Learning Guide

Tips for working with children

Last Updated: 17 August 2023


This guide will look at key areas that will support you in working with children and give you practical examples!

Interacting with children is vital in your role as it provides a foundation for your relationship with them and their families. 

The following guide will look at: 

  • Play
  • Sensory regulation 
  • Attention/ concentration
  • Movement breaks
  • Environmental set up

Utilising tips from this guide will set you up for success when working with your clients. 


  • Play is a child’s main occupation 
  • Every child is unique so meet the child where they are at
  • Incorporate sensory play! (eg. filtering rice, water play)
  • Observe what interests them, what they are playing with – consider their senses (eg. they like visual toys, they love to climb, they like to filter rice)
  • Include yourself in their play slowly – start by copying their play, use your body and your tone of voice in play
  • Ask the client’s therapists if they are using any communicative methods
  • Why is play important?
    • Develops communication skills
    • Encourages problem solving
    • Teaches children social skills
    • Teaches children how to resolve conflicts
    • Teaches children about self-regulation
    • Supports them to explore roles, interests, skills and relationships
  • Use the information below to guide where your client may be in their play skills and meet them there

How neurodiverse children might play

Social stages of play for child 0 – 6yrs+



Stage of Play Play Suggestions for interaction
0-3 months

Unoccupied play

  • At this stage babies are making lots of movements with their arms, legs, hands feet, etc
  • They are learning about how their body moves
  • Visually tracking moving toys, will reach towards toys
  • Uses both hands to explore toys
  • Face-to-face interactions like Peek-a-boo (big expressions, tone of voice, different sounds) 
  • Toys and visual items above their head. Move toys from side to side
  • Use toys with different textures
  • Musical toys
0-2 years

Solitary play

  • Often play alone – may not be interested in playing with others yet
  • Will explore objects with both hands and mouth
  • Big movements (eg. bouncing up and down, rocking)
2 years

Onlooker play

  • Watches other children playing but does not play with them – will often use language to find out more about the play
  • This can take place at any time but is common at 2 years
  • Big movements (eg. bouncing up and down, rocking)
  • Face-to-face interactions like Peek-a-boo (big expressions, tone of voice, different sounds) 
  • Musical toys
  • Toys with different textures and colours
  • Cause and effect toys
2 – 3 years

Parallel play

  • Children play next to each other but with little involvement with each other
  • They may have similar toys and copy each other
  • Social skills are developing and being learnt through observation
  • Enjoys listening to songs
  • Enjoys listening/ looking at a book
  • Pretend play (eg. cooking). Lots of modeling!
  • Variety of toys and textures (eg. lego, blocks)
  • New and interesting toys
  • Cause and effect toys
  • Drawing using crayons, textas
  • Play in different environments (eg. playground)
2 – 3 years

Associate play

  • Small group play
  • They may talk and engage with one another
  • They may trade toys
  • There are no rules
  • This play develops problem solving/ cooperation
  • Messy play (Eg. sandpit, painting)
  • Play in different environments (eg. playground)
  • New and interesting toys


Sensory Regulation

  • Sensory regulation is important for every child – getting a child to a “just right” level of arousal will support them in interactions, engagement and activities
  • For many children, they need support to regulate and process stimuli that are coming in from their environment and their body. This support is called co-regulation
  • Prior to doing any activity with a child, it is important to determine if they are regulated
    • Are they not listening to instructions?
    • Are they constantly moving around?
    • Are they seeking sensory input?
    • What do you notice?

As you can see from the graph, your arousal would fluctuate throughout the day. Some children are under aroused and will need to be brought up to meet a good level of arousal. Other children are over aroused and need to be brought down to meet their optimal level of arousal. 

It is important to recognise this as under and over arousal can lead to less engagement with session and poorer outcomes in the child achieving their goals. 

Ideas to support regulation needs:

Senses Low arousal (bring them up to optimal level) High arousal (bring them down to optimal level)
Smell (olfactory) Sharp strong smells (eg. cinnamon, mint, zest) Soft smells (diffuser with jasmine)
Sight High contrast colours

Visually appealing toys

Low light

Calm down environment (eg. dark room/ tent)

Proprioceptive Bouncing on an exercise ball

Jumping on trampoline

Simon Says

Dance party

Riding a bike

Helping out with the groceries, carrying a laundry basket

Wall push ups

Animal walks

Vestibular Spinning, rocking, jumping

Chasey/ tag

Linear movements, slow, repetitive
Taste Pungent flavours: lemon, bubbly water Crunchy snack (eg. apple, carrot, cereal) 
Auditory Music with fast tempo

Motivating songs

Calming music

Reduce noise 

Tactile Textured items: plush toys Textured items: plush toys
Interoception Temperature checklist (for those who are unable to regulate their body temperature) 

Eg. Is the sun out? Am I sweating? Is my mouth dry?


Alerting activities (eg. chasey) to raise heart rate

Slow breathing techniques (eg. starfish breathing)



Heavy work

Attention/ Concentration

  • Incorporate things that your child finds interesting/ engaging and think about how you can include these in your session to meet their goals 
  • Consider if their lack of attention is due to dysregulation. Do they need a quick break?
  • How to tell if a child is no longer paying attention: 
    • Not following instructions
    • Attention is elsewhere
    • Distracted
    • Trying to do another activity

For more tips and ideas on activities please visit https://www.theottoolbox.com/ 

Movement breaks

  • A full session may be difficult for a client to engage in 
  • Consider having short bursts of activities
  • Consider using movement breaks within the sessions in-between different activities
    (eg.) Goal: Developing handwriting skills. Activity idea: painting with butcher’s paper stuck up on the wall outside to encourage arm stabilisation and putting their body in a different position.
  • Are there equipment/ different things around the house that can be used for a break or part of the session?
    (eg.) Peanut ball: this can be a good alternative for a table top activity if the client is seeking lots of movement throughout the session
  • Consider using a break system or using a fidget box to support them for table top activities (eg. you can utilise 2 break cards per session which they are allowed to use when they need)
Movement breaks ideas
Animal walks
Doing the activity away from the table (eg. on the floor and doing tummy time, against the wall, outside)
Just dance
Wall push ups

*Check out Twinkl and the OT Toolbox for some great FREE resources

Environmental setup

  • Consider your environment prior to starting the session
  • Consider your client’s individual needs – do they get distracted if there is a lot of visual clutter on the table?
  • You can set up the client for success by ensuring that the environment is set up appropriately for the session (ie. minimise distractions and only take out items necessary for the activity)
  • Utilise visuals like a schedule to help them understand what is coming up next


The above resources will be a useful tool in your work with children. Now you will have a better understanding of the following: 

  • how to interact with children at varying stages of play
  • sensory regulation needs and activity ideas
  • how to address attention and concentration difficulties
  • implementing movement breaks
  • considerations around environmental set up. 

These will help set you up for success when working with children!

Fora's Occupational Therapy team


Fora's Occupational Therapy team

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