The Seeds OT Model — the formal structure
The first four parts built this up slowly — conditions, patterns, how intervention actually works, and the kind of attention that holds it all together. This part puts it on the table in one piece. Three propositions. The terms worth knowing. The reasoning cycle. A mapping tool you can take into a session tomorrow. And the bit that matters most: why this is occupational therapy, and not just systems thinking with an OT label on it.
What the Seeds OT Model actually is
It is a way of paying attention. A framework for thinking carefully about what is happening with a child, and where your effort is most likely to help. It does not replace your assessment tools, your diagnostic frameworks, or your evidence-based interventions — it sits quietly underneath them and holds the thinking together.
Three ideas carry it. The first: how a child regulates, takes part, and copes arises from many things interacting at once, rather than from a single cause you can name. The second: the difficulties we actually see — the meltdowns, the refusal, the anxiety, the not-eating, the not-wanting-to-go-to-school — are usually patterns that recur under certain conditions, not fixed traits sitting inside the child. The third: therapy tends to help when it changes the conditions that keep producing the pattern, and not only when it reaches for the symptom in front of us.
Underneath those three is something quieter still. Difficulties have causes. The causes accumulate. And a good many of those conditions can be changed. That is the whole of it. Everything that follows is about holding it well.
The web looks complicated. How it works does not.
The terms worth knowing
Six words recur throughout this series. They are worth learning well, because they travel — into your notes, into supervision, into a conversation with a teacher who has fifteen minutes and a worried parent beside them. A shared vocabulary is much of what lets several people hold a complicated picture together without losing the thread.
- Condition
- Something in or around the child that makes a pattern more or less likely. Conditions can be biological, sensory, relational, occupational, environmental, school-based or structural. A few are fixed. Plenty can be changed or worked around.
- Pattern
- A difficulty that keeps recurring under particular conditions. It is real in what it does — but it is not a fixed object. It is being remade, over and over, by the conditions around it. Shift those and the pattern usually shifts too.
- Loop
- When the fallout from a pattern becomes a new condition that keeps the pattern going. A child masks all day and comes home empty; empty turns into dysregulation; dysregulation into conflict at home; conflict raises everyone's stress; stress makes tomorrow harder — and round it goes. Pull one piece on its own and little moves, because everything else is still feeding it.
- Leverage point
- A spot in the web where change is both realistic and likely to ripple outward. Finding one is a judgement call: of all the conditions in play, which matter most right now — and which are actually within reach this month?
- Occupation
- The activities daily life is built from — sleep, meals, play, movement, self-care, school, transitions, making things, being with people, resting. Here it is both a clinical domain and the thing you work through. It is where health gets built or worn down, one ordinary day at a time.
- Therapeutic stance
- How you show up to a complicated case. Not racing to a single tidy explanation. Staying curious about what the picture is actually showing you instead of forcing it into a box. Acting carefully without faking more certainty than you have — and being honest enough to change course when the situation does something you didn't expect.
What this changes about how you work
It begins with the questions we ask. Change the question and you notice different things; you have different conversations with families, you write different formulations, you begin intervention somewhere else entirely. The toolkit need not change. The first question does — and here is how that sounds in practice.
In time, once these become the questions you ask first, the model stops feeling like a framework and starts feeling like the way you already think. That is usually the sign it is working.
Before we take the parts one at a time, it helps to see them held together.
The model, in one picture
The diagram below is the whole model at once: the conditions of a child's life arranged around the difficulty they shape, the loops that keep that difficulty turning, and the direction good therapy tends to move things. Read it as a system, because that is what it is.
Conditions orbit a pattern, loops keep it spinning, and intervention nudges the orbits until the whole thing reorganises.
The picture rests on three quiet claims. They are easy to say and easy to skim past, so it is worth slowing down on each one — where difficulty comes from, what a difficulty actually is, and how change happens.
The three propositions
None of the three stands alone. Each leads into the next, and the third returns to the first — which is why the diagram turns rather than stacks: causality, then ontology, then intervention, circling back round again.
Three claims, each leading into the next — causality, then ontology, then intervention, and back round.
Functioning emerges from conditions
How a child regulates, participates and copes is shaped by biological, sensory, relational, occupational, environmental and social conditions all at once. They don't just add up — they pull on each other, in both directions, continuously. One factor almost never explains the whole picture.
Difficulties are patterns, not fixed objects
A difficulty can be real and serious without being a thing lodged inside the child. Meltdowns, refusal, anxiety, dysregulation, school avoidance — these are mostly patterns that keep emerging under certain conditions. They look stable because the conditions keep repeating. Move enough of them and the pattern can reorganise.
