PHYSICAL THERAPY EVALUATION
Child’s Name: Elliott Scott
Date of Birth: 8/30/15
Date of Evaluation: 1/20/2021
Chronological age: 65 months (5 years, 5 months)
Examiner: Ashley Blockburger, PT, DPT
Evaluation time: 60 minutes
Therapy Dx: Did not qualify
REASON FOR REFERRAL:
Elliott Scott was referred for a complete physical therapy evaluation to determine his continued need for
direct physical therapy services to address concerns of gross motor delay. The results of this evaluation
will aid in determining eligibility of enrollment in direct physical therapy services and in program planning. A
complete evaluation was obtained through standardized testing, clinical observation, and parent/caregiver
questionnaire.
BACKGROUND/ MEDICAL HISTORY INFORMATION:
Gender: Male
Length of Pregnancy: Unknown
Birth Weight: Unknown
Medical Diagnosis: Autistic disorder (F84.0)
Current Medications: Loratadine for allergies
Allergies: cats, dust, pollen, bees, milk, penicillin
Pertinent Medical History: Limited birth information was reported. Elliott was born with jaundice. Elliott
suffers from allergies and asthma. He has a past medical history of febrile seizures. He has a history of ear
infections and had tubes placed in his ears. No gross motor milestones have been reported at this time.
Elliott engages in activities such as banging toys together, throwing toys, rough and tumble play. He enjoys
watching TV and movies. He enjoys Mickey Mouse, Blues Clues, t-ball, and jumping on the trampoline. He
has previously received speech therapy, occupational therapy and physical therapy at Little Bitty City and
JC Toddler Services.
Elliott Scott, PT eval
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Social History: Elliott’s mother described him as defiant, very quiet, destructive and nervous/anxious. She
reported that Elliott throws excessive tantrums. He prefers to play alone. He does show awareness of other
children but struggles to play with them. He had a difficult time separating from his parents.
Parent Concerns: suspected gross motor delay.
CLINICAL/BEHAVIORAL OBSERVATIONS:
Elliott Scott was seen at Little Bitty City Enrichment Center in Hot Springs, AR on January 20th, 2021 for a
complete physical therapy evaluation.
The following test results are considered to be an accurate representation of Elliott’s current gross motor
abilities.
Gait


Elliott ambulates independently community distances over level surfaces with a narrow base of
support with reciprocal arm swing.
He has difficulty navigating uneven or unlevel surfaces and demonstrates poor safety awareness
and loss of balance when navigating these surfaces. He was noted to trip over his feet several
times when navigating uneven surfaces.
Range of Motion
 Elliott demonstrated full passive range of motion in his trunk and extremities.
 He demonstrated full functional range of motion as evidenced by clinical observation and ability to
complete all therapy activities in evaluation.
Muscle Tone/Strength/Posture
 Elliott demonstrated mild decreased tone in his trunk and extremities observed through clinical
observation.
 Elliott demonstrated increased muscle stiffness and tightness throughout examination process with
all passive movements.
 Fair strength was noted in his ability to maintain sitting balance, standing balance, and balance in
tall-kneel position. Elliott was noted to adopt W-sitting position throughout evaluation denoting
decreased strength in his trunk.
 Elliott was able to transition from sitting standing to standing through half-kneel position.
Sensory Tolerance:
 Elliott demonstrated sensory seeking behaviors in the form of crashing into the crash pad over and
over again.
 He was noted to run up and down the carpeted incline throughout evaluation for additional
proprioceptive input.
 Elliott had a difficult time making eye contact with therapist to receive and follow instructions,
requiring max verbal cues and often times tactile cues to help him attend to therapy activities.
 He demonstrated decreased body awareness and had a difficult time positioning himself according
to therapist instructions even with therapist demonstrating.
Elliott Scott, PT eval
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TESTS ADMINISTERED:
Standardized Assessment
Test of Gross Motor Development 2 (TGMD-2)
The Test of Gross Motor Development 2 (TGMD-2) is a standardized test of gross motor function for
children ages 3-11 years, 9 months, which measures performance in locomotion (i.e. running, galloping,
skipping, hopping, leaping, etc.) and in object control (i.e. catching, throwing and kicking). Each skill tested
has certain criteria, which must be observed as the child performs the skill. In addition to providing
standardized scores, this test also breaks down skills into parts and allows the tester to identify particular
weaknesses in movement components within a skill. Each gross motor skill includes several performance
criteria. The child receives a score of 1 if the component is performed correctly and a zero if the component
is not performed correctly. After completing this procedure for two trials, the examiner totals the scores the
two trials to obtain a raw skill score for each item. The raw skill scores are added up toa raw subtest score.
