Free Developmental Assessment

Please fill out this Developmental Assessment if you have any concerns.

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By 6 months of age

Answers

Does your child smile back at you and other family members? Does your child turn their head towards sound or voice? Does your child roll front to back and back to front? Does your child squeal and babble different sounds? Does your child sit while leaning on his/her hands? Does your child enjoy playing “peek-a-boo?” Does your child bring the bottle to his/her mouth with both hands? Does your child bring toys and teethers to their mouth to explore? Does your child open their mouth as a spoon of food approaches?

By 12 months of age

Answers

Does your child pull to standing at furniture? Does your child lower his/her self to sitting on the floor, from standing, without falling? Does your child cruise sideways around furniture? Does your child clasp hands together well? Does your child pick up small items with fingers and thumb? Does your child stack 2 blocks? Does your child point with his/her index finger? Does your child copy movements like “pat-a-cake” or “bye-bye?” Does your child repeat sounds like “baba,” “mama” or “dada?” Does your child participate in two-way conversation? Does your child feed him/herself with his/her fingers? Does your child eat a variety of food textures?

By 18 months of age

Answers

Does your child climb into an adult chair and turn around to sit? Does your child walk independently? Does your child push/pull a large toy around the room? Does your child stack 4-6 blocks? Does your child remove shoes when they are unlaced? Does your child use at least 3 words besides “mama” or “dada? Does your child respond to questions? Does your child identify 1-2 body parts when named? Does your child use a spoon to feed themself?

By 24 months of age

Answers

Does your child run without falling? Does your child throw a tennis size ball about 3-5 ft in the direction of a target? Does your child jump up 2 inches from the floor with both feet? Does your child jump from a bottom step? Does your child imitate a horizontal stroke with a pencil/crayon? Does your child pull his/her pants down with assistance? Does your child point and use words to get your attention? Does your child understand and follow simple directions? Does your child drink from an open cup?

By 3 years of age

Answers

Does your child safely make sharp turns while running? Does your child avoid obstacles in his/her path? Does your child catch a ball with his/her arms and hands extended? Does your child kick a ball about 6 feet? Does your child put his/her socks and shoes on? Does your child comfort others when they are crying? Does your child have an established sleep schedule? Does your child have at least 100 words? Does your child combine 2 ideas in a sentence, like: “I want an apple and a banana. Does your child walk up stairs while placing 1 foot on each step, alternating his/her feet, on 4 steps without holding onto something?

By 4 years of age

Answers

Does your child hop on 1 foot forward 10 times? Does your child pedal a tricycle for a long distance and turn corners or make a u-turn? Does your child imitate a square drawing on a piece of paper? Does your child match 6 colors? Does your child cut out a small square or triangle with blunt tip scissors? Does your child button front-opening buttons? Does your child undress daily, at designated times, without reminders? Does your child dress independently when asked? Does your child quiet down after active periods and wait for instructions? Does your child return objects to assigned places when asked? Does your child tell you a story from a book or video? Does your child say all the sounds at the beginning, middle and end of a word?

By 5 years of age

Answers

Does your child jump, gallop and hop at least 8 consecutive times? Does your child skip 8 steps using opposing arm and leg movements? Does your child hit a target with a tennis ball from 12 ft away using an overhead throw? Does your child run while pumping his/her arms? Does your child print his/her own name? Does your child draw a picture of at least 3 objects? Does your child place shoes on the correct feet? Does your child adapt to changes in routine? Does your child pay attention without excessive distraction? Does your child play games with rules, like Candyland or kickball? Does your child produce grammatically correct sentences? Do you understand your child’s speech in conversation?

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Please fill out this Developmental Assessment if you have any concerns.

Please Select Your Child's Age Range: Close

0 – 6 months
6 – 12 months
12 – 18 months
18 months – 24 months
24 months – 3 years
3 years – 4 years
4 years to 5 years

6 Months

Does your child smile back at you and other family members?

Yes No

Does your child squeal and babble different sounds?

Yes No

Does your child sit while leaning on his/her hands?

Yes No

Does your child enjoy playing “peek-a-boo?”

Yes No

Does your child bring the bottle to his/her mouth with both hands?

Yes No

Does your child open their mouth as a spoon of food approaches?

