When to Consider an Occupational Therapy Evaluation

Ask the Experts by Lauren Vanderlist

Q: When should I consider an occupational therapy evaluation for my child? Are there symptoms or red flags that I should be concerned about?

A: When your child has difficulty with activities of daily living (e.g. dressing, grooming, eating), play activities (e.g. toy play, coloring, building, playing games), or participation in learning environments (e.g. writing, staying attentive, following directions) an occupational therapy evaluation may be necessary. Your child’s strength and coordination, sensory processing, social-emotional development, fine and visual motor skills will be assessed to determine why they are having difficulty.

Below are examples of behaviors that may warrant an evaluation. Please reach out to a professional to discuss your concerns further.

Red Flags >> Sensory Processing

• Excessively upset with changes in routine, difficulty transitioning
• Busy, on the go, poor attention
• Poor safety awareness
• Frequently refusing new foods
• Mouths non-food objects after the age of 2 years
• Avoidant of different textures, dislikes getting messy
• Lethargic, easily fatigued, avoidant of movement

Red Flags >> Fine and Visual Motor Skills

• Uncoordinated, weak hand(s)
• Fisted hand(s), neglecting to use one hand, or failing to use hands together
• Difficulty releasing objects into a container
• Unusual grasp on writing utensil after 4 years
• Difficulty with puzzles
• Difficulty drawing shapes or writing letters

Red Flags >> Activities of Daily Living

• Not finger feeding by 12 months
• Not using spoon by 18 months (spillage is ok!)
• Difficulty drinking from open cup
• Unable to put on most clothing, with assistance, by 3 years
• Difficulty with buttons, zippers and/or tying shoes

Red Flags >> Social Emotional

• Limited eye contact, return of smiles or other positive advances
• Limited response to name or familiar voice
• Little imitation of movements and facial expressions
• Limited pointing, waving, or reaching by 12 months
• Unusual play with toys (e.g. lining up, spinning wheels)

Lauren Vanderlist is an occupational therapist with over nine years of experience working with children. She graduated from Washington University in St. Louis with a Master of Science in Occupational Therapy. Lauren has practiced in a variety of settings and worked with children of all ages and diagnoses. She is also a Certified PLAY Project Consultant, providing specialized services to young children with autism and their families. Lauren currently provides home-based occupational therapy and PLAY Project services. She can be reached at (248) 629-0193 or Lauren.V@BrightConnectionsOT.com. You can also visit www.BrightConnectionsOT.com for more information. Lauren is a member of The Family Center’s Association of Professionals.

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