SWYC: 9 months

  • SWYC: 9 months

    9 months, 0 days to 11 months, 31 days
  • Birth Date:*
     - -
  • Today's Date:*
     - -
  • Format: (000) 000-0000.

  • DEVELOPMENTAL MILESTONES

    Most children at this age will be able to do some (but not all) of the developmental tasks listed below. Please tell us how much your child is doing each of these things. PLEASE BE SURE TO ANSWER ALL THE QUESTIONS.
  • Holds up arms to be picked up*
  • Gets into a sitting position by him or herself*
  • Picks up food and eats it*
  • Pulls up to standing*
  • Plays games like "peek-a-boo" or "pat-a-cake"*
  • Calls you "mama" or "dada" or similar name*
  • Looks around when you say things like "Where's your bottle?" or "Where's your blanket?"*
  • Copies sounds that you make*
  • Walks across a room without help*
  • Follows directions - like "Come here" or "Give me the ball"*

  • BABY PEDIATRIC SYMPTOM CHECKLIST (BPSC)

    These questions are about your child's behavior. Think about what you would expect of other children the same age, and tell us how much each statement applies to your child
  • Does your child have a hard time being with new people?*
  • Does your child have a hard time in new places?*
  • Does your child have a hard time with change?*
  • Does your child mind being held by other people?*
  • Does your child cry a lot?*
  • Does your child have a hard time calming down?*
  • Is your child fussy or irritable?*
  • Is it hard to comfort your child?*
  • Is it hard to keep your child on a schedule or routine?*
  • Is it hard to put your child to sleep?*
  • Is it hard to get enough sleep because of your child?*
  • Does your child have trouble staying asleep?*

  • PARENT'S CONCERNS

  • Do you have any concerns about your child's learning or development?*
  • Do you have any concerns about your child's behavior?*

  • FAMILY QUESTIONS

    Because family members can have a big impact on your child's development, please answer a few questions about your family below:
  • Does anyone who lives with your child smoke tobacco?*
  • In the last year, have you ever drunk alcohol or used drugs more than you meant to?*
  • Have you felt you wanted or needed to cut down on your drinking or drug use in the last year?*
  • Has a family member's drinking or drug use ever had a bad effect on your child?*
  • Within the past 12 months, we worried whether our food would run out before we got money to buy more.*
  • Should be Empty: