Occupational Therapy Assessment Report: Nick's Development

This occupational therapy assessment report focuses on Nick, a three-year-old child referred for evaluation due to concerns about his motor, cognitive, and sensory development. The assessment, based on observations from video recordings of Nick in a preschool setting, examines his motor performance, including gross and fine motor skills, and sensory processing abilities. The report also assesses Nick's cognitive skills, social and behavioral development. Key observations highlight challenges in motor coordination, grasping, and sensory perception, alongside his social engagement and willingness to learn. Additional sources of information, including standardized testing and interviews, are recommended to provide a comprehensive understanding of Nick's developmental profile. The interpretation of results suggests potential neurological considerations and the need for targeted occupational therapy interventions to support his development. The report concludes with a summary of the findings and recommendations for further action, including potential standardized tests like the Bayley Scale of Infant Development (BSID) and Movement ABC-2 Teacher Checklist.

Running head:OCCUPATIONAL THERAPY ASSESSMENT
Occupational Therapy Assessment
Name of the Student
Name of the University
Author Note

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EXECUTIVE SUMMARY
Nick is a three-year-old child whose preschool teacher informed his mother of some
concerned about his gross motor, fine motor and cognitive skills. His mother asked for a full
occupational therapy assessment. This report is focused on the observation done on Nick
during his playing sessions. Here, it was observed that he had some issues with his motor
skills and sensory perception as well as cognitive skills. Some of the observations may point
towards a neurological abnormality. However, he is very socially active and friendly. Finally
it can be concluded that his issues can be easily helped with a little bit patience and
encouragement.

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Table of Contents
Introduction................................................................................................................................3
Client identification................................................................................................................3
Purpose of assessment............................................................................................................3
Assessment context................................................................................................................3
Observations...............................................................................................................................4
Motor performance.................................................................................................................4
Sensory processing.................................................................................................................5
Cognitive skills.......................................................................................................................5
Social/Behavioural development...........................................................................................6
Additional sources of information.............................................................................................6
Appropriate standardized testing................................................................................................7
Interpretation of results..............................................................................................................8
Conclusion..................................................................................................................................9
Reference..................................................................................................................................10

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Introduction
Client identification
This report focuses on a three-year-old toddler named Nick (the child wearing blue t-
shirt in the videos) who was born on 10th March, 2017.
Purpose of assessment
Nick has been enrolled in occupational therapy due to his mother’s concerns. The
purpose of this assessment is to observe his activities and performance to make a judgement
and pinpoint his developmental issues.
Assessment context
Nick’s mother was contacted by his pre-school teacher who expressed her concerns
about Nick’s gross motor and fine motor skills, and his cognitive development. Hence, Nick’s
mother requested an occupational therapy assessment. This will be done based on the
following videos.
Video 1: Toddler Observation video pictures 002.avi. (2020)
Video 2: Toddler Observation Video 3. (2020)
Video 3: Toddler Video Outdoor. (2020)
Here, the judgement will be based on a set of indoor activities (for example, playing
with the toys, grabbing different toys and looking for them, climbing the stairs) as well as
outdoor activities (running, looking for others, playing with other children). It is important to
look at different set of activities in order to do proper assessment.
Nick is currently in preschool level. His country and education system is unknown.
No information on his family or family financial situation has been given.

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Observations
Motor performance
Right of the bat, it was seen that Nick was slower in comparison to the kids similar in
age. His posture was awkward and slow requires a lot of effort moving. In Video 1 where the
toddlers were trying to move up the stairs, Nick took almost twice the amount of time. His
moves seemed to be unstable as he was falling down more often than the other kids. He was
not able to stay upright as long as others. He did have a good range of motion and kept trying
till he got up the stairs. He took a long time to climb up the stairs and was sitting down in
every step. In Video 2, he ran with a rather stiff set of motions. His hands were stiff at his
side and he seemed to be having a bit trouble with walking/running straight. In video 3, he
was running with similar posture which seemed better outdoors due to more space. He
seemed to be running with a sort of hopping motion and sometimes fell down, but he
promptly got up.
In case fine motor skills, Nick seemed to be having problems with grasping the toys in
Video 2. This grasps were awkward and he placed the toys at the wrong part of the ladder
multiple times. In the video 3, he grabbed the spoons and jars for pouring the water
awkwardly and proceeded to hold them the wrong way. In Video 3, he tried to grab for the
ball in the water, but his hand slipped multiple times. This indicated that he had trouble
grasping things. In Video 3, he was holding and ball and made a motion to throw it, but the
ball slipped from his grasp. Sometimes he was also not sure how to grab something. In the
video 2, Nick was unsure how to pick up smaller things. Hence, he seemed to be fumbling.
Sometimes, Nick seemed to lack the strength to grab the things required, but he did not stop
trying. He continuously tried till he was able to do it.

