Marge LeBlanc’s words—“The child is the one who has language in their heads, before we ever decided that we would partner with them on it. We don’t need all the precursors.”—invite us to rethink how we approach learning, development, and therapy. In the context of childhood occupational therapy, this idea highlights a fundamental truth: the child is already an active agent in their own development. Our role is to walk alongside them, not to dictate the path.
What Does “Child-Led” Really Mean?
The term “child-led” is frequently used in therapy, education, and parenting. It suggests that the child’s interests, motivations, and abilities should drive the process. However, in occupational therapy, we sometimes see an unintended contradiction: activities are labelled “child-led,” yet they remain structured by adult expectations.
A truly child-led approach means:
Recognising that the child’s internal experience—what they are noticing, feeling, and attempting—is valuable and meaningful, even if it doesn’t fit neatly into predetermined goals.
Trusting that children come with innate curiosity, sensory preferences, and a deep understanding of their own needs.
Responding to their engagement in real-time, rather than requiring them to move through a linear progression of “pre-skills” before we allow them access to activities they find meaningful.
Moving Beyond Precursors
In traditional therapeutic models, there’s often an emphasis on prerequisites—such as assuming a child must develop certain fine motor skills before engaging in writing, or specific sensory processing patterns before participating in play. However, child-led occupational therapy flips this script. Instead of seeing development as a checklist, we meet children where they are and engage them in activities that matter to them right now.
For example:
A child doesn’t need to master a pincer grasp before being allowed to explore drawing or self-feeding. They might find their own way to adapt and engage with the activity.
A child doesn’t need to tolerate certain sensory inputs before being welcomed into play. They might naturally regulate themselves when provided with the autonomy to choose what feels right.
A child doesn’t need to “comply” before being given a voice in their own therapy. Their communication—whether verbal, non-verbal, gestural, or sensory-driven—is already valid and meaningful.
Partnering With, Not Directing
When we say therapy is child-led, we must genuinely commit to that idea. This means:
Observing rather than directing.
Offering opportunities rather than imposing tasks.
Valuing the child’s experience as the foundation of therapy rather than trying to fit them into pre-designed intervention models.
True partnership in therapy means respecting that children are already engaged in the process of learning and growing. Our role is not to force development but to support and scaffold it in ways that honour the child’s natural engagement with the world.
When we embrace a genuinely child-led approach, we acknowledge that development does not need to be forced or pre-sequenced. As occupational therapists, parents, and educators, our work is to create an environment where children feel safe, supported, and able to follow their intrinsic motivations.
Children already know how to lead. Are we truly listening?
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