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Starting out in pediatrics can feel overwhelming, and it’s easy to fall into some common traps. In this episode, we’re sharing the top 5 mistakes new pediatric therapists make (yes, we made them too!) and how to avoid burnout while still giving your clients the best support possible.
We cover:
Why staying on top of continuing education is essential
The danger of passive treatment sessions
How to involve families for better carryover
Why a bottom-up approach matters in pediatrics
The importance of setting boundaries and self-care
If you’re a new grad or new to pediatrics, let us know which tip resonated most with you!
We’d love to answer your questions on the podcast! Fill out this form -https://harkla.typeform.com/to/ItWxQNP3
All Things Sensory Podcast Instagram
Starting a career in pediatric occupational therapy can be exciting—but also overwhelming. As a new therapist, you're eager to help children thrive, yet the learning curve is steep, the caseloads are full, and the pressure to “get it right” can be intense.
The good news? You're not alone—and you don’t have to learn everything the hard way.
Whether you’re fresh out of school or transitioning into pediatrics from another setting, this guide breaks down the top 5 mistakes new pediatric OTs make—plus actionable strategies to help you grow with confidence, avoid burnout, and become the therapist your clients need most.
The mistake: Putting continuing education on the back burner or scrambling to complete CEUs last minute.
As a pediatric OT or COTA, ongoing learning is non-negotiable. Beyond meeting licensing requirements, continuing education helps you fill the gaps left by formal training, stay current with evidence-based practices, and discover new tools to better support your clients.
OT Tip: Create a “Therapy Binder” with plastic sleeves to organize certificates, CEU logs, course notes, and state renewal info. This simple system is a game-changer—especially if you ever get audited.
What to do instead:
Make learning a habit: Schedule time monthly or quarterly to take a course or listen to a podcast (even during your commute).
Focus on areas you see in practice: Primitive reflexes, executive functioning, and sensory processing often top the list.
Choose quality over quantity: Prioritize CEU-accredited, evidence-based programs taught by experienced clinicians.
The mistake: Sitting back during sessions—relying on your plan while catching up on documentation.
We get it. You're busy, documentation piles up fast, and sometimes a child just needs to swing for 10 minutes. But disengaging during sessions can become a slippery slope.
Why it matters:
Children are perceptive. They know when you're not fully present.
Therapy becomes less effective without active engagement and feedback.
It’s easy to burn out when you're not feeling connected to your work.
What to do instead:
Treat every session as if a caregiver or mentor is observing.
Embed documentation time into your schedule (even if it means reducing your caseload slightly).
If you're feeling disengaged, check in with yourself: Are you overwhelmed? Under-supported? Burned out? Open communication with supervisors is essential.
If passive sessions are a symptom of burnout, it's time to pause and reassess before quality of care—and your own wellbeing—suffers.
The mistake: Focusing only on the child and not collaborating with caregivers.
Caregivers are the true carryover champions. If they’re not involved, therapy progress often stalls once the session ends.
What to do instead:
Ask what’s realistic at home. Instead of handing out complex sensory diets, collaborate with families to create routines that fit their lifestyle.
Offer simple, clear takeaways. A visual schedule, one calming strategy, or a five-minute movement routine is often more helpful than a thick handout packet.
Bring families into sessions. If possible, invite them to observe or join the last few minutes to model strategies and answer questions.
Remember, parents are often overwhelmed. Empower them by starting small and building confidence over time.
The mistake: Focusing only on surface behaviors and academic tasks—while overlooking the foundation.
Children struggling with focus, handwriting, or behavior often have underlying sensory processing challenges or retained primitive reflexes. A bottom-up approach means starting with the nervous system, sensory needs, and motor development—then building toward executive functioning and academic success.
What to do instead:
Prioritize nervous system regulation in every session—think swinging, crawling, deep pressure, or proprioceptive input.
Learn about primitive reflexes and how they influence movement, posture, and behavior.
Start sessions with sensory prep—it improves attention, engagement, and outcomes.
If a child can’t sit still, the answer isn’t always a fidget—it might be a retained STNR or vestibular under-registration.
The mistake: Taking on too much, skipping breaks, and neglecting your own needs.
You became a therapist to help others, but you can’t pour from an empty cup. Burnout is real—and it's common among early-career OTs.
What to do instead:
Advocate for a sustainable schedule: Seeing 6–8 clients in a row without breaks isn't sustainable long-term.
Build in self-care time: Whether it’s 10 minutes outside, a proper lunch, or weekly yoga—make it non-negotiable.
Seek mentorship: Don’t hesitate to ask for guidance. You deserve to feel supported as you grow into your role.
“Make sure you’re taking time to go outside, drink water, and do your best not to take work home.” —Rachel & Jessica, All Things Sensory Podcast
If you’re a new grad or new to pediatrics, give yourself grace. You’re learning on the job, and that’s okay.
Every therapist starts somewhere—and mistakes are part of the journey. What matters most is staying curious, connected, and committed to doing your best—for your clients and for yourself.
BORING, BUT NECESSARY LEGAL DISCLAIMERS
While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science & art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views & opinions on how to address common sensory challenges, health related difficulties & what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.
Keep in mind that we may receive commissions when you click our links & make purchases. However, this does not impact our reviews & comparisons. We try our best to keep things fair & balanced, in order to help you make the best choice for you.
This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.
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