April 6, 20210-2 Months Developmental Questionnaire This quiz should take a maximum of 5 minutes. The final question will allow you to add comments for any questions you have not discussed or covered in the quiz. Depending on the child’s age within the range, answering “NO” isn’t necessarily a cause for concern. The difference between a 2 week old and a 2-month-old is significant. With that in mind, we will ask about your child's age and have a specialist look over your responses. We are happy to reach out to you if there's anything we see that the computer may have overlooked. First Name Last Name Zip Code Your Email Phone Number w/ Area Code Child's Age (e.g. 6 weeks) [Physical Developmental Skills] My child can lift and turn their head when seated with supports. Yes No [Physical Developmental Skills] When on their belly, my child can lift head off of the floor. Yes No [Physical Developmental Skills] My child bends and straightens both of their arms and both of their legs when lying on their back. Yes No [Physical Developmental Skills] My child can hold their head with some wobbles. Yes No [Physical Developmental Skills] When on their side, my child can roll to their back. Yes No 1 out of 3 [Occupational Developmental Skills] My child looks in the directions of sounds. Yes No [Occupational Developmental Skills] My child can be quieted with music or suckling. Yes No [Occupational Developmental Skills] My child can be easily startled. Yes No [Occupational Developmental Skills] My child feeds easily. Yes No [Occupational Developmental Skills] My child can focus on faces and bright objects nearby. Yes No [Occupational Developmental Skills] My child smiles at other people. Yes No [Occupational Developmental Skills] My child studies or is aware of their hands. Yes No 2 out of 3 [Speech Developmental Skills] My child coos. Yes No [Speech Developmental Skills] My child can recognize familiar voices. Yes No [Speech Developmental Skills] My child startles with loud noises. Yes No [Speech Developmental Skills] My child smiles when spoken to. Yes No [Speech Developmental Skills] My child has different cries for different needs. Yes No 3 out of 3 Please fill in the comment box below. Time is Up! Time's up
