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Home
Conditions
Autism Spectrum Disorder
Attention Deficit Hyperactivity Disorder
Developmental Delay
Emotional Disorders
Intellectual Disorders
Learning Disabilities
Therapies
Auditory Integration
Behavior Modification Therapy
Cognitive Behaviour Therapy
Nutrition Therapy
Occupational Therapy
Physiotherapy
Remedial Education
Speech Therapy
Social Skills Therapy
Book A Consultation
Podcast
Blog
FAQ
About
About Us
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Home
Conditions
Autism Spectrum Disorder
Attention Deficit Hyperactivity Disorder
Developmental Delay
Emotional Disorders
Intellectual Disorders
Learning Disabilities
Therapies
Auditory Integration
Behavior Modification Therapy
Cognitive Behaviour Therapy
Nutrition Therapy
Occupational Therapy
Physiotherapy
Remedial Education
Speech Therapy
Social Skills Therapy
Book A Consultation
Podcast
Blog
FAQ
About
About Us
Locations
Franchise
Work With Us
Menu
Home
Conditions
Autism Spectrum Disorder
Attention Deficit Hyperactivity Disorder
Developmental Delay
Emotional Disorders
Intellectual Disorders
Learning Disabilities
Therapies
Auditory Integration
Behavior Modification Therapy
Cognitive Behaviour Therapy
Nutrition Therapy
Occupational Therapy
Physiotherapy
Remedial Education
Speech Therapy
Social Skills Therapy
Book A Consultation
Podcast
Blog
FAQ
About
About Us
Locations
Franchise
Work With Us
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Step
1
of
10
10%
1. General Information
Parent Disclaimer: This tool is not a substitute for clinical diagnosis. Consult a healthcare professional for a comprehensive evaluation.
A. Child's Gender
*
Boy
Girl
B. Child's Age
*
1-2 years
2-3 years
3-4 years
4-5 years
5-6 years
6-8 years
8-12 years
12-16years
2. Fine Motor Skills
Skills involving small muscle movements, especially in the hands, like grasping or drawing.
A. Can your child pick up small objects using thumb and one finger?
*
Never
Rarely
Sometimes
Always
B. Can your child stack two or more blocks?
*
Never
Rarely
Sometimes
Always
C. Can your child turn the pages of a book one at a time?
*
Never
Rarely
Sometimes
Always
A. Can your child draw a straight line?
*
Never
Rarely
Sometimes
Always
B. Can your child use a spoon without spilling?
Never
Rarely
Sometimes
Always
C. Can your child open a jar or turn a doorknob?
*
Never
Rarely
Sometimes
Always
A. Can your child cut paper with safety scissors?
*
Never
Rarely
Sometimes
Always
B. Can your child open bottles, jars, or bag zips?
*
Never
Rarely
Sometimes
Always
C. Can your child button their own shirt?
*
Never
Rarely
Sometimes
Always
A. Can your child draw a square shape on paper?
*
Never
Rarely
Sometimes
Always
B. Can your child lace up their own shoes?
*
Never
Rarely
Sometimes
Always
C. Can your child use a Spoon and Fork properly?
*
Never
Rarely
Sometimes
Always
A. Can your child draw a triangle shape on paper?
*
Never
Rarely
Sometimes
Always
B. Can your child tie their own shoelaces?
*
Never
Rarely
Sometimes
Always
C. Can your child write their own name?
*
Never
Rarely
Sometimes
Always
A. Can your child write legible sentences?
*
Never
Rarely
Sometimes
Always
B. Can your child use tools like scissors and rulers accurately?
*
Never
Rarely
Sometimes
Always
C. Can your child tie complex knots?
*
Never
Rarely
Sometimes
Always
A. Can your child write legibly and consistently with a pen or pencil?
*
Never
Rarely
Sometimes
Always
B. Can your child manipulate small objects with precision, such as tying shoelaces or using keys?
*
Never
Rarely
Sometimes
Always
C. Can your child accurately cut along a line or shape using scissors?
*
Never
Rarely
Sometimes
Always
A. Can your child write legibly and quickly?
*
Never
Rarely
Sometimes
Always
B. Can your child handle tools for schoolwork, like using a compass or protractor, with precision?
*
Never
Rarely
Sometimes
Always
C. Can your child write legibly for extended periods, such as taking notes during a class lecture, without hand fatigue?
*
Never
Rarely
Sometimes
Always
Hidden
Fine Motor Skills Sum
Hidden
Fine Motor Skills Recommendation
Occupational Therapy is strongly recommended to improve hand-eye coordination and object manipulation.
