Screening Questions (Older Children)

Step 1 of 2

Please give a brief account (minimum 1 line – maximum 3 lines for each question) of what they were like through childhood not just what they are like now.

Name of Child *

First

Last

Age of Child *

• Any significant current or serious past health issues (eg epilepsy, significant learning difficulties etc)? *

• Do they make and keep friends easily? *

• Are they quite go with the flow or do they struggle with new things, changes of plans etc? *

• Did they enjoy imaginary and pretend play from early childhood (before the age of 3 etc)? *

• Was there any significant speech and language delay? *

• Do they pick up on subtle language such as sarcasm, figures of speech, irony etc yet? We expect this from the age of about 6. *

• Are they an angry child often? If so, triggers? *

• Do they tend to be anxious much of the time? If so, triggers? *

• Do they easily put themselves in others shoes emotionally? *

• Do they generally quite readily do as they are told? If not, how old was she/he when this tendency started? *