Aims: The aims of this study were to assess how many patients received occupational therapy after diagnosis of developmental disorder (DD) in child psychiatrist practices in Germany and which factors influenced the prescription of occupational therapy. Methods: This study was a retrospective database analysis in Germany utilising the Disease Analyzer® Database (IMS Health, Germany). The study population included 11,112 children aged between 3 and 17 from 13 child psychiatrist practices. The observation period was five years in total. Results: 32% of study children were referred for occupational therapy within three years of first diagnosis of DD. Younger age, female gender, statutory health insurance, specific DD of motor function or reaction to severe stress and adjustment disorders positively influenced the referral rate and time of occupational therapy. Conclusions: One out of three children with DD receive the referral of occupational therapy within three years of first diagnosis of DD.