Occupational therapy programs tables of content

Posturing: +/- Decebrate_____________ Decorticate____________
IV MOTOR RESPONSE TO SENSORY STIMULATION___________________________________________

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V VOCALIZATIONS/VERBALIZATIONS IN RESPONSE TO SENSORY STIMULATION_________________

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VI UPPER EXTREMITY EVALUATION

AROM/PROM______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(CONTINUES)

Muscle Tone/Spasticity:

Date

Within Normal Limits

Flaccid

Mild

Moderate

Severe

R

L

R

L

R

L

R

L

R

L

Internal Rotators

Pectoralis

Biceps

Triceps

Forearm pronators

Wrist flexors

Finger flexors

Thumb flexors

Other

VI COGNITION

Response to Verbal Commands	No Response	Consistent	Inconsistent	Comments
1. “Open your eyes”
2. “Stick out your tongue”
3. “Squeeze my hand”
4. “Hold up two fingers”
5. “Touch body parts”
6. States/recognizes name
7. Nods head appropriately in response to questions
8. Initiates automatic tasks with cues
9. Initiates automatic tasks without cues