Purpose: Tablet technologies are being used in pediatric occupational therapy (OT) despite a dearth of literature supporting their use. The purpose of this study was to investigate key strategies and decision-making considerations occupational therapists are using with tablet technologies to develop preliteracy skills with preschool aged children. Method: An ethnographic study of three pediatric occupational therapists (one school-based; one private clinic; and one school-based/private clinic) was conducted through semi-structured interviews and observations of the participants using the tablet. Results: One central theme, that tablets are “just a tool,” and three subthemes, that tablets are versatile, motivating, and fun, were identified. Results indicated that participants in this study are using tablets purposefully as a tool and as an alternative to traditional preliteracy activities. Conclusion: It is becoming more important for therapists to integrate the tablet and other mainstream technology into their practice in order to assist children in learning how to navigate an increasingly digital world. Further research regarding the efficacy of using tablet technology in pediatric occupational therapy is recommended
