What Does an Occupational Therapist Actually Do?
Occupational therapy (OT) is one of the most misunderstood therapies in India. Many parents hear "occupational" and think it is about jobs. In fact, OT is about daily "occupations" — activities of daily life that are meaningful to the person. For a child, that means playing, learning, eating, dressing, and participating in family and school life.
For autistic children, OT specifically addresses:
- Sensory processing: Designing a "sensory diet" to regulate the nervous system; helping children tolerate haircuts, loud sounds, food textures
- Fine motor skills: Handwriting, using scissors, buttoning, tying shoelaces
- Gross motor skills: Coordination, balance, riding a bicycle
- Self-care: Dressing, toileting, bathing, eating with utensils
- Visual-motor integration: Eye-hand coordination needed for school tasks
- Executive function: Planning, organizing, managing belongings
- Play skills: Teaching structured play that builds towards social play
Signs Your Child Needs OT
- Handwriting is significantly worse than peers (letters reversed, very slow, uncomfortable to hold pencil)
- Cannot sit at a desk for a class without constant movement
- Extreme reactions to haircuts, nail cutting, clothing textures, or food textures
- Bumps into things frequently, poor spatial awareness
- Cannot dress independently by age 8
- Refuses most foods due to texture
- Very clumsy compared to peers
Sensory Integration Therapy
A subspecialty within OT, sensory integration therapy uses a specially equipped sensory gym (swings, crash pads, weighted vests, textured surfaces) to help the child's nervous system learn to process sensory input more effectively. Sessions look like play — the child is swinging, climbing, crashing into bean bags — but the therapist is carefully designing the sensory challenge.
This is one of the most evidence-supported interventions for autism-related sensory differences.
Cost of OT in India (2026)
Private clinics:
- Metro cities: ₹800–2,500 per session (45–60 minutes)
- Tier 2 cities: ₹500–1,200 per session
- Sensory gym sessions may cost slightly more due to equipment
Government / subsidized:
- AYJNISHD centres (Mumbai, Delhi, Kolkata, Secunderabad): free or subsidized
- District Early Intervention Centres: free
- Government medical college OT departments: ₹100–500 per session
How many sessions needed:
- Minimum: 2 per week for meaningful progress
- Optimal: 3–5 per week in intensive early intervention phase
- Home programme (exercises from the OT to do at home) is essential
Finding a Qualified OT in India
A qualified OT in India should hold:
- Bachelor of Occupational Therapy (BOT) — 4.5-year degree
- Master of Occupational Therapy (MOT) — specialization optional but valuable
- Registered with All India Occupational Therapists' Association (AIOTA) and Rehabilitation Council of India (RCI)
Do not accept OT from someone without these qualifications.
The OT Assessment
Before starting therapy, a good OT will do a full assessment including:
- Sensory profile questionnaire (parents complete)
- Clinical observation of sensory, motor, and self-care skills
- Standardized assessments (Bruininks-Oseretsky, Beery VMI, Sensory Profile 2)
- School observation or school report review
The assessment results in a therapy plan with specific goals and measurable outcomes. Ask to see the assessment report.
What to Look for in a Good OT
- Explains what they are doing and why
- Gives you a home programme and teaches you how to do the activities
- Sets specific, measurable goals (not vague "sensory improvement")
- Adjusts the programme as the child progresses
- Communicates with the speech therapist and school