MICRO QUESTIONNAIRE: YOU AND YOUR CHILD SECTION A. MOTOR: SIX TO EIGHT YEARS OF AGE A 2 / Section instructions SECTION A1. MOTOR: FINE: SIX TO EIGHT YEARS A1 /// 1. 2. 3. / 4. 5. 6. 7. 8. 9. 10. 11. 12. 1
SECTION A2. MOTOR: GROSS: SIX TO EIGHT YEARS OF AGE A2 /// 13. 14. 15. 16. / 17. 18. 19. 20. SECTION B. SOCIAL AND EMOTIONAL: SOCIAL: SIX TO EIGHT YEARS OF AGE B Section Instructions ` SECTION B1: SOCIAL DEVELOPMENT B1 Social Skills description - 2
/// 21. 22. 23. 24. 25. 26. 27. 28. / 29. 30. 31. 32. 33. 34. 35. 36. / 37. / SECTION B2. SOCIAL AND EMOTIONAL: EMOTIONAL: SIX TO EIGHT YEARS OF AGE B2 ///- 38. 39. / 40. 41. / 42. / 43. 44. / 45. / 46. 3
SECTION C. COGNITIVE: SIX TO EIGHT YEARS OF AGE C / /// Section instructions ///- 47. / 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 4
66. / 67. 68. 69. 70. 71. 72.? 73. 74. 75. 76. 77. 78. 79. 80. 81. Joey 82. 83. / SECTION D. LITERACY: D / 5
Section instructions SECTION D1: LITERACY: READING: SIX TO EIGHT YEARS OF AGE D1 /// 84. 85. 86. 87. / 88. 89. 90. 91. cat hat 92. 93. 94. pool drool pool toy 95. snake bake 96. ten toys tend to tip toward top. 97. 98. cowboy boy cow 99. bake b c cake 100. babysitter 101. baby 102. b/d/p/q- m/n/h- h/k/b/- z/s 103. 6
SECTION D2. LITERACY: WRITING: SIX TO EIGHT YEARS OF AGE D2 /// 104. 105. 106. 107. 108. / 109. 110. 111. 112. 113. 114. 115. 116. SECTION D3. LITERACY: MATH: SIX TO EIGHT YEARS OF AGE D3 /// 117. 118. 119. 120. / 121. 122. 123. 124. 125. 126. 127. 128. 129. 130. 131. 7
SECTION E. LANGUAGE: E SECTION E1: LANGUAGE: RECEPTIVE: SIX TO EIGHT YEARS OF AGE E1 /// 132. 133. 134. 135. boys 136. mice 137. She walked. 138. He ate his food. SECTION E2. LANGUAGE: EXPRESSIVE: SIX TO EIGHT YEARS OF AGE E2. /// 139. 140. / 141. 142. 143. () 144. 145. 146. 147. 148. 149. 8
150. 151. 152. I slept well last night. 153. I walked all the way to the store and back. 154. 155. 156. 157. I like playing games with you. 158. So far, I ve lost two baby teeth. 159. I slept well last night SECTION E3. LANGUAGE: PRAGMATICS: SIX TO EIGHT YEARS OF AGE E3 /// 160. 161. 162. / 163. 164. 165. 166. / 167. (/ ) 9
SECTION E4. LANGUAGE: ARTICULATION: SIX TO EIGHT YEARS OF AGE E4. /// 168. 169. sh SECTION F. ADAPTIVE: SIX TO EIGHT YEARS OF AGE F / /// 170. 171. 172. 173. 174. 175. 176. 177. SECTION G. SENSORY PROCESSING/SENSORY SENSITIVITY: SIX TO EIGHT YEARS OF AGE G / Section instructions 10
/// 178. 179. 180. 181. 182. 183. 184. 185. 186. / 187. 188. 189. / 190. / 191. 192. 193. 194. 195. 196. 197. 198. 199. 200. / 201. 202. 203. 204. 205. 206. 207. / 208. 209. 11
Section H: questions for professionals H / / 12
Section I: Am I fostering my child s development I 1. / 2. 3. 4. 5. 6. 7. 8. 9. a. book b. Susie Sat Still c. c- a- t d. cow e. toy t b boy. 10. 11. 12. 13. 13