Therapeutic Play Activities That Help Students with Developmental Delays

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All Work and No Play, No Way! Having Fun While Teaching Students with Developmental Delays

I’m employed as a pediatric occupational therapist and I frequently work with children diagnosed with developmental delays. I am often asked what kinds of activities I incorporate into therapy, and I always answer play activities! You see an occupational therapist helps individuals obtain independence with whatever their occupation might be, and for a child, his or her primary occupation is play. A child learns about the world through the physical exploration that occurs during play, so the most natural and fun way to work on areas of weakness with a child who has developmental delays is through play.

Developmental delays can occur in a variety of areas including:

  1. Fine Motor Skills – using the small muscles in the hands such as with writing and cutting.

  2. Gross Motor Skills – using the larger muscles as when walking and jumping.

  3. Cognitive Skills – the ability to think and problem solve.

  4. Social and Emotional Skills – the ability to interact with others appropriately and maintain self-control.

  1. Speech and Language Skills – The ability to pronounce words and speak and process language.

It is beneficial to find play activities that address each of the skill areas listed above. Even though every child that you work with may not have delays in all of these areas, it doesn’t hurt to practice and work on all of the skills. Addressing each of these skill areas through play makes it fun and keeps the child engaged in the activity, which is exactly what you want. It should never feel like work! What follows is a list of play activities that addresses each of the skill areas.

Fine Motor Skills

  • Play with Legos – Have the child use the thumb, index and middle fingers to put the blocks together and pull them apart while building fun structures. This works on creativity while strengthening the small muscles in the hands.
  • Play with play-dough or putty, rolling it into small balls and different shapes and designs. You can have the child roll it out using a rolling pin to work on bilateral skills which also strengthens the arm and hand muscles.
  • String beads – This is great for eye hand coordination while working on grasping skills. You can even have the child string fruit loops or other types of similar cereal and let him or her eat it afterwards!
  • Drawing pictures on a Magnadoodle – This is a fun toy that kids love! It is helpful to prop it up in a vertical position while the child writes and draws on it because that requires the child to hold his or her wrist in an extended position, which is good for fine motor control. Have the child imitate strokes, designs and letters. Kids will have a blast doing so!

Gross Motor Skills

  • Play Hopscotch – This works the leg muscles, helps with jumping, motor planning and muscle coordination.
  • Simon says – Instruct the child to follow a variety of gross motor instructions such as “Simon says march in place, stomp, jump" etc.
  • Play the hokey pokey game “you put your right hand in, you take your right hand out…, etc.” This is great activity for gross motor skills and body awareness!
  • Build an obstacle course for the child to navigate through. Make it appropriately challenging to each individual child, and work on directionality skills at the same time by instructing the child to “climb in, around, over and under, etc.”

Cognitive Skills

  • Puzzles – There are a variety of different levels of puzzles from simple to complex. Tangrams are also great. These are great for problem solving as well as visual perceptual skills.
  • Following a Treasure Map/Scavenger Hunt – You can make this as difficult or easy as it needs to be.
  • The Memory Card Game – You can use a regular deck of cards or you can use cards that have pictures. It may be necessary to vary the number of cards that you use based on the age and/or developmental level of the child that you are working with. Kids usually have a great time with this game.
  • Playing Store – This is a great opportunity to work on counting money, making change, and making purchases. It’s especially fun for the kids if you have a toy cash register.

Social and Emotional Skills

  • Board games that require problem solving are always a great option for this area and kids must work on turn taking skills, which requires patience.
  • Reading Social Stories – Social stories were developed by Carol Gray and describe a skill, situation or concept and the appropriate way in which a child should respond. Students usually have fun listening to these stories and learning from them.
  • Bingo – This is another option for working on turn taking and because losing is always a possibility, this is a great way to learn about dealing with loss and disappointment. Because Bingo is a group activity, it requires social interaction which is nice, and of course, Bingo is always fun!
  • Play Charades – This is a great way for kids to notice the expressions and body language of other children as well as to work on turn taking, patience and impulse control.

Speech and Language Skills

  • Which One Doesn’t Belong Game – This activity can be completed with a worksheet (can be found in “Highlights Magazine”) or with actual items. It works on problem solving and verbal skills and you can also address articulation and language skills at the same time.
  • I Spy Game – This is a fun game in which the teacher or therapist looks around the room and says “I spy with my little eye a ____” and picks and item and describes it. The other person then attempts to guess what the item is. The student then takes a turn “spying and item.” This game is great for critical thinking, listening and reasoning skills.
  • Scrabble – This is a great game to work on spelling, vocabulary, word recognition and articulation.
  • Go Fish Card Game – Every child loves this traditional card game and it requires the use of language because the child must use language skills to request cards from one of their partners, for example, “Susie, do you have any fives?” You can use a regular deck of cards or buy a special deck of “Go Fish” cards.

These are just some suggestions for incorporating play when working on various skills with children with developmental delays. Now that you have some specific ideas, go ahead and get creative and come up with some of your own ideas! Before you know it, you will have an even longer list of fun and entertaining activities. Just remember, always keep it fun and playful!


Case-Smith, Jane. Occupational Therapy for Children. Mosby/Elsevier, 2010

Parham, D. & Fazio, L. S. Play in Occupational Therapy for Children. Mosby/Elsevier, 2007