OVERALL

Parents and providers may use the space below or the back of this sheet for additional comments.

1. Do you think your child hears well? YES q NO qIf no, explain:

2. Do you think your child talks like other children her age? YES q NO qIf no, explain:

3. Can you understand most of what your child says? If no, explain:

4. Do you think your child walks, runs, and climbs like other children his age? If no, explain:

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