Monitor progress; consider periodical assessments to check if intervention becomes necessary.
Appears to be typically developing in fine motor skills; no immediate intervention needed.
3. Gross Motor Skills
Abilities using large muscles for movements like walking, running, and balancing.
A. Can your child walk without support?
*
Never
Rarely
Sometimes
Always
B. Can your child kick a ball forward?
*
Never
Rarely
Sometimes
Always
C. Can your child climb onto furniture unassisted?
*
Never
Rarely
Sometimes
Always
A. Can your child run without tripping?
*
Never
Rarely
Sometimes
Always
B. Can your child jump with both feet off the ground?
*
Never
Rarely
Sometimes
Always
C. Can your child kick a ball forward?
*
Never
Rarely
Sometimes
Always
A. Can your child climb stairs alternating feet?
*
Never
Rarely
Sometimes
Always
B. Can your child hop on one foot?
*
Never
Rarely
Sometimes
Always
C. Can your child ride a tricycle?
*
Never
Rarely
Sometimes
Always
A. Can your child hop on one foot more than once?
*
Never
Rarely
Sometimes
Always
B. Can your child catch a ball thrown towards him/her from 5 feet away?
*
Never
Rarely
Sometimes
Always
C. Can your child balance on one foot for at least 5 seconds?
*
Never
Rarely
Sometimes
Always
A. Can your child skip/hop for 10 steps in one go?
*
Never
Rarely
Sometimes
Always
B. Can your child swing on a swing set, pumping their legs themselves?
*
Never
Rarely
Sometimes
Always
C. Can your child perform a somersault?
*
Never
Rarely
Sometimes
Always
A. Can your child ride a bicycle without training wheels?
*
Never
Rarely
Sometimes
Always
B. Can your child catch a small ball using only their hands?
*
Never
Rarely
Sometimes
Always
C. Can your child perform basic dance steps?
*
Never
Rarely
Sometimes
Always
A. Can your child successfully engage in activities that require hand-eye coordination, such as catching a ball from 10 feet away?
*
Never
Rarely
Sometimes
Always
B. Can your child handle utensils like a fork and knife proficiently while eating?
*
Never
Rarely
Sometimes
Always
C. Can your child perform tasks that require both hands working together in a coordinated way, such as tying a knot or opening a jar?
*
Never
Rarely
Sometimes
Always
A. Can your child maintain balance on one foot for at least 20 seconds without support?
*
Never
Rarely
Sometimes
Always
B. Can your child execute activities that require sequential movements, like hopping over a series of obstacles?
*
Never
Rarely
Sometimes
Always
C. Can your child perform activities that require coordination of both upper and lower body, like carrying a tray with water glasses or tea cups while navigating through a crowded space?
*
Never
Rarely
Sometimes
Always
Hidden
Gross Motor Skill Sum
Hidden
Gross Motor Skill Recommendation
Physiotherapy is strongly recommended to improve mobility and coordination.
Monitor progress and physical development.
Appears to be typically developing in gross motor skills; no immediate intervention needed.
4. Language & Communication Skills
How your child speaks, understands, interacts, and communicates with others.
