Pediatric Occupational Therapy Evaluation

[YOUR COMPANY NAME]

Date: [Date]

Introduction

This document provides an extensive framework for evaluating the developmental progress of pediatric patients undergoing occupational therapy. This form is designed to facilitate objective and quantitative assessments across various domains.

Overview of the Evaluation

We will evaluate the progress of each patient concerning specific developmental disorders or delays, using predefined criteria to ensure consistency in the evaluation process across varying cases and scenarios.

Rating Scale

Utilize a numerical scale or descriptive scale to assign ratings for each criterion. Numerical scales typically range from 1 to 5, with 1 representing the lowest level of performance or need and 5 representing the highest.

1. Poor: Indicates significant challenges or deficits requiring immediate intervention.

2. Fair: Signifies moderate difficulties that impact daily functioning and necessitate targeted intervention.

3. Average: Represents some challenges but with functional abilities within an expected range.

4. Good: Demonstrates strengths and proficiency in the area being assessed.

5. Excellent: Reflects exceptional skills or abilities exceeding expectations for the child's age or developmental level.

Evaluation Criteria

Criteria	Description	Rating (1-5)
Sensory Processing	Evaluates the child's ability to process and respond to different sensory inputs including touch, sound, taste, and visual stimuli.
Motor Coordination	Assesses the child's gross and fine motor skills and their ability to move and control their body with coordination.
Behavioral Changes	Focuses on positive or negative shifts in the child's behavior throughout therapy.
Social Skills	Evaluates the child's ability to interact appropriately with others, such as family members, peers, and caregivers.
Mental Flexibility	Assesses the child's mental adaptability to changes in routine, challenges, or new learning situations.
Practice-based Learning	Measures the child's ability to apply learned skills from therapy settings into daily activities and routines.

Additional Comments and Notes

Criteria	Notes
Sensory Processing
Motor Coordination
Behavioral Changes
Social Skills
Mental Flexibility
Practice-based Learning

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