Therapy works by shifting conditions
Intervention tends to land best when it changes what's making the pattern likely, rather than only chasing the symptom. You look for leverage points — conditions that are both influential and reachable right now. Direct skill-building still matters; it often just works better once the surrounding conditions have been sorted first.
A difficulty is real — but it doesn't exist apart from the conditions that keep producing it. Once you see that, it changes what you look for, what you ask, and where you work.
Three claims describe how the world works. They do not yet tell you what to do on a Tuesday morning with a real child in front of you. So the next piece turns the ideas into a way of working.
The clinical reasoning cycle
It is less a checklist than a circuit you return to: you watch, you map, you find where change is possible, you try something small, you watch again. Attention moving around the loop, never quite finished.
Nine steps as a wheel. Each lights up in turn, travels round, and hands back to the first. Tap any step to hold it.
Name the pattern
What keeps happening, and when's it most visible — at home, at school, in transitions, at meals, at bedtime? How often, how intense, how long has it been around?
Map the conditions
Across all six domains. What's present in this child's life? What do you already know, and what still needs a closer look?
Find the recurrence
When does it ramp up? When does it ease? What's reliably there just before it shows? The timing is where the pattern gives itself away.
Spot the loops
Which effects of the pattern are now feeding it? Poor sleep worsening regulation, dysregulation worsening home stress — where could you cut in?
Sort fixed from changeable
Some things can change — routines, sensory load, pacing. Some can only be accommodated — neurology, disability. Some you just respect.
Find a leverage point
Which condition is both influential and reachable? Often it's upstream of the difficulty, or sitting around the child rather than inside them.
Intervene carefully
Shift a condition or two without pretending you control the whole system. The model doesn't tell you which intervention — it tells you where to look.
Watch the response
Did it shift? Which way? What moved, what didn't? Did anything change somewhere you weren't expecting? What has the system told you about itself?
Refine and go again
Adjust to what you've learned. Build on what worked, rethink what didn't. The cycle doesn't finish — families keep moving, and good work moves with them.
A sequence is still abstract until you sit down with one child and one difficulty and write it out. The tool below is where the thinking becomes ordinary work.
The pattern-mapping tool
Take a single recurring difficulty and map what surrounds it — what comes before, what keeps it going, what protects the child, what can be changed and what must simply be understood. It is built to be filled in: in assessment, in supervision, or while drafting a formulation.
A working map for any presenting pattern — colour-tracked from cool causes through to the hot aftermath.
- Sleep quality and length
- Hunger / nutritional state
- Sensory load across the day
- Social demands and masking
- Transitions, unpredictability
- Illness or pain
- Family stress levels
- Adult co-regulatory response
- Sensory conditions right then
- Escape or control options
- Relational safety in the moment
- Communication demands
- Body state and fatigue
- Predictability of what's next
- Shame or relational rupture
- Caregiver exhaustion
- Avoidance taking root
- School or peer fallout
- Disrupted routines
- Knocked confidence
- Extra stress loading the next round
Where are the effects turning back into causes? Map the cycles keeping the pattern alive.
What helps this child when it's there? A safe relationship, predictable routines, movement, time outside, one solid friend, calm mealtimes, enough sleep, a regulated adult nearby.
By now a fair question has probably surfaced: isn't this just systems thinking? Plenty of disciplines map conditions and loops.
What makes this distinctly OT
What makes this occupational therapy, and not a borrowed diagram, is where it keeps its attention — on daily life itself, and on a child's capacity to take part in it. One question sits at the centre of OT, and six anchors are where it looks to answer it.
One question sits at the centre. Six anchors are where OT looks for the answer.
“What's happening between this child and daily life?”
The six anchors are where OT looks for the answer
The clinical material
Sleep, meals, play, movement, transitions and routines are where health is built or worn down — not background, the actual work.
The aim
Not removing a symptom, but real participation — in family life, play, school, friendships, the things that matter to the child.
A domain in itself
The gap between what the setting demands and what the child can manage right now. Poor fit is a problem to solve, not a flaw to fix.
Core territory
Sensory processing sits between nervous-system state, regulation and daily participation. Core clinical ground here, not an optional extra.
Where regulation is built
The body going about its day — moving, resting, eating, playing, taking in sensory input. That's where OT works.
A condition of its own
The rhythm of a day — demand against rest, structure against freedom, challenge against mastery — is itself a condition OT is built to read and adjust.
