Special Education

Teaching Students with Fetal Alcohol Syndrome

Appendix 7: Motor Skills Checklist

Appendix 7: Motor Skills Checklist

Name: ________________________ Date of Birth: ________________________
School: ________________________ Grade: ________________________

Motor Skills Mostly Sometimes Never
Shows interest in putting thoughts down in print _______ _______ _______
Able to print and write with ease _______ _______ _______
Interested in and enjoys physical activity (e.g. walking., skipping, throwing) _______ _______ _______
Demonstrates age-appropriate ability in physical activity (as above) _______ _______ _______
Able to move, balance, handle materials _______ _______ _______
Participates in activities to develop upper body strength _______ _______ _______
Can control stops, starts, changes of direction at different speeds _______ _______ _______
Develops patterns of action using the body/equipment alone _______ _______ _______
Develops patterns of action using the body/equipment with a partner _______ _______ _______
Participates effectively in group games _______ _______ _______
Shows agility, confidence, ingenuity and precision in fine motor skill activities _______ _______ _______
Shows agility, confidence, ingenuity and precision in gross motor skill activities _______ _______ _______
Demonstrates agility, confidence, ingenuity, and control in using body/equipment to solve problems requiring coordination of thought and physical activity _______ _______ _______

Comments
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Completed by: __________________________________________________________
Relationship to student: __________________________________________________________
Date: __________________________________________________________