Age-based occupational therapy screening checklist - Google Form

Do you feel like the OT screening forms out there are too basic or general? Do you feel silly indicating on the form that a 7-year-old is able to draw a square? Do you wish your screening form includes skill items that are more appropriate for the child’s age or grade? If you answered “Yes” to one or more of these questions, then this resource is for you!

This resource includes 6 screening checklists for different ages and grade levels. The age-based skill items were gathered from a variety of developmental tests and books. Grade levels and ages included:

• Prekindergarten (Age 3 years)
• Prekindergarten (Age 4 years)
• Prekindergarten (Age 5 years)
• Kindergarten (Ages 5-6 years)
• 1st Grade (Ages 6-7 years)
• 2nd Grade (Ages 7-8 years)

How does it work?

Start by entering the student’s name and selecting the student's grade/age. The Google Form will then take you to the appropriate screening checklist that has a list of skills that are based on the student’s grade level and age. Some skills emerge at an age range that go slightly beyond the typical age range for a specific grade. For example, the Kindergarten Screening Checklist may include skills that emerge between 4 and 5 years or 6 and 7 years. Mark "Yes" if the student is able to demonstrate the skill based on observation or report. Mark "No" if the student is unable to demonstrate the skill based on observation or report. Mark "N/A" if the skill was not assessed. Each checklist includes many skill items. Complete as many or as few sections or skill items as you'd like. Once you complete the checklist, you will get to a section in which you can enter additional information.

Categories of skills covered

• Prekindergarten (Age 3 years) - Attention, Blocks/Cubes, Cutting, Drawing, Dressing and clothing fasteners, Feeding, Grasp on a drawing/coloring tool, Gross motor, Pegs, Puzzles, Stringing and lacing, Tracing, Washing and drying hands
• Prekindergarten (Age 4 years) - Attention, Blocks/Cubes, Coloring, Cutting, Drawing, Dressing and clothing fasteners, Feeding, Folding paper, Gluing, Grasp on a drawing/coloring tool, Gross motor, Pegs, Stringing, Tracing, Washing and drying hands
• Prekindergarten (Age 5 years) - Attention, Clothing and fasteners, Cutting, Drawing, Feeding, Folding paper, Gross motor, Matching, Pencil grasp, Printing, Puzzles, Tracing
• Kindergarten - Attention, Cutting, Clothing and fasteners, Drawing, Feeding, Folding paper, Gross motor, In-hand manipulation, Matching, Pencil grasp, Puzzles, Tracing, Writing
• 1st Grade - Attention, Cutting, Clothing fastener, Feeding, Folding paper, In-hand manipulation, Writing
• 2nd Grade - Cutting, Feeding, In-hand manipulation, Writing

Refer to the Preview page for additional information.

Printing

I personally like the convenience of having this Google Form checklist on a tablet while screening students. However, if you'd prefer to fill out a paper form, print the section of the Google Form with the list of the skills. To do this, preview the Google Form by clicking the eye icon. Complete the first page and click Next. Print this page. You can print preview, make adjustments, and print the pages you need.

July 2022: This screening checklist now has a printable version. For the printable version of this checklist, click here.