Theoretical foundations
None of this is new, and the model makes no claim to be. What it does is gather a particular set of established ideas and turn them toward a single question: how to understand and help children whose difficulties are real, yet cannot be pinned to one cause or located as a fixed trait inside the child. If you reference it in academic or report work, anchor it to these frameworks rather than treating it as something invented from nothing.
Person-Environment-Occupation
The main structural backbone — occupational performance comes out of the interaction of person, environment and occupation.
Model of Human Occupation
Volition, habituation and performance capacity as dimensions of functioning. Routines, roles and occupational identity as clinical ground.
Biopsychosocial Model
Biological, psychological and social factors running at once. The foundational multi-causal frame in health and disability.
Ecological Systems Theory
Development as nested inside environmental systems — family, school, community, culture — each shaping and shaped by the rest.
Dynamic Systems Theory
Behaviour as emerging from many subsystems self-organising over time. Patterns as attractors that can reorganise when conditions shift.
Somatic & Movement Frameworks
Body-based approaches, including Bonnie Bainbridge Cohen's work — how developmental movement and sensory experience shape regulation and function.
Polyvagal-Informed Practice
Autonomic state as a mediating condition for regulation, social engagement and participation. Safety as the prerequisite for learning and connection.
Social Determinants of Health
Income, housing, access and structural conditions as real determinants of health and participation — active clinical conditions, not background.
Attachment & Co-regulation
Regulatory capacity built through relationship. Co-regulation as the route by which self-regulation slowly comes online.
Occupational Science
Daily occupations as the primary medium of health, development and wellbeing. The study of what people do as the basis for understanding what they need.
Each of these contributes something. What the model does is hold them together around a single thread: difficulties arise from conditions, appear as patterns, and can be moved by shifting those conditions. The model only makes that thread explicit, and gives it a home in paediatric OT.
The Seeds OT Model — in short
Three propositions, one idea underneath. Functioning emerges from conditions. Difficulties are patterns, not fixed objects. Therapy works by shifting conditions. And under all three: difficulties have causes, the causes pile up, and conditions can be changed.
The language travels. Condition, pattern, loop, leverage point, occupation, therapeutic stance — once these are second nature they move straight into supervision, reports and conversations with families and teachers.
The reasoning is a cycle, not a checklist. Observe, map the conditions, find the loops, sort fixed from changeable, pick a leverage point, intervene, watch, refine — then go again, because children and families keep moving and the picture moves with them.
The mapping tool is where it gets practical. Take any presenting pattern and map what surrounds it — what comes before, what keeps it going, what protects, what can shift. That's where the model stops being an idea and becomes actual clinical work.
It's grounded in OT. Occupation, participation, environmental fit, sensory experience, embodied daily life, occupational balance — these are what make it specifically an OT model, not a systems framework wearing an OT badge.
It pulls existing frameworks together — it doesn't replace them. PEO, MOHO, biopsychosocial theory, ecological systems, dynamic systems, somatic frameworks, polyvagal-informed practice, attachment and social determinants all feed in. It's a way of organising what you already know.
It's a way of reasoning, not a promise of outcomes. Not a diagnostic system, not a protocol. A way to think clearly when the picture is complicated — find the conditions, understand the pattern, work out where to start.
Reflect on the whole model
These are for looking back across the series and noticing what's actually shifted in how you work — not just what you've read.
- Pick a child on your current caseload and run them through the mapping tool in Visual Summary 4. What does it surface that your existing formulation hadn't quite caught? Where are the leverage points you haven't tried yet?
- Which single idea from across the five parts has changed how you're thinking about a child or family right now — and what are you going to do differently because of it?
- How would you explain this model to a colleague who hasn't read it, in three or four sentences? What's easy to say, and what gets harder? That gap is usually exactly where the useful thinking still needs to happen.
Questions about the model
Can this model be used with adults, or is it only paediatric? +
How does this relate to trauma-informed practice? +
How do I use this in NDIS report writing? +
Is the Seeds OT Model published or peer-reviewed? +
What if the presenting concern is mainly medical or psychiatric? +
At heart, the model says something plain. Difficulties do not arrive from nowhere. They build because conditions have gathered — biological, sensory, relational, environmental — in a way that makes one particular pattern very likely. And because those conditions can usually be understood, some of them can be changed.
This is not a new way of working. It is what careful occupational therapy has always looked like when it is going well. What the model offers is a clearer way to see what is gathering, to notice which conditions are driving the pattern, and to find where change might begin.
Find the conditions. Understand the pattern. Change what can be changed — and hold the rest with care.