Sensory Assessments As Part of a Unified Early Learning Testing Protocol

School based screenings for young children are common, but what do they test, and are they enough?  They are usually generalized for fine and gross motor, basic perception and social/emotional development.

All of this information is important and very valuable, but for some children essential insights into the quality of a specific performance are not addressed in what “TOTEMS”* used to call “quick and dirty” overviews. (TOTEMS and AOTA program Training Occupational Therapists for Educational Management Systems).

Some children just seem to be missing the ability to “stay with the group”.  (That is what I hear a lot of when parents call about their young children.) Discovering “why” often falls to the OT doing a specialized assessment.

Many preschool and lower school directors respond to these children by suggesting facilitators who stay with the child during school.  While in many cases these individuals do an excellent job, they are also expensive and make the child “stand out” from their peers within the classroom.

Screening for developmental issues can help both the parent and the school administrator decide on the best placement for the child.  While the majority of early learners do very well in traditional typical programs, the ones that do not suffer in the same situation.  That is when seeking an alternative modified program may be advised.

Learning should never hurt, and early learning should be joyous. For the child with sensory developmental issues school can be a scary place.  Try to think about going to the same place everyday but not being able to recognize it as familiar.  Think about going to a familiar place but finding noise, smells or light noxious.  Put yourself in the “shoes” of a child with postural instability and asking them to sit a table for any length of time.

Knowing these things before the child enters the classroom can make the difference success or failure for these young learners.  It is also good information for both parents and teachers to have on all children.  Therefore a unified assessment process should include a parent checklist and an admissions or early in the school year assessment.

The parent checklist should include items that address self-care, family participation, self-calming and interests as well as the standard motor/task areas. A sample of such a checklist is offered below.

Children’s Special Services, LLC Parent In Take Checklist©

Dear Parent: Your child ________________________has been referred for an occupational therapy assessment/screening. As part of this process, you are being asked to please fill out this checklist and return it to the school prior to the screening. Thank you.

________________________________OTR/L._________________________date

SELF CARE

__Problems taking on/off coat

__Cannot tie shoes

__Cannot manipulate buttons, snaps, zippers

__Unkempt

__Rejects going to the bathroom

__Cannot use utensils easily

__Spills drink often

__Needs reminders to keep track of belongings

__Rejects certain fabrics

__Resists toilet training

__Messy eater

__Picky eater (explain)

__Always wears socks, long sleeves even in warm weather

__Habituates wearing 1-2 specific outfits

__Other__________________________

MOTOR SKILLS

__Poor motor learning (new skills)

__Mixed and/or no hand preference

__Does not attempt to initiate writing first name

__Does not like to (or never liked to) scribble

__Does not like to draw/write

__Frustrated with fine motor tasks

__Difficulty when trying to copy simple shapes

__Poor gross motor (Running, jumping, skipping)

__Looses place when looking at a book that is being read to him/her

__Walked early did not spend a lot of time crawling

__Poor grasp (awkward use of pencil/crayon)

__Poor writing pressure

__Motor performances seem unusually slow

__Cannot color inside the lines as needed

__Poor reproduction of shapes/forms/

designs

__Poor cutting skills

__Shows no preference for his/her right and left handedness

__Holds back with gross motor games

__Rejects tasks that have multiple parts (figure-ground perception)

__Other__________________________

TASK BEHAVIORS

__Difficulty staying focused

__Disorganized

__Over-organized

__Overly dependent on teacher/parent

__Does not seem to hear when instructions are given

__Poor (task) sequencing skills

__Sloppy work areas

__Easily distracted

__Difficulty initiating tasks

__Difficulty transitioning from one skill/task to another

__Needs instructions repeated

__Gets confused easily

__Cannot sit easily in “circle time”

__Restless when riding in a car

__Work pace is much slower than peers

__Difficulty with instructions that are more than 1-2 familiar steps

__Other__________________________

SOCIAL

__Not many or few friends

__Complains that “someone hit” them

__Difficulty with cooperative tasks

__Multiple somatic (physical) complaints

__Poor eye contact when speaking to peers, adults, new acquaintances (circle one)

__Seems fearful of new situations/places

__Argumentative

__Difficulty with self-calming when upset

__Hangs of people or things

__Cannot tolerate things out of “place”

__Difficulty demonstrating affection

__Wants to but is hesitant to interact with peers

__Prefers to play alone rather than with peers

__Difficulty discerning personal space

__Poor verbal expression of thought, ideas, and feelings

__Overly sensitive to corrective remarks (criticisms)

__Avoids talking out in class, and/or participating in discussions

__Easily frustrated in social situations

__Not understand jokes

__Difficulty reading body language or facial expressions

__Uses oral language that is less mature than peers

__Does not wait to ask for help if an adult is talking

__Other_________________________

©Children’s Special Services, LLC 2006 revised 2010 (May be used with copyright designation only)

The teacher would also be asked to fill out this checklist and the results compared.  It is important to (gently) explain to the parent that life on “Planet Home” is very different than life on “Planet School”*.  It is often hard for parent to get that they have been “trained” by their children to anticipate areas that may be stressful for them and thus circumventing challenging situations.  This is particularly difficult if the child in question is number one! (*From Learning Re-Enabled, Mosby/Elsevier Books)

Parents of young children are often focused on are they “having fun” and are they “happy”, while teachers are focused on the physical, intellectual, emotional and the neurological actions and reactions impacting learning.  Unfairly, teachers are often deemed “unfriendly” by parents or having a “personality conflict” when issues are revealed. 

The Occupational Therapist can play a pivotal role in the assessment and learning environment by explaining development to the parent and the teacher so that increased understanding can be attained.  The OT can also help explain the crucial importance of early intervention and discouraging the “wait and see” attitude many parents may choose if they do not fully understand the issues. 

And we all can be reminded of the famous quote by Mel Levine, MD author of One Mind at a Time, “children do not outgrow anything but their clothes.”

As Occupational Therapists one of our many roles with children is to make sure they grow with their clothes.