Post on 03-May-2018
Occupational Therapy School Skills Assessment
TherapyFunZone.com 2010 1
Name: Date:Date of Birth: Age: School: Therapist:
Right Left First Last
Notes: Notes:
Tripod Quadrupod Adapted tripod Gross PronatedDynamic
Static5 finger Thumb tuck Thumb wrap Tripod, closed
web spaceFinger wrap
Notes:
? — ? ? + X ? ?
Notes:
Straight line Curved line Circle Square Picture Hold paper
Move paperNotes:
Handed: Able to write name:
Pencil grasp:
Copy shapesFollow Maze
Scissor Skills
Occupational Therapy School Skills Assessment
TherapyFunZone.com 2010 2
(translation, shift, and rotation) Yes NoSquirrel 5 coins into palmMove coins from palm back to fingersMove two balls or marbles around in handMove pencil with one hand from writing to erasing positionCircle the type of grasps attained:Gross Palmar Scissors Radial Digital Neat PincerNotes:
Yes NoAble to follow an object with eyes? Left and Right
Up and DownAble to copy letters from the letter board to paper?When bringing an object towards eyes, do they converge naturally?Notes:
Total Number Number wrong Number right Percent correctNumber of Letters in sample
Letter formationLine placement
Number of Letter spaces in sampleNumber of Word spaces in sampleNumber of Sentence spaces in sample
In-Hand Manipulation Skills
Visual Tracking
Handwriting Sample
Occupational Therapy School Skills Assessment
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Copy Shapes
Occupational Therapy School Skills Assessment
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Cut on the lines
Occupational Therapy School Skills Assessment
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Occupational Therapy School Skills Assessment
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Occupational Therapy School Skills Assessment
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Follow the maze with your pencil. Stay inside the lines.
Start
Follow The Maze
Occupational Therapy School Skills Assessment
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Hold this paper up high in front of the student and have them copy each letter in order one at a time. This simulates copying work from the board.
A M
F L
T K
P D
R C
S O
H Z
Letter Board
Occupational Therapy School Skills Assessment
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Handwriting
Copy
Dictate
Student Name ___________________________Date_________
I like to pet a dog.
Occupational Therapy School Skills Assessment
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Handwriting
Self-generated SentencesWrite 1-3 sentences about the picture, or another subject.
Occupational Therapy School Skills Assessment
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Functional School Skills Assessment
Student: School: DOB:Therapist: Teacher: Date:
Assessment Scale: 1 = unable, 2 = poor, 3 = functional, 4 = age level or above
Put on/take off coatOpen and close zippersButtonSnapTie a bowPut on/take off boots, shoesOpen backpackHang jacket and backpack on hookGet books in and out of backpackManage lockerSafely and efficiently negotiates school settingNegotiates gym related/playground activitiesTurn, push, pull knobs to school doors
Negotiate obstacles in the lunch room (tables, cansSeat self at table safelyManage money at food lineCarry tray to table Open food packagesEat and drink without excessive messUse utensils for eatingPour liquidsUse a napkinClean up space after eatingOpen and close lunch box
SCHOOL RELATED SELF CARE SKILLS 1 2 3 4 COMMENTS
NEGOTIATE THE SCHOOL CAFETERIA 1 2 3 4 COMMENTS
Occupational Therapy School Skills Assessment
TherapyFunZone.com 2010 12
Manage door in and out of bathroomManage clothes fasteners for toiletingManage clothing (pants up down)Get on and off the toiletReach toilet paperWipe independentlyReach the sinkWash handsDry hands
Sit at desk in upright positionSit in chair without fallingMaintain balance while doing table top activitiesModulate activity levelRespond appropriately to unexpected or loud noiseRemain focused on tasks with distractionsTolerate textures of clothing or classroom materialTransition from one activity to anotherOrganize desk, notebook, folders, and backpackAble to use scissorsAble to use glueAble to use a rulerAble to use a staplerAble to use a computerGet books and papers in and out of deskWrite on white board
Uses a mature grasp pattern for writingWriting legibleCorrect letter formationSpaces letters and words properlyUses the right pressure on the pencilWrites within space availableColor with controlWrite with appropriate speedLeft/right progression when writing
UTILIZE THE BATHROOM 1 2 3 4 COMMENTS
CLASSROOM ACTIVITIES/MATERIALS 1 2 3 4 COMMENTS
HANDWRITING 1 2 3 4 COMMENTS
Occupational Therapy School Skills Assessment
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