Screening Tool - Center for Pediatric Therapy

Screening Tool

Check my child's development

Gross Motor Development

Walks along furniture

Stands all by themselves, without holding onto anything

Can move from sitting on the floor to standing and standing to the floor without falling

Crawls on hands and knees

Gets into and out of sitting while playing on the floor

Fine Motor Development

Grasps a thick crayon or pencil

Turns a page in a cardbook book

Pulls off shoes

Feeds self finger foods (such as puffs)

Cooperates with dressing and undressing by straightening arm to put it into a sleeve and bending their arm to take it out of the sleeve.

Puts objects into others, such as will drop blocks into a bowl or bucket

Speech Development

Waves bye bye

Babbles using different sounds

Eats coursely chopped food

Takes turns vocalizing

Points or gestures (for example, will raise their arms if they want to be held)

Sensory Development

Cries during bath time or refuses to take a bath

Avoids messy play

Cries or fights when you try to brush their hair or teeth

Avoids being held and snuggled

Becomes easily upset, compared to other children their same age

Is frightened by typical sounds such as the vacuum or a toilet flushing

Is not able to calm down easily after being upset

Is unable to sit down to perform an activity, look at a book, or play a game

Avoids climbing and exploring at the playground

Avoids looking at you or others in the eye when being spoken to

Grinds their teeth

Refuses to try new foods

Is not cooperative for their age

Has difficulty with changes in routine, such as Dad is picking them up from school today instead of mom

Avoids wearing different types of clothing textures, or is very particular about the feel of the clothes they wear

Is particular about what socks they wear, or insists to wear them inside out

Gets dizzy or car sick easily

Appears to be anxious

If 2 years old and older - refuses to eat what is served at dinner making it a stressful time for the family.

Seems to be in constant motion, cannot sit still, unless playing on an electronic device

Has a limited diet - does not eat a wide varietv of foods for their age

Gross Motor Development

Walks along furniture

Stands all by themselves, without holding onto anything

Can move from sitting on the floor to standing and standing to the floor without falling

Crawls on hands and knees

Gets into and out of sitting while playing on the floor

Fine Motor Development

Grasps a thick crayon or pencil

Turns a page in a cardbook book

Pulls off shoes

Feeds self finger foods (such as puffs)

Cooperates with dressing and undressing by straightening arm to put it into a sleeve and bending their arm to take it out of the sleeve.

Puts objects into others, such as will drop blocks into a bowl or bucket

Speech Development

Waves bye bye

Babbles using different sounds

Eats coursely chopped food

Takes turns vocalizing

Points or gestures (for example, will raise their arms if they want to be held)

Sensory Development

Cries during bath time or refuses to take a bath

Avoids messy play

Cries or fights when you try to brush their hair or teeth

Avoids being held and snuggled

Becomes easily upset, compared to other children their same age

Is frightened by typical sounds such as the vacuum or a toilet flushing

Is not able to calm down easily after being upset

Is unable to sit down to perform an activity, look at a book, or play a game

Avoids climbing and exploring at the playground

Avoids looking at you or others in the eye when being spoken to

Grinds their teeth

Refuses to try new foods

Is not cooperative for their age

Has difficulty with changes in routine, such as Dad is picking them up from school today instead of mom

Avoids wearing different types of clothing textures, or is very particular about the feel of the clothes they wear

Is particular about what socks they wear, or insists to wear them inside out

Gets dizzy or car sick easily

Appears to be anxious

If 2 years old and older - refuses to eat what is served at dinner making it a stressful time for the family.

