This episode of New PossibilOTs explores the top-down and bottom-up approaches in occupational therapy with clear, practical examples. The discussion begins by defining both approaches in simple terms to support understanding for new and developing therapists. The top-down approach focuses on participation in meaningful tasks and daily occupations. It aims to improve performance through adaptations, environmental changes, or skill development that supports functional outcomes. The bottom-up approach targets the underlying components that influence successful participation. These components may include fine motor skills, gross motor development, sensory processing, or cognitive foundations.
The episode highlights the importance of recognising when each approach is most effective. Listeners are encouraged to consider the child’s goals, family priorities, and participation needs before selecting an intervention pathway. The discussion explains that therapists rarely use one approach in isolation. Instead, both approaches often complement each other to create a balanced and holistic plan. The episode reinforces that all strategies should link back to functional participation and meaningful daily routines.
The conversation also explores challenges within healthcare funding systems. It discusses how outcome measures may prioritise underlying skills rather than occupation-based progress. The episode highlights the need for continued advocacy for occupation-centred practice in paediatric settings. Listeners are reminded that clear communication with families and teams supports shared understanding of therapy decisions and expected outcomes.
This episode provides practical reflection points for therapists at any stage. It encourages clinicians to remain flexible, thoughtful, and focused on participation when planning intervention. The discussion closes by inviting listeners to continue exploring approaches that support meaningful change in children’s everyday lives.
🎧 Listen now on your preferred podcast platform.
Website: https://newpossibilots.com.au/podcast/
Instagram: https://www.instagram.com/newpossibilots/
