[Blog] Ep 55. The Power of Occupational Therapy for Your Child

ft. Dr. Mahek Uttamchandani, Director of Stepping Stones PTC, centre for occupational therapy.

Introduction

As parents, we often navigate a maze of questions about our child’s development—Are they growing well? Are they hitting their milestones? Is this behavior normal or something to be concerned about? One powerful, yet often misunderstood, support system available to families is occupational therapy (OT). Despite its proven benefits, OT still carries a sense of stigma and confusion, especially in India where therapy can feel like a last resort.

In this enlightening episode of The Modern Indian Parent Podcast, host Sanchita Daswani sits down with Dr. Mahek Uttamchandani, a leading pediatric occupational therapist and director at Stepping Stones PTC, Mumbai. With over 20 years of experience, Dr. Mahek breaks down what occupational therapy really is, when it’s needed, how it can help children thrive, from newborns with reflux to school-goers struggling with focus, emotional regulation, or daily routines.

Dr. Mahek’s Journey into Occupational Therapy

Dr. Mahek began by explaining that occupational therapy is a branch of healthcare aimed at helping individuals gain independence in their daily occupations. In India, it is studied in medical colleges and treated as a primary healthcare profession, unlike in the West where it can be pursued even after studying arts or other subjects. For children, their daily occupations are to grow, play, and learn and when there's dysfunction in any of these areas, occupational therapy can help bridge the gap.

She shared that when exploring healthcare career options, she knew she didn’t want to become a physician or surgeon. Occupational therapy appealed to her because it allowed her to combine her passion for medicine and science with creativity and playfulness. Pediatric OT, in particular, stood out due to the critical role early childhood plays in lifelong development. She emphasized that early intervention can prevent more complex issues from emerging in adolescence or adulthood.

With nearly two decades of experience, Dr. Mahek has worked across various clinics and trained in the US and UK. She currently runs Stepping Stones PTC in Mumbai and is also empaneled with neonatal units at Reliance Foundation Hospital and SRCC Children’s Hospital.

Why Is There a Stigma Around Occupational Therapy?

Dr. Mahek explains that in India, therapy is often seen through a lens of fear or shame.

• Many parents view their child as an extension of themselves, making it difficult to accept any perceived flaws.

• The Western idea of promoting independence contrasts with India’s family support system where others “do things” for the child.

• Awareness is increasing, especially in IB and international schools.

What Is Occupational Therapy?

Occupational therapy helps individuals become independent in their daily lives. For children, their primary “occupations” are playing, learning, and growing.

• Dr. Mahek defines it as a health profession that improves functional independence.

• OT addresses issues like trouble with brushing teeth, writing, eating, or socializing.

When Should a Parent Consider Occupational Therapy?

You don’t need to wait for a crisis.

• Dr. Mahek recommends getting an assessment if you notice even mild delays.

• OT requires a valid therapeutic goal, so there must be a real dysfunction.

• Life skills like swimming or gymnastics may suffice if no dysfunction is found.

What Are Some Signs to Look Out for That a Kid Needs Therapy?

Dr. Mahek advises watching for delays that disrupt daily function.

• Diagnoses like autism, ADHD, or cerebral palsy

• Difficulty with daily routines—eating, bathing, handwriting

• Increasing referrals for emotional and social regulation concerns

The Rise of Specialists in Child Care

Dr. Mahek explains that the noticeable rise in child-focused specialists today like occupational therapists, child nutritionists, and sleep consultants is not necessarily because more children are facing problems, but because modern parents are more informed and proactive. Earlier generations may have overlooked or normalized many challenges that today’s parents choose to explore and address. With greater access to research and resources, today’s parents are asking deeper questions and are more willing to adapt their parenting styles to better support their child’s overall development. She also points out that modern lifestyles, changing family structures, and new scientific findings about emotional development and childhood experiences have all contributed to this shift.

Key reasons behind the rise of specialists in child care:

• Parents today are more aware and ask more questions about their child’s development.

• There is a greater willingness to explore newer, more emotionally supportive parenting methods.

• Scientific research has highlighted the long-term impact of poor emotional environments in early childhood.

• There is increasing recognition of the role emotional well-being plays in shaping future health and behavior.

• Modern nuclear families and busy work lives mean parents may need more external support in child-rearing.

Occupational Therapy for Newborns: Reflux and Colic

OT can benefit even newborns, particularly for feeding and digestion.

• Dr. Mahek assesses latch quality and feeding posture.

• She recommends upright or left-lateral positioning for reflux.

• Educates parents on responsive caregiving—recognizing cues for hunger and satiety.

Defining Sensory Processing Disorders

Dr. Mahek describes sensory processing as a natural neurological process that takes place in all of us—it’s how our brain receives, filters, and responds to sensory information from our environment. When this system doesn’t work efficiently, a child may become either overly sensitive or under-responsive to stimuli like touch, sound, movement, or taste. This can affect their ability to play, eat, interact, or feel safe. She notes that while awareness about sensory processing disorders has increased only in recent decades, lifestyle shifts like less outdoor play and more screen time may also be contributing to a genuine rise in such difficulties among children today.

Common signs and contributing factors of sensory processing disorders:

• Children may refuse to touch certain foods or textures, or avoid messy play (signs of tactile sensitivity).

