Communication and Social Language Checklist
Please answer the following questions and provide any detail that might be helpful in evaluating your child.
Child's Name
*
First Name
Last Name
Does your child have friends his/her own age?
Does your child play well with other children?
Is your child aware of the rules of social play? (turn-taking, etc.)
Does your child enjoy competitive sports?
Does your child enjoy imaginative play? What does he/she like to pretend?
Does your child avoid social contact with other children during free play times or at parties (etc.)?
Does your child sometimes make inappropriate or rude comments without understanding how the comment might offend?
Does your child feel comfortable with making apologies or understand when best to use them?
Does your child sometimes expect you, or someone else, to know something about their thoughts, feelings or experiences, even if you were not with them at the time?
Does your child need a lot of reassurance when things change or go wrong?
Is the distress or even affection that your child shows in proportion to the situation?
Does your child follow peer pressure or is he/she indifferent?
Does your child understand idioms or metaphors, or does he get confused by the literal meaning of phrases?
Is your child's "tone of voice" normal or is it monotone or an imitation from a TV show or cartoon?
Does your child have good eye contact? Are there ever times when he/she loses eye contact with you or others?
When your child is confused in a conversation will he/she ask for clarification?
What kind of books does your child like to read?
Does your child have specific interests or hobbies or topics?
Does your child have an exceptional long-term memory for events and facts?
Does your child become unduly upset by changes in routine or expectations?
Does he/she have good motor coordination?
Does he/she exhibit fear or distress due to sensory issues such as ordinary sounds (vacuum, loud TV), light touch to skin or scalp, wearing particular clothing items, unexpected noises, lights, noisy or crowded places?
Does he/she have a tendency to flap or rock when excited or distressed?
Does he/she have a low or high sensitivity to pain?
Was your child late acquiring speech?
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