A. Does your child respond to simple commands like "come here"?
*
Never
Rarely
Sometimes
Always
B. Can your child say at least three words?
*
Never
Sometimes
Rarely
Always
C. Does your child point to objects or pictures when they are named?
*
Never
Rarely
Sometimes
Always
A. Can your child form two-word sentences (e.g., "want milk")?
*
Never
Rarely
Sometimes
Always
B. Does your child know their own name and age?
*
Never
Rarely
Sometimes
Always
C. Can your child identify basic colours?
*
Never
Rarely
Sometimes
Always
A. Can your child speak in full sentences?
*
Never
Rarely
Sometimes
Always
B. Can your child name at least ten different objects?
*
Never
Rarely
Sometimes
Always
C. Can your child understand and follow a three-step command? For example, "Pick up your toy, put it in the box, and then close the lid."
*
Never
Rarely
Sometimes
Always
A. Can your child tell a simple story consisting of 10 lines?
*
Never
Rarely
Sometimes
Always
B. Can your child form complete sentences in any language to ask for something specific, like requesting a particular snack or toy?
*
Never
Rarely
Sometimes
Always
C. Can your child understand spatial words like "under" or "above," regardless of language?
*
Never
Rarely
Sometimes
Always
A. Can your child speak clearly enough to be understood by people outside the family?Can your child speak clearly enough to be understood by people outside the family?
*
Never
Rarely
Sometimes
Always
B. Can your child understand and answer who, what, where, why questions?
*
Never
Rarely
Sometimes
Always
C. Can your child understand the concept of opposites (e.g., hot/cold, fast/slow)?
*
Never
Rarely
Sometimes
Always
A. Can your child engage in detailed conversations, including back-and-forth dialogue?
*
Never
Rarely
Sometimes
Always
B. Can your child read a simple paragraph, understand its meaning and explain to you in his/her own words?
*
Never
Rarely
Sometimes
Always
C. Can your child understand simple figurative expressions, like saying something is "as fast as a car" to describe speed, in any language?
*
Never
Rarely
Sometimes
Always
A. Can your child write a short essay or story that includes an introduction, body, and conclusion?
*
Never
Rarely
Sometimes
Always
B. Can your child understand and correctly use figurative language, like explaining what the phrase "time flies" means?
*
Never
Rarely
Sometimes
Always
C. "Can your child follow complex multi-step directions, such as 'Go to your room, pick up the blue book from your desk, and bring it to me in the living room'?"
*
Never
Rarely
Sometimes
Always
A. Can your child articulate abstract concepts or emotions, such as explaining what "justice" or "freedom" means to them?
*
Never
Rarely
Sometimes
Always
B. Can your child understand and interpret complex texts, like comprehending the main ideas of a news article or a book?
*
Never
Rarely
Sometimes
Always
C. Can your child follow and engage in group discussions by both listening to others and contributing meaningful ideas?
*
Never
Rarely
Sometimes
Always
Hidden
Language & Communication Sum
Hidden
Language & Communication Recommendation
Speech Therapy is strongly recommended to facilitate better communication skills.
Monitor progress; consult a speech therapist for possible early interventions.
Appears to be typically developing in language and communication; no immediate intervention needed.
5. Cognitive Skills
Abilities related to thinking, problem-solving, memory, and understanding concepts.
