Ideas at Play: An Occupational Therapy (OT) Podcast

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Conversational AI in pediatric OT is moving faster than the research. Lacy and Michele discuss a 2026 narrative review that sorts the evidence into four pathways based on who the AI is talking to: therapists, caregivers, children, and students. Most of the ideas and research are just beginning to emerge, and a lot is borrowed from other fields, but one pathway is rising to the top as the best place to start.

We share our own thoughts in the Research Review and encourage you to read the original articles too.

Pergantis, P., Bardis, N., Skianis, C., & Drigas, A. (2026). Conversational artificial intelligence in pediatric occupational therapy: A comprehensive narrative review of emerging applications, transferable evidence, and future directions. International Medical Education, 5(3), Article 93. https://doi.org/10.3390/ime5030093

Cason, J., Gafni-Lachter, L., Richmond, T., & Jacobs, K. (2026). Worldwide survey on artificial intelligence in occupational therapy. Work. Advance online publication.https://doi.org/10.1177/10519815261469529

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Cerebral palsy interventions work best when matched to a child's GMFCS level, and one umbrella review sorts the evidence into green, yellow, and red. Michelle reviews what it found across postural control, postural management, and tone management, including one green-light intervention you may not expect, a few popular approaches the evidence doesn't support, and why the same intervention can be right for a child at level II and wrong for a child at level V. We break down what to trial this week based on the child in front of you.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Toohey, M., Blatch-Williams, R., Budini, K., Ferreira, A., Griffin, A., Hines, A., Jackman, M., Lind, K., Massey, J., Mc Namara, M., Mitchell, J., Morgan, C., Norfolk, E., Paton, M. C. B., Polyblank, D., Reedman, S., & Novak, I. (2024). Effectiveness of postural interventions in cerebral palsy: Umbrella systematic review. Paediatrics and Child Health, 34(8), 257–278.https://doi.org/10.1016/j.paed.2024.06.003

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Weighted blankets show up in therapy rooms, bedrooms, and shopping carts. Lacy and Michele discuss three recent reviews on weighted blankets for sleep, pain, mood, and daily function. Learn who they seem to help most (and who they don't) and where the research still has gaps.

We share our own thoughts in the Research Review and encourage you to read the original articles too.

Dawson, S., Charlton, K., Ng, L., Cleland, J., Bulto, L., Page, M., & Attrill, S. (2024). Weighted blankets as a sleep intervention: A scoping review. American Journal of Occupational Therapy, 78(5), Article 7805205160. https://doi.org/10.5014/ajot.2024.050676

Yu, J., Yang, Z., Sun, S., Sun, K., Chen, W., Zhang, L., Xu, J., Xu, Q., Liu, Z., Ke, J., Zhang, L., & Zhu, Y. (2024). The effect of weighted blankets on sleep and related disorders: A brief review. Frontiers in Psychiatry, 15, Article 1333015. https://doi.org/10.3389/fpsyt.2024.1333015

Jaślikowska, A., Niderla, N., Rzeszutek, J., Rachwał, N., Grzyb, W., Kurnik, M., Grzybowska, D., Idzik, K., & Kubicki, A. (2026). Weighted blankets as a non-pharmacological intervention for sleep, mental and neurodevelopmental disorders: A narrative review. Journal of Education, Health and Sport, 95, Article 73069.https://doi.org/10.12775/JEHS.2026.95.73069

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Pediatric OTs use play in nearly everything we do, but how much of it is actually play? In this episode, we review the play-work continuum, which separates free play from play as a vehicle for goals. Michele also shares 10 ways to apply it in your sessions, from writing goals for play to setting up the environment and how to facilitate safe rough-and-tumble play.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Brown, T., & Lynch, H. (2023). Children's play–work occupation continuum: Play-based occupational therapy, play therapy and playwork. Canadian Journal of Occupational Therapy, 90(3), 249–256. https://doi.org/10.1177/00084174221130165

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Sensory garments are everywhere and frequently marketed to our clients and families — but almost none of the research asks what happens after a parent clicks "buy." This episode discusses a study with off-the-shelf sensory garments and their impact on participation for autistic children. The results split in a way that may change how you talk to families about these products — and expose a bigger problem with how we measure outcomes for autistic kids in the first place.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Mische Lawson, L., Foster, L., Hamner, K., & Wright, L. (2022). Exploring effects of sensory garments on participation of children on the autism spectrum: A pretest-posttest repeated measure design. Occupational Therapy International, 2022, Article 3540271.https://doi.org/10.1155/2022/3540271

