How Do I Know If My Child Needs Occupational Therapy?
Assessing Children 0-3 Years Old
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Muscle tone seems poor/ flaccid
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When child is picked up they don't brace themselves, feels like dead weight
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Difficulty consoling self, unusually fussy
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Unable to bring hands together and bang toys
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Slow to roll over, creep, sit or stand
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Does not want to explore environment
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Difficulty babbling
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Cries or becomes tense when moved through space (like airplane)
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Frequent fisting of hands after 6 months of age
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Dislikes baths or waterplay
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Does not choose age appropriate toys
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Resists being held, is squirmy when cuddled too long, does not settle with touch
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Sucking difficulties
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Overly active, seeks excessive movement
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Unable to settle down, sleep difficulties
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Anxious or cries if child cannot see parent
*Adapted from OTA Watertown with permission (2005)
Assessing Children 0-3 Years Old
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Muscle tone seems poor/ flaccid
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When child is picked up they don't brace themselves, feels like dead weight
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Difficulty consoling self, unusually fussy
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Unable to bring hands together and bang toys
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Slow to roll over, creep, sit or stand
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Does not want to explore environment
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Difficulty babbling
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Cries or becomes tense when moved through space (like airplane)
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Frequent fisting of hands after 6 months of age
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Dislikes baths or waterplay
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Does not choose age appropriate toys
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Resists being held, is squirmy when cuddled too long, does not settle with touch
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Sucking difficulties
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Overly active, seeks excessive movement
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Unable to settle down, sleep difficulties
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Anxious or cries if child cannot see parent
Assessing Children 3-5 Years Old
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Clumsy, falls frequently, seems to trip over their own feet
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Muscle tone seems poor / flaccid
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When child is picked up they don't brace themselves, feels like dead weight
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Easily tantrums, does not recover within a few minutes
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Breaks crayons, pencil points, toys easily
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Frequently says “I can't do it” to age appropriate self-care & play tasks
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Overly active, unable to slow down, moves quickly from one toy to another
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Delayed language development
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Difficulty focusing attention, or over-focused and unable to shift attention to the next task
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Dislikes bathing, haircuts, nail trimming and cuddling
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Needs more practice than other children to learn new skills
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Avoids playground activities
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Unable to settle down, sleep difficulties
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Dislikes coloring in lines, doing puzzles or cutting with scissors
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Does not enjoy jumping, swings or having feet off the ground
Assessing Children 6-15 Years Old
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Clumsy, falls frequently, seem to trip over their own feet
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Breaks pencil tips frequently and/or writes with heavy pressure
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Dislikes handwriting, fatigues quickly with written class work
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Poor self-esteem and self-confidence
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Avoids gym class and sports activities
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Hard time paying attention and following directions
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Overly active, unable to slow down
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Frequent letter reversals such as b and d; poor letter/word spacing
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Difficulty focusing attention, or over-focused and unable to shift attention to the next task
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Dislikes swimming, bathing, haircuts, nail trimming, or hugs
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Needs more practice than other children to learn new skills
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Overreacts to touch, smell, taste and sounds
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Unable to settle down, sleep difficulties
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Finds it difficult to make friends with children of the same age, prefers to play with adults or younger children rather than peers
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Does not enjoy jumping, swings or having feet off the ground
Assessing Adults
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Quickly fatigues, especially posture, slumps at desk
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Clumsy with everyday activities and accident prone
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Balance difficulties, becomes disoriented and/or fearful on elevators or escalators
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Poor self-esteem and self-confidence
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Disorganized in home and work activities
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Hard time following several step instruction for motor task
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Overly active, unable to slow down
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Dislikes crowds or accidental jostling in public situations such as standing in line at the movie theater or shopping in store aisles
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Difficulty focusing attention, or over-focused and unable to shift attention to the next task
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Difficulty in maintaining intimate relationships, difficulty with physical closeness, hugs, or cuddling
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Needs more practice than other people to learn new skills