My Four-Year-Old Needs Therapy?!


One day after school, my son’s dedicated and very attentive teacher pulled me aside to talk. Oh no, I thought. What did he do now?

It turned out that she wanted to voice some concerns—not over his behavior—but about his motor skills. She said he’s a super smart kid, but she felt that physically he wasn’t on the same level. He seemed to be having some trouble with his movements and spatial relationships.

I admit, I didn’t take her totally seriously at the time—and that’s probably because I didn’t really understand what she was trying to tell me. I mean, yeah, he’d always been a clumsy kid and sometimes had trouble climbing around on the playground. I chalked it up to genetics; we are not graceful or particularly athletic people. I said I’d mention it to my son’s doctor next time we went in for a checkup. Then, after a couple weeks had gone by and I hadn’t done anything about it, the teacher took me aside again and kindly asked me if she could ask the school guidance counselor to recommend him for physical and occupational therapy.

Whoa there. What? She thinks my four-year-old needs therapy?!

It finally hit me that the teacher was really seeing something “off.” I still didn’t understand what it was, but I agreed to meet with the counselor—who also brought in the school psychologist. They also recommended occupational therapy. For a four-year-old. I thought it was crazy, but then I reminded myself that they know a lot more about early childhood development than I do; they have degrees in this kind of stuff. So, still a little unsure, I took my son to the pediatrician the next week. And—you guessed it—he also referred us to occupational therapy.

That was a tough day. Because with the pediatrician involved, the whole thing started getting real. This was a diagnosis. This meant something was wrong with my kid. I did what any terrified modern mother would do—I turned to my mommy group. I was really surprised (and more than a little relieved) to learn that many of them had had some sort of physical or occupational therapy for their kids. And they’d done it for a variety of reasons—such as poor coordination, low muscle tone, sensory processing disorder, visual perception, eating problems, and gross or fine motor delays. They went on and on about how great it was for their kids and several of them highly recommended an OT practice in my neighborhood.

So, feeling a little better, I made an appointment. After our initial evaluation, the therapist explained to me that there was simply a disconnect going on inside my son’s head—his body hasn’t fully learned how to listen to his brain. It’s incredibly frustrating for him because he can’t always make his body do what he’s asking of it. She explained that it’s like he’s trying to push a shopping cart with a wonky wheel all day long.

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That is when the lightbulb came on for me. I thought about one day last Spring when the weather was nice and we went to the greenway to take a walk/ride with another mom and her boy who is a little younger than my son. The other boy was zooming around on his balance bike—literally going circles around us. My boy was huffing and puffing to keep up on his tricycle. He had refused even to try to ride his bike because it was “too hard.” I am ashamed to admit that I thought he was just being difficult. I get it now. It really is harder for him than for other kids.

We’ve got a long road ahead of us; but when I get down about that, I try to remind myself that at least we’re on the road. We’ve identified the problem, and we’re working on it now—while my son is still very young. I honestly don’t know how long it would have taken me to figure it out on my own.

So I am filled with gratitude—for the teacher who noticed something was wrong and wouldn’t let me blow it off, for the occupational therapy (OT) staff who have my boy believing that his therapy sessions are just play times, and for the moms who shared their experiences with me and let me know that I didn’t need to panic.

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If you’re out there and you’re thinking about occupational therapy for your child, know that you’re not alone. Know that it can help your child. Know that it’s one of the best things we’ve done for ours.



  1. Thanks for sharing your story. We were literally just referred to OT today and I have mixed feelings. Hearing over and over how beneficial it will be has really helped. Thank you!

  2. This is such a great article! Kudos to that teacher for her perceptiveness, the OT for her thoughtful explanations, and to you for pursuing help! I am a pediatric occupational therapist in Nashville and have worked with so many wonderful families navigating these waters for the first time. Community is so important! So is asking questions to make sure you and your son’s team are speaking the same language. Collaboration is the name of the game! Thank you for writing about your experience so thoughtfully. I am confident your words will help so many families!


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