Seems to be in constant motion, cannot sit still, unless playing on an electronic device

Has a limited diet - does not eat a wide varietv of foods for their age

Gross Motor Development

Walks up and down 3-4 steps with hand on railing

Walks backwards 5 steps

Throws a ball while keeping standing balance

Rides a push bike (bike without pedals)

Walks all by themselves with arms at side

Fine Motor Development

Turns over a box of toys to dump them onto the floor

Turns a small knob or dial on a toy, such as a pop up toy

Gets a spoon into mouth right side up

Helps to dress and undress self by moving their arms and legs to help get them into sleeves and pants

Picks up a crayon and will mark on paper without staying on the paper

Feeds self food with their fingers

Speech Development

Says 2 words together that are typically said together, such as "all done"

Names at least 5 items

Responds to yes/no

Retrieves objects from another room when asked

Identifies body parts

Uses 10-20 words

Sensory Development

Cries during bath time or refuses to take a bath

Avoids messy play

Cries or fights when you try to brush their hair or teeth

Avoids being held and snuggled

Becomes easily upset, compared to other children their same age

Is frightened by typical sounds such as the vacuum or a toilet flushing

Is not able to calm down easily after being upset

Is unable to sit down to perform an activity, look at a book, or play a game

Avoids climbing and exploring at the playground

Avoids looking at you or others in the eye when being spoken to

Grinds their teeth

Refuses to try new foods

Is not cooperative for their age

Has difficulty with changes in routine, such as Dad is picking them up from school today instead of mom

Avoids wearing different types of clothing textures, or is very particular about the feel of the clothes they wear

Is particular about what socks they wear, or insists to wear them inside out

Gets dizzy or car sick easily

Appears to be anxious

If 2 years old and older - refuses to eat what is served at dinner making it a stressful time for the family.

Seems to be in constant motion, cannot sit still, unless playing on an electronic device

Has a limited diet - does not eat a wide variety of foods for their age

Gross Motor Development

Stoops down to pick up a toy and returns to standing

Jumps down off low surface, such as curb at the park

Jumps forward about 4 inches

Goes up stairs without using a rail, placing both feet on each step

Throws a ball 3 feet in air

Kicks a ball 3 feet forward without direction

Rides a push bike (bike without pedals)

Fine Motor Development

Stoops down to pick up a toy and returns to standing

Jumps down off low surface, such as curb at the park

Jumps forward about 4 inches

Goes up stairs without using a rail, placing both feet on each step

Throws a ball 3 feet in air

Kicks a ball 3 feet forward without direction

Rides a push bike (bike without pedals)

Speech Development

Uses 2 word phrases regularly, such as "car go", "more milk"

Demonstrates verbal turn taking

Has at least 100 words

Understood by listeners 25-50% of the time

Follows simple 2 step commands, such as "pick up your ball and put it in the toybox"

Eats table foods with different textures such as, cut up green beans, small pieces of chicken, and pasta

Sensory Development

Cries during bath time or refuses to take a bath

Avoids messy play

Cries or fights when you try to brush their hair or teeth

Avoids being held and snuggled

Becomes easily upset, compared to other children their same age

Is frightened by typical sounds such as the vacuum or a toilet flushing

Is not able to calm down easily after being upset

Is unable to sit down to perform an activity, look at a book, or play a game

Avoids climbing and exploring at the playground

Avoids looking at vou or others in the eve when being spoken to

Grinds their teeth

Refuses to try new foods

Is not cooperative for their age

Has difficulty with changes in routine, such as Dad is picking them up from school today instead of mom

Avoids wearing different types of clothing textures, or is very particular about the feel of the clothes they wear

Is particular about what socks they wear, or insists to wear them inside out

Gets dizzy or car sick easilv

Appears to be anxious

If 2 years old and older - refuses to eat what is served at dinner making it a stressful time for the family.

Seems to be in constant motion, cannot sit still, unless plaving on an electronic device

Has a limited diet - does not eat a wide varietv of foods for their age

Gross Motor Development

Walks up stairs without using a rail, placing one foot on each step

Rides a tricycle

Hops 3 times on each foot

Kicks a large ball towards a target

Jumps down about 24 inches

Slides down a slide at the playground

Climbs well on a jungle gym

Fine Motor Development

Grasps a pencil with thumb and fingers instead of fist

Screws and unscrews lar lids

Eats with a fork (with spillage)

Pours accurately from one container to another, such as pouring a cup of water into a bucket during water play

Completes a simple 3 piece puzzle

Can dress and undress with loose clothing and with help to get the clothing facing the correct way

Snips (makes small cuts) with scissors

Speech Development

Has about 1000 words

Converses in sentences

Asks questions, such as "What is that? Where did mommy go?"

