Get Developmental History Questionnaire

Filling out the Developmental History Questionnaire is a crucial step in assessing the developmental needs and history of a child or teenager. This guide provides clear and supportive instructions for completing the form online, ensuring that all necessary information is accurately captured.

Follow the steps to complete the questionnaire effectively.

1. Click ‘Get Form’ button to access the Developmental History Questionnaire and open it in your chosen editing tool.
2. Begin by entering the name of the child or teen in the designated field, followed by their date of birth and current age. Be sure to indicate the gender as well.
3. Next, fill in the name of the person completing the questionnaire and their relationship to the child or teen. This helps in understanding the context of the information provided.
4. In the Pregnancy section, answer whether the birth was planned and provide the ages of both parents at the time of birth. Include any reasons for having a child at that time.
5. Detail any complications or significant life events that occurred during pregnancy. Include any concerns the mother had during this period.
6. Indicate if the birth mother used any specific substances during pregnancy, checking any that apply and specifying others if necessary.
7. In the Labor and Birth section, describe any problems experienced during labor or delivery, along with the duration of labor and time spent in the hospital.
8. Provide information regarding the health of both the mother and the baby immediately after birth, including the baby’s APGAR score and birth weight.
9. Explain whether the child was breastfed or bottle-fed and for how long. Include insights about bonding experiences during infancy.
10. Describe the primary caregivers during the child's first three years and any changes since then.
11. Rate the child’s functioning as an infant and toddler in areas such as behavior, feeding, sleeping, motor development, language, and relational development.
12. Provide a comprehensive overview of the child's temperament, attachment, emotional expression, and any notable fears.
13. Discuss the child's relationships with parents, guardians, siblings, and extended family members, along with who currently resides in the household.
14. Give an account of family relationships with peers and adults, as well as any special friendships or attachments.
15. Detail the child's school history, including their responses to school beginnings, favorite subjects, academic performance, and any noted difficulties.
16. Outline any behavioral concerns that have arisen both currently and throughout the child’s upbringing.
17. Describe the methods of discipline used to encourage behavioral changes.
18. Mention any significant losses or traumas the child has experienced.
19. Reflect on whether the child reminds you of anyone in the family or any notable events from your childhood.
20. Finally, ensure the questionnaire is signed by the parent or guardian before submitting. You can then save any changes made to the form, download it, print it, or share it online.

Complete your Developmental History Questionnaire online today for a comprehensive assessment.