School based screenings for young children are common, but what do they test, and are they enough? They are usually generalized for fine and gross motor, basic perception and social/emotional development.
All of this information is important and very valuable, but for some children essential insights into the quality of a specific performance are not addressed in what “TOTEMS”* used to call “quick and dirty” overviews. (TOTEMS and AOTA program Training Occupational Therapists for Educational Management Systems).
Some children just seem to be missing the ability to “stay with the group”. (That is what I hear a lot of when parents call about their young children.) Discovering “why” often falls to the OT doing a specialized assessment.
Many preschool and lower school directors respond to these children by suggesting facilitators who stay with the child during school. While in many cases these individuals do an excellent job, they are also expensive and make the child “stand out” from their peers within the classroom.
Screening for developmental issues can help both the parent and the school administrator decide on the best placement for the child. While the majority of early learners do very well in traditional typical programs, the ones that do not suffer in the same situation. That is when seeking an alternative modified program may be advised.
Learning should never hurt, and early learning should be joyous. For the child with sensory developmental issues school can be a scary place. Try to think about going to the same place everyday but not being able to recognize it as familiar. Think about going to a familiar place but finding noise, smells or light noxious. Put yourself in the “shoes” of a child with postural instability and asking them to sit a table for any length of time.
Knowing these things before the child enters the classroom can make the difference success or failure for these young learners. It is also good information for both parents and teachers to have on all children. Therefore a unified assessment process should include a parent checklist and an admissions or early in the school year assessment.
The parent checklist should include items that address self-care, family participation, self-calming and interests as well as the standard motor/task areas. A sample of such a checklist is offered below.
Children's Special Services, LLC Parent In Take Checklist©
Dear Parent: Your child ________________________has been referred for an occupational therapy assessment/screening. As part of this process, you are being asked to please fill out this checklist and return it to the school prior to the screening. Thank you.
________________________________OTR/L._________________________date
SELF CARE__Problems taking on/off coat __Cannot tie shoes __Cannot manipulate buttons, snaps, zippers __Unkempt __Rejects going to the bathroom __Cannot use utensils easily __Spills drink often | __Needs reminders to keep track of belongings __Rejects certain fabrics __Resists toilet training __Messy eater __Picky eater (explain) __Always wears socks, long sleeves even in warm weather __Habituates wearing 1-2 specific outfits __Other__________________________ |
MOTOR SKILLS__Poor motor learning (new skills) __Mixed and/or no hand preference __Does not attempt to initiate writing first name __Does not like to (or never liked to) scribble __Does not like to draw/write __Frustrated with fine motor tasks __Difficulty when trying to copy simple shapes __Poor gross motor (Running, jumping, skipping) __Looses place when looking at a book that is being read to him/her | __Walked early did not spend a lot of time crawling __Poor grasp (awkward use of pencil/crayon) __Poor writing pressure __Motor performances seem unusually slow __Cannot color inside the lines as needed __Poor reproduction of shapes/forms/ designs __Poor cutting skills __Shows no preference for his/her right and left handedness __Holds back with gross motor games __Rejects tasks that have multiple parts (figure-ground perception) __Other__________________________ |
TASK BEHAVIORS__Difficulty staying focused __Disorganized __Over-organized __Overly dependent on teacher/parent __Does not seem to hear when instructions are given __Poor (task) sequencing skills __Sloppy work areas __Easily distracted | __Difficulty initiating tasks __Difficulty transitioning from one skill/task to another __Needs instructions repeated __Gets confused easily __Cannot sit easily in “circle time” __Restless when riding in a car __Work pace is much slower than peers __Difficulty with instructions that are more than 1-2 familiar steps __Other__________________________ |
SOCIAL__Not many or few friends __Complains that “someone hit” them __Difficulty with cooperative tasks __Multiple somatic (physical) complaints __Poor eye contact when speaking to peers, adults, new acquaintances (circle one) __Seems fearful of new situations/places __Argumentative __Difficulty with self-calming when upset __Hangs of people or things __Cannot tolerate things out of “place” __Difficulty demonstrating affection | __Wants to but is hesitant to interact with peers __Prefers to play alone rather than with peers __Difficulty discerning personal space __Poor verbal expression of thought, ideas, and feelings __Overly sensitive to corrective remarks (criticisms) __Avoids talking out in class, and/or participating in discussions __Easily frustrated in social situations __Not understand jokes __Difficulty reading body language or facial expressions __Uses oral language that is less mature than peers __Does not wait to ask for help if an adult is talking __Other_________________________ |
©Children’s Special Services, LLC 2006 revised 2010 (May be used with copyright designation only)
The teacher would also be asked to fill out this checklist and the results compared. It is important to (gently) explain to the parent that life on “Planet Home” is very different than life on “Planet School”*. It is often hard for parent to get that they have been “trained” by their children to anticipate areas that may be stressful for them and thus circumventing challenging situations. This is particularly difficult if the child in question is number one! (*From Learning Re-Enabled, Mosby/Elsevier Books)
Parents of young children are often focused on are they “having fun” and are they “happy”, while teachers are focused on the physical, intellectual, emotional and the neurological actions and reactions impacting learning. Unfairly, teachers are often deemed “unfriendly” by parents or having a “personality conflict” when issues are revealed.
The Occupational Therapist can play a pivotal role in the assessment and learning environment by explaining development to the parent and the teacher so that increased understanding can be attained. The OT can also help explain the crucial importance of early intervention and discouraging the “wait and see” attitude many parents may choose if they do not fully understand the issues.
And we all can be reminded of the famous quote by Mel Levine, MD author of One Mind at a Time, “children do not outgrow anything but their clothes.”
As Occupational Therapists one of our many roles with children is to make sure they grow with their clothes.
