Occupational Therapy Pre-Primary Referral Guidelines
If a number of difficulties are exhibited in the following areas, and are interfering with the child’s ability to perform at an age appropriate level within the pre-primary environment, an Occupational Therapy referral is recommended.
RED text indicates a red flag for an OT referral
PENCIL SKILLS
- Does not use a tripod grasp for drawing or writing
- Unable to write name
- Drawing of a person does not include head, facial features, arms and legs
- Unable to copy ____ | O +
- Unable to copy \ / X
- Unable to copy square
- Drawing of a house is unrecognisable
- Hand tremor present when drawing
- Holds head close to paper when drawing
- Avoids drawing
- Unable to colour a simple picture staying within lines
- Wavy lines instead of straight when tracing around a template
CUTTING SKILLS
- Unable to correctly place fingers in scissor loops
- Unable to cut along a 10cm curved line
- Unable to cut out a circle or triangle
- Elbows winging or tucked in tightly against side of body
FINE MOTOR SKILLS
- Unable to close fist and wriggle thumb
- Difficulty with threading task
- Difficulty folding paper in half and in half again
- Unable to build a 6 cube steps in imitation
- Unable to complete wooden puzzle (9 pieces)
- Does not demonstrate hand preference
- Unable to pick up small items using thumb and index with other fingers curled out of the way
- Unable to touch each fingertip to thumb
- Difficulty pasting simple shapes on paper
- Difficulty with nuts and bolts
INDEPENDENT SKILLS
- Unable to play or ‘work’ without adult supervision for 10 minutes
- Unable to unwrap food wrap from lunch
- Unable to manage buttons on clothing
- Unable to use a knife to spread food items
- Unable to open zip lock bag
- Difficulty cutting soft food using knife and fork
GROSS MOTOR SKILLS
- Fatigues easily whilst sitting on mat – leans on furniture or others for support
- Unable to stand on one leg for 5 seconds
- Unable to maintain seated posture at table for activity’s duration
- Unable to hop on one foot for 8 hops
- Unable to jump 5x – feet together and on the spot
- Difficulty catching and throwing beanbags
- Difficulty walking on tip toes
SENSORY
- Avoids messy play (paints, play dough, sand)
- Covers ears frequently
- Needs assistance to eat lunch
- Twirls or spins self frequently during the day
- ‘On the go’ significantly more than peers
- Eats or licks non-food items
- Does not finish activity before starting another
- Enjoys looking at moving and spinning objects more than peers
- Difficulty copying body postures
SOCIAL SKILLS
- Limited imaginative play – for example: home corner; dressing up
- Unable to follow games with simple rules for example: hide and seek; duck duck goose
- Finds it difficult to take turns