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Sometimes he seemed to be putting less effort than was required to do a job, like
picking up toys. He also seemed to get disoriented sometimes and stopped before proceeding
with a task. He did not seem to be planning to do anything before attempting, although there
were sometimes a small pause before he proceeded to do his motions. Nick had significantly
good eye-to-hand coordination and he seemed to focus on the toy before trying to pick it up
in Video 2.
Sensory processing
In terms of sensory processing, Nick seems to be able to learn from his peers quite
well. When he was not able to do a task properly, he observed his peers and tried to copy
their motions. He seemed to be good at copying and repeating the motions he saw working
for others and he did so till it worked. He also seemed to realise when something was failing,
and changed his tactics. However, in some cases he seemed to having trouble perceiving. In
Video 3, when he tasted the water from the tub, it was clearly did not taste very good.
Nevertheless he kept trying to taste it from different sides of the tub. In Video 2, he tried to
find cars in the wrong way even if they were touching his knees.
Cognitive skills
In terms of cognition, Nick seemed to pay attention to his peers and try to learn their
motions in order to do something. He kept trying to repeat the motions he saw them do. He
was willing to learn and try new things, and then he was also very active in going through the
motions. He never sat dejected, and he never stopped actively trying. However, he seemed to
have a short attention span and did not wait before trying what he saw. Once he was able to
do something (e.g. successfully climb the stairs in Video 1) he repeated the motions very
closely and successfully which showed that he remembered what he learned. Sometimes, he
also picked up something and stared at it.

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Social/Behavioural development
In terms of social and behavioural skills, Nick seemed to be a friendly child. In Video
3, he promptly handed over the ball when the lady asked for it. In the same video, he picked
up the ‘bunny scissors’ from the water and offered it to the person behind the camera. He was
also very in friendly with children his age and seemed to follow them quite easily rather than
being shy. He seemed to be cheerful and willing to learn.
Additional sources of information
Apart from the observations that have been made from the video, some other activities
may be undertaken to make a more precise judgement of Nick’s condition.
 It might be helpful to observe how well Nick can do his day-to-day activities such as
eating using cutleries, getting dressed, using the toilet independently. A normal three-
year-old should be moderately able to do these activities with a bit of help.
 It is important to properly observe his speech patterns in a quiet area and also see him
interact with his family members and friends.
 It should be observed how well he is capable of following instructions. At this age,
the child should be able to follow relatively complex instructions and able to process
sensory information pretty well. If not, that may signify a problem (Mitchell et al.,
2015)
 It is a good idea to interview his mother to find more information about his home life,
medical history, family bonding, financial conditions and healthcare access. It is also
worthwhile to ask if she sustained any injury during pregnancy. This may direct
towards whether Nick is suffering from any serious developmental conditions.

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 It is may be a good idea of let Nick pick his own activities rather than directing them
towards it. This can assess the child’s ability to engage in activities of his own choice
(Case-Smith & O'Brien, 2014).
 Nick’s handwriting and pencil gripping abilities must be tested as this may provide
useful insight in his strength development (Alaniz et al., 2015).
Appropriate standardized testing
Standardized tests are helpful in providing judgements about a child’s motor skills,
cognitive functions and social or behavioural skills. Standardized tests are an integral part of
the occupational therapy process. In case of Nick, appropriate tests may be
1- Bayley Scale of Infant Development (BSID).
This test has been priced at 1185 dollars and takes about 45 to 60 minutes. This is useful in
assessing the cognitive development as well as motor development in children. This test can
be considered suitable for Nick as the videos show some level of abnormality with his motor
functions. Nick’s cognitive development is likely to be nearly normal, but he may have some
issues regarding his motor functions (Manandhar et al., 2016). By taking this test, his issues
can be targeted and rectified via occupational therapy if required.
2- The products that may be helpful in this is Movement ABC-2 Teacher Checklist
This test has been priced at around 976 pounds and it takes around 20 to 40 minutes to
complete. It can be taken both individually or in a group. This is the Movement Assessment
Battery for Children 2, used for evaluating gross and fine motor function problems in
children. It is meant for children three-years and above. It is useful in children with
neurodevelopmental disorder. Nick may have some problems regarding manual dexterity as
well as balancing as can be seen from many instances in the video (Zoia et al., 2019).

