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Does My Child Need OT? A Checklist

If you are asking yourself this question, you may have witnessed some behaviors that have you wondering: ‘Is this typical?’ The best advice to give parents is to request an Occupational Therapy consultation. A consultation is a short meeting between the therapist, child and the caregivers. This meeting allows you as the caregiver to express your concerns with a trained and board certified therapist. The therapist can guide development in age appropriate motor skills, feeding skills, socialization, language, and many more behaviors and developmental milestones. At the consultation, you can decide together if a more in-depth observation is needed.

Below is a checklist of milestones from Birth – 5.5 Years of Age:

Newborn:
  closes fingers around object/ closes hand into tight fist
  alert and interested in sights and sounds
  turns head towards sounds
  lifts and turns head part way while laying on belly
  brings hands to mouth

3-5 Months:
  reaches for an object in view
  brings both feet to mouth
  can balance while in sitting
  begins to transfer items from hand to hand
  hands come together in play
  uses mouth to explore objects in environment
  strong gag response, rooting reflex
  visually tracks an object from side to side

6-8 Months:
  rolls from back to stomach
  looks for objects when they disappear from sight
  sits alone without support
  plays peek-a-boo
  picks up two small objects with one hand
  independently bottle feeds self without a mess
  drinks out of a cup with help
  feeds self cracker or cookie
  eye movements independent of head movements

9-11 Months:
  attends to a book or toy for 2 minutes
  raises to hands and knees
  “cruises” furniture and walls
  from stomach, raises to sitting position to reach for a toy
  pulls self to stand, and lowers back down
  imitates a scribble
  picks up a spoon by the handle
  removes socks and unties shoes
  imitates adults use of tools, such as combing hair
  attempts spoon-feeding
  picks up small objects using thumb and finger grasp

12-14 Months:
  builds a tower of 2 or more blocks
  marks with a pencil or crayon
  puts small objects in a cup or container
  plays with other children side by side
  climbs up on furniture or a chair
  walks without help
  insists on feeding self
  drinks from a cup without help
  creeps up two steps on hands and knees
  kneels/stands by self without help
  throws small ball
  opens book and turns a few pages at a time
  stirs spoon in a cup
  helps a little when being dressed
  points to objects, toys, or people
  waves to people

15-24 Months:
  walks backwards several steps
  stacks a tower of 4 or more blocks
  kicks a ball forward with good balance
  jumps forward 4 inches without falling
  stoops to pick up a toy without falling
  grasps marker with thumb and first finger, wraps remaining fingers around marker
  turns 3 pages in a book
  feeds self with a spoon and eats with a fork
  points to two of own body parts

2- 2 ½ Years:
  places 1 foot on each step, walks up 4 steps
  draws a vertical line
  runs; walks sideways and backwards
  initiates overhand throw and underhand throw
  removes screw on lid from a bottle
  stacks 8 -10 blocks
  strings 2- 4 beads on a shoelace
  identifies 2 body parts from a picture

2 ½ – 3 Years:
  washes and dries hands independently
  cuts with small scissors
  plays pretend games
  catches soft objects with both hands
  can jump down from one foot heights
  can string large beads on a shoelace or string

3- 3 ½ Years:
  hops forward on one foot, then the other foot
  runs with arms moving back and forth
  cuts paper into small pieces
  traces horizontal line
  unbuttons (only) large buttons
  undresses self with some help
  toilet trained
  rides tricycle using pedals
  draws or copies a complete circle

3 ½ – 4 Years:
  hops forward on one foot, then the other
  dresses and undresses with some help
  buttons and unbuttons large buttons
  carries out a series of 3 directions
  paints with a crayon/brush over the full page
  learning to take turns during a game
  plays make-believe games with other children
  cuts across and down paper with scissors

4 – 5 ½ Years:
  completes a forward roll accurately
  touches each finger to thumb
  draws a man with a head and legs
  compares different textures like soft or smooth
  names heavier of two objects in hands
  hops on one foot
  able to walk the full length of a balance beam
  participates and enjoys group interactions
  copies a (+) “plus sign” and a “V”
  dresses/undresses except for laces and back buttons, some zippers and snaps
  eats with a fork and spoon

5 ½ – 6 Years:
  with hands on hips, jumps back and forth across a line
  accurately imitates arm movements/ copies Simon Says postures
  draws a six part unmistakable man
  points front, back, near, up, down, with eyes closed
  aware of, but confuses left from right
  in pictures identifies objects that are beside, between, in middle, in front of
  bounces and catches small ball
  folds paper in half twice with edges parallel
  draws a triangle from a copy
  runs and skips

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