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12 Month Questionnaire - Cornerstone Pediatrics

Ages & Stages Questionnaires : A Parent-Completed, Child-Monitoring SystemSecond EditionBy Diane Bricker and Jane Squireswith assistance fromLinda Mounts, LaWanda Potter, Robert Nickel, Elizabeth Twombly,andJane FarrellCopyright 1999 by Paul H. Brookes Publishing 1 Year Questionnaire On the following pages are questions about activities children do. Yourchild may have already done some of the activities described here,and there may be some your child has not begun doing yet. For eachitem, please check the box that tells whether your child is doing theactivity regularly, sometimes, or not Points to Remember: Be sure to try each activity with your child before checking a box.

YES SOMETIMES NOT YET COMMUNICATION Be sure to try each activity with your child. 1. If you ask her to, does your baby play at least one nursery game even if you don’t show her the activity yourself (e.g., “bye-bye,” “Peekaboo,”

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