Occupational Therapy

advice for children with

developmental delay
Everyday baby essentials for eating,
bathing, sitting and playing
Information for
parents and carers

Playing
Playing in different positions with a variety of toys will help all aspects of your child’s
development and prepare them for developing independence in activities of daily living.

Top tips for developing finger control:

• Ensure your child is well supported in any position they are comfortable in.

Early play skills:

• Choose rattles that are easy to grasp and
transfer from hand to hand, and hand to
mouth, and have a range of textures.

• Play gyms encourage reaching up with

whole arm movements which are important for developing
hand control and shoulder strength.

Later play skills:

• Choose toys that have holes in to encourage your child to use their
index finger ie. using a pointed finger.
• Choose toys with buttons or parts to twist, turn, pull and push.
Later play skills cont’d:
• Choose toys that involve, stacking, sorting,
posting, putting things in / out. These will help
your child to learn how to let go, match shapes,
and develop a range of grasps.
• Give your child opportunity to experience
different textures within their play, e.g. sand,
water, playdough, dry pasta, etc.
• Household objects, such as pegs and wooden
spoons, can also provide great play experiences
for your child.

Sitting
Spending time in a well supported sitting position allows children to develop their hand skills so
they can play and join in other everyday activities, such as feeding themselves and getting dressed.
Different sitting positions are useful at different ages, and for different occupations.
The following chairs are examples of seating, separate from your child’s car seat, that are
available in mainstream shops.

Early sitting (0-9 months) top tips:

• Baby bouncers with a deeper seat will help your child’s hips to stay in a better position.

• Look for a baby bouncer that keeps your child’s head, tummy
and hips in the middle.

• Look for a baby bouncer that supports your child’s shoulders,

and helps them to bring their hands forward, in line with
their vision.

• Additional padded support may be required initially.

NOTE: Using a car seat for long periods of time in the home
may restrict your child’s movement and vision, and delay
independent sitting balance.

Floor sitting top tips:

• Use more supportive positions if you are focusing on developing play, vision or hand skills.
• Use less support if you are focusing on developing their sitting balance, and use toys that
require less effort.
• Using different positions throughout the day for different activities gives the best
opportunities for development.
• Some seats can be useful for short periods to help children to participate in activities with
friends and family.
• Avoid propping your child with cushions on the family sofa.
Floor sitting top tips cont’d: Baby snug chairs and other
floor sitters with play trays
Inflatable / cushioned floor supports
and straps can work well
are good for children who have just
to help your child develop
developed head control and early
their hand skills and
sitting balance, and no longer need to
interaction in a safe and
rely on their arms to prop on the floor.
supported position.

Chairs like these should only

be used following manufacturer
guidelines and when your child has developed
some head, neck and trunk control.

NOTE: Some children will arch back when

tired of sitting - supervise your child at all
times when in a chair.

Box sitting top tips:

• Your baby needs to
experience sitting with their
knees in line with their hips,
and their feet flat on the
floor (box sitting, or chair
sitting position).

• Sitting on a small stool or

booster seat on the floor,
helps your child to develop
better use of their leg
muscles in preparation for Both of these booster seats are available from high street stores
standing. such as Boots, Tesco, Mothercare, and online from Amazon.

Highchairs top tips:

Look for:
• Sturdy hip strap and pommel, to prevent child slipping forwards.
• Over-shoulder straps that fit snuggly.
• Narrow gap between your child’s tummy and the tray.
• Hips and knees at right angles, so that your child is in an upright
position for swallowing safely.
• Shoulders, arms and hands should be forward, so they naturally
rest on the tray.
• Avoid highchairs that are fixed in a reclined position.
• Look for a highchair that can be brought as close to the family
dining table as possible, to encourage your child to develop their social interaction skills.
• Use rolled up towels, or pieces of foam to add additional support if needed.
• Highchairs can be a place for play, as well as feeding.
Bathing
• You may feel more confident letting your child play in the bath if you use something
to support them.
• Bath time should be a fun place for you, your child, and their sibling to play together,
and playing with bath toys is an excellent way to develop hand skills.
• As sitting balance develops, seats that support round their tummy help your child play in
the water.

0-9 months
Reclined seat with pommel

You need to be able

to lift your child out of
this type.

Even with support, never leave your child unattended!

Toileting
Children with developmental delay and low muscle tone sometimes struggle with balance and
stability which may affect their confidence and comfort on the toilet.

When using the toilet, something to support their feet and something close to
hold onto with their hands may be all that is required to make them feel safe.

Early potty training – choose a potty chair that has a high back rest,
handles / arm rests and allows your child to sit with their feet flat on the floor.

When your child can use the toilet, you can either use a seat and
step combination, or a separate insert with a handle and foot stool.

+ OR
 Feeding
Children often begin feeding themselves with their fingers from 9 months.
Between 12– 18 months, they will begin to take interest in holding their own spoon.
Feeding skills develop best when children are sitting in a comfortable and well supported position.

Top tips for developing cutlery skills:

• Use child size spoons with thick, easy grip handles
that curve inwards and have flat shallow bowls.

• Avoid spoons and forks with thin narrow handles.

• Use children’s dishes with raised sides, so that your

child can scoop the food against the side of bowl.

• Give hand over hand help to begin with to learn the

scooping motion to bring the spoon to their mouth, or
stabbing motion for using a fork.

• Gradually reduce the amount of assistance you provide.

• Use textured foods that will stay on the spoon easily to

practice with initially, e.g. mashed potato, fromage frais.

Get messy! If in doubt about your child’s

This helps children to ability to eat certain foods, or if
explore, learn and refine you are concerned they aren’t
their skills. swallowing properly, consult
your health visitor. A speech
Messy play ideas - jelly, therapy feeding assessment
angel delight, yogurt, may be advised.
baby food.

Contact us Help us get it right

ICAN Admin If you have a complaint, concern, comment or compliment please let
3rd Floor Stockdale House us know by speaking to a member of our staff. We learn from your
Headingley Office Park feedback and use the information to improve and develop our services.
Victoria Road If you would like to talk to someone outside the service contact the
Leeds LS6 1PF Patient Experience Team on 0113 220 8585, Monday to Friday 9.30am
Tel: 0113 843 3620 to 4.30pm or email [email protected]

We can make this information available in Braille, large print,

audio or other languages on request.

These information sheets are not to be reproduced

without permission from the author. Childrens Occupational Therapy Team
© Leeds Community Healthcare NHS Trust, Jan 2017 ref: 1783 www.leedscommunityhealthcare.nhs.uk