Page 54 - 2016 Handbook FINAL 4.18.16

First Language English
13. Do other children make fun of the child’s speech? Yes/No Yes/No

14. Do adults understand what the child says? Yes/No Yes/No

15. Does your child have problems understanding or Yes/No Yes/No
new words?

16. Does your child pause, repeat words or parts of words? Yes/No Yes/No

17. Does your child follow directions? Yes/No Yes/No

18. Does your child use complete sentences? Yes/No Yes/No

19. Does your child use gestures to communicate? Yes/No Yes/No

20. Can your child pronounce so that most of his Yes/No Yes/No
speech is understood?

21. How does your child relate with children who speak the native language? ______________________

__________________________________________________________________________________

22. How does the parent feel about the child’s speaking ability in both languages?

First Language: ____________________________________________________________________

English: __________________________________________________________________________

23. How does the child’s speaking ability compare to younger siblings in both languages?

First Language: ____________________________________________________________________

English: __________________________________________________________________________

24. How does the child’s speaking ability compare to other children of the same age and background?

First Language: ____________________________________________________________________

English: __________________________________________________________________________

25. Are there current or past medical concerns? _____________________________________________

26. Was there anything unusual or difficult about your child’s pregnancy, delivery or infant/baby

development? _____________________________________________________________________

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