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Up to 50% of kids with developmental coordination disorder (DCD) also have ADHD — and that overlap changes how motor gains actually stick. We're back with another episode on CO-OP: goal, plan, do, check, and 8 strategies for building motor skills through problem-solving instead of repetition. If you've been using a repetition-based, motor-learning approach with a child and haven’t seen much success, this episode has an alternative worth trying. And....if you missed it, check out our other episode on CO-OP with episode 35.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Izadi-Najafabadi, S., Gunton, C., Dureno, Z., & Zwicker, J. G. (2022). Effectiveness of Cognitive Orientation to Occupational Performance intervention in improving motor skills of children with developmental coordination disorder: A randomized waitlist-control trial. Clinical Rehabilitation, 36(6), 776–788. https://doi.org/10.1177/02692155221086188

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“You gain what you train” — but what does that actually look like session to session? In this episode, Michele and Lacy review a case study that has all the ingredients of a solid motor learning intervention for self-feeding with a spoon. We talk through how the intervention was built, what actually improved (and what didn't), and where the study's limitations leave room to make this more practical — think play, caregiver coaching, adaptive tools.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Jajal, R. N., Vaghela, M. R., & Patel, B. N. (2026). Establishing independent spoon feeding through a structured motor-based shaping protocol in a child with developmental delay. International Journal for Multidisciplinary Research (IJFMR), 8(2), 1–13.https://doi.org/10.36948/ijfmr.2026.v08i02.73433

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Daily living skill performance can be hard to learn for autistic teens, even when their cognition is average or above average. This episode covers a randomized controlled trial testing a manualized program that teaches laundry, cooking, and money management to autistic adolescents, compared head-to-head with the well-respected PEERS program. We cover the results and how an OT lens could take this already-strong intervention even further.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Duncan, A., Meinzen-Derr, J., Ruble, L., Fassler, C., & Stark, L. J. (2023). A randomized clinical trial targeting daily living skills in autistic adolescents without an intellectual disability before the transition to adulthood. Journal of Developmental & Behavioral Pediatrics, 44(9), e590–e596. https://doi.org/10.1097/DBP.0000000000001222

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Down syndrome is one of the most common diagnoses OTs work with, yet the research base behind it is surprisingly small. This week, Lacy and Michele discuss a new AJOT scoping review featuring some of the most unexpected interventions they've ever covered, from elephants to qigong massage to traditional dance. Behind the fun, though, is a bigger story about where this research is happening, and where it's falling short.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Long, K. L., Barrios Lago, M. S., & Nelson, E. L. (2026). Occupational therapy interventions in Down syndrome: A scoping review. American Journal of Occupational Therapy, 0(0). https://doi.org/10.1177/19437676261464084

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Picture a beach in Aotearoa New Zealand — a gnarled pōhutukawa tree perfect for climbing, a rope swing hanging over the sand, and a stick sized exactly to a child's height, ready for a game passed down through generations. In this milestone 80th episode, we sit down with, Susi King, a Playmaker from New Zealand to explore how culture, land, and indigenous wellbeing frameworks shape pediatric OT practice on the other side of the world. And, hear about the new burnout-day tradition she shares with her whole team and the talking button she never travels without.

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A 6 year-old can't hold onto multi-step directions long enough to follow them — not because he isn't listening, but because his working memory drops the information before he can act on it. This week, Michele brings a real case to the table and digs into a 2024 study comparing two cognitive strategies — enactment and visualization — to see which one actually helps kids with autism and intellectual disability with working memory. Spoiler: one of them is the clear winner, and it's not the one you'd expect if you've ever thought about autistic kids as natural visual thinkers.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Xie, T., Ma, H., Wang, L., & Du, Y. (2024). Can enactment and motor imagery improve working memory for instructions in children with autism spectrum disorder and children with intellectual disability? Journal of Autism and Developmental Disorders, 54(1), 131–142. https://doi.org/10.1007/s10803-022-05780-z

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Can a therapist facilitate meaningful handwriting improvement through telehealth? A recent randomized controlled trial out of Ankara, Turkey put that question to the test with kids ages six to eight with the inattentive type of ADHD — and the results are not what Lacy and Michele expected. Listen to hear what the researchers actually did over eight weeks of telehealth sessions and why the approach "shouldn't" have worked. Plus: a Nailed It story with an escalating four-year-old and a floor-mat find that solved a years-long clinic space war.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Kaplan Kılıç, B., Bumin, G., & Öğütlü, H. (2025). Effect of telerehabilitation on handwriting performance in children with attention deficit hyperactivity disorder: Randomized controlled trial. Child: Care, Health and Development, 51(e70055).https://doi.org/10.1111/cch.70055