A. Can your child point to one body part when asked?
*
Never
Rarely
Sometimes
Always
B. Does your child show interest in simple games like "peek-a-boo"?
*
Never
Rarely
Sometimes
Always
C. Can your child fit a square block into a square hole?
*
Never
Rarely
Sometimes
Always
A. Can your child sort objects by shape or colour?
*
Never
Rarely
Sometimes
Always
B. Can your child complete a simple puzzle?
*
Never
Rarely
Sometimes
Always
C. Does your child understand the concept of "two"?
*
Never
Rarely
Sometimes
Always
A. Can your child recognize and name basic shapes?
*
Never
Rarely
Sometimes
Always
B. Can your child count to ten?
*
Never
Rarely
Sometimes
Always
C. Can your child match shapes or colours without assistance?
*
Never
Rarely
Sometimes
Always
A. Can your child recognize and name all basic colours?
*
Never
Rarely
Sometimes
Always
B. Can your child correctly identify and take out 3 objects from a set of 10?
*
Never
Rarely
Sometimes
Always
C. Can your child understand the concept of time (e.g., morning, afternoon, night)?
*
Never
Rarely
Sometimes
Always
A. Can your child recognize basic arithmetic symbols (plus, minus)?
*
Never
Rarely
Sometimes
Always
B. Can your child identify the letters of the alphabet?
*
Never
Rarely
Sometimes
Always
C. Can your child understand the concept of yesterday, today, and tomorrow?
*
Never
Rarely
Sometimes
Always
A. Can your child perform basic arithmetic (addition and subtraction)?
*
Never
Rarely
Sometimes
Always
B. Can your child group objects based on more than one attribute (e.g., colour and shape)?
*
Never
Rarely
Sometimes
Always
C. Can your child tell the time on a watch?
*
Never
Rarely
Sometimes
Always
A. Can your child perform multiplication and division?
*
Never
Rarely
Sometimes
Always
B. Can your child understand the concept of percentages?
*
Never
Rarely
Sometimes
Always
C. Can your child interpret simple graphs or charts?
*
Never
Rarely
Sometimes
Always
A. Can your child organise and manage their time effectively to complete homework or projects by deadlines?
*
Never
Rarely
Sometimes
Always
B. Can your child identify logical flaws in statements, such as spotting the error in "If it's raining, the ground is wet. The ground is wet, so it's raining"?
*
Never
Rarely
Sometimes
Always
C. Can your child discuss ethical or moral dilemmas, such as what they would do if they found money on the street?
*
Never
Rarely
Sometimes
Always
Hidden
Cognitive Skills Sum
Hidden
Cognitive Skills Recommendation
Cognitive Behaviour Therapy is strongly recommended for enhancing cognitive development.
Monitor cognitive skills; further assessments may be beneficial.
Appears to be typically developing cognitively; no immediate intervention needed.
6. Social & Emotional Skills
Understanding emotions, interactions, forming relationships, and connecting with others.
A. Does your child show attachment to familiar adults?
*
Never
Rarely
Sometimes
Always
B. Does your child exhibit fear of strangers?
*
Never
Rarely
Somtimes
Always
C. Does your child comfort themselves by thumb-sucking, holding a security object, etc.?
*
Never
Rarely
Sometimes
Always
A. Does your child play alongside other children (parallel play)?
*
Never
Rarely
Sometimes
Always
B. Does your child express affection openly?
*
Never
Rarely
Sometimes
Always
C. Can your child understand simple "please" and "thank you" etiquette?
*
Never
Rarely
Sometimes
Always
A. Does your child play cooperatively with other children for at least 15-20 minutes?
*
Never
Rarely
Sometimes
Always
B. "Does your child try to comfort a crying peer or sibling by offering a toy or a hug?"
*
Never
Rarely
Sometimes
Always
C. Does your child understand the concept of "mine" and "yours"?
*
Never
Rarely
Sometimes
Always
A. Does your child cooperate with other children and can engage in group games?
*
Never
Rarely
Sometimes
Always
B. Does your child follow household rules like not touching sharp objects or staying away from the stove?
*
Never
Rarely
Sometimes
Always
C. Can your child recognize and verbally express basic emotions like happiness, sadness, or anger?
*
Never
Rarely
Sometimes
Always
A. Does your child understand the concept of taking turns in games?
*
Never
Rarely
Sometimes
Always
B. Can your child ask 'who, what, where, why' questions during storytime or conversations?
*
Never
Rarely
Sometimes
Always
C. Can your child understand the concept of opposites, such as identifying that 'hot' is the opposite of 'cold' or 'fast' is the opposite of 'slow'?
*
Never
Rarely
Sometimes
Always
A. Does your child exhibit sportsmanship in games, including losing gracefully?
*
Never
Rarely
Sometimes
Always
B. Can your child distinguish between real events and pretend or imaginary scenarios, like understanding that a fairy tale is not a real story?