The subtest score is then converted to a standard score and a gross motor quotient. A standard score of
less than seven is indicative of a gross motor delay. A gross motor quotient of less than 89 is also indicative
of gross motor delay. Percentiles can also be obtained for each subtest.
Elliott’s scores are as follows:
Raw Score Standard
Score
Locomotor
33
10
Percentile
Rank
50
Object
22
7
16
Control
Sum of Standard Scores: 17
Gross Motor Quotient: 91
Overall percentile: 27
Average Age Equivalent: 4 years, 7 months
Standard Deviation: -0.61
Age
Equivalency
5 years, 6
months
3 years, 9
months
Percent
Delay
0%
Standard
Deviation
0
67%
-0.99
*Note: A quotient is a standard score with a mean of 100 and standard deviation of 15; therefore, a normal quotient score
ranges between 85-115. A quotient score reflecting 1.5 standard deviations below the mean equals 85 or less. A percentile
ranking indicated the percentage of all children this age that would be expected to score lower than this child does.
Elliott’s gross motor quotient score of 91 indicates that he is performing below the normal range for his age
with a standard deviation of -0.61, which indicate his gross motor skills are below what is expected for his
age. He presents with a mild gross motor delay compared to what is expected of other children his age.
Sensory Processing Measure (SPM):
The Sensory Processing Measure is an integrated system of rating scales that enables assessment of
sensory processing issues, praxis, and social participation in elementary school-aged children
(kindergarten to sixth grade). The SPM consists of three forms: Home, Main Classroom, and School
Environment that can be used to measure problems in social participation, planning and ideas (praxis), and
five sensory systems: visual, auditory, tactile, body awareness (proprioception), and balance and motion
(vestibular). It is intended to support the identification and treatment of children with sensory processing
difficulties. A higher raw score indicates a higher level of dysfunction and the percentile score represents
the percentage of children in the normative sample who scored lower than the child who is being evaluated.
The T-score has a mean of 50 and a standard deviation of 10: thus, T-score from 40-59 are within normal
function, 60-69 represents moderate dysfunction, and 70+ represents severe dysfunction.
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SPM-P Main Classroom Form
Scales
Social Participation
(SOC)
Vision (VIS)
Raw Score
28
T-Score
65
Percentile
93
Interpretive Range
Some Problems
19
75
>99
Hearing (HEA)
20
76
>99
Touch (TOU)
Taste and Smell
Body Awareness
(BOD)
Balance and Motion
(BAL)
Planning and Ideas
(PLA)
Total Systems
Systems (TOT)
17
7
23
72
n/a
79
98
n/a
>99
Definite
Dysfunction
Definite
Dysfunction
Definite dysfunction
n/a
Definite dysfunction
31
75
>99
21
62
88
117
78
>99
Definite
Dysfunction
Raw Score
21
T-Score
69
Percentile
97
Interpretive Range
Some Problems
25
71
98
Hearing (HEA)
31
80
>99
Touch (TOU)
34
76
>99
Taste and Smell
Body Awareness
(BOD)
Balance and Motion
(BAL)
Planning and Ideas
(PLA)
Total Systems
Systems (TOT)
9
20
n/a
71
n/a
98
25
75
>99
15
64
92
Definite
Dysfunction
Definite
Dysfunction
Definite
Dysfunction
n/a
Definite
Dysfunction
Definite
Dysfunction
Some Problems
144
76
>99
Definite
Dysfunction
Some Problems
SPM-P Home Form
Scales
Social Participation
(SOC)
Vision (VIS)
Definite
Dysfunction
According to the SPM, Elliott demonstrated an overall definite dysfunction in his sensory processing
abilities, praxis, and social participation. When comparing the SPM Home and Classroom forms, he
demonstrates about the same sensory processing delays in the classroom and at home. He demonstrated
a definite dysfunction is all categories except planning and idea, which he demonstrated some problems in
the classroom and at home.
