Referral Guidelines


If a number of difficulties are exhibited in the following areas, and are interfering with the child’s ability to perform at an age appropriate level within the home, day care, kindergarten, pre-primary or school environment, an Occupational Therapy referral is recommended.

Fine Motor

Sensory Cognitive/Perceptual Behaviour
Difficulty controlling pencil to draw, write, colour and/or trace
Pencil pressure too heavy/light
Immature pencil grasp affecting pencil skills
Inconsistent hand preference
Holds head close to paper when writing
Does not use non-preferred hand to assist and stabilise
Difficulty cutting
Avoids fine motor activities
Slow to complete work
Hand tremor
Difficulty with buttons/zips
Difficulty with hand action songs
Difficulty copying name
Difficulty drawing a person
Excessive body movements whilst writing eg. movements of other hand/mouth
Repeatedly adjusts position of body and/or paper when performing pencil activities
Fearful when feet leave the ground
Dislikes moving play equipment
Dislikes being touched
Dislikes getting hands dirty, and/or playing with sand, play dough, paints etc. Excessive touching of objects and  people
Tends to use mouth instead of hands to learn about toys
Likes to take frequent movement breaks
Tires easily
Covers ears frequently
Distracted by noise
Very sensitive to noise

Slow to learn or master new skills
Difficulty copying shapes
Lacks body awareness - bumps into things
Seems to understand verbal instructions but cannot complete the task
Difficulty with ball skills
Difficulty with visual tracking, loses place when reading
Squints, rubs, watery eyes
Difficulty finding objects against a cluttered background
Difficulty putting puzzles together


Low self esteem
Inappropriate or immature behaviour
Has difficulty getting along with peers
Reluctant to new and/or challenging tasks