Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. – Step 1 of 8Is My Child’s Development On Track? Do you want to check on your child’s development? We have provided a simple yet effective questionnaire to determine if your child’s development is on track or if it would be wise to consider taking steps to ensure your little one’s future success. Just take a few minutes to complete the quiz, fill out some information and check all the boxes that apply. (This take approximately 15 minutes.) Let’s get started! My Child's Age is *Choose ageUnder 12 months1 year old18 months old2 years old3 years old4 years old5 years old6 years oldChild Out of Range Sorry, this Developmental Checklist is only available to Assess Children between the ages of 12 months to 6 years old. NextSo Let’s Talk About Your Child’s Big Movements… My One Year Old… (check all that apply) My 18 Month Old… (check all that apply) My Two Year Old… (check all that apply) My Three Year Old… (check all that apply) My Four Year Old… (check all that apply) My Five Year Old… (check all that apply) My Six Year Old… (check all that apply) 1 Year Old (12-17 months) Gross Motor DevelopmentWalks along furniturePulls up to standGets into and out of sittingCrawls on hands and knees without dragging one leg or scooting in sittingCan move from sitting on the floor to standing and standing to the floor without falling18 month old Gross Motor DevelopmentWalks independently with arms at sidePut arms out to protect head when they fallWalks backwards 5 stepsAble to crawl upstairsThrows a ball while maintaining balanceRides a push bike (bike without pedals)2 year old Gross Motor Development Stoops down to retrieve toy and returns to standingJumps down off low surface, such as curb at the parkJumps forward about 4 inchesGoes up stairs without rail (placing both feet on each step)Throws a ball 3 feet in airKicks ball 3 feet forward without directionRides a push bike (bike without pedals)3 Year Old Gross Motor DevelopmentWalks up stairs without rail (one foot on each step)Rides a tricycleHops 3 times on one footKicks a large ball towards a targetJumps down about 24 inchesSlides down a slide at the playgroundClimbs well on a jungle gymAble to stop quickly when running4 year old Gross Motor DevelopmentStands on one foot for 5 seconds (hands on hips)Hops 5-8 times on each footRides a 2-wheeled bike with training wheelsWalks backwards on a line over 4 feetJumps forward 30 inchesClimbs well on a jungle gymWalks downstairs without using a rail, placing one foot on each step5 year old Gross Motor Development Completes sit upsAble to skip, alternating feetCompletes jumping jacksCompletes push-upsPerforms somersaultsClimbs well on jungle gymHas begun to jump ropeThrows the ball to hit a targetSwings without being pushedPumps legs to keep the swing going6 year old Gross Motor Development Runs with coordinationCompletes sit upsAble to skipCompletes jumping jacksRides a 2-wheeler without training wheelsCompletes push-upsPerforms somersaultsClimbs well on jungle gymIs able to jump ropeThrows the ball to hit a targetSwings without being pushedPumps legs to keep the swing goingPreviousNextNow, Let’s Talk About Your Child’s Small Movements… My One Year Old… (check all that apply) My 18 Month Old… (check all that apply) My Two Year Old… (check all that apply) My Three Year Old… (check all that apply) My Four Year Old… (check all that apply) My Five Year Old… (check all that apply) My Six Year Old… (check all that apply) 1 Year Old (12-17 months) Fine Motor DevelopmentAble to grasp toys and let them go againCan bring toys to mouth or bang them togetherAble to bring his hands together at the middle of his/her body (e.g. clapping)Able to feed herself/ himself finger foods, using her thumb and pointer finger to pick up foodTurns a page in a cardboard bookPulls off shoesIs able to hold bottle to feed selfCooperates with dressing and undressing by straightening arm to put it into a sleeve and bending their arm to take it out of the sleeve.Puts objects into others, such as will drop blocks into a bowl or bucket18 months Fine Motor DevelopmentGrasp thick crayon or pencil in fist, does not markPoints at things using his pointer finger (e.g. pictures in a book)Use a pincer grasp (thumb and pointer finger) to pick up small objectsHelps to dress and undress self by moving their arms and legs to help get them into sleeves and pantsPulls shoes offPuts objects into others, such as putting large round pegs into pegboardUses both hands during play (most children do prefer one hand over the other)Turns a small knob or dial on a toy, such as a pop up toyPicks up a crayon and will mark on paper without staying on the paperGets a spoon into mouth right side upTurns over a box of toys to dump them onto the floor2 years Fine Motor DevelopmentDrinks from regular open cup that does not have a lid or spoutDrinks from a