Developmental History Pregnancy / neonatal / infancy:
Developmental milestones and concerns:
Did/does your child have problems with the following developmental milestones? Please note the dates you had concerns about the problem.
How well does your child get along...
Please check any of the following medical issues that apply to your situation. Add comments if necessary:
Please identify if there is a history of the following problems in the child's geneticor natural family, and indicate briefly the problem and relative (for example,seizures in a maternal aunt).