What did you see in the evaluation, and what were you looking for?

Evaluations look at specific components such as grip, balance, attention to task, or sensory response, and the therapist can say which ones held up and which did not. Hearing the reasoning makes the plan easier to follow when a session looks like play.

Which everyday tasks are we working on first, and why those?

Occupational therapy is organised around tasks, not muscles: dressing, handwriting, cooking, getting to the bus. If the first target is not a task that matters in your week, say so, because the choice is negotiable.

If this is working, what will be different in six weeks?

A concrete answer sounds like fastening two buttons unaided or finishing a meal without a rest. Vague answers about improved function give you nothing to check the plan against later.

How will we measure that: a standard assessment, or something we can see at home?

Standardised scores satisfy insurers and schools but move slowly. Ask for one home-observable marker as well, so you are not waiting on a reassessment to know whether to keep going.

What should home practice look like on an ordinary day?

Ask for the plan that fits a bad day, not an ideal one. Programmes fail on the days someone is late, tired, or unwell, so the version that survives those days is the version that gets done.

Special Contexts

Questions to Ask an Occupational Therapist

Questions for a parent, partner, or carer at an occupational therapy evaluation or plan review, covering goals, home practice, equipment, school and workplace adjustments, and when therapy should end.

20 questions, each with the reason to ask it · includes a conversation guide

Open any question to see why it works.

1
What did you see in the evaluation, and what were you looking for?
Evaluations look at specific components such as grip, balance, attention to task, or sensory response, and the therapist can say which ones held up and which did not. Hearing the reasoning makes the plan easier to follow when a session looks like play.
2
Which everyday tasks are we working on first, and why those?
Occupational therapy is organised around tasks, not muscles: dressing, handwriting, cooking, getting to the bus. If the first target is not a task that matters in your week, say so, because the choice is negotiable.
3
If this is working, what will be different in six weeks?
A concrete answer sounds like fastening two buttons unaided or finishing a meal without a rest. Vague answers about improved function give you nothing to check the plan against later.
4
How will we measure that: a standard assessment, or something we can see at home?
Standardised scores satisfy insurers and schools but move slowly. Ask for one home-observable marker as well, so you are not waiting on a reassessment to know whether to keep going.
5
What should home practice look like on an ordinary day?
Ask for the plan that fits a bad day, not an ideal one. Programmes fail on the days someone is late, tired, or unwell, so the version that survives those days is the version that gets done.
6
How long should it take, and what do we drop first if there is no time?
Giving you a priority order prevents the whole routine being abandoned when the evening collapses. If every part is described as equally important, nothing gets done.
7
What changes to the home would help right now?
Environmental changes such as a different chair height, a grab rail, or moving frequently used items to waist level often produce more function than added effort does. Ask which are worth doing this week.
8
What could the school or workplace do differently?
The therapist can name adjustments that others are used to arranging: seating, extra time, a slanted writing surface, task order. Ask them to put it in writing, since a letter carries more weight than a request from a family.
9
How do you decide when to adapt the task rather than build the skill?
Both are legitimate, and the balance says a lot about the plan. Ask which goals they expect to reach through practice and which are better solved by changing the task or the tool.
10
How do you handle a session when there is pain, fatigue, or refusal?
You are checking whether the plan bends. Listen for specific adjustments, such as shortening the session, changing the order, or working in a different position, rather than pushing through.
11
What equipment is worth trying, and can we try before buying?
Adaptive equipment is often expensive and often abandoned. Many services have loan cupboards or trial periods, and a therapist who fits and reviews the item is more use than a catalogue recommendation.
12
How does this fit with physiotherapy, speech therapy, or medical care, and who coordinates?
When several clinicians are involved, exercises can conflict and appointments can pile onto one day. Ask for a named coordinator so you are not the only person holding the whole picture.
13
What records do you need from us, and what will insurers or the school ask for?
Funding decisions often turn on documentation rather than progress. Ask exactly which log, form, or evidence to keep from the start, because reconstructing it later is difficult.
14
How many sessions are approved, and what happens when they run out?
Knowing the number early lets you decide how to spend it, for instance on training you to run the programme rather than on supervised repetition. Ask what a renewal request needs.
15
What safety risks should we watch for at home?
Falls, burns, choking, and skin damage are the usual concerns, and the specific ones depend on the person's condition. Ask what to remove or change rather than what to remember.
16
Is there anything we are currently doing that we should stop?
Families often keep up an old exercise, a piece of equipment, or a level of help that now gets in the way. Therapists rarely volunteer this unless asked.
17
What would make you change the plan, and when do we review it?
A named review date prevents a plan running unchanged for months. Ask what result would count as enough progress to move on and what result would count as a plateau.
18
What would suggest something else is going on that needs a different referral?
Therapists notice signs that belong to another specialty: vision, hearing, pain, mood, a change in medication. Knowing which signs to report keeps a stall from being read as low effort.
19
How will we know when it is time to reduce or finish therapy?
Discharge criteria set in advance protect against both stopping too early and continuing out of habit. Ask what the plan is for keeping gains afterwards.
20
What is one thing we should do before the next session?
Ending with a single action means the session leaves the room. If the answer is a list, ask which item comes first.

