The purpose of this paper is to present a preliminary, qualitative review of a therapeutic programme for preschool children and their parents in severely under-resourced contexts to aid the development of the underlying skills required to be ready for formal school. A team of two pairs, each comprising an occupational therapist and a community worker, responded to teachers' requests to assist struggling children in their classes. This led to the development of a programme focusing on Grade R classes, by firstly helping teachers to develop their capability and confidence in assessing and assisting children to develop the abilities underlying vital school-readiness skills during whole-class, therapeutic group sessions. Secondly, parent group sessions were added to empower parents to understand and support their children's development needs at home and so to complement the work done by teachers in the classroom. This second aspect, of working with the parents, developed owing to observations of the children's irregular school attendance, scant parent-school contact, and teachers' reports indicating that parents were not aware of, nor equipped to deal with, the challenges faced by their children. Implications for practice, for planning and for further research are discussed.