therapy – An Important Intervention in SLD

Occupational Therapy

By Pravitha Gopinathan Senior Occupational Therapist, Dubai Health Authority M.O.T (Advanced Paediatrics) SI Certified, TLP certified Occupational Therapy (OT) perspective integrates the theoretical basis of the profession with the current, accepted and common definition of learning disability
May 2, 2025

The prevalent definition is: Learning disabilities is a general term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical skills. These disorders are intrinsic to the individual and presumed to be due to central nervous system dysfunction. They may occur at any stage throughout the life cycle. Although learning disabilities may occur concomitantly with other limiting conditions, e.g. sensory impairment, mental retardation, emotional and social disturbance, psychiatric disorder or external conditions such as cultural differences, insufficient or inappropriate instruction, they are not the direct result of those conditions. (NJCLD, 1990/1994). 

Relevance of Occupational Therapy (OT) for children with Specific Learning Disability (SLD)

Occupational therapists are concerned with the nature of the client’s occupational identity as well as occupational performance. The goal of occupational therapy with people who have learning disabilities is to enable them to participate in the different activities and occupations that they want and/or must perform, in the various environments in which they function – physical, social, familial, cultural and institutional. Involvement in these occupations enables a person to integrate within the community and function and participate in daily life activities as a basis for health, wellbeing, self-confidence and quality of life.

In concert with the theoretical base of the profession, occupational therapists are aware that learning disabilities differ in their severity and in the way they manifest in different individuals. Likewise, learning disabilities can affect not only academic performance but also the various functions in which the individual is involved. Thus, occupational therapists assist people with learning disabilities in coping with the effects of the disability on various activities and occupations, such as academic studies, activities of daily living, social participation, play, leisure, work and family life. Moreover, occupational therapists deal with the early identification and prevention of difficulties in functioning and in learning. The work of occupational therapists among people with learning disabilities is usually carried out as part of a multidisciplinary team, with each profession contributing its unique knowledge and specialization.

Occupational therapists use Remediation, Accommodation and Modification strategies for managing dysgraphia. Commonly used occupational therapy treatment strategies include: 

• Perceptual Motor training 
• Motor learning
• Cognitive training 
• Sensory Integrative Therapy training
• Biomechanical and Neuro-developmental training Children are frequently referred by teachers to school-based occupational therapists for handwriting difficulties in the classroom.

Occupational therapists are responsible for identifying underlying motor, sensory, cognitive, or psychosocial deficits that may interfere with the development of legible handwriting, and for selecting intervention strategies to overcome those deficits.

They work to reduce the deficits in sensory-motor performance components such as eye-hand coordination, visuo-motor integration and in-hand manipulation that are significantly correlated with poor handwriting.

Development of handwriting skills

•  Handwriting is a complex skill which requires the maturation and integration of cognitive, visual, perceptual, and fine motor skills.
• Eye-hand coordination, visual perception, auditory perception, directionality, sequencing, and memory also develop with maturation and experience in the early years and are thought to be the underlying components required for handwriting.

Tips to help children with learning disability in school

1. Positioning: When in class or at home, make sure the child’s feet are supported when seated. Poor posture and poor balance occur when feet are dangling. 
2. Establish organisation and routine: Plan ahead to choose outfits, breakfast, and packing lists for backpacks according to school schedule. Establishing a consistent routine means less rush in the morning. 
3. Task completion: A visual schedule or checklist can help children participate in and complete tasks more independently. Example: visual schedule on the steps for hand washing. 
4. Make time for practice: If your child is learning to do-up fasteners, zippers, buttons, snaps, give extra time for them to practice independently. Start practicing on weekends and progress to weekdays. 
5. Clothing confidence: Encourage easy on/off clothing such as pullovers, sweatpants, leggings and slip on or Velcro shoes especially when at school to increase your child’s independence. 
6. Multi-sensory learning: When helping with homework, remember that we all have different styles of learning, and often learn best when multiple sensory systems are involved. For example: practicing printing letters is much more meaningful when using fingers to print in foam or using chalk to practice. 
7. School organisation: Support your child in keeping an organised agenda to have a routine to write down and check off homework. Establish consistency in keeping the agenda at the same place at school and home. 
8. Encourage play: Promote playfulness in activities that are motivating or meaningful to your child. If kids are struggling with play, it can be adapted to make safe toys within reach, or simplify the activity. Try to introduce a new activity on an individual basis before doing it in a group setting. 
9. School success: Connect with the teacher to review class rules and routines like recess, lunch, etc., so that your child is prepared and knows classroom expectations. 
10. Sleep: Establish a consistent routine for wake and sleep times, and limit screen time – television, smart phone, computer and other devices before bed.

Effectiveness of Occupational Therapy in the School Environment

According to S. Shahagian Whalen, 2003:

Research evidence to date supports the effectiveness of occupational therapy in the school setting with students experiencing occupational performance challenges. OT is effective in helping children attain goals and develop skills in areas underlying and supporting school performance. Occupational therapists help in reframing the views and expectations of the student by the adults in the environment. Collaborative consultation with parents and teachers appears to be an essential component of the service delivery to maximize effectiveness of and satisfaction with the intervention provided by the occupational therapist. The evidence presented relates to a variety of diagnoses and needs, including students with physical disabilities, developmental coordination disorder, fine motor difficulties, developmental delays and learning disabilities.