When Should a Parent Refer a Child to Occupational Therapy?

Birth to 2 Months:
-doesn’t blink
-does not grasp objects placed near palm

3 Months
-does not follow an object with her eyes
-hands remain closed almost all of the time
-frequently resists being held
-becomes upset when moved, as when being picked up, laid down, or handed
from one familiar person to another

4 Months
-does not swipe at or reach for objects
-does not bring hands or objects to his mouth
-frequently irritable for no apparent reason
-does not place both hands on her bottle while fed

5 months
-does not hold his own bottle
-doesn’t smile at his image in a mirror

6 Months
-involuntarily drops objects after only a few moments
-does not actively grasp large finger foods such as teething cookies when they are
placed on the highchair tray
-is excessively and consistently upset by leaving the home

7 months
-does not transfer an object from one hand to the other

10 months
-not beginning to pick up small objects
-does not poke with index finger
-is not accepting a variety of food textures
-is excessively upset by being dressed, diapered, bathed, or having hair groomed

12 months
-isn’t able to pick up a cheerio or other small object with tip of the thumb and
the tip of the index finger
-is not sleeping through the night most of the time
-is not interested in exploring toys made for one year-olds
-is excessively upset by sound of siren, barking dog, vacuum cleaner, or other
familiar loud noise

15 months
-cannot put a one-inch object into a container with a slightly bigger opening
-cannot stack two cubes
-cannot put a round form into a round shape on a puzzle

18 months
-cannot point to a few of the following body parts: eyes, nose, mouth, hair,
tummy, legs, feet, and hands
-cannot turn pages of a cardboard book, or regular small book two or three pages
at a time.
-cannot stack four blocks
24 months
-play with toys only by tapping, shaking, or throwing
-cannot unscrew top of a one-inch or two-inch bottle
-cannot remove socks, untied shoes, or pull-on pants without help

30 months
-cannot imitate drawing a vertical line or a circular scribble on paper immediately
after seeing an adult draw these lines
-cannot stack eight to ten cubes
-cannot imitate drawing a horizontal line immediately after seeing an adult draw
a horizontal line

36 months
-cannot remove all pull-on clothing after fasteners have been undone
-does not imitate the actions of adults in the home
-does not pretend during play



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