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Michele found 74 outcome measures to consider for her autistic preschoolers! She and Lacy discuss the top measures from the recent scoping review: which tools show up most in the research, which ones earn a five-star rating for covering the most ground, and where our biggest blind spot as OTs is hiding. Plus, hear about a fun self-care app that may help you as we head into the new school year.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Ghahramani, S., Hassani Mehraban, A., Alizadeh Zarei, M., & Ghahramani, S. (2024). Occupational therapy outcome measures in preschool children with autism spectrum disorders: A scoping review. OTJR: Occupational Therapy Journal of Research, 44(4), 568–576. https://doi.org/10.1177/15394492241246547

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Too cartoonish. Too advanced. Too many worksheets — nothing fit, so Lacy built her own money management program from scratch. This week she's breaking down exactly how she did it: from backwards design to key ingredients and changes made along the way, it's a behind-the-scenes look at turning a need into a working program. Plus, a listener question worth its own deep dive on neurodiversity affirming practice.

Request the money management program discussed by using this form.

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“Sensory” is everywhere in pediatric OT, but how do you actually know if and when to try a sensory activity schedule? How do you set one up? When do you know if it is working — or if you're just guessing and hoping? This week, Michele walks through her real system for building a sensory activity schedule from the ground up, from figuring out what a kid actually needs, to adapting it to classrooms or homes, to knowing exactly when to call it a win (or cut your losses).

Use this linkto request the research cheat sheet for sensory activity schedules.

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Ep. 74 Michele and Lacy continue their Summer of Discovery series. This time, Lacy shares what she's learned from supervising more than 50 fieldwork students, from building a program to knowing exactly when to loop in the academic fieldwork coordinator (a lesson she learned the hard way, twice). Lacy walks through how she structures orientation, communication, and supervision to turn nervous students into confident new therapists — and shares the one rule she gives every student on their first day.

*Student name "Dylan" in the Failed It segment is a pseudonym.

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Ep. 73. This summer, Michele and Lacy are switching things up with a six-episode series sharing programs or topics they genuinely love. The research articles may not always be front and center, but the same clinical reasoning is. First up, Michele shares the social-emotional program that's changed how she runs her social connection group where elementary-aged kids turn big feelings into something they can actually name, talk about, and work through together.

We share our own thoughts in this episode and encourage you to check out the program too. A Little SPOT Series – Diane Alber

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What do early career occupational therapists really prioritize when choosing their first OT job? Spoiler alert: salary ranks 9th out of 16 factors. In this episode, we break down a fascinating Canadian study that surveyed early career occupational therapists about what actually matters in their job search—and the findings might surprise you. We reveal the top intrinsic and extrinsic factors driving OT employment decisions, why 60% of new grad occupational therapists have jobs lined up before graduation, and how OT priorities shift between your first job and your second (or third!) job. Occupational therapy students will learn what to look for in job searches, OT employers will discover how to attract top talent, and experienced therapists can reflect on whether their current position aligns with what truly matters to them.

We share our own thoughts in the Research Review and encourage you to read the original article too.

Lui S, Boniface J, Boniface G, Drynan D. Employment Decisions of Newly Graduated Occupational Therapists. Canadian Journal of Occupational Therapy. 2024;92(2):76-84. doi:10.1177/00084174241274742

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When you think of therapy in the swimming pool, swim lessons probably come to mind. However, occupational therapy practitioners use water for so many life skills! This week, Michele dives into research from Spain that reveals how aquatic therapy can be beneficial for autistic children in OT settings. The results? Better school performance, improved social competence, and happier kids overall. Plus, Michele shares her own terrifying pool story of a little girl who loved staying under the water for a long time and the treatment strategy to ensure her safety.

We share our own thoughts in the Research Review and encourage you to read the article too.

Güeita-Rodríguez, J., Ogonowska-Slodownik, A., Morgulec-Adamowicz, N., Martín-Prades, M. L., Cuenca-Zaldívar, J. N., & Palacios-Ceña, D. (2021). Effects of aquatic therapy for children with autism spectrum disorder on social competence and quality of life: A mixed methods study. International journal of environmental research and public health, 18(6), 3126. Effects of Aquatic Therapy for Children with Autism Spectrum Disorder on Social Competence and Quality of Life: A Mixed Methods Study

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Episode 70 calls for something special! We tackle your real-world pediatric OT questions, from the buzzwords worth knowing to the advice that actually sticks. Thank you for being the heart of this podcast. Here's to 70 more!

If you liked this episode, check out our first round of listener questions in episode #50.

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