Name: Age:5 Date:

Skills and Patterns

Low Typical High

• Arousal/Alertness
• Affect/ Emotion
• Attention
• Activity level

Seek
• Social Interaction Avoid

Sensitive
Comment: Appropriate.

Hyper
• Reactions: Hypo

(In general) Fluctuating

Comment: Appropriate.
 • Sit-up

2
*No. of times?

✓
Poor Adequate Good
*Core stability

Comment:

✓
• Spiderman crawl *Smooth fluid movement

✓
*Four limbs coordination
Comment:

10
• Press up *No. of times?

✓
Poor Adequate Good
*Upper limb stability
Comment:

1
• Ball Skill *No. of times?

Poor Adequate Good

✓
✓
*Throwing?

*Catching?
Comment:In dribbling, he became great after practice, initially not very good.

5
 • Left/Right Insert pins into Board *No. of times?

✓
Yes No
*Swap hands?

Comment:Clumsy, as he dropped pins onto the floor, he only managed one pin in into the
board.

5/5
• Hop scotch (A row of 5 spots for single legged hopping) *No. of times?

Comment:Left-footed very good at this activity.

• Pencil grasp

Comment: Static grasp but turning into palmar grasp (lower level at pencil grasp). He was
holding pencil high up on pencil shaft.

TIP-Test of Ideational Praxis(Assess ability to recognise and act upon object affordances)
No. of times: 40
Motor Planning Maze Assessment (Use of a curve maze to move the grommet from one side to
the other)
Time: 15 seconds

Summary:
Good gross motor skills, his dynamic balance, muscle tone and core stability are all good.
However, eye-hand coordination skills such as ball skills is difficult. Require many practice in
order to accomplish this area. Find motor skills is difficult too, especially in spatial and
perceptual skills. He is observed to do a reversal of letters written on paper and difficulty in
crossing his midline, such as moving from left to right back to the left. Cheerful cooperative and
confident child. No difficulties in attention in one-on-one setting.
Ideation- Coming up with a plan
Motor planning(Ideomotor)- Using the body to accomplish tasks
Execution- Putting sequences of actions together to accomplish the goal
(not the motor skill but the ability to determine whether or not the actions
will meet or have met the goal)