*
Never
Rarely
Sometimes
Always
C. Does your child have at least one close friend?
*
Never
Rarely
Sometimes
Always
A, Does your child understand the implications of gossip and rumours?
*
Never
Rarely
Sometimes
Always
B. Can your child recognize and manage complex emotions like jealousy or embarrassment?
*
Never
Rarely
Sometimes
Always
C. Can your child recognize and respond appropriately when someone is sad or upset, such as offering a comforting word or gesture?
*
Never
Rarely
Sometimes
Always
A. Can your child understand the consequences of actions on their future, such as how skipping school could affect their grades?
*
Never
Rarely
Sometimes
Always
B. Can your child navigate complex social situations, like resolving a disagreement among friends without escalating the conflict?
*
Never
Rarely
Sometimes
Always
C. Does your child have a nuanced understanding of friendship and relationships, such as recognizing the importance of trust and communication?
*
Never
Rarely
Sometimes
Always
Hidden
Social & Emotional Sum
Hidden
Social & Emotional Recommendation
Behavior Modification Therapy is strongly recommended to improve social and emotional skills.
Monitor social interactions and emotional responses.
Appears to be typically developing in social and emotional domains; no immediate intervention needed.
7. Adaptive Functioning
Daily self-help skills, including dressing, eating, and personal hygiene.
A. Can your child drink from a cup without spilling?
*
Never
Rarely
Sometimes
Always
B. Can your child eat finger foods without assistance?
*
Never
Rarely
Sometimes
Always
C. Can your child help in dressing themselves, like putting on a hat?
*
Never
Rarely
Sometimes
Always
A. Can your child wash and dry their hands?
*
Never
Rarely
Sometimes
Always
B. Can your child undress themselves?
*
Never
Rarely
Sometimes
Always
C. Can your child drink from a cup without a lid?
*
Never
Rarely
Sometimes
Always
A. Can your child put on his or her own clothes?
*
Never
Rarely
Sometimes
Always
B. Can your child brush their teeth with assistance?
*
Never
Rarely
Sometimes
Always
C. Can your child wash their hands unassisted?
*
Never
Rarely
Sometimes
Always
A. Can your child pour liquid without spilling?
*
Never
Rarely
Sometimes
Always
B. Can your child brush their teeth without assistance?
*
Never
Rarely
Sometimes
Always
C. Can your child use the toilet unassisted?
*
Never
Rarely
Sometimes
Always
A. Can your child pack their own school bag?
*
Never
Rarely
Sometimes
Always
B. Can your child make a simple sandwich?
*
Never
Rarely
Sometimes
Always
C. Does your child understand basic road safety rules, like waiting for a signal or holding an adult's hand near traffic?
*
Never
Rarely
Sometimes
Always
A. Can your child prepare a simple meal (e.g., cereal, sandwich)?
*
Never
Rarely
Sometimes
Always
B. Can your child take a shower without assistance?
*
Never
Rarely
Sometimes
Always
C. Can your child make a simple purchase at a store?
*
Never
Rarely
Sometimes
Always
A. Can your child use basic household appliances (e.g., microwave, washing machine)?
*
Never
Rarely
Sometimes
Always
B. Can your child independently plan and execute a simple household chore, such as setting the table for dinner, without needing step-by-step guidance?
*
Never
Rarely
Sometimes
Always
C. Can your child manage simple budgeting tasks (e.g., saving and spending pocket money)?
*
Never
Rarely
Sometimes
Always
A. Can your child manage their own schedule and commitments?
*
Never
Rarely
Sometimes
Always
B. Can your child prepare a full meal?
*
Never
Rarely
Sometimes
Always
C. Can your child perform basic first aid?
*
Never
Rarely
Sometimes
Always
Hidden
Adaptive Functioning Sum
Hidden
Adaptive Functioning Recommendation
Occupational Therapy is strongly recommended to enhance daily living skills.
Monitor progress in adapting to everyday tasks.
Appears to be typically developing in adaptive functioning; no immediate intervention needed.
8. Behavioural Issues
Patterns of actions or reactions that might be of concern, like aggression or withdrawal.