straw using lipsLooks at picture books by themselvesZips and unzips zippers if someone latches it for them to get them startedTakes off their own clothesUses play dough, paint and paperScribbles without going off paperBuilds a 4-6 block towerImitates drawing a vertical linePuts square, round and triangular shapes into board or a shape sorterAble to put a simple, large puzzle piece into a wooden puzzleCan feed self with a spoon or forkFine Motor Development for 3-Year OldsGrasps pencil with thumb and fingers instead of fistScrews and unscrews jar lidsEats with a fork (with spillage)Pours accurately from one container to anotherCompletes a simple 3 piece puzzleCan dress and undress with loose clothing and with help to get the clothing facing the correct wayAble to hold scissors and snip on paperAble to draw straight lines or circlesSnips (makes small cuts) with scissorsCan stack up several blocksFine Motor Development for 4-Year OldsPuts socks on correctlyPuts shoes (does not yet tie) on correctlyButtons and unbuttons quarter inch buttons, such those on a button down shirtColors almost entirely within lines of circleAble to draw a circle and straight lines independentlyDraws a person with 3 different body parts (e.g. head, arms, legs or head, eyes, mouth)Dresses and undresses without much helpCopies a crossCAN string ½ inch beads onto a laceCan use a fork and spoon wellFine Motor Development for 5-Year OldsHolds crayons or pencils with thumb and fingersCopies and cuts a squareCopies color/shape sequenceLatches and zips the zipper on their coatTraces around own hand with crayonCompletes simple dot to dot picturesAble to copy a couple lettersPuts socks on correctlyCut along a straight lineAble to draw a circle, square and cross (+)Able to put on shirts, pants, socks, and shoes (with some help with fasteners)Able to feed himself well with a spoon and fork6 years Fine Motor Development Dresses and undresses selfReads and writes numbers one to 10Writes first and last nameTies shoesDraws a person with six different body partsColors within linesOpen zip lock bags and food wrappersCuts out simple shapes with scissorsPreviousNextNow, Let’s Talk About Your Child’s Communication… My child…(please check all that apply) My 1 Year Old… (check all that apply) My 18 Month Old… (check all that apply) My 2 Year Old… (check all that apply) My 3 Year Old… (check all that apply) My 4 Year Old… (check all that apply) My 5 Year Old… (check all that apply) My 6 Year Old… (check all that apply) 1 Year Old (12-17 months) Speech DevelopmentFeeding self with fingersHas one or two words (hi, dog, dada, mama)Babbles using different sounds such as “tata upup bibibibi”Uses speech or noncrying sounds to get and keep attentionTurns and looks in direction of soundsTakes turns vocalizingPoints or gestures (for example, will raise their arms if they want to be held)Waves bye-byeEnjoys games like peek-a-boo and pat-a-cakeRecognizes words for common items like “cup”, “shoe”, “book”, or “juice”Begins to respond to requests (e.g. come here, want more)18 Month Old Speech DevelopmentUses 10-20 wordsSays 2 words together that are typically said together, such as “all done”Names at least 5 itemsResponds to “yes/no”Retrieves objects from another room when asked2 year Old Speech DevelopmentFrequently uses 2 word phrase such as (“more cookie,” “no juice,” “mommy book”).Uses some one- or two- word questions (“Where kitty?” “Go bye-bye?” “What’s that?”).Demonstrates verbal turn takingHas at least 50 wordsUnderstood by listeners 25-50% of the timeFollows simple 2 step commands, such as “pick up your ball and put it in the toybox”Eats table foods with mixed textures such as, cut up green beans, small pieces of chicken, and pastaListens to simple stories, songs, and rhymesPoints to a few body parts when asked.Points to pictures in a book when named.Uses many different consonant sounds at the beginning of words.3 Year Old Speech DevelopmentHas about 1000 wordsConverses in sentences — Uses two or three words to talk about and ask for thingsAsk questions such as “What is that? Where did mommy go?” why?Responds to “what” and “where” questionsUnderstood by listeners 75% of the timeCan follow 3 step verbal commands, such as “pick up your blanket, take it upstairs and put it on your bed”Uses k, g, f, t, d, and n sounds.Understands differences in meaning (“go-stop,” “in-on,” “big-little,” “up-down”).Listens to and enjoys hearing stories for longer periods of timeChews and swallows most adult foods including steak and raw veggies4 Year Old Speech DevelopmentUses at least 1500 wordsUses 4-5 word sentencesUnderstands time concepts of now/later, before/after, first/thenUses contractions (don’t)Asks many questions including “who” and “why”Understood by listeners 80% of the timePeople outside of the family usually understand child’s speechFollows multi-step directions, such as “go