Infant/ Toddler Checklist: ____ My infant/toddler has problems eating. ____ My infant/toddler refused to go to anyone but me. ____ My infant/toddler has trouble falling asleep or staying asleep ____ My infant/toddler is extremely irritable when I dress him/her; seems to be uncomfortable in clothes. ____ My infant/toddler rarely plays with toys, especially those requiring dexterity. ____ My infant/toddler has difficulty shifting focus from one object/activity to another. ____ My infant/toddler does not notice pain or is slow to respond when hurt. ____ My infant/toddler resists cuddling, arches back away from the person holding him. ____ My infant/toddler cannot calm self by sucking on a pacifier, looking at toys, or listening to my voice. ____ My infant/toddler has a "floppy" body, bumps into things and has poor balance. ____ My infant/toddler does little or no babbling, vocalizing. ____ My infant/toddler is easily startled. ____ My infant/toddler is extremely active and is constantly moving body/limbs or runs endlessly. ____ My infant/toddler seems to be delayed in crawling, standing, walking or running. Pre-School Checklist: ____ My child has difficulty being toilet trained. ____ My child is overly sensitive to stimulation, overreacts to or does not like touch, noise, smells, etc. ____ My child is unaware of being touched/bumped unless done with extreme force/intensity. ____ My child has difficulty learning and/or avoids performing fine motor tasks such as using crayons and fasteners on clothing. ____ My child seems unsure how to move his/her body in space, is clumsy and awkward. ____ My child has difficulty learning new motor tasks. ____ My child is in constant motion. ____ My child gets in everyone else's space and/or touches everything around him. ____ My child has difficulty making friends (overly aggressive or passive/ withdrawn). ____ My child is intense, demanding or hard to calm and has difficulty with transitions. ____ My child has sudden mood changes and temper tantrums that are unexpected. ____ My child seems weak, slumps when sitting/standing; prefers sedentary activities. ____ It is hard to understand my child's speech. ____ My child does not seem to understand verbal instructions. School Age: ___ My child is overly sensitive to stimulation, overreacts to or does not like touch, noise, smells, etc. ___ My child is easily distracted in the classroom, often out of his/her seat, fidgety. ___ My child is easily overwhelmed at the playground, during recess and in class. ___ My child is slow to perform tasks. ___ My child has difficulty performing or avoids fine motor tasks such as handwriting. ___ My child appears clumsy and stumbles often, slouches in chair. ___ My child craves rough housing, tackling/wrestling games. ___ My child is slow to learn new activities. ___ My child is in constant motion. ___ My child has difficulty learning new motor tasks and prefers sedentary activities. ___ My child has difficulty making friends (overly aggressive or passive/ withdrawn). ___ My child fïgets stuck' on tasks and has difficulty changing to another task. ___ My child confuses similar sounding words, misinterprets questions or requests. ___ My child has difficulty reading, especially aloud. ___ My child stumbles over words; speech lacks fluency, and rhythm is hesitant. Adolescent/Adult: ___ I am over-sensitive to environmental stimulation: I do not like being touched. ___ I avoid visually stimulating environments and/or I am sensitive to sounds. ___ I often feel lethargic and slow in starting my day. ___ I often begin new tasks simultaneously and leave many of them uncompleted. ___ I use an inappropriate amount of force when handling objects. ___ I often bump into things or develop bruises that I cannot recall. ___ I have difficulty learning new motor tasks, or sequencing steps of a task. ___ I need physical activities to help me maintain my focus throughout the day. ___ I have difficulty staying focused at work and in meetings. ___ I misinterpret questions and requests, requiring more clarification than usual. ___ I have difficulty reading, especially aloud. ___ My speech lacks fluency, I stumble over words. ___ I must read material several times to absorb the content. ___ I have trouble forming thoughts and ideas in oral presentations. *While this checklist can't diagnose a child with SPD, it can be a helpful guide to see if additional testing should be done. When filling out this checklist, think about the child's behavior during the past six months. | | |