Red Flags: Signs Your Child May Benefit from an OT Evaluation

It can be difficult to determine if your child is staying on track or falling behind for meeting fine and gross motor milestones or showing any signs of sensory system dysfunction. After all, these skills are obtained at varying rates among children, and falling outside of the typical age ranges for a skill does not necessarily mean the child is developmentally delayed. The following is a list of observations to watch for that may indicate your child could benefit from an occupational therapy evaluation:


  1. Avoids or refuses touching certain items, wants to clean hands quickly when messy, disruptive when in close proximity to other people
  2. Doesn’t notice when messy, touches people or objects excessively, frequently gets in people’s personal space
  3. Frequently runs into other people or objects, seems clumsy, and has difficulty maintaining a seated position (i.e. slumps or sprawls out or fidgets)
  4. Is slow to participate in physical activities, withdraws from active environments, or refuses to participate in team games
  5. Has trouble functioning in a loud or busy environment, may appear to be oblivious (i.e. not tuning into what you say), misses oral directions more frequently than others
  6. Overly bothered by loud noises, covers ears to protect from sound
  7. Misses written or demonstrated directions, has trouble keeping materials organized, overly distracted by other activity in the room
  8. Notices small changes, comments on small details, avoids eye contact


  1. Showing delays across multiple fine and/or gross motor milestones
  2. Difficulty using both sides of the body together (i.e. using two hands to complete a task)
  3. Appears to neglect one side of their body
  4. Decreased activity endurance, “floppy” limbs, poor postural control
  5. Lack of flexibility, rigid joints, tight or stiff muscles
  6. Appears to be far less coordinated than peers (i.e. frequently trips or falls)
  7. Frequently drops or has trouble picking up small objects or playing with small toys
  8. Has trouble holding utensils for feeding or writing/coloring
  9. Has handwriting that is not legible

Red flags do not mean that your child will need occupational therapy services. However, if you are observing some of the red flags listed above or are concerned about your child’s development, it may be beneficial to schedule an evaluation with an occupational therapist.

-Glenna Nave, M.S., OTR/L