PLAY EVALUATION
PLAY EVALUATION
Play evaluation by Dr.Arunkumar.RM
1. General Information:
1. Name
2. age
3. Sex
4. Date of evaluation
5. Hospital NO(IP/OP)
6. Diagnosis
7. Informant(s):
8. Presenting Problem:
2. Previous Play Experiences
1. Solitary play
2. Play with others:
Mother, father , sisters, brothers, playmates ,other family members,
pets
3. Play with toys and materials (earliest preferences)
4. Gross physical play
5. Pretend and make-believe play
6. Sports and games: group collaboration group competition
7. Creative interests: arts crafts
8. Hobbies, collections, other leisure time activities
9. Recreation/social activities
3. Actual Play Examination
1. With what does the child play?Toys materials pets
2. How does the child play with toys and other materials?
3. What type of play is avoided or liked least?
4. With whom does the child play? self parents brothers sisters peers others
5. How does the child play with others?
6. What body postures does the child use during play?
7. How long does the child play with objects? with people?
8. Where does the child play? home: indoors outdoors community: park school church other areas
9. When does the child play?daily schedule for weekday and weekend
4. Describe the physical setting
Who was present?
5. Describe the activities performed by the child
Gross Motor
1. Balance:
2. Coordination:
3. Motor Planning:
4. Sequencing:
5. Endurance:
6. Mobility:
7. Quality of Movement:
8. Overall Skill:
Fine Motor
1. Manipulation of Objects:
2. Grip:
3. Strength:
4. Overall Effectiveness:
Social
1. Participation:
2. Negotiating:
3. Peer Interactions:
4. Sharing:
Imitative
1. Creativity:
2. Novelty:
3. Use of Toys:
Language
1. Expression:
2. Communication:
3. Imagination:
Attitude
1. Approach:
2. Affect:
3. Spontaneity:
4. Teasing:
5. Mischief:
6. Describe the adult supervision. Did it facilitate or inhibit play?
7. Play Description
8. Play Prescription
Comments