early intervention home

EARLY CHILDHOOD TEACHER/CAREGIVER QUESTIONNAIRE

(If child is enrolled in a daycare/nursery school/babysitter)

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Please check "Yes" if you have any concerns about the following areas of development.

(play skills, attention to task, remembering and readiness activities)

(ability to engage others and interact in their environment, follow routines, directions, learn rules and expectations)

(understand and express wants, needs and ideas, articulation)

(manipulating toys, pre-writing skills, small muscle development)

(sitting, standing, moving from place to place, large muscle development)

(self-care skills-feeding, dressing/undressing, hygiene/toileting, sleeping)