OT Checklist

Occupational Therapy Checklist

If a child exhibits an absence or delay in any of these skills, an occupational therapy referral is indicated.

 Two - Three Months:

  • visually track objects side to side
  • grasp reflex
  • crawling reflex
  • ability to hold head up 45 degrees prone
  • maintain head in midline in prone position
  • sit unsupported

Four - Six Months:

  • turn head in all directions/no head lag
  • roll side to side / stomach to back
  • good unsupported sitting

Seven - Twelve Months:

  • balances head well
  • pushes up on hands/knees and rocks
  • back and forth
  • creeping with object in one hand
  • developing pincher grasp
  • holding / carrying cup or spoon to mouth
  • undresses self

Eighteen Months - Two Years:

  • good pincher grasp
  • places objects (cubes) into container
  • beginning to scribble
  • walking
  • stacking toys
  • tolerant of movement activities such as rocking / spinning (sit n' spin) / swinging
    or water play
  • don simple clothing

Three Years:

  • feeds self with utensils without difficulty
  • dresses self with assistance with fasteners in awkward places
  • lacing toys
  • building six block tower


Four Years:

  • tolerant of different textures: sand, shaving cream; gooey / etc.
  • jumps well
  • throws a ball overhead
  • cuts well with scissors

Five - Six Years:

  • color, cut, and glue independently
  • print capital letters with minimal reversals
  • complete simple mazes / dot to dot / hidden pictures
  • tripod pencil grip on pencil when writing
  • identify colors / coins independently
  • copies geometric designs
  • skips / jumps rope with good balance
  • maintains balance on one foot with eyes closed

Seven Years:

  • Left / Right discrimination
  • follows 3 step instructions
  • hopscotch

Nine Years:

  • has trouble holding head up while sitting
  • writes in cursive with correct formation,
  • sizing, spacing, and on-line placement
  • frequently clumsy / appears weak/falls
  • oversteps or under steps obstacles
  • does not enjoy playground equipment
  • accident prone

Symptoms regardless of age:

  • lines drawn too light/dark/wobbly
  • difficulty with bilateral hand coordination
  • difficulty crossing midline
  • difficulty with action sequences/timing
  • disorganized with classroom materials
  • poor body awareness
  • intolerant of prone position
  • dislikes having face/hair washed/cut
  • dislikes certain clothing: turtlenecks/tight/ loose/sleeves pulled up/shorts
  • dislikes being hugged/kissed unless self
  • initiated/often pulls away from contact
  • inappropriate social behaviors
  • fear of heights/jumping/stair steps/ playground equipment
  • intolerant of body position changes: upside down hanging
  • child is floppy, mouth always stays open; will not stay on all fours, squat, or kneel