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

  • 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
  • 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
  • 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
  • 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
  • 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
  • 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


  • 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

Please call AIM Therapy on 08 6150 8339 if you have any further questions.