Be prepared. Before contacting your pediatrician:

• Write down and bring concrete examples of the concerns you have about your child and their ability to engage in daily activities, the more specific the better.

• If possible, take short video clips or pictures of your child engaging in these activities.

• ​If your child is under the age of 6, review age appropriate milestones and make notes of the ones your child has not met.

• https://www.cdc.gov/ncbddd/actearly/milestones/index.html

Be clear and specific. In order for your child’s physician to refer for an occupational therapy evaluation, they need to determine that the occupational therapy evaluation and subsequent treatment is “medically necessary.” Clearly state why you believe your child needs occupational therapy services. Share how long you have noticed these concerns, when/where they typically occur, what you have tried so far (if anything), and any factors that help or worsen the situation.

Relate it back to function. Explain how your areas of concern are interfering with the child’s ability to function and complete daily activities. For instance, instead of saying they are having “ sensory issues” or “trouble with fine motor skills” give specific examples of the impact such as:

• Due to their challenges with accepting different textures and types of food they have an extremely limited diet

• Their avoidance of touching or playing with anything messy is preventing them from playing with their peers

• Because they have difficulty grasping manipulating small objects they are unable to button and zip their clothing independently

• They have difficulty participating in social events due to being overwhelmed by loud noises, large crowds, etc.

The physician recommends occupational therapy,

now what happens?

If the physician recommends occupational therapy services they may send the referral to a recommended clinic or give it to you to choose a therapist or clinic. The process will look different for each physician/network, so before leaving your appointment make sure you have asked any questions you have and are clear on what to do next. It is a good idea to do your own research to find a clinic that is a good fit for your family, and to clarify that they accept your insurance.

Before your initial occupational therapy appointment, the occupational therapist/facility will likely ask for your insurance/payment information and send you an intake form and any other needed paperwork. Sometimes additional forms or questionnaires will be requested prior to the first visit in order to obtain more information for the evaluation process. This could include a checklist or questionnaire about the child’s sensory processing, executive function, or self-care skills.

The occupational therapy evaluation typically occurs during the initial visit and will include gathering important background and developmental information. It may be helpful to bring the same information (such as pictures, videos, or developmental checklist) about your child’s concerns that you brought to the pediatrician. The evaluation process may also include an assessment or observation of your child’s skills to get a better picture of how they function. After the evaluation the therapist will collaborate with the caregivers (and the child if age appropriate) to determine goals and a treatment plan.

References

Division of Medicaid and Health Financing. (2022). Utah Medicaid Provider Manual Section 2: Physical Therapy and Occupational Therapy Services. https://medicaid.utah.gov/utah-medicaid-official-publications/

University of Utah Health. (2023). Does My Child Need Occupational Therapy? https://healthcare.utah.edu/life-skills-clinic/does-my-child-need-occupational-therapy

Kiley, C. How to Talk to Your Child’s Doctor About Your Sensory Concerns. Mama OT.

http://mamaot.com/how-to-talk-to-your-childs-doctor-about-your-sensory-concerns/