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Referral Indicators

Occupational therapy focuses on the following areas of development. If you notice any differences in the following skills where function is affected, a referral to occupational therapy may be appropriate.



Gross Motor (physical skills like running, jumping and co-ordination) 


• Clumsy – often trips over, bumps into things, awkward movements 

• Poor balance 

• Weaker than other children his/her age (floppy/lethargic) 

• Difficulty with hopping, jumping, skipping, running, throwing/catching a ball compared with other children his/her age 

• Avoids or shies away from playgroup equipment 

• Poor posture 

• Difficulty copying body position or performing new motor sequences 

• Restless – likes to move around or fidget when sitting in a chair or on the floor 


Fine motor (table top skills, eg using pencils and scissors) 


• Hasn’t developed a dominant hand 

• Difficulty holding pencil, immature grasp 

• Difficulty using scissors 

• Alternates hands when crossing the midline 

• Draws on one half of the paper only 

• Difficulty with drawing, copying shapes or colouring-in 

• Difficulty with manipulating small objects/fine dexterity tasks 

• Can’t use both hands together with ease (bilateral movement) 


Sensory processing 


• Sensitive to noise 

• Avoids water/sand/messy play 

• Has a big reaction to touch, has trouble waiting in a line 

• Constantly touching or mouthing non-food objects

• Under-responsive to the environment; does not seem to notice being touched, having food on their face etc 

• Seems unaware of own body or body position in space 


Visual perception 


• Has trouble completing puzzles/block designs appropriate to child’s age 

• Difficulty copying shapes, numbers, letter formations 

• Difficulty sorting objects according to shape, size and colour 

• Has a hard time finding things eg. objects in locker or desk 

• Letter/number reversals 

• Difficulty discriminating similarities and differences 

• Difficulty copying from the blackboard 

• Difficulty with position concepts (in front of, behind, under...) 


Self-help skills (such as dressing, using cutlery) 


• Difficulty with dressing – sorting back from front, doing up fastenings 

• Difficulty with eating – picky eater, messy eater, spills often, difficulty managing cutlery 

• Toileting – difficulty managing clothes, wiping self, opening/closing taps to wash hands 




• Gets easily distracted, finds it hard to concentrate 

• Doesn’t shift attention easily from one thing to another

• Has trouble paying attention to complete a task 

• Difficulty settling or separating, often restless

• Has a hard time making friends




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