Before Recommending a Digital Tool: Questions Pediatric OTs Should Be Asking

A practical OT lens for apps, games, timers, visual supports, and classroom tech

Digital tools are now part of pediatric practice.

Apps, games, timers, visual schedules, AAC systems, classroom platforms, and therapy videos all show up in our work. Some are useful. Some are not. Most depend on the child, the task, the environment, and the support around them. As pediatric OTs, we do not need to be anti-screen or pro-screen. That framing is too small.

The better question is: What role is this tool playing, and does it support participation?

A digital tool can make something more accessible, visual, predictable, motivating, or easier to share across settings. It can also add cognitive load, increase sensory input, create new barriers, or pull the child away from what we are trying to support.

The tool is only one part of the equation.  The entire context matters.

Things We Should Be Asking Ourselves….

1. What role will this tool play?

Before recommending a digital tool, name its job clearly.

Is it supporting communication?
Making a routine more predictable?
Giving visual feedback?
Supporting memory or planning?
Reducing the language load?
Making practice more engaging?

If we cannot explain what the tool is doing, that is usually a sign to reconsider. A tool does not need to do everything. It just needs to do something useful for this child, in this context.

2. Is this replacing, supporting, or extending the activity?

Digital tools can play different roles.

Sometimes they replace a barrier. For example, speech-to-text may let a child share ideas without handwriting becoming the whole task.

Sometimes they support the activity. A visual timer may help a child understand how long something will last.

Sometimes they extend the activity. A digital drawing app might help a child plan something they later build, write, or share off-screen.

What we want to avoid is accidentally replacing the meaningful part of the occupation.

If the goal is peer interaction, is the tool supporting connection or pulling the child into solo use?

If the goal is dressing, cooking, handwriting, movement, or classroom participation, is the tool helping the child engage with that real-world task, or has the tool become the task.

3. Does it create new barriers?

Digital tools are often introduced to solve a problem, but they can create new ones. A timer might support transitions, but the sound may be overwhelming. A visual schedule might help with predictability, but the child may not be able to navigate it independently. A game might be motivating, but it may be too fast, too visually busy, or too difficult to adjust.

As OTs, we can look beyond the promise of the tool and notice the actual demands:

• What motor skills does this require?

• How much visual information is on the screen?

• How much language does the child need to process?

• Is the audio helpful or distracting?

• Can the child access the tool without constant adult rescue?

• Does it work in the real environment where it will be used?

A tool can be well designed and still be the wrong fit for a particular child, task, or setting.

4. Does it fit the rest of the context?

A tool that works beautifully in a quiet therapy room may not work in a busy classroom. A strategy that works at home with one adult may not be realistic in a group setting. Context matters.

Before recommending a digital tool, think about where, when, and with whom it will actually be used.

Will it be used during a therapy session, classroom routine, home practice, transition, waiting period, group activity, or independent task?

Who will set it up?

Does it need internet access, headphones, charging, logins, adult prompting, or specific device settings?

Families and educators need tools that fit into real routines, not tools that require everyone to rebuild the day around them.

5. Can I teach the child how to use it?

A digital tool is not automatically accessible just because it is available. Children usually support to learn how, when, and why to use it.

That might include how to pause a game, ask for help, adjust volume, use a visual timer, navigate a communication system, follow a digital schedule, or notice when a tool is helping versus frustrating.

Adults usually need teaching too. A tool is more likely to be useful and used when the people around the child understand its purpose and can support it consistently. The recommendation is only the start.  The teaching, modeling, adjustment, and follow-through are where the tool becomes usable.

6. What happens when it is turned off?

This is one of the most important questions. Not because digital tools are bad, but because pediatric OT is ultimately concerned with participation in real life.  There might be times the tool is not appropriate to use; there will be times when the battery runs out.

What carries over after the screen is turned off or unavailable?  

Do alternatives need to be available?

Depending on the purpose of the digital tool, the answers to these questions will be very different.  They are important to think through when planning for a digital device or tool.

7. Is there a better option available?

Sometimes the best digital tool is not digital. A paper visual schedule might be easier to access than an app. A sand timer might work better than a phone timer. A real object might be more meaningful than a picture. A movement break might meet the need better than a calming video.

That does not mean digital tools are lesser. It means we should choose based on fit, not novelty. The best tool is the one that helps the child participate in a way that is meaningful, realistic, and respectful.

Sometimes that will be an app.

Sometimes it will be a visual card, a pencil, a peer, a quiet corner, a cardboard box, or a game of “the floor is lava.”

Clinical reasoning helps us tell the difference.

Final thoughts

Digital tools are not automatically good or bad. They are tools. They can support communication, predictability, access, motivation, shared play, visual clarity, planning, and participation. They can also add demand, increase distraction, or become disconnected from the real task. That is why pediatric OTs have an important role in these conversations.

We can help teams move past “screens are good” or “screens are bad” and toward better questions:

What role is this tool playing?
Does it support the activity?
Does it reduce barriers or create new ones?
Can the child access it?
Can we teach it?
What happens when it is turned off?
Is there a better option?

The point is not to use more digital tools. The point is to use the right tools, in the right way, for the right reason.