The developmental screener does not provide a diagnosis or identify children as having a developmental issue, but helps parents or caregivers determine if further evaluation by a doctor or other professional may be necessary. The results of the screener will be shared with you after you complete it. There is no cost to take the screener.

** MCHAT Screener should be used for children ages 16-30 months

** ASQ Screener should be used for children ages 1 month to 60 months. Use a screener that closely matches the child’s current age.

On the following pages are questions about activities babies may do. Your baby may have already done some of these activities described here, and there may be some that your baby is not doing yet. For each item, select whether your baby is doing the activity regularly, sometimes, or not yet.

Important things to remember:

• Try each activity with your baby before marking a response.
• Make completing this questionnaire a game that is fun for you and your baby.
• Make sure your baby is rested and fed.

On the following pages are questions about activities babies may do. Your baby may have already done some of these activities described here, and there may be some that your baby is not doing yet. For each item, select whether your baby is doing the activity regularly, sometimes, or not yet.

Important things to remember:

• Try each activity with your baby before marking a response.
• Make completing this questionnaire a game that is fun for you and your baby.
• Make sure your baby is rested and fed.

On the following pages are questions about activities babies may do. Your baby may have already done some of these activities described here, and there may be some that your baby is not doing yet. For each item, select whether your baby is doing the activity regularly, sometimes, or not yet.

Important things to remember:

• Try each activity with your baby before marking a response.
• Make completing this questionnaire a game that is fun for you and your baby.
• Make sure your baby is rested and fed.

On the following pages are questions about activities babies may do. Your baby may have already done some of these activities described here, and there may be some that your baby is not doing yet. For each item, select whether your baby is doing the activity regularly, sometimes, or not yet.

Important things to remember:

• Try each activity with your baby before marking a response.
• Make completing this questionnaire a game that is fun for you and your baby.
• Make sure your baby is rested and fed.

On the following pages are questions about activities children may do. Your child may have already done some of these activities described here, and there may be some that your child is not doing yet. For each item, select whether your child is doing the activity regularly, sometimes, or not yet.

Important things to remember:

• Try each activity with your child before marking a response.
• Make completing this questionnaire a game that is fun for you and your child.
• Make sure your child is rested and fed.

At this age, many toddlers may not be cooperative when asked to do things. You may need to try the following activities with your child more than one time. If possible, try the activities when your child is cooperative. If your child can do the activity but refuses, mark “yes” for the item.

On the following pages are questions about activities children may do. Your child may have already done some of these activities described here, and there may be some that your child is not doing yet. For each item, select whether your child is doing the activity regularly, sometimes, or not yet.

Important things to remember:

• Try each activity with your child before marking a response.
• Make completing this questionnaire a game that is fun for you and your child.
• Make sure your child is rested and fed.

At this age, many toddlers may not be cooperative when asked to do things. You may need to try the following activities with your child more than one time. If possible, try the activities when your child is cooperative. If your child can do the activity but refuses, mark “yes” for the item.

On the following pages are questions about activities children may do. Your child may have already done some of these activities described here, and there may be some that your child is not doing yet. For each item, select whether your child is doing the activity regularly, sometimes, or not yet.

Important things to remember:

• Try each activity with your child before marking a response.
• Make completing this questionnaire a game that is fun for you and your child.
• Make sure your child is rested and fed.

On the following pages are questions about activities children may do. Your child may have already done some of these activities described here, and there may be some that your child is not doing yet. For each item, select whether your child is doing the activity regularly, sometimes, or not yet.

Important things to remember:

• Try each activity with your child before marking a response.
• Make completing this questionnaire a game that is fun for you and your child.
• Make sure your child is rested and fed.

On the following pages are questions about activities children may do. Your child may have already done some of these activities described here, and there may be some that your child is not doing yet. For each item, select whether your child is doing the activity regularly, sometimes, or not yet.

Important things to remember:

• Try each activity with your child before marking a response.
• Make completing this questionnaire a game that is fun for you and your child.
• Make sure your child is rested and fed.

Please write your child’s responses below:

Thank you for completing the questionnaire. Please click the submit button below.