A. Does your child frequently have temper tantrums during activities like mealtime or bedtime that last for more than 10 minutes and are difficult to manage?
*
Never
Rarely
Sometimes
Always
B. Does your child frequently bite or hit others?
*
Never
Rarely
Sometimes
Always
C. Can your child sit still for short periods, such as while reading a story?
*
Never
Rarely
Sometimes
Always
A. Does your child frequently defy or challenge adult requests, such as refusing to put away toys when asked?
*
Never
Rarely
Sometimes
Always
B. Does your child show extreme separation anxiety from primary caregivers, such as crying excessively when left with relatives or ayahs?
*
Never
Rarely
Sometimes
Always
C. Does your child often seem unusually withdrawn, avoiding social interactions during family gatherings
*
Never
Rarely
Sometimes
Always
A. Does your child frequently interrupt conversations?
*
Never
Rarely
Sometimes
Always
B. Does your child struggle with sharing toys?
*
Never
Rarely
Sometimes
Always
C. Does your child exhibit mood swings, such as going from happy to irritable, when transitioning between activities or places?
*
Never
Rarely
Sometimes
Always
A. Does your child continue to defy rules like running indoors or using toys improperly even after multiple corrections?
*
Never
Rarely
Sometimes
Always
B. Does your child struggle to calm down after playing tag or receiving an exciting gift?
*
Never
Rarely
Sometimes
Always
C. Does your child struggle with making eye contact during conversations?
*
Never
Rarely
Sometimes
Always
A. Does your child frequently argue with adults, especially during mealtime or bedtime routines?
*
Never
Rarely
Sometimes
Always
B. Does your child exhibit signs of excessive shyness or withdrawal during social events or group activities?
*
Never
Rarely
Sometimes
Always
C. Does your child frequently interrupt others, especially while they are speaking or engaged in an activity?
*
Never
Rarely
Sometimes
Always
A. Does your child have emotional outbursts, such as crying or yelling, that seem disproportionate to situations like losing a game or receiving a minor correction?
*
Never
Rarely
Sometimes
Always
B. Does your child show signs of anxiety, like excessive worrying or phobias?
*
Never
Rarely
Sometimes
Always
C. Does your child exhibit repetitive behaviours (e.g., hand-flapping, rocking)?
*
Never
Rarely
Sometimes
Always
A. Does your child exhibit mood swings that seem extreme, such as going from joyful to angry in a short span of time without a clear reason?
*
Never
Rarely
Sometimes
Always
B. Does your child engage in risky behaviour, like climbing high places or running across the street without looking, without considering the potential consequences?
*
Never
Rarely
Sometimes
Always
C. Does your child frequently challenge authority figures, such as teachers or parents, by openly defying rules or instructions?
*
Never
Rarely
Sometimes
Always
A. Does your child engage in behaviours that are risky, such as attempting stunts or dares that could result in injury?
*
Never
Rarely
Sometimes
Always
B. Does your child exhibit signs of emotional withdrawal that seem excessive, such as avoiding social interactions for extended periods, even with close family and friends?
*
Never
Rarely
Sometimes
Always
C. Does your child frequently clash with authority figures, such as arguing with teachers or openly defying household rules?
*
Never
Rarely
Sometimes
Always
Hidden
Behavioural Issues Sum
Hidden
Behavioural Issues Recommendation
Behavior Modification Therapy or Cognitive Behaviour Therapy is strongly recommended for behavioural issues.
Monitor behaviour; consult a psychologist if issues persist.
Appears to be typically developing in behaviour; no immediate intervention needed.
