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57) Combines Words Office Use Comments Yes No
Does your child put two words together when she speaks, such as want drink, get down. 

Language

90 % 2y-1 
 
75% 22-1 mo

 
58) Names one picture Office Use Comments Yes No
Can your child name at least one picture correctly?
(cat, dog, bird, horse)

 

Language

90%  2y-3wk

75% 23mo-3
59) Body Parts Office Use Comments Yes No
Can your child point to body parts as you name them one at a time? nose-mouth-hand-tummy
60) Jumps up Office Use Comments Yes No
Without letting your child take a running jump, tell him to jump over something placed on the floor. Did he get both feet off the floor when trying to jump over this object.
61) Puts on clothing Office Use Comments Yes No
Can your child put on any of his own clothing such as shoes, pants, T-shirt
62) Points to 4 pictures Office Use Comments Yes No
Tell your child to point to different pictures of animals (bird,cat,dog,horse,man)
63) Tower of  8 cubes Office Use Comments Yes No
Can your child stack 8 or more cubes or blocks on top of each other?
64) Speech is half understandable Office Use Comments Yes No
When your child talks to people who do not know him well, is the speech one half understandable.
65) Names four pictures Office Use Comments Yes No
Can your child name four pictures correctly?
66)Washes and dries hands Office Use Comments Yes No
Can your child wash and dry his hands well enough so you do not have to do it for them?
67) Office Use Comments Yes No
Ask you child to tell you the name of one of his friends. 
68)Imitates vertical lines Office Use Comments Yes No
Do not help or correct your child with this task. Draw a straight vertical line  on a piece of paper and ask your child to draw one next to it.
69) Knows two actions Office Use Comments Yes No
Show you child the pictures and ask his to point to the correct picture as you ask, one at a time, which one flies, says meow, talks, gallops, barks? Did your child point to two or more correctly?
70) Broad jump Office Use Comments Yes No
Without letting your child take a running start, tell her to jump length-wise over a sheet of paper placed length-wise. Did he do this without landing on the paper?
71) Balance-Each foot for 3 secs. Office Use Comments Yes No
Have your child balance on his right foot as long as he can without holding on to something. How long did he balance on each foot?
72) Knows two adjectives Office Use Comments Yes No
write down your Childs answer to the following question. Do not give help.

1)What do you do when you are cold_________________________

2)What do you do when you are tired_________________________

3)What do you do when you are hungry______________________

Examples of correct response 
Cold, shiver,"put on coat""go inside"
Tired-yawn, "go to sleep" "take a nap"
Hungrey-"eat" "ask for food""have lunch"
73) Thumb wiggle Office Use Comments Yes No
Make a fist with your thumb pointing up and wiggle your thumb. Have your child imitate you first with one hand then the other hand.
74) Name one color Office Use Comments Yes No
Point to 4 similar objects all of different colors and ask your child to name each one. Did he name one or more colors? (yellow, green, red, blue)
75) Use of two objects  Office Use Comments Yes No
Write down your child's answer to each of the following. Ask each question one at a time and wait for an answer.

What do you do with a cup_____________

What is a chair used for_______________

What is a pencil used for______________

Did your child answer at least two questions? 
76) Counts 1 Office Use Comments Yes No
Tear 4 small pieces off a piece of paper. Tell your child to give you one piece of paper. If your child gives you more than once piece circle No. If your child gives you only one, ask him how many pieces of paper you have, if he says one circle yes

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