Making occupational therapy work at home

Practical guidance for the conversation itself.

How to prepare and follow up

Bring a description of a normal day

Write down where the day goes wrong: the ten minutes at the sink, the stairs, the school morning. Therapists work from tasks, and a specific account of one difficult hour is worth more than a general description of the condition.

Ask for the practice to be demonstrated and then do it yourself

Watching is not the same as doing. Perform the practice once in the session with the therapist watching, so errors get corrected before they are rehearsed at home for a month.

Record the session plan in the person's own words

Where the person receiving therapy can say what they are working on and why, adherence holds up better. Write the goal on paper and keep it where the practice happens.

A home practice routine that survives a bad week

Four steps

1Attach the practice to something that already happens daily, such as a meal or brushing teeth.
2Keep the equipment set up in place rather than packed away.
3Do the short version on hard days instead of skipping it.
4Note in one line what happened, so the therapist can adjust from evidence.

Common pitfalls

Gains that only appear in the clinic

A skill performed with the therapist and nowhere else usually means the home or school setting is different in some way that matters. Describe the setting rather than reporting failure.

Loading too much onto one carer

Programmes with several daily elements tend to stop entirely. Agree on one or two, and ask for the rest to wait until those hold.

Helping more than the person needs

Stepping in early keeps the task smooth and slows independence. Ask the therapist where to allow struggle and where to intervene.

A one-page goal sheet

Fields to fill in with the therapist

1The task, described as it happens in real life
2The help currently needed, and from whom
3What success looks like, in observable terms
4What we do at home, and how long it takes
5Review date and who reports what

The questions

What did you see in the evaluation, and what were you looking for?

Which everyday tasks are we working on first, and why those?

If this is working, what will be different in six weeks?

How will we measure that: a standard assessment, or something we can see at home?

What should home practice look like on an ordinary day?

How long should it take, and what do we drop first if there is no time?

What changes to the home would help right now?

What could the school or workplace do differently?

How do you decide when to adapt the task rather than build the skill?

How do you handle a session when there is pain, fatigue, or refusal?

What equipment is worth trying, and can we try before buying?

How does this fit with physiotherapy, speech therapy, or medical care, and who coordinates?

What records do you need from us, and what will insurers or the school ask for?

How many sessions are approved, and what happens when they run out?

What safety risks should we watch for at home?

Is there anything we are currently doing that we should stop?

What would make you change the plan, and when do we review it?

What would suggest something else is going on that needs a different referral?

How will we know when it is time to reduce or finish therapy?

What is one thing we should do before the next session?