Background <p>Teaching and learning are core components of occupational therapy practice, with therapists commonly positioned as ‘educating’ the client. Despite its acknowledged importance, however, little attention has been given to developing discipline-specific learning theories that reflect current practice.</p> Aim <p>This research aimed to construct a theory explicating the process of learning that occurs between therapists and clients.</p> Methods <p>The study was conducted in the context of therapy provision to pre-school children requiring long-term intervention. Constructivist grounded theory methodology was used to analyse data generated through 23 interviews with 11 parents and eight occupational therapists who worked with them, five filmed routine therapy sessions, and nine photographs of instructional materials. A substantive theory of ‘Responsive learning: Learning from and with each other’ was constructed.</p> Findings <p>The learning process is complex, dynamic, and bidirectional, with participants learning from and with each other in response to changing needs, situations, and context. It is deeply relational, where ongoing connection and partnership are crucial for mutual learning, moving forward together, and integrating learning into everyday life.</p> Conclusion and significance <p>These findings reveal the importance of therapists establishing collaborative relationships, being cognizant co-learners with clients, and responding to learning in practice.</p>