6 Occupational Therapy Activities - Down Syndrome



As I have mentioned in the past we do 3 different types of therapy with Hazel on a regular basis:

1. Occupational therapy (OT)

2. Speech therapy

3. Physical therapy (PT)


This post will focus on OT. To learn more about OT click here and here. Also, there is a great book I mentioned in my last PT post called, "Fine Motor Skills in Children with Down Syndrome." Between the help we get from our OT and this book, I feel I have a really well-rounded idea as to the skills Hazel needs to work on.

As I mentioned in the PT post, Hazel is very focused on gross motor development at this stage. She is walking, dancing, balancing and in her opinion, all that leaves little time for her to sit still and build a puzzle. We all have our challenges.

OT has become an extremely trying experience on a daily, although lately it seems to be looking up.

She is into throwing her pegs, eating her puzzle pieces and walking away with everything. Some days I feel like a complete failure, others I feel success. Such is parenting I guess???

My goal whenever we do OT activities is to try and make Hazel think we are playing and that it’s a good idea.

I begin by creating a play circle. I take out a few toys that reinforce the concept or skill we are working on and scatter them around the room. I like to give her the option of which one she would like to play with by letting her explore and move to the toy that interests her. However, I think now I might have to put her in a booster chair on the floor because she is far to excited about the fact that she has control to get up and walk away from me now.


Usually, our OT sessions vary in length and take place several times a day or whenever we are sitting and playing together.

Here are some of the activities we do:

(oh yes...before I forget to mention, I must say that we do NOT do all these activities everyday. Only supermom could manage that...I mean, I'm close but I just can't find a cape I like)



1. Board Books

We are trying to encourage Hazel to turn the pages of a book. Also, working on manipulating flap or pop-up books. She has been working on getting only the one page to turn at a time as well as lifting flaps or sliding tabs.

I have tried:

  • Putting tape tabs on each page for easy grip
  • Hand-over-hand (less is more)
  • Books that have “peek-a-boo” tabs and lift flaps (working on both object permanence and page manipulation)


PicMonkey Collage


2. Puzzles

Big knob puzzles are a winner in this house. Hazel loves them so we play with them often. Lots of modeling - taking pieces out and putting them back in. Again, I do hand-over-hand with her. She tries so hard to get them to go in the right spots. Circle is her favourite. She has been really working hard on this and making great strides. I'm super proud!



3. Pegs

Putting small pegs in a pegboard or even this Melissa & Doug peg toy. It’s pretty straightforward. No re-inventing the wheel on this one.

Pegs are not well received by Hazel. The absolute lost thing on earth she wants to do with them is put them in the hole. Throw - YES. Eat - Of course! Bang together and pull apart - ABSOLUTELY! But NO - never put them in the hole. Difficult to even get her to try.

Need a new plan. Any suggestions???

The pegboard our OT uses has a little bit bigger holes, which are outlined with a black sharpie marker. It makes it a little bit easier to see the target. She suggested we could use a piece of Styrofoam with handmade outlined holes in it. We haven’t tried it yet.



4. Toys with Slots, Pull Apart Pieces & Stacking Blocks

Piggy bank, monkey barrel, Alpha-pops, snap beads, Velcro veggies. We use any blocks we have and try to go from stacking big ones to smaller ones.


PicMonkey Collage


5. Self-feeding

We use the suction cup bowl and spoon that came with it (although I heard they have spoons that curve toward their mouth that I might try too). I try to give her something she really enjoys like ice cream, yogurt, oatmeal etc. It’s very messy but she’s getting better all the time. I also give her Popsicles a lot. She definitely knows her way around a Popsicle (and an ice cream cone). We do try the fork as well but I do A LOT of hand-over-hand with her to help her get the food on it. She’s good about bringing it to her mouth if it’s loaded.

6. Isolating the index finger

We have several toys that she needs to push the buttons on to get them to sing her favourite songs and this is great motivation for her. I put the toys out and she finds the buttons and off she goes. There’s usually a lot of dancing, clapping and smiling with this activity, so naturally it's one of my favourites.

Also, I give her blueberries and Cheerio’s to eat.


Small Disclaimer: I just want to remind everyone again that these activities were given to Hazel, for Hazel, by her OT. If you would like to try any of these at home with your babes, please ask someone in your local community for support and advice on what will work best for your children.