Screening Questions (Preschool)

Please answer the following questions:

Name of child *

First

Last

Age of Child *

• Any significant ill-health such as epilepsy, learning difficulties etc? *

• Do they show interest in other similarly aged children and are they happy to be amongst them? *

• Are they quite 'go with the flow' or do they seem unsettled out of routine, when leaving the house etc? *

• Do they show any evidence of pretend play? *

• Do they have any words (how many?) or put words together to make two word sentences ? *

• Do they show 'anticipatory understanding' - interest or excitement if you mention things they like such as biscuits, ‘Daddy’s home!’ etc if they do not have a visual cue (cannot see them)? *

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

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

• Do they generally quite readily do as they are told? *

• Do they do 'stereotypies' (if you are not sure what these are, google and look at a video) *

Your name *

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Your email *