Referral Observations

REFERRAL OBSERVATIONS

The following behavioral observations may indicate the need for a referral for additional testing by a specialist. (Remember there may be developmental/age variations to consider.):

Lack of eye contact - Child does not make eye contact with other children or adults.

Echolalia- Child repeatedly “echoes” the words, sentences, or phrases of the adult.

Perseveration- Child repeats the same vocalization or motor act as a response to several consecutive tasks.

Transposition of words within sentences- Child verbalizes several utterances in which the words become reversed in order (e.g., “You see me how do this?”).

Lack of or severe deficit in imitative ability- Child does not attempt an imitation of a response on request or does not approximate accuracy in most imitative responses.

Severe comprehension deficits- Child frequently demonstrates that he/she does not understand your directions regarding tasks appropriate for his/her age. Child requires two or more demonstrations of most tasks appropriate for age.

Unintelligible conversational speech- Child’s speech cannot be understood.

Moderate to severe behavior deficits- Child tantrums when demands are placed on him/her. Child refuses to attempt tasks. Child displays strange or socially unacceptable behavior, such as crawling under or behind furniture, licking materials frequently, damaging materials, or displaying strange mannerisms (e.g., flapping body parts, rocking while sitting, or swaying while standing).

Extreme distractibility and/or impulsivity- Child disrupts by interrupting, moving away from contact, and/or “grabbing” toys/materials or unrelated objects. Adult is unsuccessful in multiple attempts to re-direct the child’s attention.

Written reversals and transversals after age 8, or after age 7 if extreme and with difficulty correcting errors.

Notable variability in academic skills- For example, good reading comprehension and good math calculation with very poor writing skills.

High frustration in response to extensive written work.

Notable behavior problems or emotional outbursts after age four despite varied intervention efforts.

Good oral performance with poor written performance appropriate to age.

Forgetfulness from day to day, especially in children who seem bright.

Increasing academic delays from year to year.

Notable difficulty with reading appropriate to age in otherwise highly verbal children.