This information is optional. It is not stored and used only for inclusion on the assessment result printout.
Child's First Name:
Does your child:
Hold their pencil awkwardly so that control is difficult or press too hard or lightly on the page?
Find it difficult to perform drawing/colouring/writing for long periods (pain/tired)?
Perform tasks slower than their peers or with less refined skill/neatness for their age?
Fail to use space on the page appropriately (e.g. start at right not left, and starts new lines inappropriately)?
Have trouble working out HOW to draw (e.g. asks adults to draw for them) or WHAT to write?
Hold scissors and/or paper awkwardly when cutting or avoid cutting activities?
Have difficulty turning the paper when cutting (so looks clumsy/awkward using 2 hands)?
Find it difficult to cut through different cutting textures (eg cardboard, paper)?
'Snip' the paper rather than 'cut' along the line or does the outcome look choppy?
Struggle to stay on the line when cutting, especially for curved or geometric shapes?
Use their whole hand rather than fingertips to hold/use small objects (eg Lego, blocks & puzzles)?
Find it difficult to hold and control cutlery (when cutting food)?
Need prompting to look at the details when completing a worksheet or copying a picture?
Lack consistent use of one dominant hand for object manipulation or task performance?
Find it difficult to open lunch boxes/bags/pencil cases or to do up buttons/zips/laces?
Find it difficult to maintain static (still) positions for an extended period of time, (so that they frequently move: e.g. rolling on the floor or changing sitting positions)?
Seem careless, clumsy or rougher than intended in play or appear slow to react (e.g. misses a ball thrown at them)?
Need to watch peers before attempting the task (to learn how to do it)?
Have difficulty riding a bike/scooter, walking a balance beam or climbing an A-Frame?
Take longer than typical to master new skill or forgets how if not practiced regularly?
Tire quickly or have a slumped posture (at the table, on the matt, or in play)?
Look like they are putting in more effort than typical to physical play or positions?
Avoid physical play (eg falling frequently, being silly or refusing when tasks are difficult)?
Only participate in physical play for a short period of time or only in short spurts?
Look clumsy, lack co-ordination, trips frequently or seem overly cautious on the playground?
Find it difficult to refine/modify skill performance (e.g. throwing/kicking longer to reach target)?
Avoid bat and/or ball skills (or look awkward and stiff in movements)?
Display limited tolerance/persistence for learning new skills?
Require step-by-step instructions and explicit modelling of movements to succeed?
Find it hard to combine 2 movements together with control and consistency (e.g. step and throw)?
Require extensive help to fall asleep (eg patting/adult lying with them)?
Take a long time to calm after becoming 'wound up' or distressed?
Display excessive dislike of food textures/temp./teeth cleaning/hair brushing?
Find it difficult to tolerate certain clothing articles/fabrics/tags/shoes?
Have trouble tolerating changes in routine, so that they seek routine and/or constant reassurance of routine (or need advanced warning of change)?
Seek out movement so much it interferes with tasks (eg spins, fidgets, can't sit still)?
Seem lazy/lethargic/day-dreamy/hard to motivate/in their own world or are constantly on-the-go, find it hard to wait/are physically active?
Require constant reminders to stay on task or flit between activities without completing them?
Avoid large groups of people (playground, classroom, parties) / prefer solitary play?
Get 'wound up' in busy (noisy) environments (eg shopping centres, kids parties)?
Have difficulty beginning a task and/or sustaining performance independently?
Have difficulty problem solving independently when confronted by a challenge (may give up easily, get frustrated or refuse)?
Require tasks to be broken down and demonstrated one step at a time?
Have difficulty transferring a learnt skill from task to task (eg different variations of addition)?
Find it difficult to retain learnt skills if not continually practiced?
Have difficulty determining and collecting materials for a task (eg calculator, eraser AND maths book for Maths lesson)?
Packing/unpacking their school bag or knowing how to pack away a mess?
Lose track of personal items (eg sweater, hat, lunch box)?
Fail to correctly generate and sequence the steps in a task (eg morning routine)?
Have difficulty following day-to-day routines that are well known to them (replace reader, hand up diary and then put bag away)?
Show poor task persistence (e.g. gets very frustrated when can't complete a task)?
Have difficulty starting and continuing independent play with a broad range of activities (constantly seeking adult guidance)?
Have difficulty locating familiar items in the environment (e.g. shoes, pyjamas, favourite toys)?
Have difficulty completing multiple verbal instructions independently?
Have difficulty remembering everyday requirements (e.g. making bed or cleaning teeth before bed)?
Have difficulty correctly sequencing task performance (e.g. underwear first when dressing)?
Need more help physically cleaning teeth/brushing hair than age appropriate?
Get easily distracted when performing routine activities so not completed?
Take a long time to initiate or perform a task?
Look like they 'just can't get it together' (disorganised thinking)?