upstairs, brush your teeth, put on your jammies and pick out a book”Chews and swallows most adult foods including steak, raw veggiesTalks about activities at school or at friends’ homes.Talks about what happened during the day. Uses about 4 sentences at a time.Says rhyming words, like hat-catUses pronouns, like I, you, me, we, and theyUses some plural words, like toys, birds, and busesUses a lot of sentences that have 4 or more words.Usually talks easily without repeating syllables or words.Hears you when you call from another room.Hears television or radio at the same loudness level as other family members.Understands some colors and shapesUnderstands words for family, like brother, grandmother, and aunt5 Year Old Speech DevelopmentUses a variety of sentencesVocabulary of 2000 wordsCan tell a story with plotUnderstood by listeners 90-100% of the timeAsks questions to get more informationUnderstands time concepts (today tomorrow, yesterday)Uses contractions, such as don’t and can’tChews and swallows most adult foods including steak, raw veggiesSays all speech sounds in words. May make mistakes on sounds that are harder to say, like l, s, r, v, z, ch, sh, th.Responds to “What did you say?”Talks without repeating sounds or words most of the timeNames letters and numbersUses sentences that have more than one (1) action word, like jump, play, and get. May make some mistakes, like “Zach got two video games, but I got one.”Keeps a conversation goingTalks in different ways depending on the listener and place. May use short sentences with younger children or talk louder outside than inside.Understands words for order, like first, next, and last.Hears and understands most of what is said at home and in school.Follows multi-step directions, such as “go upstairs, brush your teeth, put on your jammies and pick out a book”Follows classroom directions, like “Draw a circle on your paper around something you eat.”6 years Speech Development Uses a variety of sentencesVocabulary of 2600 to 7000 wordsCan tell a story with plotUnderstood by listeners 90-100% of the timeAsks questions to get more informationUses more speed sounds correctlyEngages in play with othersUses pronouns correctly(I, me, you, he, she, they)Understands time concepts (today, tomorrow, yesterday)Uses contractions such as don’t, wouldn’t, and can’tFollows multi step directions such as take off your shoes, hang up your coat, take your folder out of your backpack, and put your lunch box on the counter.Chews and swallows most adult foods including steak, raw veggiesPreviousNextNow, Tell Us How Meal Times Are Going… My 1 Year Old… (check all that apply) My 18 Month Old… (check all that apply) My 2 Year Old… (check all that apply) My 3 Year Old… (check all that apply) My 4 Year Old… (check all that apply) My 5 Year Old… (check all that apply) My 6 Year Old… (check all that apply) Early Feeding Concerns Coughing or choking during eatingArching or stiffening of the body during feedingBeing very irritable/fussy during or after feedingTaking a really long time to eat a meal (more than 30-45 minutes)Frequent spitting upGetting sick often with pneumonia or chest infectionsGurgly, hoarse, or breathy voice after eatingLess than normal weight gain or growthLots of leakage of food or liquid from the mouthCoughing, gagging, or throwing up during or after mealsHas a limited diet — does not eat a wide variety of foods for their ageStuffing mouth with foodHolding food inside pockets in mouth for long periodsDifficulty accepting new textures of foodAvoidance behaviors to specific foods and textures (gagging, vomiting, blocking the spoon with hands or closed lips, crying, pushing food away, etc)Abnormal bowel movements that last longer than a few days (diarrhea, constipation, loose stool)Skin reactions to foods (dry patches, hives, raHe/shes) Note: If your child seems to be having a severe allergic reaction to a food (difficulty breathing, turning red, developing hives or rash on the face/chest), you should seek medical help immediatelyFeeding ConcernsRegular coughing or choking during eatingRefuses to eat what is served at dinner making mealtimes stressfulTaking a really long time to eat a meal (more than 30-45 minutes)Getting sick often with pneumonia or chest infectionsGurgly, hoarse, or breathy voice after eatingLess than normal weight gain or growthLots of leakage of food or liquid from the mouthCoughing, gagging, or throwing up during or after mealsStuffing mouth with foodHolding food inside pockets in mouth for long periodsDifficulty accepting new textures of foodAvoidance behaviors to specific foods and textures (gagging, vomiting, blocking the spoon with hands or closed lips, crying, pushing food away, etc)Refusing to eat more than a few foods, or refusing to eat anything from one of the food groupsBeing extremely rigid about how food is prepared or how it is servedAbnormal bowel movements