FUNCTIONAL STRENGTHS AND LIMITATIONS:
Strengths: Elliott is able to perform the following skills:
Locomotor:
 Run 50’ with arms moving in opposition, with both feet off the ground for a brief period
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






Land on heels or toes when running with nonsupport leg bent approximately to 90 degrees
Gallop with arms bent to waist level at takeoff with both feet off the floor for a brief period
Maintain a rhythmic pattern for four consecutive gallops
Leap over an object by taking off on one foot and landing on the other
Reach forward with the arm opposite the lead foot when leaping
Jump horizontally taking off and landing with both feet at the same time
Slide sideways 25’, stepping sideways with the lead foot following with the trailing foot to a
point next to the lead foot
 Step four consecutive step-slide cycles to the left and the right half of the time
 Maintain his body aligned sideways so shoulders are aligned to the line while stepping
sideways
 Hop by swinging the nonsupport leg forward in a pendular fashion to produce force half of the
time
 Flex arms and swing them forward to produce force when hopping up and down
 Take off and land on his right foot 3 consecutive times when hopping
 Take off and land on his left foot 3 consecutive times when hopping, half of the time
Object Control:
 Strike a stationary ball with a bat using hip and shoulder rotation during the swing
 Transfer his weight to his foot when batting half of the time
 Align his body so that the nonpreferred side of the body faces an imaginary tosser during t-ball
activities half of the time
 Extend arms to reach for a ball when tossed to him
 Run up and kick a stationary playground ball with a rapid continuous approach to the ball
 Throw a tennis ball overhanded with a downward movement of his arm during windup
 Rotate hips and shoulders where the nonthrowing side faces the target when throwing a ball
forward overhanded
 Follow through by releasing a ball diagonally across the body toward the non-preferred side when
throwing a tennis ball overhanded at a target
 Roll a ball underhanded by swinging his hand down and back reaching behind the trunk before
releasing the ball
Functional mobility skills with ability to:
 Pedal a tricycle on indoor and outdoor surfaces independently
 Transition from sit to stand through half kneel
 Walk/run on level surfaces with good balance and control
Limitations: Elliott is not yet able to perform the following age-appropriate skills:
Locomotor:
 Gallop by stepping forward with the lead foot and placing the trailing foot to a position adjacent or
behind the lead foot
 Keep the foot of the nonsupport leg behind his body when hopping
 Prepare for jumping horizontally by flexing both knees and extending arms behind his body
 Extend arms upward and forward reaching full extension above his head when jumping horizontally
Object Control:
 Grip a bat with the dominant hand above the nondominant hand in preparation for batting activities
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





Dribbly a playground ball 4 consecutive times by contacting the ball with one hand at belt level,
pushing the ball with fingertips only and keeping the ball in front of or outside of the foot on the
preferred side
Place hands in front of body with elbows flexed in preparation for catching a ball
Use hands only to catch a ball
Throw a ball overhanded by transferring his weight by stepping with the foot opposite the throwing
hand
Stride forward with the foot opposite the throwing hands when rolling a ball underhanded while
bending his knees to lower his body
Release a tennis ball close to the floor so it does not bounce when rolling it underhanded
Functional mobility skills:
 Maintaining balance and demonstrate appropriate body awareness when walking over obstacles
(stepping-stones, obstacle course, etc.) or other uneven surfaces
 Engage in appropriate peer play activities
 Participate in tasks that require attention to follow several step commands
 Mirror play activities demonstrated by therapist/peers
INTERPRETATION OF RESULTS:
Informed Clinical Opinion/Impressions
Elliott is an energetic, active little boy who demonstrates a mild delay in the development of his gross motor
skills according to the TGMD-2. He has made good progress over the past year, meeting 4 short term
objectives and improving to an average age equivalent of 4 years, 7 months. He does not qualify for direct
physical therapy services based on the TGMD-2, which are a reflection of his gross motor skills and
abilities. It is evident that Elliott presents with severe sensory processing deficits according to his scores on
the SPM-P home and classroom forms. At this time, it does not appear that Elliott’s sensory processing
deficits are interfering with his gross motor skills. It is recommended that Elliott continue to practice his
object control and ball skills at home and in the school setting to prevent him from falling behind in his
ability to carry out age-appropriate gross motor skills.
It is the informed clinical opinion of the examiner that Elliott’s sensory processing deficits are evident but do
not appear to be interfering with his ability to engage in and carry out age-appropriate gross motor activities
at this point. His sensory processing deficits would be best addressed by occupational therapy services at
this time. It is recommended that Elliott be referred to OT to further assess his sensory processing delays.
Elliott can be re-evaluated at a later date if he does not continue to develop gross motor skills appropriately
or if his parents or PCP have any concerns about his gross motor development.
If there are any questions regarding this evaluation report, recommendations or plan of care, please feel
free to contact Little Bitty City Enrichment Center at (501) 525-4855.
__________________________________
Ashley Blockburger, PT, DPT
__________________________
Date
cc: PCP; Parent
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