April 19, 20219-10 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 birthday 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 Childs Age (e.g. 9.5 months) [Physical Developmental Skills] My child can pull to stand using a stable object for support. Yes No [Physical Developmental Skills] My child can stand by holding on to objects and furniture. Yes No [Physical Developmental Skills] My child can sit without support while playing with a toy. Yes No [Physical Developmental Skills] My child is crawling on hands and knees, and navigate obstacles. Yes No [Physical Developmental Skills] My child is able to stand at surface and bounce his/her legs. Yes No [Physical Developmental Skills] My child is able to cruise sideways along a surface in both directions. Yes No [Physical Developmental Skills] My child is able to hold support and lower to sitting on the floor without falling. Yes No [Physical Developmental Skills] My child is able to take a few steps with support. Yes No 1 out of 3 [Occupational Developmental Skills] My child can let go of objects on purpose. Yes No [Occupational Developmental Skills] My child can bang toys together. Yes No [Occupational Developmental Skills] My child can play alone or with an adult with about 5 minutes of focus. Yes No [Occupational Developmental Skills] My child can remove toys from boxes and containers. Yes No [Occupational Developmental Skills] My child has a few favorite toys they prefer to play with. Yes No [Occupational Developmental Skills] My child likes water play. Yes No [Occupational Developmental Skills] My child responds to music by bouncing and swaying. Yes No [Occupational Developmental Skills] My child can feed themselves finger foods. Yes No [Occupational Developmental Skills] My child can hold and drink from lidded cups. Yes No [Occupational Developmental Skills] My child can be weary of new places and people. Yes No [Occupational Developmental Skills] My child can wave goodbye. Yes No 2 out of 3 [Speech Developmental Skills] My child can follow sounds by turning their head. Yes No [Speech Developmental Skills] My child shows interest when I'm talking to them. Yes No [Speech Developmental Skills] My child vocalizes to get attention. Yes No [Speech Developmental Skills] My child might point or use gestures to communicate. Yes No [Speech Developmental Skills] My child recognizes commonly used words. (bottle, juice, etc.) Yes No [Speech Developmental Skills] My child smiles during a game of peek-a-boo. Yes No [Speech Developmental Skills] My child imitates some of my sounds. Yes No [Speech Developmental Skills] My child understands the word "no". Yes No [Speech Developmental Skills] My child uses their finger to point at things. Yes No 3 out of 3 Please fill in the comment box below. Time's up
