Young kids

When to refer to an OT for help

Kids Handwriting

Handwriting Concerns

  • Writes with too much pencil pressure, too little pressure

  • Irregular sequencing of strokes when forming letters

  • Poor pencil grasp

  • Problems with spacing, alignment and sizing of letters/words

  • Slumped posture; holds head close to paper

  • Lack of established hand dominance

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Vision/Visual Perceptual Concerns

  • Difficulty copying from board

  • Reversal of letters or numbers after 7 years old

  • Unusual eye movements; difficulty with eye tracking

  • Difficulty discriminating, colors, shapes, doing puzzles

  • Difficulty writing on lines, poor alignment

  • Difficulty copying designs, numbers, letters

  • Difficulty with eye hand eye foot coordination

Kid drawing
Kid Eating Meal

Fine Motor/Self Care Concerns

  • Difficulty with zipping, tying shoes,

  • Difficulty managing utensils, food packages, feeding self

  • Messy eater, difficulty swallowing, drinking from a straw

  • Needs assistance with toileting

  • Difficulty using both hands together

  • Lack of well-established hand dominance 

  • Difficulty cutting with scissors

  • Difficulty coloring or drawing

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Gross Motor Concerns

  • Postural concerns

  • Complaints of pain during physical activities

  • Stiff and awkward movements

  • Lacks age-appropriate strength and endurance

  • Lacks age-appropriate coordination (hop, skip, jump, run, etc.)

  • Clumsy—bumps into things, falls, unsafe mobility on playground, PE

Kid Jumping Trampoline
Enjoying Clean Water

Sensory Processing Concerns

1. Touch

  • Reacts emotionally or aggressively to touch

  • Finds some clothing distressing to wear

  • Avoids messy activities: glue, clay, paint

  • Scratches or picks at skin

2. Taste/Smell

  • Avoids certain tastes or food smells

  • Picky eater, especially regarding food textures

  • Strong reactions to certain smells: perfume, cleaners, etc

3. Movement 

  • Becomes distressed when feet leave the ground

  • Avoids gross motor activities

  • Dislikes when head is upside down (e.g. somersaults)

4. Hearing

  • Difficulty functioning in noisy environment

  • Holds hands over ears or appears startled by everyday noises

  • Doesn’t respond when name is called, but hearing is OK

  • Tunes out during class discussions

5. Vision

  • Bothered by bright lights

  • Covers eyes to protect from light

  • Watches everyone as they move around the room

  • Has difficulty finding objects in desk or drawer

6. Sensation seeking

  • Enjoys making strange noises

  • Can’t sit still, fidgets, rocks in chair

  • Becomes overly excited during movement activity

  • Touches people or objects

  • Jumps from one activity to another

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