Common Referral Criteria for Occupational Therapy Includes:

Gross Motor: (Upper Body Strength, muscle tone, trunk stability)

 Slumps in chair
 Holds head up with hand
 Fidgety in chair
 Leans on things when standing
 Tires easily (fatigues before peers, difficulty finishing assignments)
 Muscles seem tight and rigid
 Muscles seem weak and floppy
 Low Endurance
 Tremors
 Difficulty with hopping, skipping, running, compared to same age peers
 Clumsy or seems to not know how to move body; bumps into things
 Tendency to confuse left and right body sides (after age 6)
 Falls frequently
 Reluctant to participate in sports or physical activity

Fine Motor: (grasp patterns, hand/wrist strength, in-hand manipulation)

 Awkward grasp on pencil/scissors
 Writing pressure too light/too heavy
 Drops things easily
 Flexes wrist when writing/cutting
 Experiences hand fatigue/pain
 Excessive hand perspiration
 Poor isolation on fingers on keyboard
 Writing not fluid
 Tries to avoid drawing, coloring, cutting, or writing
 Non-dominant hand fails to hold paper stable when writing/coloring
 Shows inconsistent hand dominance if older than age 6
 Difficulty manipulating fasteners
 Written assignments illegible (spacing, letter height)
 Immature/awkward scissors grasp
 Difficulty with keyboarding skills

Visual Perceptual/Motor/Handwriting/Oculomotor: (body perception, visual perception,
visual motor integration, eye-hand coordination, visual focus and tracking)

 Poor letter recognition
 Poor letter formation
 Poor letter/word spacing/alignment
 Inaccurate or slow copying/reading
 Difficulty completing reading/writing (loses place, omits words, add words)
 Poorly organized writing
 Cannot think of what to write about
 Poor drawing skills
 Unable to accurately draw a person
 Letter/word reversals (past 1st grade)
 Difficulty coloring within boundaries
 Difficulty staying on lines with cutting
 Confuses right/left (past kindergarten)
 Poor alignment of numbers in math
 Poor memory for written directions
 Poor spelling skills
 Moves head back and forth while reading
 Eye watering/rubbing/squinting
 Poor eye-hand coordination in gym
 Does not recognize or fix own errors well
 Difficulty with mazes and/or dot-to-dots
 Difficulty copying designs with manipulatives or on paper/graphs/dot maps
 Rubs eyes, squints, head close to paper
 Difficulty duplicating shapes, words, and numbers from the board, book, or model
 Looses place on page (reading or writing)

Sensory Processing: (touch, visual processing, auditory processing, movement, body
awareness)

 Avoids or has difficulty with eye contact
 Is easily distracted by visual stimulation
 Seems not to understand what was said
 Seems overly sensitive to sounds
 Appear reluctant to participate in sports
 Distracted by lots of noise and games
 Unable to follow 2-3 directions
 Prefers to touch rather than be touched
 Often seems overly active
 Avoids getting hands messy (art)
 Hits or pushes other children
 Seems more sensitive to pain than others
 Oblivious to bruises/heavy falls
 Complains that others hit/push him/her
 Mouths clothing/objects frequently
 Difficulty making friends
 Tends to prefer to play alone
 Has strong desire for routine/sameness
 Intense and easily frustrated
 Has strong outbursts of anger/frustration
 Lacks carefulness/Impulsive
 Bumps into things frequently
 Moves in/out of chair while working
 Falls out of chair
 Seems clumsy
 Seems to deliberately fall or tumble
 Distracted by background noises
 Fearful moving through space (swing)
 Avoids activities that challenge balance
 Avoids playing on playground equipment
 Extremely picky eater; often refuses foods kids typically eat at school/daycare