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

 

Strength:

  • 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