Pediatric Case History Language (24-36 Months)
Please choose yes or no, and fill out the blanks provided where appropriate.
Child's Name:
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First Name
Last Name
Does your child:
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Rows
Yes
No
Point to body parts when asked?
Understand the difference between a direction that tells him/her to put something in, on, off, under something else?
Point to action in pictures (Who is sleeping, eating, running? Etc.)
Know 4 parts of clothing?
Understand pronouns (me, my, your)?
Understand the function of objects? (Show me what we use to eat. Show me what we wear on our feet. etc.)
Understand simple descriptive concepts? (big, little, wet, cold)
Follow two-step, related directions without help? (Get the cup and give the baby a drink.)
Understand quantity words? "get one" "get some" "get the rest" "get it all"
Bring you something from another room?
Choose one requested item from a group of five objects?
Answer "yes" and "no" question correctly?
Respond to simple "wh" questions? (What, who, where)
List the body parts your child can point to and knows:
List the clothing items your child knows and can point to:
Does your child:
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Rows
Yes
No
Use at least 50 words?
Name pictures in books or photographs?
Use words more than gestures?
Ask simple questions? (Where is it?, What's that?)
Answer with "yes" and "no"
Use two word phrases?
Use plurals?
Combine 3-4 words in spontaneous speech?
Answer "what" and "where" questions?
Use at least ten different verbs?
Use at least two descriptive words? (big, wet, cold, etc.)
Use possessive nouns? (my, mine)
Use basic 4-5 word sentence?
How many words does your child have? List as many as you can.
How does your child request a specific toy, movie or food?
How does your child let you know that he wants or needs something to happen? (tv on, reach something, to swing, etc.)
How does your child ask for help when he can't get something done by him/herself?
How does your child let you know if he/she does not like something?
List examples of two word phrases your child uses:
Submit
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