Thanks Dee Dee, I do agree that real life experiences are hugely important, and I do have some aversion to how much we medicalize kids in our society (probably because I'm in a medical field that deals with kids) , which is why we have held out on OT for so long.
Your great suggestions made me giggle a bit, however, because my DS has refused so many of the grow motor ones! We actually have horses, and he loves to help feed them, but no way no how is he getting on one, or even an elderly pony at a pony ride. We are currently paused on swim lessons because after a year and a half with various teachers he still won't put his face in the water and insists he is a "surface creature" and it's going to stay that way. One of the swim teachers suggested we sign him up for debate... He loves playground equipment (although he is a bit careful about very high ladders or steep slides), so for now I'm just holding onto the idea that playground climbing and running is pretty complex motor training.