(Acknowledgments to Speech Pathology and Occupational Therapy Departments Gippsland Southern Health Service)

Four Years

Refer to Speech Pathologist if:

• Child cannot follow simple concepts like "up" or "big".
  
• Child's speech is difficult to understand most of the time.
  
• Child stutters.  Child drools excessively.
  
• Voice is husky, hoarse or disappears at times.
  
• Child doesn't seem to be hearing instructions.
  

Refer to Occupational Therapist if:

• Walks with wobbly gait - unable to run or walk on narrow line.
  
• Unable to grip strongly with either hand.
  
• Disorganised - appears "clumsy and floppy or tight."
  
• Difficulty holding crayon between thumb, index and middle fingers to draw 0 and man.
  
• Difficulty holding scissors - opening and closing them.
  
• Unable to use fork and spoon.
  
• Difficulty undressing/dressing self.
  
• Unable to play with others, prefers to play alone.
  
• Appears fearful to be lifted above the ground.