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8 Month Questionnaire
For children 7 months 0 days through 8 months 30 days
Today's date:
03
/
14
/
2025
Baby's information:
Name:
Birthdate:
MM
/
DD
/
YYYY
# of weeks premature:
Gender:
Male
Female
Person filling out questionnaire:
Name:
Relationship to baby:
Parent
Guardian
Grandparent or other relative
Foster parent
Teacher
Child care provider
Other
Specify other:
Address:
Phone:
Email:
Names of people assisting in questionnaire completion:
The following questions are about activities babies may do. You baby may have already done some of the activities described here, and there may be some you baby has not begun doing yet. For each item, please check the button that indicates whether you baby is doing the activity regularly, sometimes, or not yet.
Important points to remember:
1. Try each activity with your baby before marking a response.
2. Make completing this questionnaire a game that is fun for you and your baby.
3. Make sure your baby is rested and fed.
Communication
1. If you call your baby when you are out of sight, does she look in the direction of your voice?
Yes
Sometimes
Not yet
2. When a loud noise occurs, does your baby turn to see where the sound came from?
Yes
Sometimes
Not yet
3. If you copy the sounds your baby makes, does your baby repeat the same sounds back to you?
Yes
Sometimes
Not yet
4. Does your baby make sounds like "da," "ga," "ka," and "ba"?
Yes
Sometimes
Not yet
5. Does your baby respond to the tone of your voice and stop his activity at least briefly when you say "no-no" to him?
Yes
Sometimes
Not yet
6. Does your baby make two similar sounds like "ba-ba," "da-da," or "ga-ga"?
(The sounds do not need to mean anything.)
Yes
Sometimes
Not yet
Gross Motor
1. When you put your baby on the floor, does she lean on her hands while sitting?
(If she already sits up straight without leaning on her hands, mark "yes" for this item.)
Yes
Sometimes
Not yet
2. Does your baby roll from his back to his tummy, getting both arms out from under him?
Yes
Sometimes
Not yet
3. Does your baby get into a crawling position by getting up on her hands and knees?
Yes
Sometimes
Not yet
4. If you hold both hands just to balance your baby, does he support his own weight while standing?
Yes
Sometimes
Not yet
5. When sitting on the floor, does your baby sit up straight for several minutes without using her hands for support?
Yes
Sometimes
Not yet
6. When you stand your baby next to furniture or the crib rail, does he hold on without leaning his chest against the furniture for support?
Yes
Sometimes
Not yet
Fine Motor
1. Does your baby reach for a crumb or Cheerio and touch it with his finger or hand?
(If he already picks up a small object the size of a pea, mark "yes" for this item.)
Yes
Sometimes
Not yet
2. Does your baby pick up a small toy, holding it in the center of her hand with her fingers around it?
Yes
Sometimes
Not yet
3. Does your baby try to pick up a crumb or Cheerio by using his thumb and all of his fingers in a raking motion, even if he isn't able to pick it up?
(If he already picks up the crumb or Cheerio, mark "yes" for this item.)
Yes
Sometimes
Not yet
4. Does your baby pick up a small toy with only one hand?
Yes
Sometimes
Not yet
5. Does your baby successfully pick up a crumb or Cheerio by using his thumb and all of his fingers in a raking motion?
(If he already picks up a crumb or Cheerio, mark "yes" for this item.)
Yes
Sometimes
Not yet
6. Does your baby pick up a small toy with the tips of her thumb and fingers?
(You should see a space between the toy and her palm.)
Yes
Sometimes
Not yet
Problem Solving
1. Does your baby pick up a toy and put it in his mouth?
Yes
Sometimes
Not yet
2. When your baby is on her back, does she try to get a toy she has dropped if she can see it?
Yes
Sometimes
Not yet
3. Does your baby play by banging a toy up and down on the floor or table?
Yes
Sometimes
Not yet
4. Does your baby pass a toy back and forth from one hand to the other?
Yes
Sometimes
Not yet
5. Does your baby pick up two small toys, one in each hand, and hold onto them for about 1 minute?
Yes
Sometimes
Not yet
6. When holding a toy in his hand, does your baby bang it against another toy on the table?
Yes
Sometimes
Not yet
Personal-Social
1. While lying on her back, does your baby play by grabbing her foot?
Yes
Sometimes
Not yet
2. When in front of a large mirror, does your baby reach out to pat the mirror?
Yes
Sometimes
Not yet
3. Does your baby try to get a toy that is out of reach?
(She may roll, pivot on her tummy, or crawl to get it.)
Yes
Sometimes
Not yet
4. While your baby is on his back, does he put his foot in his mouth?
Yes
Sometimes
Not yet
5. Does your baby drink water, juice, or formula from a cup while you hold it?
Yes
Sometimes
Not yet
6. Does your baby feed himself a cracker or a cookie?
Yes
Sometimes
Not yet
Overall
1. Does your baby use both hands and both legs equally well?
Yes
No
If no, please explain:
2. When you help your baby stand, are his feet flat on the surface most of the time?
Yes
No
If no, please explain:
3. Do you have concerns that your baby is too quiet or does not make sounds like other babies?
Yes
No
If yes, please explain:
4. Does either parent have a family history of childhood deafness or hearing impairment?
Yes
No
If yes, please explain:
5. Do you have concerns about your baby's vision?
Yes
No
If yes, please explain:
6. Has your baby had any medical problems in the last several months?
Yes
No
If yes, please explain:
7. Do you have any concerns about your baby's behavior?
Yes
No
If yes, please explain:
8. Does anything about your baby worry you?
Yes
No
If yes, please explain:
OVERALL: NO CONCERN
OVERALL: POTENTIAL CONCERN
COMM
POTENTIAL REF
GROSS
POTENTIAL REF
FINE
POTENTIAL REF
PROB SOLV
POTENTIAL REF
PERS-SOC
POTENTIAL REF
SUBMIT FORM
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