An occupational therapy assessment is not an exam, and it does not give your child a label. Using standardised tests, observation during play, and conversations with parents, we build a picture of how your child is actually doing across six areas: sensory integration, primitive reflex integration, gross and fine motor skills and coordination, visual perception and handwriting, attention and executive function, and self-care and everyday participation. The assessment takes about 60 to 90 minutes and can be carried out at your home. Afterwards, the therapist explains the results and the direction for training to parents straight away.
An occupational therapy assessment covers the following six areas. Each one comes with 'examples you might see at home', and there is no need to remember any of the tool names.
How the brain takes in and organises touch, sound, movement and other signals — which affects sitting still, concentrating and learning.
Whether the automatic responses of babyhood have faded with growth; leftover reflexes can affect sitting posture, handwriting and emotions.
Posture, balance, running and jumping, throwing and catching, and finger strength — the foundations for dressing, eating and writing.
How the eyes 'follow' and 'scan', how what is seen is understood, and how that turns into copying and handwriting.
Staying focused, remembering steps, switching between activities, planning what comes first — the brain's 'conductor'.
Eating, dressing, toileting, tidying up, and how fully your child takes part in activities at home and at school.
The assessment is made up of three parts, and all three are essential:
Chosen to suit your child's age and needs, these compare your child's performance with other children of the same age to give an objective score.
During play and set tasks, the therapist observes sensory integration and reflex integration following an established framework. This part has no score, but it is often the key to explaining 'why your child can't manage something'.
Through questionnaires and conversation, we learn how your child does at home and in the classroom. One hour in the assessment room does not always show the whole picture.
At this stage the assessment alternates between play and short tasks. For children under three, we mainly observe through play and rely on the everyday information parents provide; children aged three to six can already complete brief pencil-and-paper and pre-writing tasks (such as drawing shapes, cutting paper, or writing their own name), and the assessment includes these tasks directly.
There is no WISC-IV below the age of six. Three preschool cognitive or developmental assessments are commonly used in Hong Kong:
If your child already has one of these reports, the therapist will help you understand what it says and explain which parts the occupational therapy assessment adds. We do not provide cognitive assessments at this clinic.
The five indexes of the WPPSI-IV (Hong Kong version), understood through everyday examples:
| Index | What it measures | How parents can understand it |
|---|---|---|
| Verbal Comprehension | Understanding and expressing in words | Whether they can briefly say what happened after hearing a story; whether they can explain 'why we wash our hands' |
| Visual Spatial | Understanding what they see and building with it | Whether they can build blocks to match a picture; whether they understand which piece goes where in a jigsaw |
| Fluid Reasoning | Spotting patterns and working things out | Playing a 'what colour comes next' sequencing game; noticing what two things have in common |
| Working Memory | Holding information in mind and finishing the task | Whether they can remember a two-step instruction such as 'go to the room, get your coat, then turn off the light' |
| Processing Speed | Working quickly and accurately | Quickly finding a matching pair in a pile of socks; how fast they play 'spot the difference' |
If you have not read the explanation of the indexes above, you may want to start with the cognitive assessment notes for each age group. This section answers just one question: how the two assessments differ, and why they are worth doing together.
Put simply: a cognitive assessment measures 'ability' — whether your child's brain has the capacity; an occupational therapy assessment measures 'performance' — how much your child actually manages in real tasks and real settings. Where they overlap is in processing speed, perceptual reasoning and working memory. When a particular index is low, an occupational therapy assessment can tell apart whether the cause is motor, visual perception, eye control, sensory integration, leftover reflexes or attention — and the direction of training differs for each.
Whether your child's brain has the capacity — arriving at index scores through standardised tests.
In one sentence: a cognitive assessment answers 'does my child have this ability'; an occupational therapy assessment answers 'why can't they do it despite having the ability, and how can they be helped to do it'.
A Primary 2 pupil whose WISC-IV Verbal Comprehension and Perceptual Reasoning were both above average, but whose Processing Speed was clearly low; the teacher reported slow copying and often being unable to finish classroom work.
What the occupational therapy assessment found
Visual-motor integration was normal, but handwriting speed was in the slower range for their age and pen pressure was too heavy; visual scanning was slow; reflex integration observation showed a leftover neck reflex; and the sensory questionnaire showed difficulty sustaining attention amid classroom noise.
Direction for training
Focused on reflex integration, eye control, handwriting efficiency and adapting to the classroom setting — rather than repeating visual perception training.
The therapist explains the results for each area straight away, and how they relate to your child's everyday difficulties.
Using the Canadian Occupational Performance Measure (COPM), the therapist works with you to choose the three to five everyday tasks you most want to improve — for example 'tidying their own desk' or 'finishing Chinese homework within thirty minutes' — as the goals for training and the basis for measuring progress.
The first training session can usually be arranged within a week.
Delivered within seven working days, it can be used to apply to the school for support, for a doctor's referral, or for an insurance claim. See the assessment fees page for details.
It depends on whether the difficulties have been resolved. A cognitive assessment answers 'is the ability there'; an occupational therapy assessment answers 'why can't they do it, and how can they'. If the report shows wide gaps between the indexes, or your child still has difficulty with handwriting, attention, emotions or self-care, an occupational therapy assessment can find the reasons and set a direction for training.
No. The assessment is intended to understand your child's functioning and the reasons behind it; a diagnosis is the responsibility of a doctor or psychologist. If the assessment finds that other professionals should be involved, the therapist will suggest a direction for referral.
The tools we use fall into three groups: those with Hong Kong or Chinese-speaking children's data, those with Taiwan norms (Traditional Chinese), and those that are internationally standardised. Every report states the source of each tool's norms, and makes up for differences in norms using samples of your child's homework and the views of parents and teachers.
No. Preschool assessment is play-based, and your child does not need to cooperate with pencil-and-paper tests. The earlier you understand how sensory integration, reflex integration and gross and fine motor skills are developing, the earlier adjustments can be made in everyday life.
It can be used for support applications related to fine motor skills and handwriting; the school will handle these according to its own procedures. Other kinds of accommodation generally require a report from a doctor or psychologist, and the therapist will explain honestly what the report can be used for.
In general a doctor's referral is needed; if your child has been given a diagnosis for the relevant condition by a doctor within the past twelve months, you can book directly. Please describe your child's situation when you enquire on WhatsApp, and we will let you know what documents are required.
Enquire on WhatsApp about arranging an assessment, and we will explain the documents needed based on your child's situation.
WhatsApp UsThe content on this page is intended to help parents understand the scope of the assessment and does not constitute a diagnosis.
