Recently, leaders in the occupational therapy profession have challenged us to affirm the value of occupational therapy, to substantiate what we do, to interrogate systems and to focus on what most matters to clients. To collectively reflect on the call to action raised by these scholars, I will share my research that involved listening to children and families as they spoke about their experiences with occupational therapy. I plan to raise questions for us to consider as we evaluate the current state of our practice and our efforts to address what genuinely matters to families. This lecture will draw on the conceptual foundations of theories about family-centered care and provide examples from research literature and practitioner and client narratives to imagine possibilities for attending to what matters to families.