1. When you talk to your child, does he/she look in the direction of your voice?
     For example: Does your child turn his/her head and/or move his/her eyes to look for you?


 2. Does your child vocalize or make sounds in response to your smile or voice?


 3. Does your child have different cries to indicate different needs?
     For example: Does your child's “ hungry cry“ sound different from the sound he/she makes when tired? 


 4. Does your child express pleasure or displeasure by using sounds other than crying or laughing?
     For example: Does your child make “happy” sounds or sounds of frustration?


 5. Does your child bring toys or objects to his/her mouth?
     For example: Does your child mouth objects or place objects in his/her mouth?


 6. Does your child laugh?


 7. Does your child engage in “vocal play” by producing a wide variety of sounds?
     For example: Does your child produce sounds that range from very high pitch (squeals) to very low pitch (growls) and does  
     does he/she produce "raspberries” by putting lips tightly together and blowing air to produce a vibrating, play-like sound?


 8. Does your child produce two or more vowel sounds, such as “ah” or “ooh” ?


 9. Does your child recognize his/her name (or nickname)?


10. Does your child shout or use vocalizations / make sounds to get your attention?


11. Does your child imitate sounds you or others make?


12. Does your child repeat two similar sounds together (not necessarily referring to a specific object  or person?
      For example: Does your child say things like “bababa” or “dadada” ?


13. When you say things to your child like “want up?” or “bye-bye” does your child respond by lifting his/her arms or waving?
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14. Does your child put different sounds together?
      For example: Does your child say things such as "bah-dah ", " ah-bee-tah” or " ah-mee-ga “ ?


15. Does your child vocalize while gesturing to let you know what he/she wants?
      For example: Does your child point or motion toward a desired object while vocalizing?


16. Does your child say any word besides “ mama ” or “ dada ” ?
      For example: A " word can be an attempt at a real word such as " ba for " ball • or " wawa for water.


17. Does your child give you an object when you ask for it?
      For example: If you say " Give me your shoes " or " Give me the ball ", does your child respond correctly?


18. Does your child follow simple 1-step directions?
      For example: If you say " Go get your shoes" or "Put the toy on the bed ", will your child respond correctly?


19. When you name different objects, does your child point to them?
     For example: "you say " Where Is the ball? " or See the truck? , will your child point to the correct object?


20. Can you tell by the way your child's voice sounds that he/she is asking a question?
      For example: When your child is babbling but you can't make out the words, can you still tell that he/she is trying 
      to ask a question by a rise in pitch at the end of the babbles?


21. Does your child identify basic body parts on himself/herself?
      For example: Can your child point to hls/her nose, mouth, toes, and hair?


22. Does your child say at least 10 meaningful words that you consistently recognize?
     The words don't have to be pronounced perfectly. For example: if your child consistently uses " ba " for " bottle ", 
     this counts as a word.


23. Does your child point to objects named in books?
     For example: "if you say something like " Show me the cat " does your child point to the correct picture?


24. Does your child spontaneously repeat words that he/she has heard in conversation?


25. Does your child follow two-step directions?
      For example: "If you say something like " Go get your shoes and put them on the table " or " Go get your coat 
      and give it to your grandma " will he/she respond correctly?


26. Does your child understand the meaning of at least four action words without the use of gestures?
      For example: "If you say " jump " or " throw " without demonstrating the action, will he/she respond correctly?


27. Does your child understand " what ", " where ", and" who" questions?


28. Does your child name familiar objects in a room?


29. When you point to pictures in a book, does your child name them?


30. Does your child understand location words such as " in ", " on ", and " out" ?


31. Does your child combine two or more words together to form simple phrases?
      For example: Does your child say things like " want ball " or " mommy sit " ?


32. Does your child have at least a 50 word spoken vocabulary?


33. Does your child understand the concept of " one" ?
      For example: "If you point to a group of blocks and ask your child to hand you " one ", will your child respond correctly?


34. Does your child follow 3-step directions without getting distracted?
      For example: "If you say something like " Go to your room, get your bear and bring it to me ", will your 
      child respond correctly?

35. Does your child say" I ",  me ", and" you "?


36. Does your child understand color words?
      For example: "If you say something like " Point to the red one " will he/she correctly identify the object?

37. Is your child starting to use size concepts?
      For example: Does your child say words like. " big " and " little " ?

38. Is your child using sentences that are four words in length?


39. Is your child adding ". s " to words to indicate " more than one " ?
      For example: Does your child say " cats " for more than one cat or " spoons " for more than one spoon?

40. Can your child tell you what to do with simple objects?
      For example: "If you say something like " Here is a toothbrush, what do we do with a toothbrush? " will he/she tell 
      you what it is used for?


41. Is your child adding " ing " to the end of verbs to indicate ongoing action?


42. Does your child use the words" a", " an ", and " the "?
      For example: Does your child use words like " a bed ", .. an apple ", and " the ball " ?


43. Can your child name common shapes such as circle, triangle, square, and star?


44. Does your child understand concepts like " least ", " most ", and " first "?


45. Does your child understand concepts like" short ", " tall ", and" long" ?


46. Does your child use the plural pronouns " we ", "they ", " them ", and " us "?


47. Is your child adding " ed " to the end of verbs to indicate an action that happened in the past?
      For example: Does your child say words like " jumped " and " played " ?


48. Does your child spontaneously produce sentences that are 10 or more words in length?


49. Can your child name items that belong to a common category?
      For example: "If you say '"tell me three fruits you Iike " or " TeII me the names of three animals ", will your
      child respond correctly?

50. Can your child retell a story or event with a beginning, middle, and end without using pictures?
      For example: Does your child tell a complete story (beginning, middle, and end) so you understand the story 
      and what your child is expressing/explaining?

51. If you name an object, can your child describe two things about the object?
      For example: "If you say, " tell me two things about a bike " will your child respond correctly?


52. Does your child ask you about the meanings of words and then use the word in a sentence?

Your Name
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Instructions: Please check the box for each question indicating whether or not your child is consistently demonstrating the task.

     Check "YES" if  - 

                     - Your child consistently demonstrates the skill or behavior.
                     - Your child has consistently demonstrated the skill in the past and has moved on to other skills.

                     NOTE: Do not check "yes" unless your child has demonstrated the behavior more than once.

     Check "NOT YET" if -     

                      - Your child has not yet consistently demonstrated the skill or behavior.

             ​You may find that your child is already doing many of these items (or may have done them at some point in the past) while other items your child may not be                    doing yet.   This is very common.  

       ​​Begin with the first question and progress through each one until you answer "not yet" for 5 questions in a row.  At that point you can stop filling out the questionnaire.  

       Click the "Submit" button at the end of the questionnaire.   
Remember!

You must start with question #1. The first several questions are most appropriate for infants and toddlers. If you have an older child and they demonstrated that skill when they were a baby, please check "yes" for that item.
Gender
email address (required)
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Remember:  Stop after you have answered "not yet"
 5 times in a row.
Remember: 
Stop after you have answered "not yet" 5 times in a row.

Then, proceed to the bottom of the page and click "submit."
Remember: 
Stop after you have answered "not yet" 5 times in a row.

Then, proceed to the bottom of the page and click "submit."
Remember: 
Stop after you have answered "not yet" 5 times in a row.

Then, proceed to the bottom of the page and click "submit."
Remember: 
Stop after you have answered "not yet" 5 times in a row.

Then, proceed to the bottom of the page and click "submit."
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