CAMHS OT SCREENING TOOL

Name: ........................................................................... Date of Birth: ...............................................

Age: ................ Yrs .................................... Months

CHI Number: ................................................

Clinician(s) Scoring: ..............................................................................................................................

PARENT/CARER SCREENING TOOL & QUESTIONNAIRE

EDUCATION SCREENING TOOL & QUESTIONNAIRE

School
Activities

Home
Activities

a. Able to use learning materials

a. Able to use learning materials

b. Able to make effective shapes/letters/writing

b. Able to make effective shapes/letters/writing

c. Able to engage in sports/leisure

c. Able to engage in sports/leisure

d. Able to engage in curriculum

d. Able to engage in curriculum

e. Able to clean after toilet at school

e. Able to organise themselves

f. Able to get dressed after P.E./gym

f. Able to get dressed after P.E./gym

a. Able to clean after toileting/personal hygiene

a. Able to clean after toileting/personal hygiene

b. Able to manage their clothing

b. Able to manage their clothing

c. Able to help with/manage snacks

c. Able to help with/manage snacks

d. Able to help with/clean up effectively

d. Able to help with/clean up effectively

e. Able to get prepared for school

e. Able to prepare for school

f. Able to move from one activity to another

f. Able to move from one activity to another

g. Tolerates most sensations

h. Engages in activities quietly/calmly

a. Able to participate with peers after school

b. Able to play with peers in activities

c. Able to take part in after school clubs

d. Able to take part in social events

g. Tolerates most sensations

h. Engages in activities quietly/calmly

a. Able to ride bike/rollerblade etc

b. Able to play with friends in activities

Community
Activities

None of Some of Most of All of

the time the time the time the time

c. Able to take part in out of school clubs

d. Able to take part in social events

EDUCATION OBSERVATIONS OF ACTIVITY FREQUENCY - WHAT

PARENTAL OBSERVATIONS OF ACTIVITY FREQUENCY - WHAT

None of Some of Most of All of

the time the time the time the time

School
Activities

Life Skills
that relate to
School

Community
Activities

e. Able to take part with family in leisure activity

e. Able to take part with peers in leisure activity

f. Able to manage clothes before/after activities

f. Able to manage clothes before/after activities

None of Some of Most of All of

the time the time the time the time

None of Some of Most of All of

the time the time the time the time

Confidence

Social Skills

Organisational
Skills

a. Organises routines

b. Copes with change in routine

b. Copes with change in routine

Routine &
Role

c. Copes with a variety of activities

c. Copes with a variety of activities

d. Understands their responsibilities

d. Understands their responsibilities

e. Manages multiple responsibilities

e. Manages multiple responsibilities

a. Confident in their abilities

a. Confident in their abilities

b. Enjoys daily activities

b. Enjoys school activities

c. Satisfied with performance in activities

c. Satisfied with performance in activities

d. Identifies what he/she wants to get better at

d. Identifies what he/she wants to get better at

e. Keeps trying despite challenges

e. Keeps trying despite challenges

a. Plays well with others

a. Plays well with others

b. Chatty/sociable and talks with friends

b. Chatty/sociable and talks with friends

c. Speaks clearly when with others

c. Speaks clearly when with others

d. Understands others feelings

d. Understands others feelings

e. Can ask for the support he/she needs

e. Can ask for the support he/she needs

a. Organises and uses objects for activities

a. Organises and uses objects for activities

b. Maintains concentration throughout activities

b. Maintains concentration throughout activities

c. Works out problems if stuck on a task

d. Follows through instructions for activities

e. Does the steps of an activity in the right order

a. Can navigate around physical environment

b. Community environment has opportunities

c. Access to the things to help them take part

c. Works out problems if stuck on a task

d. Follows through instructions for activities

e. Does the steps of an activity in the right order

a. Can navigate around physical environment

b. Community environment has opportunities

c. Access to the things to help them take part

Environment

EDUCATION OBSERVATIONS OF CHARACTERISTICS OF CHILD - WHY

PARENTAL OBSERVATIONS OF CHARACTERISTICS OF CHILD - WHY

Routine &
Role

a. Organises routines

Confidence

Social Skills

Organisational
Skills

Environment

d. Family members are available for support

d. School staff are available for support

e. School environment supports school activities

e. School environment supports school activities

f. Does activities in usual/accepted way

f. Does activities in usual/accepted way

None of Some of Most of All of

the time the time the time the time

Physical Skills

a. Completes activities without being clumsy

a. Completes activities without being clumsy

b. Completes activities without losing balance

b. Completes activities without losing balance

c. Grips objects effectively when doing activities

c. Grips objects effectively when doing activities

d. Physical dexterity to complete activities

d. Physical dexterity to complete activities

e. Completes activities without physical fatigue

e. Completes activities without physical fatigue

a.

a.

b. Your pupil seems confident and self assured

c.

Calm and can be separated from parent/carer

b. Your child seems confident and self assured

Emotions &
Sensations

None of Some of Most of All of

the time the time the time the time

Physical Skills

Emotions &
Sensations

Calm and can be separated from parent/carer

Undaunted/willing to tackle new experiences

Undaunted/willing to tackle new experiences

d. Appropriately sensitive to their environment

d. Appropriately sensitive to their environment

e.

e.

c.

Your childs alertness is about right

Your pupils alertness is about right

The ACHIEVE team are committed to undertaking psychometric testing of the ACHIEVE Assessment Toolkit. If you require information about these tools
please contact Professor Kirsty Forsyth at kforsyth@qmu.ac.uk