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Questionnaires: Six to Twelve

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MICRO QUESTIONNAIRE: YOU AND YOUR CHILD

  • Introduction

    Children grow and develop very fast. It is not always easy to know whether or not they are developing typically and meeting developmental milestones.

    As the parent of a child who is between the ages of 6 and 12 years, you might be worried about a certain behavior that your child is displaying -- only to find out that this type of behavior is typical for a child who is the same age as your child.

    On the other hand, you might feel that a particular behavior that did not concern you at a previous time is now a problem and should be addressed right away, either by yourself or by a professional.

    If you do worry about your child’s development, the following questionnaire will help you pinpoint where these concerns about your child lie. It will also guide you to the appropriate professionals and/or agencies that you should contact.

    Section description

    This questionnaire contains information about possible concerns about your child's overall development between the ages of 6 and 12 years old.  This questionnaire is for you to fill out, and to share it with someone of your trust. Because it is a pdf document, it must be printed and only you will know the responses to it. There is no risk for someone else looking at this questionnaire.

    We advise you to start with this set of questions. They will help you find out if you need to find out more about specific information about worries or concerns about your child’s development.

    Please note that this questionnaire is NOT a test of your child’s abilities. It is only meant to be used as a guide that will help you determine whether or not your child is developing typically.

    This questionnaire does not replace professionals such as child psychologists, physiotherapists, occupational therapists, speech and language pathologists, early childhood teachers or physicians. If you are concerned about your child’s development, we advise you to seek professional help as soon as possible. This website provides you with different agencies and resources where you can go for help in your community.

    Section instructions

    • This section contains general statements about different aspects of your child development that may be of your concern.
    • For example, you may find that you are very concerned about some aspects of your child development in one area such as motor skills. At the same time you may have a little bit of (or slight) concern for your child’s language skills, and that you have no concerns about your child’s emotional development.
    • Please check one of the boxes for each item. As you go through this section, check all the items that are relevant for you.

    Alternate languages:

    SECTION A. MOTOR: END OF KINDERGARTEN

    Section description

    • The following questions relate to your child’s motor skills. The skills are in sequential order; for example the item that describes “running” is listed earlier on in the list than “jumping”.
    • In this section, there is specific information about your child’s motor skills, that is, your child’s ability to use his/her hands, move around and be as independent as his/her age permits.

    Section instructions

    • Please indicate how much you agree to each of these statements by checking one of the boxes for each question:

    A1. Motor Fine: End of Kindergarten

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

  • A2. Motor Gross: End of Kindergarten

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

  • SECTION B: SOCIAL/EMOTIONAL: END OF KINDERGARTEN

    Section description

    • The following statements relate to your child's social and emotional skills.
    • In the social skills section, there is specific information about your child's social skills, that is, the way your child relates to others and interacts with them in socially acceptable ways.
    • In the emotional skills section, there is specific information about your child's emotional skills, for example, how your child expresses his/her feelings.
    • In the warning signs/red flags section, there is specific information about behaviours that might be of specific concern, for example, statements about hitting or biting that occur frequently or on a regular basis.

    Section Instructions

    • Please indicate how much you agree to each of these statements by checking one of the boxes for each item

    B1: Social and Emotional: Social Development

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

  • B2: Social and Emotional: Emotional Development

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

  • B3. Social/Emotional: Warning Signs/Red Flags: End of Kindergarten

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child

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    SECTION C. INTELLECTUAL/COGNITIVE: END OF KINDERGARTEN

    Section description

    The following questions relate to your child's intellectual/cognitive skills.

    • This section contains information about how your child deals with the world around him/her, how well he/she is able to solve problems and how well he/she is able to recognize and express basic information such as colors and shapes.

    Section instructions

    • Please indicate how much you agree to each of these statements by checking one of the boxes for each question:

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

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    SECTION D. LITERACY: END OF KINDERGARTEN

    Section description

    The following questions relate to your child's academic skills.

    • This section contains information about your child's ability to perform basic skills that are related to academic development.

    Section instructions

    • Please indicate how much you agree to each of these statements by checking one of the boxes for each question:

    D1. Literacy: Rearing: End of Kindergarten

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

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    D2. Literacy: Writing: End of Kindergarten

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

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    D3. Literacy: Math: End of Kindergarten

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

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    SECTION E. LANGUAGE: END OF KINDERGARTEN

    Section description

    The following statements refer to your child's language and communication skills.

    • This section is sub-divided into 4 mini-sections: receptive language, expressive language, articulation and pragmatics
    • Please indicate how much you agree to each of these statements by checking one of the boxes for each item.

    E1. Language: Expressive: End of Kindergarten

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

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    E2. Language: Receptive: End of Kindergarten

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

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    E3. Language: Pragmatic: End of Kindergarten

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

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    E4. Language: Articulation: End of Kindergarten

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

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    SECTION F. ADAPTIVE/SELF-HELP: END OF KINDERGARTEN

    Section description

    The following section contains information about your child's self help skills or how he/she takes care of him/herself.

    • Please indicate how much you agree to each of these statements by checking one of the boxes for each question:

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

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    SECTION G. SENSORY PROCESSING/SENSORY SENSITIVITY: KINDERGARTEN

    Section description

    • The following section contains information about your child’s sensory processing skills

    Section instructions

    • Please indicate how much you agree to each of these statements by checking one of the boxes for each question:

    I am (very much/somewhat/slightly, not) concerned that my (5-6 year-old) child does not

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    SECTION H: QUESTIONS FOR PROFESSIONALS

    In this section, we have compiled a list of questions that could help voice any concerns you may have about your child’s development, to the appropriate professionals (for example, pediatrician, general practitioner, public health nurse…):

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    SECTION I: AM I FORSTERING MY CHILD'S DEVELOPMENT

    This section contains information that could help you foster your child’s development. 

    Please tick all statements that apply to you and if most of the following statements apply to you and your home, chances are you are!

 

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