• Everyday tasks like brushing hair, getting a haircut, or wearing certain clothes may cause distress.

• Sensory overload may affect focus, social interactions, and learning.

• Increased screen exposure and reduced free, unstructured play can interfere with healthy sensory development.

• Many children who were considered "colicky" or "fussy" babies are later found to have underlying sensory issues.

She emphasizes the importance of distinguishing between mild dislikes and actual dysfunction. If a child refuses to wear their school uniform because of its texture, or takes three hours to finish a meal due to aversions, it goes beyond preference as it disrupts daily life. That’s when parents should consider occupational therapy. Dr. Mahek cautions against rushing into therapy just because it's trending in parent circles. Instead, parents should look for clear signs that the child’s quality of life is being impacted.

Helping Kids Struggling at Mealtimes

Children with tactile sensitivities may reject foods and textures.

Dr. Mahek recommends:

• Avoiding “desensitization” and instead using heavy muscle and deep pressure activities (e.g., pushing/pulling)

• Introducing food play to build familiarity and comfort

• Respecting the child’s response and being patient rather than forceful

The Difference Between Toddler Tantrums and Actual Struggles

How can you tell if it’s just a tantrum or a deeper issue?

• Dr. Mahek suggests looking for a cluster of signs, not just one.

• If hair washing, brushing, clothing tags, and food textures all cause distress, it's more than a phase.

• Trial adaptations (like using a bath visor) can help rule out simple dislikes.

How to Help Kids That Can’t Focus

Dr. Mahek addresses a growing concern among parents today—children who struggle to focus, especially during tasks like writing, reading, or structured activities. While it’s often said that “kids are just being kids,” she points out that attention span does follow developmental expectations. A useful guideline she shares is: a child’s age plus two minutes equals their expected attention span. So, a four-year-old should be able to focus for about six minutes.

She explains that reduced focus in children today is often linked to changes in lifestyle. Many children have less opportunity for free play, are overscheduled with classes, and are increasingly exposed to screens, even in educational settings. All of this impacts the child’s ability to regulate their body and mind. However, Dr. Mahek urges parents to observe whether the focus issues are across all areas (home, school, play), or if it’s limited to tasks the child simply doesn’t enjoy because sometimes, it’s not about attention, it’s about interest.

She recommends an assessment if attention challenges are consistent and begin affecting learning, social engagement, or daily tasks.

Key insights and suggestions from Dr. Mahek:

• A child’s attention span can be roughly calculated as age + 2 minutes.

• Reduced unstructured play, screen exposure, and overscheduling can disrupt attention regulation.

• Lack of focus across various settings (not just one) may indicate a deeper issue worth exploring.

• Children may appear distracted not because they can't focus, but because they lack the skills needed for the task (e.g., perceptual or motor skills).

• Misalignment between a child’s temperament and the kind of extracurriculars or learning activities they’re placed in can worsen focus issues.

• Activities involving movement and sensory input (like outdoor play, climbing, or sports) help regulate attention naturally.

• When attention challenges consistently interfere with functioning, it’s time to consult an occupational therapist for a deeper assessment.

Understanding Shyness and Social Skills

When is shyness just a personality trait, and when is it a concern?

• Dr. Mahek emphasizes looking at attachment and emotional safety.

• A child might be shy by nature, but if it affects friendships, school participation, or leads to bullying, it's time to investigate.

• She recommends evaluating parent-child dynamics, social-emotional skills, and sensory issues.

The Process of Occupational Therapy Assessment

Dr. Mahek outlines a structured and personalized approach to therapy. The evaluation typically unfolds in three parts:

• Parent Interview: The first step is a detailed conversation with the parents. Dr. Mahek gathers insights starting from the pregnancy and birth history to the child’s developmental milestones and current concerns. This helps establish context and understand the child’s journey from a caregiver’s perspective.

• Unstructured Observation: Next, the child is observed through play-based interaction. Since play is the child’s primary occupation, this method helps evaluate how the child moves, responds, engages, and regulates themselves in a natural setting. The observation is informal, but guided by key developmental and sensory parameters.

• Objective Testing: The final part involves standardized assessments, which are evidence-based tools that provide quantifiable data. Tests like the SPM, SIFTT, and others may be used to assess sensory processing, handwriting, motor coordination, and behavioral patterns. These remove subjectivity and confirm whether the observed concerns align with validated clinical markers.

Once all three parts are complete, Dr. Mahek and her team compile the findings to define therapeutic goals and choose the most appropriate intervention methods.

• Testing tools like SIFT and SOSI are used to validate findings.

• Therapy is play-based, individualized, and uses evidence-backed approaches like:

  • Sensory Integration

  • Neurodevelopmental Therapy

  • The Solihull Approach (for understanding behavior)

Dr. Mahek advises that duration varies per child—it can be short or long-term based on how quickly the dysfunction turns into function.

Conclusion

Occupational therapy isn’t just for major concerns. It’s a deeply supportive practice that can help your child feel seen, safe, and empowered in their everyday life.

To get more real-life insights and practical tips on peaceful mealtimes, social development, or sensory challenges, listen to the full episode of the Modern Indian Parent Podcast with Dr. Mahek Uttamchandani.