Yes No

6 months to 12 months

Does your child pull to standing at furniture?

Yes No

Does your child lower his/her self to sitting on the floor, from standing, without falling?

Yes No

Does your child cruise sideways around furniture?

Yes No

Does your child clasp hands together well?

Yes No

Does your child pick up small items with fingers and thumb?

Yes No

Does your child stack 2 blocks?

Yes No

Does your child point with his/her index finger?

Yes No

Does your child copy movements like “pat-a-cake” or “bye-bye?”

Yes No

Does your child repeat sounds like “baba,” “mama” or “dada?”

Yes No

Does your child repeat sounds like “baba,” “mama” or “dada?”

Yes No

12 months to 18 months

Does your child climb into an adult chair and turn around to sit?

Yes No

Does your child walk independently?

Yes No

Does your child push/pull a large toy around the room?

Yes No

Does your child stack 4-6 blocks?

Yes No

Does your child remove shoes when they are unlaced?

Yes No

Does your child use at least 3 words besides “mama” or “dada?

Yes No

Does your child respond to questions?

Yes No

Does your child identify 1-2 body parts when named?

Yes No

Does your child use a spoon to feed themself?

Yes No

18 months to 24 months

Does your child run without falling?

Yes No

Does your child throw a tennis size ball about 3-5 ft in the direction of a target?

Yes No

Does your child jump up 2 inches from the floor with both feet?

Yes No

Does your child jump from a bottom step?

Yes No

Does your child imitate a horizontal stroke with a pencil/crayon?

Yes No

Does your child pull his/her pants down with assistance?

Yes No

Does your child point and use words to get your attention?

Yes No

Does your child understand and follow simple directions?

Yes No

Does your child drink from an open cup?

Yes No

24 months to 3 years

Does your child safely make sharp turns while running?

Yes No

Does your child avoid obstacles in his/her path?

Yes No

Does your child catch a ball with his/her arms and hands extended?

Yes No

Does your child kick a ball about 6 feet?

Yes No

Does your child put his/her socks and shoes on?

Yes No

Does your child comfort others when they are crying?

Yes No

Does your child have an established sleep schedule?

Yes No

Does your child have at least 100 words?

Yes No

Does your child combine 2 ideas in a sentence, like: “I want an apple and a banana.

Yes No

Does your child walk up stairs while placing 1 foot on each step, alternating his/her feet, on 4 steps without holding onto something?

Yes No

3 years to 4 years

Does your child hop on 1 foot forward 10 times?

Yes No

Does your child pedal a tricycle for a long distance and turn corners or make a u-turn?

Yes No

Does your child imitate a square drawing on a piece of paper?

Yes No

Does your child match 6 colors?

Yes No

Does your child cut out a small square or triangle with blunt tip scissors?

Yes No

Does your child button front-opening buttons?

Yes No

Does your child undress daily, at designated times, without reminders?

Yes No

Does your child dress independently when asked?

Yes No

Does your child quiet down after active periods and wait for instructions?

Yes No

Does your child return objects to assigned places when asked?

Yes No

Does your child tell you a story from a book or video?

Yes No

Does your child say all the sounds at the beginning, middle and end of a word?

Yes No

4 years to 5 years

Does your child jump, gallop and hop at least 8 consecutive times?

Yes No

Does your child skip 8 steps using opposing arm and leg movements?

Yes No

Does your child hit a target with a tennis ball from 12 ft away using an overhead throw?

Yes No

Does your child run while pumping his/her arms?

Yes No

Does your child print his/her own name?

Yes No

Does your child draw a picture of at least 3 objects?

Yes No

Does your child place shoes on the correct feet?

Yes No

Does your child adapt to changes in routine?

Yes No

Does your child pay attention without excessive distraction?

Yes No

Does your child play games with rules, like Candyland or kickball?

Yes No

Does your child produce grammatically correct sentences?

Yes No

Do you understand your child’s speech in conversation?

Yes No

Name

Phone

Your child's age

Your child's initials

Your zip code

Schedule an Evaluation Today!

Little Wonders Pediatric Therapy is here to help your child achieve their fullest potential. Give us a call at (704) 752-1616 today to schedule an evaluation. Or, if you have any questions, our friendly and knowledgeable staff will be happy to help.

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