An OT perspective on working with dyspraxic people - Written by Helen Buteux

Occupational therapy is a female-dominated industry. According to the Health Care Professional Council, 89% of Occupational Therapist practitioners are women (HCPC, 2025).

This is empowering for women and provides a wealth of female role models and leaders within our profession. I have been inspired by and learned so much from so many of my colleagues, who are mostly women. 

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In my 12 years as a children's occupational therapist (OT) I have seen a lot of people with dyspraxia or suspected dyspraxia. So, why have I seen so many young people with dyspraxia? I will explain what an occupational therapist does and how we can help people with dyspraxia.

What is Occupational Therapy?

 The Royal College of Occupational Therapists website explains ‘Occupational therapy helps you live your best life. An occupational therapist helps people overcome challenges completing everyday tasks or activities – what we call ‘occupations’. Occupational therapists see beyond diagnoses and limitations to hopes and
 aspirations’ (RCOT, 2025).

Making a referral. 

Occupational therapists work in a variety of settings such as the NHS, schools or private practices. Each service will have its own referral criteria and referral forms. 
An occupational therapist will work together with the person and their family, if appropriate, to identify a specific goal or goals. This will guide the course of therapy. It is important that any goals set are meaningful for the person.

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What types of occupations can an occupational therapist help with? 

Anything! Most NHS and local authority services will have referral criteria, so it’s worth checking your local services first or looking for an independent therapist. Examples of occupations are endless, but could include:
- Using scissors
- Riding a bike
- Tying a tie or shoelaces 
- Being able to make a cup of tea or follow a recipe to cook a meal
- Handwriting difficulties

How do OTs help people achieve their goals? 

The evidence tells us that the most effective method for OTs to support people to achieve their goals, is to use an approach called the top-down approach (Novak and Honan, 2019). This means we work towards a patient-identified goal that is task or occupation-specific. The NHS website lists coordination problems as one of the main symptoms of dyspraxia. Coordination allows individuals to complete movements using multiple muscle groups together. It requires refined fine and gross motor skills alongside good sensory integration. An example of a task that requires good coordination is being able to tie shoe laces. If someone struggles with this task, it could lead to a person avoiding engaging in other occupations, such as playing outside with their friends, because they can’t tie their laces when they come undone. 

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OTs use a technique called activity analysis. This is where we break down real-life tasks into components or parts and consider what is needed to achieve the task. This includes exploring the underlying skills needed to complete the occupation, which could include physical, cognitive or perceptual factors. We observe how the person completes the task and analyse their performance to determine any changes required to reach the identified goal. A change could include modifications to the task or a change in how the person approaches the task. 

If goals are set that lack meaning for the person and aren’t motivating to them, it is unlikely to be achieved. This is more likely to happen when a goal is aimed at the underlying impairment or difficulty (coordination) rather than a task (tying shoelaces) (O’Dea, Robinson and Coote, 2019). OTs use a strengths-based approach to therapy. This means not focusing on what is wrong but identifying strengths and needs. Being strengths-based supports a positive conversation. If the OT were to focus on what the person can't do, this can lead to a negative mindset. The international clinical practice recommendations have identified that people with dyspraxia are already at risk of negative self-esteem and anxiety (Blank et al, 2019); therefore, it is important to focus on strengths.

When to see an OT

Early intervention is important to support young people who may be struggling with tasks. It can help people understand their difficulties and avoid labels such as being called 'lazy' or 'not trying hard enough', which can lead to a negative mindset and a reduction in participation in activities, which can have secondary health implications such as obesity (Blank et al, 2019). If anyone is struggling to get a diagnosis of dyspraxia, but suspects dyspraxia, it is important to highlight that people do not need a diagnosis to benefit from occupational therapy support. The Royal College of Occupational Therapists has recognised that a diagnosis can promote self-awareness, knowledge and insight (RCOT, 2021). This facilitates self-management and the identification of reasonable adjustments to support performance and participation.

I hope I have provided some insight into our female-dominated profession and how we can help people and inspire others to seek out support or even a career.