Sensory Processing Referral Checklist

Sensory Processing Includes Touch, Visual Processing, Auditory Processing, Movement, and Body Awareness

  • Avoids or has difficulty with eye contact
  • Is easily distracted by visual stimulation
  • Seems not to understand what was said
  • Seems overly sensitive to sounds
  • Appear reluctant to participate in sports
  • Distracted by lots of noise and games
  • Unable to follow 2-3 directions
  • Prefers to touch rather than be touched
  • Often seems overly active
  • Avoids getting hands messy (art)
  • Hits or pushes other children
  • Seems more sensitive to pain than others
  • Oblivious to bruises/heavy falls
  • Complains that others hit/push him/her
  • Mouths clothing/objects frequently
  • Difficulty making friends
  • Tends to prefer to play alone
  • Has strong desire for routine/sameness
  • Intense and easily frustrated
  • Has strong outbursts of anger/frustration
  • Lacks carefulness/Impulsive
  • Bumps into things frequently
  • Moves in/out of chair while working
  • Falls out of chair
  • Seems clumsy
  • Seems to deliberately fall or tumble
  • Distracted by background noises
  • Fearful moving through space (swing)
  • Avoids activities that challenge balance
  • Avoids playing on playground equipment
  • Extremely picky eater; often refuses foods kids typically eat at school/daycare
Get Your Child Scheduled with a Pediatric Therapy Expert Start the Journey Today
We don't believe our patients should wait to get the therapy services they need. Let our nationally recognized therapists help your child.
Call Now
Parent Testimonials
As a parent of a child with autism, I've always wanted him to be able to create meaningful friendships with kids his age. From the first time my son walked into Summit Pediatric Therapy, he was made to feel warm and welcome. His pediatric therapists worked tirelessly to help him develop the skills to start creating friendships. We are thankful for the life skills they helped him develop.
Summit Pediatric Therapy
2018-07-09T15:29:05-06:00
“Provider of Pediatric Speech, Occupational, Physical & Feeding Therapy to patients throughout Aurora, Centennial, Denver & Littleton”
As a parent of a child with autism, I’ve always wanted him to be able to create meaningful friendships with kids his age. From the first time my son walked into Summit Pediatric Therapy, he was made to feel warm and welcome. His pediatric therapists 
This letter was provided to Speech-Language Pathologist, Tara Lujan, MA, CCC-SLP

Summit Pediatric Therapy
2019-07-10T10:52:16-06:00
“Provider of Pediatric Speech, Occupational, Physical & Feeding Therapy to patients throughout Aurora, Centennial, Denver & Littleton”
This letter was provided to Speech-Language Pathologist, Tara Lujan, MA, CCC-SLP
Alex Bresler, MA, CCC-SLP is amazing. Lauren loves her and she has been so patient with her and really worked hard to build a positive relationship.
Summit Pediatric Therapy
2019-06-13T09:17:41-06:00
“Provider of Pediatric Speech, Occupational, Physical & Feeding Therapy to patients throughout Aurora, Centennial, Denver & Littleton”
Alex Bresler, MA, CCC-SLP is amazing. Lauren loves her and she has been so patient with her and really worked hard to build a positive relationship.
Maggie Henrksen, MA, CCC-SLP is amazing and extremely professional and proactive. My son loves going to talk with each week. Both the school and I have seen great progress with my son!

Very Happy - Thank you!!
Summit Pediatric Therapy
2019-06-13T08:37:52-06:00
“Provider of Pediatric Speech, Occupational, Physical & Feeding Therapy to patients throughout Aurora, Centennial, Denver & Littleton”
Maggie Henrksen, MA, CCC-SLP is amazing and extremely professional and proactive. My son loves going to talk with each week. Both the school and I have seen great progress with my son! Very Happy – Thank you!!
Claire Beynon-Powell, MS, CCC-SLP is great with my 13 year old. She respects him and never talks down to him.
Summit Pediatric Therapy
2019-06-13T08:40:37-06:00
“Provider of Pediatric Speech, Occupational, Physical & Feeding Therapy to patients throughout Aurora, Centennial, Denver & Littleton”
Claire Beynon-Powell, MS, CCC-SLP is great with my 13 year old. She respects him and never talks down to him.
0
Summit Pediatric Therapy
Call Us Today to Get Started