Responds to "what" and "where" questions

Understood by listeners 75% of the time

Can follow 3 step verbal commands, such as "pick up your blanket, take it upstairs and put it on vour bed"

Chews and swallows most adult foods including steak and raw veggies

Sensory Development

Cries during bath time or refuses to take a bath

Avoids messy play

Cries or fights when you try to brush their hair or teeth

Avoids being held and snuggled

Becomes easily upset, compared to other children their same age

Is frightened by typical sounds such as the vacuum or a toilet flushing

Is not able to calm down easily after being upset

Is unable to sit down to perform an activity, look at a book, or play a game

Avoids climbing and exploring at the playground

Avoids looking at you or others in the eye when being spoken to

Grinds their teeth

Refuses to try new foods

Is not cooperative for their age

Has difficulty with changes in routine, such as Dad is picking them up from school today instead of mom

Avoids wearing different types of clothing textures, or is very particular about the feel of the clothes they wear

Is particular about what socks they wear, or insists to wear them inside out

Gets dizzy or car sick easily

Appears to be anxious

If 2 years old and older - refuses to eat what is served at dinner making it a stressful time for the family.

Seems to be in constant motion, cannot sit still, unless playing on an electronic device

Has a limited diet - does not eat a wide variety of foods for their age

Gross Motor Development

Walks downstairs without using a rail, placing one foot on each step

Stands on each foot for 5 seconds with their hands on their hips

Hops 5 times on each foot

Rides a 2-wheeled bike with training wheels

Walks backwards on a line for over 4 feet

Jumps forward 30 inches

Climbs well on a jungle gym

Fine Motor Development

Puts shoes (does not yet tie) on correctly

Colors almost entirely within lines of circle

Draws a person with 3 different body parts

Dresses and undresses without much help

Copies a cross

Completes an easy puzzle

Cuts paper in half with scissors on a mostly straight line

Buttons and unbuttons quarter inch buttons, such those on a button down shirt

Speech Development

Uses 4-5 word sentences

Understood by listeners 80% of the time

Understands time concepts of now/later, before/after, first/then

Uses contractions, such as "don't"

Follows multi-step directions, such as "get dressed, go downstairs, eat your breakfast and then brush your teeth"

Asks many questions including “who” and “why”

Sensory Development

Cries during bath time or refuses to take a bath

Avoids messy play

Cries or fights when you try to brush their hair or teeth

Avoids being held and snuggled

Becomes easily upset, compared to other children their same age

Is frightened by typical sounds such as the vacuum or a toilet flushing

Is not able to calm down easily after being upset

Is unable to sit down to perform an activity, look at a book, or play a game

Avoids climbing and exploring at the playground

Avoids looking at you or others in the eye when being spoken to

Grinds their teeth

Refuses to try new foods

Is not cooperative for their age

Has difficulty with changes in routine, such as Dad is picking them up from school today instead of mom

Avoids wearing different types of clothing textures, or is very particular about the feel of the clothes they wear

Is particular about what socks they wear, or insists to wear them inside out

Gets dizzy or car sick easily

Appears to be anxious

If 2 years old and older - refuses to eat what is served at dinner making it a stressful time for the family.

