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Performance Questionnaire
Questions about whether or not your child might need physical, occupational, or speech therapy?
Take the performance survey below to know what to look for in your child. Click here for a printable version.


Gross Motor Skills:

  • Poor Jumping/Hopping Skills

  • Poor Balance

  • Difficulty Riding a Bike (pedaling and steering)

  • Uncoordinated Throwing/Catching a Ball

  • Unable to Pump a Swing

  • Gross Motor Incoordination


Social Interaction with Family and Peers:

  • Poor Communication

  • Isolated Play

  • Social Withdrawal

  • Difficulty Sharing and Taking Turns


Sensory Seeking Behaviors:

  • Hyperactivity

  • Increased Arousal Levels

  • Self-initiated Movement (spinning, rocking, crashing)


Avoidance Behaviors:

  • Texture Aversions (including food)

  • Avoidance of Movement Activities

  • Withdraw Behaviors

  • Avoidance of Noisy Crowded Places

School Related Skills:

  • Poor Handwriting

  • Short Attention Span

  • Poor Problem Solving Skills

  • Difficulty Following Directions

  • Learning Disabilities

  • Difficulties with Reading


Self Care Skills:

  • Avoidance of Grooming Activities

  • Poor Safety Awareness

  • Need Help with Dressing

  • Picky Eater

  • Difficulty with Feeding Utensils



  • Poor Upper Body Strength

  • Poor Lower Body Strength

  • Weak Postural Stability/Trunk Strength

  • Limited Hand Strength


Fine Motor Skills:

  • Poor Object Manipulation

  • Difficulty with Handwriting/Coloring

  • Unable to Complete Buttons/Zippers/Shoe Tie

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