When to refer to an OT for help:

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
  1.  Taste/Smell

  • Avoids certain tastes or food smells
  • Picky eater, especially regarding food textures
  • Strong reactions to certain smells: perfume, cleaners, etc
  1. Movement

  • Becomes distressed when feet leave the ground
  • Avoids gross motor activities
  • Dislikes when head is upside down (e.g.  somersaults)
  1.  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
  1.  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
  1. 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

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


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


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


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