Ask a new graduate occupational therapist what feels hardest in those first paediatric sessions, and self-care tasks come up again and again. Not because the tasks themselves are complicated — brushing teeth, getting dressed, using the toilet — but because so much sits underneath them. Sensory processing, motor planning, executive function, emotional regulation, even physiology. A child who “just won’t get dressed” or “refuses to sit on the toilet” is rarely being difficult. They’re usually telling you something about which system is under strain.
That’s exactly why we built the Foundations Series: four practical, clinically-grounded starting points for the self-care areas paediatric OTs are asked to support most — feeding and eating, hygiene, toileting, and dressing. Each one breaks down the drivers behind the behaviour, gives you a repeatable framework for where to start, and includes ready-to-use tools you can bring straight into a session or a parent conversation.
Here’s a taste of what’s inside each one.
Feeding & Eating: it’s rarely just about the food
Eating is one of the most neurologically demanding things a child does — postural control, oral motor coordination, sensory processing and emotional regulation, all firing at once, several times a day. When a child “only eats five foods,” the fix is almost never to start with the food itself. Using the Feeding Tree metaphor (adapted from the Brisbane Feeding Clinic’s framework), we walk through why treatment needs to start in the roots — felt safety, breathing, gut health — before working up through posture, oral motor skills, and only then variety.
A light-touch tip for your next session: if a child is resisting new foods, check the chair before you check the menu. Postural instability alone can derail feeding progress that looks, on the surface, like pure fussiness.
DOWNLOAD: Feeding & Eating — Where to Start
Hygiene: not “won’t,” almost always “can’t yet”
Teeth brushing, hair washing, showering — they look repetitive and simple from the outside, but each one is a sensory-dense, multi-step motor sequence usually attempted at the least regulated points of the day. Our START framework (Select, Task-analyse, Ask what’s driving it, Reduce demands, Try/review/transfer) gives you a repeatable way to plan for any hygiene difficulty, whether it’s a two-minute in-session decision or a full family conversation.
One thing parents rarely think to try: the mint in toothpaste can genuinely feel “spicy” to a sensitive child. A flavourless or mild toothpaste is a five-second swap that solves more resistance than any behaviour chart.
DOWNLOAD: Hygiene — Where to Start
Toileting: screen for constipation before you screen for readiness
Toileting asks more of a child’s body and nervous system than almost any other self-care task — interoceptive awareness, sequencing, sensory tolerance, and the trust to let go of control at exactly the right moment. Functional constipation is one of the most common, and most frequently missed, drivers of toileting refusal — pushing a behavioural program onto an underlying physiological issue tends to entrench the problem rather than solve it.
This pack includes our six-driver framework (constipation, toilet fear, control, pressure, life changes, sensory overload), a full readiness and prerequisite-skills checklist, and a ready-made carer questionnaire so you’re not building one from scratch.
DOWNLOAD: Toileting — Where to Start
Dressing: rarely just about the clothes
Dressing recruits nearly every developmental system a child has — sensory tolerance, bilateral coordination, motor planning, fine motor precision, body awareness and self-regulation, often under real time pressure on a school morning. We walk through the four lenses driving dressing difficulty, developmental milestones from 12 months to age six, and backward chaining — one of the best-supported strategies for building independence, because the child experiences success at the end of every single attempt.
A simple one for busy mornings: offer a choice between two pre-selected outfits rather than an open-ended choice. It supports autonomy without adding decision fatigue to an already-loaded moment.
DOWNLOAD: Dressing — Where to Start
Where to start with your own starting point
Each resource in the Foundations self-caresSeries follows the same clinical structure — the drivers behind the behaviour, developmental context, a repeatable framework, and where-to-start prompts you can use in your very next session. They’re built for new graduate paediatric OTs who want a genuine starting map, not a full assessment protocol, and they’re designed to sit alongside your own clinical reasoning rather than replace it.
If you want to go deeper once you’ve worked through these, the Parent Coaching Workshop and The Essential Paediatric Course build directly on the same frameworks — and if you’re after ongoing support, clinical supervision with Lisa Hughes draws on 30+ years of paediatric OT and business experience to help you grow your skills and your confidence with families.
