Occupational Therapy Referral:
Physical Stability:
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Poor desk posture
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Trouble keeping head upright
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Lacks strength/endurance to keep up with peers
Sensory processing, Registration and
Organization:
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Poor attention to tasks
- Withdraws from touch
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Trouble keeping hands to himself
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Loses balance during activities
Organization of Behavior:
- Irrupted by touch
- overly fearful when climbing on playground equipment
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Unable to manage belongings or class materials
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Difficulty transitioning, changing routines, sequencing directions
Fine Motor and Visual Perception:
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Poor prewriting skills (difficult with tools handling, tracing, copying, cutting)
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Poor writing skills
Social Play:
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Easily frustrated
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Has difficulty interacting with peers
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Does not engage in activities or play during unstructured time
Self-Help:
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Needs assistance with self-help and daily school activities (eating, dressing, toileting)
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Physical Therapy Referral:
Motor Control and Coordination
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Loses balance and falls frequently in class or playground
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Walks on toes, flatfooted, toes in, toes out
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Moves impulsively in the classroom
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Moves sluggishly or awkwardly
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Has difficulty using stairs, curbs, or uneven surfaces
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Has difficulty running, hopping, jumping, skipping or galloping
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Tends to use only one side of his body
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Avoids playground activities and equipment
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Tires easily, unable to keep pace with throughout school day
Posture and Balance:
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Unable to maintain seated and standing positions when occupied with school activities
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Poor positioning to use adaptive equipment
Activities of Daily living Functional Mobility:
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Unable to manage personal needs in the classroom, campus or community
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Unable to successfully maneuver or change positions within school setting (on/off floor, in/out of chair, using assistive devices)
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No independent means of mobility
Environmental Adaptation and Assistive Devices:
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Uses adaptive equipment (computer, walker, wheelchair, splint, non-oral communication device
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