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Conducting this assessment will also help the tutor decide how to help Nick in the best
possible way.
Interpretation of results
Children usually learn by observing and by experiencing following the Action-
Perception Cycle (Sharma & Cockerill, 2014). That is exactly what Nick was doing. He was
looking at his peers and repeating their actions to succeed in his motions.
However, he was slower than a typical three-year-old, as a typical child of his age
usually can apply a bit more motor skills to tasks like running and others. This signifies that
he might need help in developing his motor skills. Typically, a child of Nick’s age will walk
straight, as seen with other kids in the video. However, Nick walks with his soles bent inward
and his knees pointed out, which may be sign that his gait is not normal (Merens, 2015)
He has good hand-to-eye coordination, but his fine motor skills are not the best and he
needs a little more help in how to properly grasp things according to sizes. He repeats his
motions a lot, which usually decreases in 18 months of age. This maybe an indicator that he
has some sort of neurological abnormality (Sharma & Cockerill, 2014).
As for cognitive skills, Nick was not able to grasp the concepts and experiences as
quickly as the other kids were able to. He continued to repeat some motions after those did
not work. For example, he tried to go up the stairs backwards couple of times even after it not
working. Sometimes he has difficulty repeating some activities exactly which may also be a
cause of concern (Roley et al., 2015).
One positive point is that he never seems to get demotivated on failing at a task. He
continuously kept trying and repeating the steps till he was successful at what he was trying
to do. He also seemed curious, and tried to figure out things. He never backed out from

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experiencing anything. He is able to pick what he wants to do amongst the activities offered,
which is a good sign (Moulton et al., 2019).
Whether he was facing any problem understanding the person behind the camera was
unclear, but he gave no indication of being confused. In fact, he was very friendly and he
looked ready to share things with them by offering the bunny scissors. He was not very shy,
and though he was quiet, he did not seem withdrawn. However, if he does require any
cognitive occupational therapy, it is a good idea to start young (Maeir et al., 2014).
Conclusion
The above report concludes that Nick has some issues with his motor skills. He has
problems regarding his posture and grasping abilities but nothing too major. He is a little
slow in learning, and repeats motions, which may be a sign of neurodevelopmental
abnormality. He is friendly as well as social, and his issues can be helped with a little time
and encouragement.

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Reference
Alaniz, M. L., Galit, E., Necesito, C. I., & Rosario, E. R. (2015). Hand strength, handwriting,
and functional skills in children with autism. American Journal of Occupational
Therapy, 69(4), 6904220030p1-6904220030p9.
Case-Smith, J., & O'Brien, J. C. (2014). Occupational therapy for children and adolescents-
e-book. Elsevier Health Sciences.
Maeir, A., Fisher, O., Bar-Ilan, R. T., Boas, N., Berger, I., & Landau, Y. E. (2014).
Effectiveness of Cognitive–Functional (Cog–Fun) occupational therapy intervention
for young children with attention deficit hyperactivity disorder: A controlled
study. American Journal of Occupational Therapy, 68(3), 260-267.
Manandhar, S. R., Dulal, S., Manandhar, D. S., Saville, N., & Prost, A. (2016). Acceptability
and reliability of the Bayley scales of infant development III cognitive and motor
scales among children in Makwanpur. Journal of Nepal Health Research Council.
Merens, T. A. (2015). The toddler gait—normal or not. Pediatric annals, 44(5), 187-190.
Mitchell, A. W., Moore, E. M., Roberts, E. J., Hachtel, K. W., & Brown, M. S. (2015).
Sensory processing disorder in children ages birth–3 years born prematurely: A
systematic review. American Journal of Occupational Therapy, 69(1),
6901220030p1-6901220030p11.
Moulton, J. M., Cole, C., Ridgers, N. D., Pepin, G., & Barnett, L. M. (2019). Measuring
movement skill perceptions in preschool children: A face validity and reliability
study. Australian occupational therapy journal, 66(1), 13-22.

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Roley, S. S., Mailloux, Z., Parham, L. D., Schaaf, R. C., Lane, C. J., & Cermak, S. (2015).
Sensory integration and praxis patterns in children with autism. American Journal of
Occupational Therapy, 69(1), 6901220010p1-6901220010p8.
Sharma, A., & Cockerill, H. (2014). Mary Sheridan's from birth to five years: Children's
Developmental Progress. Routledge.
Toddler Observation Video 3. (2020). [Video]. Retrieved 7 March 2020, from
https://www.youtube.com/watch?v=7nQxWCn_dBg.
Toddler Observation video pictures 002.avi. (2020). [Video]. Retrieved 7 March 2020, from
https://www.youtube.com/watch?v=Pl3_4D6c8Io.
Toddler Video Outdoor. (2020). [Video]. Retrieved 7 March 2020, from
https://www.youtube.com/watch?v=-NKJE2aJvu4.
Zoia, S., Biancotto, M., Guicciardi, M., Lecis, R., Lucidi, F., Pelamatti, G. M., ... &
Henderson, S. E. (2019). An evaluation of the Movement ABC-2 Test for use in Italy:
A comparison of data from Italy and the UK. Research in developmental
disabilities, 84, 43-56.