that last longer than a few days (diarrhea, constipation, loose stool)Skin reactions to foods (dry patches, hives, raHe/shes) Note: If your child seems to be having a severe allergic reaction to a food (difficulty breathing, turning red, developing hives or rash on the face/chest), you should seek medical help immediatelyHas a limited diet — does not eat a wide variety of foods for their agePreviousNextFinally, Tell Us About Your Child’s Response to How They Sense The World Around Them… My 1 Year Old… (check all that apply) My 18 Month Old… (check all that apply) My 2 Year Old… (check all that apply) My 3 Year Old… (check all that apply) My 4 Year Old… (check all that apply) My 5 Year Old… (check all that apply) My 6 Year Old… (check all that apply) Early Sensory Integration Cries during bath time or refuses to take a bathCries or fights when you try to brush their hair or teethDoes not turn towards soundsDoes not show an interest in watching people’s facesDoes not smile back at me when I smile at themDoes not point at objects to show interest (point at an airplane flying over) by 14 monthsMakes very few gestures (such as pointing, waving, showing)Does not play “pretend” games (e.g. pretend to “feed” a doll) by 18 monthsDoesn’t seem to know how to play with toys or excessively lines up toys or other objectsIs attached to one particular toy or objectAvoids messy playAvoids eye contactWants to be alone 75% of the timeAvoids being held and snuggled or resists physical contactBecomes easily upset, compared to other children their same ageIs not able to calm down easily after being upsetUnusual prosody (rhythm and intonation of language talks in a flat, robot-like, or sing- song voice)Is frightened by typical sounds such as the vacuum or a toilet flushingRefuses to eat what is served at dinner making it a stressful time for the family.Refuses to try new foodsIs unable to sit down to perform an activity, look at a book, or play a gameIs not comforted by others during distressGives unrelated answers to questionsGets upset by minor changesHas obsessive interestsFlaps his hands, rocks his body, or spins in circlesAvoids climbing and exploring at the playgroundHas unusual reactions to the way things sound, smell, taste, look, or feelGrinds their teethHas flat or inappropriate facial expressionsHas a loss of speech or babbling or social skillsGets dizzy or car sick easilyDoes repetitive movements with objectsAvoids wearing different types of clothing textures, or is very particular about the feel of the clothing they wearHas a lack of sharing interest or enjoyment with othersLack of appropriate eye gazeInconsistent or no response to nameIs not cooperative for their ageIs particular about what socks they wear, or insists on wearing them inside outAppears to be anxiousSeems to be in constant motion, seems to be unable to sit still, unless playing on an electronic deviceFollows a rigid routine and has difficulty with changes in routine (e.g. Dad is picking them up from daycare one day instead Mom or insists on taking a specific route to school)Has difficulty adapting to any changes in schedule or environment (e.g. throws a tantrum if the furniture is rearranged or bedtime is at a different time than usual)Sensory IntegrationCries during bath time or refuses to take a bathAvoids messy playCries or fights when you try to brush their hair or teethPrefers not to be touched, held, or cuddledHas trouble understanding or talking about feelingsDoesn’t know how to connect with others, play, or make friendsAppears disinterested or unaware of other people or what’s going on around himDoesn’t seem to hear when others talk to herDoesn’t share interests or achievements with others (drawings, toys)Repeats the same words or phrases over and overResponds to a question by repeating it, rather than answering itAvoids looking at you or others in the eye when being spoken toUses facial expressions that don’t match what he/she is sayingDoesn’t pick up on other people’s facial expressions, tone of voice, and gesturesMakes very few gestures (such as pointing)May come across as cold or “robot-like”Reacts unusually to sights, smells, textures, and soundsMay be especially sensitive to loud noisesAbnormal posture, clumsiness, or eccentric ways of moving (e.g. walking exclusively on tiptoe)Unusual attachments to toys or strange objects such as keys, light switches, or rubber bandsObsessively lines things up or arranges them in a certain orderPreoccupation with a narrow topic of interest, often involving numbers or symbols (e.g. memorizing and reciting facts about maps, train schedules, or sports statistics)Spends long periods of time arranging toys in specific ways, watching moving objects such as a ceiling fan, or focusing on one specific part of an object such as the wheels of a toy carRepeats the same actions or movements over and over again, such as