Early Intervention

Child Developmental Checklist

(Source: http://www.sensory-processing-disorder.com)

The following lists are to give a generalized idea of different skill areas (gross motor, fine motor, cognition/problem solving, sensory, self-care, social/emotional/play skills) to look at, and when an early intervention referral and developmental therapy may be appropriate.

Gross Motor

If a child is:

• Not rolling by 7 months of age
• Not pushing up on straight arms, lifting his head and shoulders, by 8 months of age
• Not sitting independently by 10 months of age
• Not crawling ("commando" crawling , moving across the floor on his belly) by 10 months of age
• Not creeping (on all fours, what is typically called "crawling") by 12 months of age
• Not pulling to stand by 12 months of age
• Not standing alone by 14 months of age
• Not walking by 18 months of age
• Not jumping by 30 months of age
• Not independent on stairs (up and down) by 30 months of age

Red Flag:

• "walking" their hands up their bodies to achieve a standing position
• only walking on their toes, not the soles of their feet
• frequently falling/tripping, for no apparent reason
• still "toeing in" at two years of age
• unusual creeping patterns

Fine Motor

If a child is:

• Frequently in a fisted position with both hands after 6 months of age
• not bringing both hands to midline (center of body) by 10 months of age
• not banging objects together by 10 months of age
• not clapping their hands by 12 months of age
• not deliberately and immediately releasing objects by 12 months of age
• not able to tip and hold their bottle by themselves and keep it up, without lying down, by 12 months of age
• still using a fisted grasp to hold a crayon at 18 months of age
• not using a mature pincer grasp (tumb and index finger, pad to pad) by 18 months of age
• not imitating a drawing of a vertical line by 24 months of age
• not able to snip with scissors by 30 months

Red Flag:

• using only one hand to complete tasks
• not being able to move/open one hand/arm
• drooling during small tasks that require intense concentration
• displaying uncoordinated or jerky movements when doing activities
• crayon strokes are either too heavy or too light to see

Cognition/Problem Solving

If a child is:

• not imitating body action on a doll by 15 months of age (ie, kiss the baby, feed the baby)
• not able to match two sets of objects by item by 27 months of age ( ie, blocks in one container, and people in another)
• not able to imitate a model from memory by 27 months of age (ie, show me how you brush your teeth)
• not able to match two sets of objects by color by 31 months of age
• having difficulty problem solving during activities in comparison to his/her peers
• unaware of changes in his/her environment and routine

Sensory

If a child is:

• very busy, always on the go, and has a very short attention to task
• often lethargic or low arousal (appears to be tired/slow time respond, all the time, even after a nap)
• a picky eater
• not aware of when they get hurt (no crying, startle, or reaction to injury)
• afraid of swinging/movement activities; does not like to be picked up or be upside down
• showing difficulty learning new activities (motor planning)
• having a hard time calming themselves down appropriately
• appearing to be constantly moving around, even while sitting
• showing poor or no eye contact
• frequently jumping and/or purposely falling to the floor/crashing into things
• seeking opportunities to fall without regard to his/her safety or that of others
• constantly touching everything they see, including other children
• hypotonic (floppy body, like a wet noodle)
• having a difficult time with tansitions between activity or location
• overly upset with change in routine
• hates bath time or grooming activities such as; tooth brushing, hair brushing, hair cuts, having nails cut, etc.
• afraid of/aversive to/avoids being messy, or touching different textures such as grass, sand, carpet, paint, playdoh, etc.

Possible visual problems may exist if the child:

• does not make aye contact with others or holds objects closer than 3-4 inches from one or both eyes
• does not reach for an object close by

Possible hearing problems may exist if the child:

• does not respond to sounds or to voices of familiar people
• does not attend to bells or other sound-producing objects
• does not respond appropriately to different levels of sound
• does not babble

Self-Care

If a child is:

• having difficulty biting or chewing food during mealtime
• needing a prolonged period of time to chew and/or swallow
• coughing/choking during or after eating on a reguler basis
• demonstrating a change in vocal quality during/after eating (i.e. they sound gurgled or hoarse when speaking/making sounds)
• having significant difficulty transitioning between different food stages
• not feeding him/herself finger foods by 14 months of age
• not attempting to wash own hands or face by 19 months
• not assisting with dressing tasks (excluding clothes fasteners) by 22 months
• not able to deliberately undo large buttons, snaps and shoelaces by 34 months

Social/Emotional/Play Skills

If a child is:

• not smiling by 4 months
• not making eye contact during activities and interacting with peers and/or adults
• not performing for social attention by 12 months
• not imitating actions and movements by the age of 24 months
• not engaging in pretend play by the age of 24 months
• not demonstrating appropriate play with an objects (i.e. instead of trying to put objects into a container, the child leaves the objects in the container and keeps flicking them with his fingers)
• Fixating on objects that spin or turn (i.e. See n Say, toy cars, etc.); also children who are trying to spin things that are not normally spin
• having significant difficulty attending to tasks
• getting overly upset with change or transitions from activity to activity