Physiotherapy Occupational Therapy Consultation Report

PHYSIOTHERAPY OCCUPATIONAL THERAPY CONSULTATION REPORT

Children grow, learn and develop. This report is based on current findings and future references should be made with caution. This report is confidential and not meant for “third party” release without guardian consent.

NAME:

DOB:

AGE:

PARENTS/GUARDIANS:

ADDRESS:

PHONE:

THERAPIST NAME:

DATE OF REPORT:

It was great to meet NAME during our session(s). As you know NAME is still on the OT/PT waitlist, but we discussed a few recommendations for him/her while you are waiting for services. These are based on my observations during our sessions and the information you shared with me. I have summarized them below. Please feel free to ask questions, or contact me if these are not clear.

SUMMARY – only include what is relevant for this child

1.  Movement

Big muscles (gross motor) - Using the big body muscles for movement – walking, balancing, jumping, running, climbing etc.

Hand and finger muscles (fine motor) - Using the hands and fingers to manipulate objects, string beads, pick up cheerios, hold a pencil, use scissors, etc

2.  Pre-reading and writing – Do you guys have anything else to call this?

Visual perceptual skills (using the eyes and the brain to understand visual information, like shapes, letters, designs, etc)

Visual motor skills (using the eyes, brain & hands to copy shapes, designs with blocks, print letters)

3.  Sensory Behaviours (how the senses absorb and use information)

4.  Eating and Drinking

Include if there are concerns: history of reflux etc., weight gain/loss, pickiness etc.

Other Summary Comments

RECOMMENDATIONS

1.  NAME will stay (or be discharged) from the OT/PT waitlist. While waiting for services he/she will be eligible for any groups that we run that would be appropriate for him. I have attached a brochure for the ……..group in case you are able to bring him. If you are interested please let me know.

2.  Some suggestions of activities to work on with him are attached to this report. Please let me know if any of these are hard to understand!

3.  NAME is also still on the list to see……(SLP, psych etc.). (Being discharged from OT/PT will not affect NAME’s position on their waitlist.)

We apologize for the long wait, but hope that these recommendations will help you while NAME waits to be seen for more intensive assessment and therapy.

Therapist (just put your name and profession, no letters)

cc: Parents

Pediatrician

Family Physician

Preschool/Daycare

Supported Child Development Program

IDP

SLP