If there is a disability or signficant delay, therapy can help a great deal. I don't necessarily subscribe to the "wait and see" approach. DS has been in and out of physical and occupational since around his 4th birthday. His motor skills were in the average range until he was around 3 1/2 but the percentile kept dropping down, til finally he qualified for services. When he was 4 a pediatric neurologist told me he probably has dyspraxia, and he was diagnosed formally by a neuropscyh when he was 6. At age 4, he was able to draw pictures...for the neurologist he drew pictures of cats with various body parts and was able to write his name. But the problem was we just weren't seeing much progress. 4 year olds aren't expected to be able to do that much in terms of writing, but they should be able to hold a pencil (with it not being in their fist) and copy simple shapes. An OT can do a standardized eval and see where things stand. Many medical insurance policies cover OT and PT if the child tests low in one or more areas. They can also give parent assessments for the child's functioning in the home, for instance self-care skills--can the child wash their hands, put on clothes, zip their pants and button their shirt, walk up and down stairs with a reciprocal foot pattern, etc. They can also watch for sensory issues and give you an inventory to fill out. You don't even necessarily have to tell the school system if he is getting private therapies so having a "label" shouldn't be a big issue. OTs/PTs don't really give diagnoses anyway (at least not the ones we have seen), other than very generic ones for insurance purposes, like "muscle weakness". You might decide to take a "wait and see" approach, but I think evaluations in the areas where you have concern would be a good idea, esp. if your insurance covers it. You can also request an eval from the school system. I would take the referral from the pediatrician for an OT assessment (at least). If you have other concerns as well, then ask for a referral to a neurodevelopmental pediatrician or neurologist.
If you are also concerned about behavior, socialization, a motor disorder like dyspraxia, etc., most OTs will not diagnose anything. If there is any possibly he has aspergers or an autism spectrum disorder, you'll want an eval for that from someone who is qualified to diagnose. We started out with a neurodevelopmental pediatrician who then gave us referrals for a psych eval, OT/PT eval, etc. A few months later I took DS to a pediatric neurologist because of tremors in his hands and she's the one who first mentioned dyspraxia.