9. Sensory Processing
A. Does your child react negatively to new textures like grass or sand?
*
Never
Rarely
Sometimes
Always
B. Is your child sensitive to lights or sounds that don't seem to bother other kids?
*
Never
Rarely
Sometimes
Always
C. Does your child avoid or seem bothered by messy activities like finger painting?
*
Never
Rarely
Sometimes
Always
A. Is your child disturbed by everyday sounds such as a vacuum cleaner or a dog barking?
*
Never
Rarely
Sometimes
Always
B. Does your child have difficulty transitioning from one activity to another, for example, from playtime to mealtime?
*
Never
Rarely
Sometimes
Always
C. Does your child refuse to touch certain textures like sand, playdough, or wet food?
*
Never
Rarely
Sometimes
Always
A. Does your child get overly upset by loud noises or bright lights?
*
Never
Rarely
Sometimes
Always
B. Is your child extremely picky about food textures, such as refusing to eat mushy foods like 'khichdi' or crunchy foods like 'papad'?
*
Never
Rarely
Sometimes
Always
C. Does your child become clingy or irritable in new settings like a different park or relatives home?
*
Never
Rarely
Sometimes
Always
A. Is your child extremely sensitive to smells?
*
Never
Rarely
Sometimes
Always
B. Does your child still have difficulty adapting to new textures of clothing or food?
*
Never
Rarely
Sometimes
Always
C. Does your child exhibit a strong aversion to everyday sounds like a vacuum cleaner or clapping?
*
Never
Rarely
Sometimes
Always
A. Is your child overly sensitive to environmental stimuli like sirens or fireworks?
*
Never
Rarely
Sometimes
Always
B. Is your child extremely picky about food textures, such as refusing to eat mushy foods like 'khichdi' or crunchy foods like 'papad'?
*
Never
Rarely
Sometimes
Always
C. Does your child have difficulty adapting to changes in lighting or volume?
*
Never
Rarely
Sometimes
Always
A. Does your child show noticeable discomfort or irritation with certain textures, such as refusing to wear certain fabrics or eat specific foods?
*
Never
Rarely
Sometimes
Always
B. Does your child exhibit a strong preference or aversion to certain smells, such as reacting strongly to the scent of specific foods or cleaning products?
*
Never
Rarely
Sometimes
Always
C. Does your child have difficulty focusing on tasks like homework or reading when there's background noise, such as TV or people talking?
*
Never
Rarely
Sometimes
Always
A. Does your child exhibit sensitivity to specific textures in food, such as avoiding foods that are crunchy or slimy?
*
Never
Rarely
Sometimes
Always
B. Is your child overly sensitive to loud noises, such as covering their ears during everyday events like traffic or household appliances being used?
*
Never
Rarely
Sometimes
Always
C. Does your child have difficulty adapting to changes in temperature, like becoming overly distressed during hot or cold weather?
*
Never
Rarely
Sometimes
Always
A. Does your child have difficulties with sensory overload in crowded or noisy environments?
*
Never
Rarely
Sometimes
Always
B. Is your child overly sensitive or intolerant to specific food textures or tastes?
*
Never
Rarely
Sometimes
Always
C. Does your child have difficulties adjusting to new sensory experiences (e.g., new clothing materials)?
*
Never
Rarely
Sometimes
Always
Hidden
Sensory Processing Sum
Hidden
Sensory Processing Recommendation
Auditory Integration or Sensory Integration Therapy is strongly recommended for sensory issues.
Monitor sensory reactions to various stimuli.
Appears to be typically developing in sensory processing; no immediate intervention needed.
Hidden
ASD Sum
Hidden
ASD
ASD Risk Level
Hidden
ADHD Sum
Hidden
ADHD
ADHD Risk Level
Hidden
Developmental Delay Sum
Hidden
Developmental Delay
Developmental Delay Risk Level
Hidden
Emotional Disorders Sum
Hidden
Emotional Disorders
Emotional Disorders Risk Level
Hidden
Intellectual Disorders Sum
Hidden
Intellectual Disorder
Intellectual Disorder Risk Level
Hidden
Learning Delays Sum
Hidden
Learning Delay
Learning Delay Risk Level
Hidden
Condition Recommendation
10. Parent/Guardian & Child Details
Enter details for both the parent/guardian and child to ensure accurate assessment feedback.
Child's Name
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First
Last
Email
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Mobile
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Location
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City
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
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