Seems to be in constant motion, cannot sit still, unless playing on an electronic device

Has a limited diet - does not eat a wide variety of foods for their age

Gross Motor Development

Completes sit ups

Able to skip, alternating feet

Completes jumping jacks

Completes push-ups

Begins to jump rope

Throws a ball to hit a target

Can swing without being pushed, can pump legs to keep it going

Climbs well on a jungle gym

Performs somersaults

Fine Motor Development

Copies and cuts a square

Copies color/shape sequence

Latches and zips the zipper on their coat

Traces around own hand with crayon

Completes simple dot to dot pictures

Able to copy a couple letters

Puts socks on correctly

Speech Development

Uses a variety of sentences

Vocabulary of 2000 words

Can tell a story with plot

Understood by listeners 90-100% of the time

Ask questions to get more information

Uses most speech sounds correctly, except the "th" and "r" sounds

Understands time concepts (today tomorrow, yesterday)

Uses contractions, such as don't and can't

Follows multi-step directions, such as "go upstairs, brush your teeth, put on your jammies and pick out a book"

Chews and swallows adult foods

Sensory Development

Cries during bath time or refuses to take a bath

Avoids messy play

Cries or fights when you try to brush their hair or teeth

Avoids being held and snuggled

Becomes easily upset, compared to other children their same age

Is frightened by typical sounds such as the vacuum or a toilet flushing

Is not able to calm down easily after being upset

Is unable to sit down to perform an activity, look at a book, or play a game

Avoids climbing and exploring at the playground

Avoids looking at you or others in the eye when being spoken to

Grinds their teeth

Refuses to try new foods

Is not cooperative for their age

Has difficulty with changes in routine, such as Dad is picking them up from school today instead of

mom

Avoids wearing different types of clothing textures, or is very particular about the feel of the clothes they wear

Is particular about what socks they wear, or insists to wear them inside out

Gets dizzy or car sick easily

Appears to be anxious

If 2 years old and older - refuses to eat what is served at dinner making it a stressful time for the family.

Seems to be in constant motion, cannot sit still, unless playing on an electronic device

Has a limited diet - does not eat a wide variety of foods for their age

Gross Motor Development

Runs with coordination

Completes sit ups

Able to skip

Completes jumping jacks

Completes push-ups

Able to jump rope

Throws a ball to hit a target

Can swing without being pushed, can pump legs to keep it going

Climbs well on a jungle gym

Performs somersaults

Rides a 2-wheeler without training wheels

Fine Motor Development

Dresses and undresses self

Reads and writes numbers 1-10

Writes first and last name

Ties shoes

Draws a person with 6 different body parts

Colors within the lines

Opens zip lock bags and food wrappers

Cuts out simple shapes with scissors

Speech Development

Uses a variety of sentences

Vocabulary of 2600-7000 words

Can tell a story with plot

Understood by listeners 90-100% of the time

Ask questions to get more information

Uses most speech sounds correctly

Engages in play with others

Uses pronouns correctly (I, me, you, he, she, they)

Understands time concepts today tomorrow, yesterday)

Uses contractions, such as don't, wouldn't and can't

Follows multi-step directions, such as "take off your shoes, hang up your coat, take vour folder out of your backpack and put your lunch box on the counter"

Chews and swallows adult foods

Sensory Development

Cries during bath time or refuses to take a bath

Avoids messy play

Cries or fights when you try to brush their hair or teeth

Avoids being held and snuggled

Becomes easily upset, compared to other children their same age

Is frightened by typical sounds such as the vacuum or a toilet flushing

Is not able to calm down easily after being upset

Is unable to sit down to perform an activity, look at a book, or play a game

Avoids climbing and exploring at the playground

Avoids looking at you or others in the eye when being spoken to

Grinds their teeth

Refuses to try new foods

Is not cooperative for their age

Has difficulty with changes in routine, such as Dad is picking them up from school today instead of

mom

Avoids wearing different types of clothing textures, or is very particular about the feel of the clothes they wear

Is particular about what socks they wear, or insists to wear them inside out

Gets dizzy or car sick easily

Appears to be anxious

If 2 years old and older - refuses to eat what is served at dinner making it a stressful time for the family.

Seems to be in constant motion, cannot sit still, unless playing on an electronic device

Has a limited diet - does not eat a wide variety of foods for their age

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