Helping Babies and Tots in Their Development

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Please answer all questions.
If there is an answer that you don't know, please answer "no".


Cognitive: Yes No
1. Completes a 3-4 piece puzzle
2. Sorts two different objects
3. Identifies and knows gender differences of self and others
4. Listens to a story
5. Participates in pretend play activities
6. Identifies six body parts on self and others or a doll
7. Understands the difference between small and large objects
Speech: Yes No
8. Uses first and last name upon request
9. Uses plurals ("s" at the end of words)
10. Answers questions
11. Vocalizes wants and needs verbally
12. Recites a song or nursery rhyme
13. Uses 200 words or more in vocabulary
14. Repeats and uses 5 word sentences
Gross Motor: Yes No
15. Imitates large movements
16. Walks backwards
17. Jumps sideways and backwards
18. Walks stairs alternating feet
19. Imitates walking on tip toes
20. Climbs ladders at the park
Fine Motor: Yes No
21. Builds a tower with 8-9 blocks approximately one inch cubes
22. Snips with scissors on a line
23. Holds a pencil or crayon with an adult grasp
24. Imitate a 3 block formation
25. Put rings on ring stacker in correct order
Social/Emotional: Yes No
26. Follows some simple basic rules
27. Participates in circle games
28. Talks in an urgent voice when excited
29. Follows two step directions related and non-related
Self Help: Yes No
30. Uses a fork appropriately
31. Helps in bathing
32. Likes doing things independently
33. Sleeps 10-15 hours daily
34. Knows proper place for things
35. Uses toilet with assistance with daytime control

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