Occupational Therapy Checklist for Early Intervention

Document caregiver and team concerns about grasp, bilateral coordination, feeding, dressing, sensory regulation, and play participation. This helps build present levels that connect directly to IFSP outcomes or preschool IEP goals in daily routines such as meals, toileting, and circle time.

Compare the child's current skills to expected milestones for ages 0-5 in hand use, visual motor integration, postural control, and daily living skills. Milestone review supports eligibility discussions and helps determine whether goals should target delay, access, or participation.

Use a family interview to identify participation barriers during dressing, feeding, bath time, playground visits, and car seat transitions. Routine-based assessment is an evidence-based practice in Early Intervention and ensures outcomes reflect meaningful, family-prioritized needs.

Watch the child during play, snack, transitions, and caregiver-led routines rather than relying only on tabletop tasks. Natural environment observation improves the accuracy of functional goals and supports IDEA-aligned service planning for children birth to age 5.

Note patterns such as avoiding messy play, overreacting to sound, difficulty with movement, or seeking intense input during routines. These observations help shape accommodations, environmental supports, and co-regulation strategies instead of using sensory activities without a functional purpose.

Check whether orthopedic conditions, prematurity, cerebral palsy, autism, Down syndrome, vision loss, hearing loss, or developmental delay may influence positioning, access, or task performance. This step supports appropriate collaboration with PT, speech, and medical providers.

Create goals such as using a pincer grasp to pick up finger foods, stacking blocks during play, or turning pages during book routines. Functional goals are more appropriate for Early Intervention than isolated drill tasks and are easier for families to practice consistently.

Use measurable goals linked to routines, such as remaining engaged in a 5-minute play routine with adult co-regulation supports, rather than vague goals about sensory needs. This keeps occupational therapy focused on educational and developmental access.

Consider goals for spoon use, open-cup drinking, removing a jacket, hand washing participation, or tolerating toothbrushing steps. Daily living goals are especially important for children with intellectual disability, autism, developmental delay, or multiple disabilities.

For preschool-aged children, target imitation of vertical lines, simple shape copying, bead stringing, or placing puzzle pieces within center time and art. This aligns with developmentally appropriate practice and supports future handwriting readiness without pushing formal paper-pencil work too early.

Include supports such as adapted utensils, slant boards, non-slip mats, visual schedules, shorter task duration, or alternate seating when needed. Accommodations should be documented clearly so all team members can implement them consistently across settings.

Coordinate with speech-language, physical therapy, and special instruction so the child works on overlapping skills during shared routines. For example, snack can target communication, grasp, posture, and self-feeding at the same time through embedded intervention.

Incorporate blocks, pop beads, nesting cups, cause-and-effect toys, and container play to practice hand skills in motivating contexts. Evidence-based Early Intervention emphasizes responsive interaction and repeated practice within enjoyable activities.

Plan activities such as peeling stickers, squeezing sponges in water play, pulling apart toys, or helping with snack prep using soft dough or tongs. These routines support fine motor IEP goals without requiring separate therapy-only tasks.

Set up simple obstacle courses, target toss, large-piece puzzles, and vertical surface play to promote eye-hand coordination and postural control. UDL-aligned options allow children to engage through multiple materials and response modes.

Use movement songs, deep pressure through caregiver games, oral-motor supports during meals, or calming visual spaces when they improve participation in routines. Sensory strategies should be tied to a clear need and monitored for effectiveness.

Offer larger crayons, short markers, built-up handles, stabilized paper, switch-activated toys, or simplified fasteners based on the child's motor profile. These accommodations support inclusion and reduce frustration in preschool and home-based sessions.

Practice scooping, wiping hands, opening containers, removing socks, and placing toys in bins during real routines rather than simulated tasks. Embedded instruction increases generalization because the child learns in the setting where the skill is actually needed.

Structure turn-taking games, cooperative art, or parallel play with shared materials so the child practices motor and regulation skills in social contexts. This is especially helpful for children with autism or social-emotional delays who need support participating with others.

Demonstrate one strategy during a familiar routine, invite the caregiver to try it, then discuss what worked and what needs adjusting. This coaching cycle is more effective than simply handing families a list of activities.

Recommend realistic actions such as offering opportunities for finger feeding, using a visual sequence for hand washing, or practicing two-step cleanup routines. Limiting focus prevents overwhelm and improves consistency for busy families.

Help families notice early signs such as covering ears, dropping to the floor, mouthing items, or avoiding touch. Pair these observations with preventive supports, such as transition warnings, movement opportunities, or reduced visual clutter.

Suggest stacking containers, tearing paper, scooping beans with supervision, playing with washcloths in bath time, or pushing toy cars on painter's tape roads. Home-friendly materials increase follow-through and support intervention in natural environments.

Ask how meals, sleeping, dressing, and play look in the home before recommending supports. Family-centered planning improves trust and helps ensure IFSP outcomes are meaningful and practical across diverse households.

Record what the family tried, what was successful, and what obstacles limited practice, such as sibling demands or housing constraints. This documentation supports service decisions, progress reporting, and legally sound records.

Measure current performance using frequency, duration, level of prompting, or percentage of successful attempts during routines. Baseline data is necessary for writing measurable goals and demonstrating meaningful progress over time.

Document how the child performs during snack, art, cleanup, playground, or home routines with the actual materials and supports used daily. Functional data is more useful for team decisions than occasional clinic-style observations alone.

Specify whether the child needed hand-over-hand support, gestural cues, visual prompts, setup assistance, or independent completion. This makes progress reports clearer and helps teams fade prompts systematically.

Record which supports were provided, such as adapted scissors, alternate seating, movement breaks, or reduced-step tasks, and whether they improved participation. This information is essential for IEP reviews and for determining if supports should continue or change.

Check that intervention occurs in home, preschool, childcare, or community routines whenever appropriate, with pull-out services used only when justified by need. This supports IDEA requirements and Early Intervention best practice.

Summarize growth, current barriers, effective supports, and recommended next steps using family-friendly language. Clear communication supports informed decisions at IFSP reviews, transition meetings, and annual IEP discussions.

Share current fine motor, sensory, and self-help strengths, successful accommodations, and effective coaching strategies with the receiving team. Transition planning is especially important around age 3 so supports continue smoothly under Part B services.