Red Flags Suggestive of Self-Care Problems

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Self Feeding

• Poor postural control that interferes with self-feeding
• Lack of finger feeding beyond 12 months of age
• Poor use of utensils (extended use of an immature grasp pattern, poor bilateral hand use)
• Refusal to use utensils by the appropriate developmental age
• Overly messy or sloppy eater
• Inability to sit still for a meal
• Extreme resistance to finger feeding certain textures of food

Dressing

• Poor postural control that interferes with dressing
• Delayed dressing skills beyond expected age
• Poor fine motor skills (unable to button, zip, snap by the expected developmental age)
• Intolerance to certain clothing textures
• Parental report indicating that it took "forever" to teach dressing skills such as tying shoes

Bathing

• Inability to independently sit in a bathing device after 8 months of age
• Parental concern about lifting child in and out of the bathtub
• Extreme resistance to washing hair
• Inability to maneuver in and out of the bathtub by the expected age

Toileting

• Difficulty opening legs of a child when diapering
• Cannot sit independently on toilet when developmentally appropriate
• Lack of independence in managing clothing after the expected developmental age
• Delayed bowel and bladder control

Grooming

• Poor fine motor skills to manage grooming tools such as comb, toothbrush, washcloth, and soap
• "Hates" having hair cut

Sleep

• Persistent tantrums at bedtime
• Frequent waking at night beyond infancy
• Absence of or excessive bedtime rituals
• Muscles do not relax during sleep