Important:

1

Have you raised concerns with your health care team and they have dismissed your worry and said “lets wait and see”?

Yes

No

2

Have you noticed your child is behind their peers when socialising?

Yes

No

3

Have family, friends or educators ever suggested seeing a health professional?

Yes

No

4

Is your child regularly having lots of big emotions, that are not age appropriate?

Yes

No

5

Have you noticed your child is behind their peers when doing fine motor tasks (writing, cutting, threading, building)?

Yes

No

6

Have you noticed your child is behind their peers when doing gross motor tasks (walking, running, jumping, riding)?

Yes

No

7

Is your child impacted by sensory experiences (e.g. distressed by tags on clothing or eating certain textures, sensitive to sound, smell, lights or makes lots of noise, always seeking deep pressure, mouthing lots of objects)?

Yes

No

8

Is your child having any challenges with daily living tasks in comparison to age norms (such as: dressing, organising for the school day, toileting, simple meal preparation)?

Yes

No

9

Have you noticed your child to have difficulty with social cues (making and keeping friends, playing in a group, playing games and has some difficulty with being a good sport)?

Yes

No

10

Have you noticed your child having difficulty attending to tasks and concentrating even in a quiet environment, will require instructions to be repeated or appear to be ’not listening’?

Yes

No

11

Does your child often misunderstand/ignore your instructions and gestures (e.g does not follow your pointing or does not respond to their name)?

Yes

No

12

Does your child avoid pretend play? (e.g dress ups, using dolls/figures as characters in play)

Yes

No

13

Does your child frequently repeat words with only one syllable (“I, I, I, I want to go outside”), repeat part of a word (“D-d-d-addy”), draw out a sound (“Mmmilk”), have pauses where no sound comes out (“I [block] do”) or show signs of struggling to get words out?

Yes

No

14

Does your child frequently cough, gag or have a wet sounding voice when eating or drinking?

Yes

No

15

Is your child’s voice frequently breathy or hoarse, do they lose their voice frequently or have difficulty speaking at an appropriate volume?

Yes

No

16

If your child is 4 years old, can other people (not you) understand more than 41% of their communication?

Yes

No

17

If your child is 5 years old, can other people (not you) understand more than 65% of their communication?

Yes

No

18

If your child is 7 years old, can other people (not you) understand more than 79% of their communication?

Yes

No

19

Does your child use gesture to communicate? E.g pointing at an object they want)

Yes

No

20

Does your child share enjoyment with you and others? (e.g. showing you things they have created)

Yes

No

21

If your child is 3 years or older, do they have difficulty telling a story or telling you about their day?

Yes

No

22

You're Total Score:If you scored 3+ we recommend investigating further with your health team whether speech or occupational therapy would be beneficial for your child. Alternatively, book a free discovery call with us, we are here to help!

23

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