Objective: We assessed the effectiveness of an occupational therapy reading program that targeted foundational reading skills and reading participation for first and second graders in an underserved urban elementary school. Method: Eleven intervention group participants received the 10-week reading program based on the incorporation of self-generated learning strategies and sensorimotor experiences. Both intervention group and 10 control group participants received traditional classroom reading instruction based on pencil and paper exercises. Results: Statistically significant differences with large effect sizes were found between intervention and control group post-intervention scores on the Dynamic Indicators of Basic Early Literacy Skills (Z = -3.553, p < 0.000, d = 1.826) and Dolch Sight Word List scales (Z = -3.052, p < 0.002, d = 1.256). No statistically significant differences were found at posttest between intervention and control group scores on the Benchmark Assessment System and Test of Word Reading Efficiency. Questionnaire data demonstrated that intervention group participants displayed greater reading enjoyment, increased home reading participation, improved home literacy routines, and greater agency as readers, compared to the control group. Conclusion: Preliminary evidence was demonstrated for the effectiveness of the reading program in the study sample with regard to foundational reading skills and participation.