Pediatric Case History (3-4 Years of Age)
Receptive Language
Child's Name
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First Name
Last Name
Please check yes/no and fill in the blanks provided where appropriate.
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Yes
No
Understands quantity concepts (empty, a lot)
Understands equality concepts (same, both)
Understands spatial concepts (next to, beside, between, front of back, around)
Understand object function (i.e. What do you do with a cup?)
Follows two-step related directions without cues
Takes turns and plays cooperatively
Separates from primary caregiver easily
Shows frustration if not understood
Expresses ideas and feelings
Attends to name being called from another room
Uses approximately ~ 1000 words
Puts together 4-5 words
Answers more complex questions logically, such as "who", "why", "where", and "how"
Answers "If...what?" questions such as "If it starts raining, what would you do?"
Asks one-word "why" questions
Uses "what", "where", "when", "how", and "whose" when asking questions.
Asks "is" questions
Inverts auxiliary and subject in wh- questions (i.e., "Where is dad going?"
Uses pronouns: they, us, hers, his, them, her, its, our, him, ours, their, theirs
Uses "be" verb + progressive -ing (i.e. "The baby is crying.")
Uses regular and irregular past tense verbs
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