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Developmental Screening for Ages 0-3

The document is a developmental screening questionnaire (M-CHAT-R) for children aged 0-3 years, designed to assess various aspects of a child's development through a series of yes/no questions. It covers areas such as social interaction, communication, and play behaviors to identify potential developmental concerns. Parents are prompted to answer questions regarding their child's behavior and responses in different situations.

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0% found this document useful (0 votes)
25 views1 page

Developmental Screening for Ages 0-3

The document is a developmental screening questionnaire (M-CHAT-R) for children aged 0-3 years, designed to assess various aspects of a child's development through a series of yes/no questions. It covers areas such as social interaction, communication, and play behaviors to identify potential developmental concerns. Parents are prompted to answer questions regarding their child's behavior and responses in different situations.

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Developmental Screening M - CHAT- R

0 – 3 YEARS
Nombre de su hijo(a): _________________________________ Fecha de aplicación: ___________

1 If you point to something across the room, does your child look at it? YES NO
(FOR EXAMPLE, if you point to a toy, a stuffed animal, or an animal,
Does your son/daughter look at you?

2 Have you ever wondered if your child is deaf? YES NO


3 Does your child play fantasy or imaginative games? (FOR EXAMPLE, YES NO
pretends to drink from an empty cup, talks on the phone, or feeds
to eat a doll or stuffed animal
4 Does your child like to climb on things? (FOR EXAMPLE, on a chair, stairs, YES NO
the slide
5 Does your child make unusual movements with their fingers near their eyes? YES NO
(FOR EXAMPLE, he moves his fingers near his eyes in a way
unusual?)
6 Does your child point with a finger when they want to ask for something or ask for help? YES NO
(FOR EXAMPLE, point to a toy or something to eat that is outside of
its scope?)
7 Your son/daughter points with a finger when they want to show you something that captures their attention. YES NO
the attention? (FOR EXAMPLE, point to a plane in the sky or a truck
very big on the street)
8 Is your child interested in other children? (FOR EXAMPLE, does he/she look at them with YES NO
Do they pay attention to other children, smile at them, or approach them?

9 Does your child show you things by bringing them closer or lifting them up so that YES NO
you see them – not to ask for help but just to share them
with you? (FOR EXAMPLE, he shows you a flower or a stuffed animal or a car
of toy)
10 Does your child respond when you call them by their name? YES NO
EXAMPLE, it returns, speaks or babbles, or stops doing what it was doing.
doing to look at him/her?
11 When you smile at your child, does he or she smile back at you? YES NO
12 Do everyday noises bother your child? (FOR EXAMPLE, the YES NO
vacuum cleaner or music, even when it is not excessive
high?)
13 Does your child walk alone? YES NO
14 Does your child look you in the eyes when you talk to them, play with him or her, or YES NO
Did you see it?

15 Does your child imitate your movements? (FOR EXAMPLE, saying goodbye with the hand) YES NO
Dude, applaud or make some funny noise that you do?)
16 If you turn to look at something, does your child try to look at what you are YES NO
Are you watching?
17 Does your child try to get you to look at him/her/pay attention? (FOR EXAMPLE, YES NO
looks for you to give a compliment, or says "look" or "look at me"
18 Does your son/daughter understand you when you tell them to do something? YES NO
EXAMPLE, if you do not gesture, does your child understand 'put the book'
on the chair" or "bring me the blanket")
19 If something new happens, does your child look at you to see how you react to it? YES NO
regarding? (FOR EXAMPLE, if you hear a strange noise or see a toy
new, do you turn to see their face?)
20 Does your son/daughter like movement games? (FOR EXAMPLE, do they likeYES NO
that I rock him, or that I make 'the little horse' sitting him on my knees

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