flapping hands, rocking, or twirlingIs not able to calm down easily after being upsetIs unable to sit down to perform an activity, look at a book, or play a gameAvoids climbing and exploring at the playgroundGrinds their teethAvoids wearing different types of clothing textures, or is very particular about the feel of the clothing they wearIs particular about what socks they wear, or insists on wearing them inside outGets dizzy or car sick easilyDoesn’t play “pretend” games, engage in group games, imitate others, or use toys in creative waysAppears to be anxiousSpeaks in an abnormal tone of voice, or with an odd rhythm or pitch (e.g. ends every sentence as if asking a question)Seems to be in constant motion, seems to be unable to sit still, unless playing on an electronic deviceFollows a rigid routine and has difficulty with changes in routine (e.g. Dad is picking them up from daycare one day instead Mom or insists on taking a specific route to school)Has difficulty adapting to any changes in schedule or environment (e.g. throws a tantrum if the furniture is rearranged or bedtime is at a different time than usual)PreviousNextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.Let’s Get Some Information… Your Name *FirstLastYour Best Email *EmailConfirm EmailYour Best Phone NumberPhone TypeMobileHomeWorkPreviousSee My ResultsLayout Developmental Checklist Results The results below are not a diagnosis, but they are a possible indicator of your child’s developmental progress. Please contact us for more information and print this page for your records. Your Child's MovementYour child’s movement is divided into two areas of development: Gross Motor (whole body and larger movement) and Fine Motor (hand, fingers, toes and smaller movements). LayoutYour Child could use support with their Gross Motor Movements Your child may need help in this area of their development. But don’t worry! We can come along side them and help! We have wonderful physical therapists that are skilled with working with children and with helping them see progress and close those gaps. Make sure you click the button below to have us contact you. Your Child On Track in their Gross Motor Movements Your child is doing just fine in this area of their development! Your Child could use support with their Fine Motor Movements Your child may need help in this area of their development. But don’t worry! We can come along side them and help! We have wonderful occupational therapists that are skilled with working with children and with helping them see progress and close those gaps. Make sure you click the button below to have us contact you. Your Child is On Track in their Fine Motor Movements Your child is doing just fine in this area of their development! Your Child's Speech, Language and FeedingThe area’s of speech and feeding are often related. Speech has to do with the mechanics of how your child’s mouth forms words including muscles and mouth movement. Language has to do with how your child understanding what is said to them and how they interpret meaning with the words they hear and say. LayoutYour Child could use support with their Speech Development Your child may need help in this area of their development. But don’t worry! We can come alongside them and help! We have amazing speech therapists that are skilled with working with children and with helping them see progress and close those gaps. Make sure you click the button below to have us contact you. Your Child is On Track in their Speech Development Your child is doing just fine in this area of their development! Your Child may need help in the area of Feeding Your child may need help in this area of their development. But don’t worry! We can come along side them and help! You don’t have to struggle with feeding issues forever! Our occupational and speech therapists have worked wonders in this area for many of our patients. Click below and let us help you make gains in your child’s feeding and nutrition. Your Child is On Track in the area of Feeding Your child is doing just fine in this area of their development! Your Child's Sensory IntegrationLayoutYour Child may need help with Sensory Intergration Your child may need help in this area of their development. But don’t worry! We can come along side them and help! Our occupational therapist are world class when it comes to sensory intergation and can help your little one find a path toward self-regulation and increase your knowledge as a parent when it comes to sensory. Click the button below and discover the game changers when it comes to your child’s response to stimuli in thier environment. Your Child is doing well with Sensory Intergration Your child is doing just fine in this area of their development! Save Your Results by Printing to PDF. Print them out or email the PDF to your pediatrician Save Results as PDFPlease Help With My Child's Development
