1. Pencil Skills

Hold their pencil awkwardly so that control is difficult?

Yes No

Find it difficult to perform drawing/colouring/writing for long periods (pain/tired)?

Yes No

Perform tasks slower than their peers or with less refined skill/neatness for their age?

Yes No

Fail to use space on the page appropriately (eg. starts at bottom and not top, or starts on the right and not left)?

Yes No

Have trouble working out HOW to draw (eg. asks adults to draw for them) or WHAT to write?

Yes No

2. Scissor Skills

Hold scissors and/or paper awkwardly when cutting?

Yes No

Find it difficult to cut through different cutting textures (eg. cardboard,paper)?

Yes No

Avoid cutting activities?

Yes No

Snip the paper rather than cut along the line?

Yes No

Struggle to stay on the line when cutting?

Yes No

3. Manipulation

Use their whole hand rather than fingertips to hold/use small objects (eg. Duplo)?

Yes No

Find it difficult to hold and control cutlery (when cutting play-doh or food)?

Yes No

Need prompting to look at the details when doing a puzzle, worksheet or copying a picture?

Yes No

Lack consistent use of one dominant hand for object manipulation or task performance?

Yes No

Find it difficult to open lunch boxes, bags, or pencil cases; do up buttons, zips or shoe laces?

Yes No

4. Balance and Coordination

Find it difficult to maintain static (still) positions for an extended period of time, so they frequently move (eg. rolling on the floor or changing sitting positions)?

Yes No

Seem careless, clumsy, rougher than intends in play, or slow to react (dodging moving swing)?

Yes No

Need to watch peers before attempting the task (to learn how to)?

Yes No

Have difficulty riding a bike/scooter, "walking the plank" or climbing an A-frame?

Yes No

Take longer than typical to master new skills (eg. swimming, riding)?

Yes No

5. Strength and Endurance

Tire quickly or have a slumped posture (at the table, on the matt, or inplay)?

Yes No

Look like they are putting in more effort than typical, to physical play or positions?

Yes No

Avoid physical play (eg. falling frequently, being silly or refusing when tasks are difficult )?

Yes No

Only participate in physical play for a short period of time?

Yes No

Look clumsy, overly cautious in play, lacking co-ordination or trip frequently?

Yes No

6. Skill Performance and Participation

Find it difficult to refine skill performance, even with practice (eg. throwing/kicking longer to reach target)?

Yes No

Avoid bat and/or ball skills, or look awkward and stiff in movements?

Yes No

Display limited tolerance/persistence for learning new skills?

Yes No

Require step by step instructions and explicit modelling of movements to succeed?

Yes No

Find it hard to combine 2 movements together (eg. step and throw)?

Yes No

7. Self Care and Behaviour

Require extensive help to fall asleep (eg. rocking/patting)?

Yes No

Take a long time to calm after becoming "wound up" or distressed?

Yes No

Display excessive dislike of food textures/temperature/teeth cleaning/hair brushing?

Yes No

Find it difficult to tolerate certain clothing articles/fabrics/tags/shoes?

Yes No

Have trouble tolerating changes in routine, or need advanced warning of change?

Yes No

8. Attention and Activity Levels

Seek out movement so much it interferes with tasks (eg. spins, fidgets, can't sit still)?

Yes No

Seem lazy/lethargic/day-dreamy/hard to motivate/unhappy?

Yes No

Require constant reminders to stay on task, because they appear too distracted or lazy?

Yes No

Avoid large groups of people (playground, classroom, parties) or prefer solitary play?

Yes No

Get wound up in busy (noisy) environments (eg. shopping centres, kids parties)?

Yes No

9. Learning

Have difficulty beginning a task and/or sustaining performance independently (so they rely on adult prompts)?

Yes No

Have difficulty problem solving independently when confronted by a challenge (may give up easily, get frustrated or refuse)?

Yes No

Require tasks to be broken down and demonstrated one step at a time?

Yes No

Have difficulty transferring a learnt skill from task to task (eg. puzzles, maths addition, project planning)?

Yes No

Find it difficult to retain learnt skills, if not continually practiced?

Yes No

10. Organisation at or For Pre/School

Have difficulty collecting materials for a task?

Yes No

Packing/unpacking their pre-school bag or knowing how to pack away a mess?

Yes No

Lose track of personal items (eg. sweater, snack box)?

Yes No

Fail to correctly generate and sequence the steps in a task?

Yes No

Have difficulty following day-to-day routines that are well known to them?

Yes No

11. Organisation at Home

Show poor task persistence (eg. gets very frustrated when can't complete a task)?

Yes No

Have difficulty initiating and sustaining independent play with a broad range of play activities?

Yes No

Locating familiar itemsin the environment (eg. shoes, pyjamas, favourite toys)?

Yes No

Have difficulty completing multiple verbal instructions independently?

Yes No

Remembering everyday requirements (eg. making bed or cleaning teeth before bed)?

Yes No

12. Daily Skills

Have difficulty correctly sequencing task performance (eg. dressing, underwear not shirt on first)?

Yes No

Need more help physically performing tasks than age appropriate (eg. dressing, toileting, cleaning teeth, brushing hair)?

Yes No

Have difficulty identifying/remembering the steps required in familiar tasks (eg. "get ready for kindy" means make bed, have breakfast, clean teeth)?

Yes No

Take an excessively long time to initiate or perform a task (eg. put shoes on, get dressed, eat meal)?

Yes No

Look like they just can't get it together (disorganised thinking)?

Yes No