8 Month Questionnaire

Ages & Stages Questionnaires: A Parent-Completed, Child-Monitoring System

Second Edition
By Diane Bricker and Jane Squires
with assistance from Linda Mounts, LaWanda Potter, Robert Nickel, Elizabeth Twombly, and Jane Farrell
Copyright © 1999 by Paul H. Brookes Publishing Co.

On the following pages are questions about activities children do. Your child may have already done some of the activities described here, and there may be some your child has not begun doing yet. For each item, please check the box that tells whether your child is doing the activity regularly, sometimes, or not yet.

Important Points to Remember:

Be sure to try each activity with your child before checking a box.
Try to make completing this questionnaire a game that is fun for you and your child.
Make sure your child is rested, fed, and ready to play.
Please return this questionnaire by ____.
If you have any questions or concerns about your child or about this questionnaire, please call: (773) 348-8300
Look forward to filling out another questionnaire in ____ months.

Complete By Date:

8 Month Questionnaire

Please provide the following information.

Child's name:

Child's date of birth:

Child's corrected date of birth (if child is premature, add weeks of prematurity to child's date of birth):

Today's date:

Person filling out this questionnaire:

What is your relationship to the child?

Your telephone:

Your mailing address:

City:

State:

Zip code:

List people assisting in questionnaire completion:

Administering program or provider:

COMMUNICATION

Be sure to try each activity with your child.

1. If you call to your baby when you are out of sight, does he look in the direction of your voice?

Yes

Sometimes

Not Yet

Score:

2. When a loud noise occurs, does your baby turn to see where the sound came from?

Yes

Sometimes

Not Yet

Score:

3. If you copy the sounds your baby makes, does your baby repeat the same sounds back to you?

Yes

Sometimes

Not Yet

Score:

4. Does your baby make sounds like "da," "ga," "ka," and "ba"?

Yes

Sometimes

Not Yet

Score:

5. Does your baby respond to the tone of your voice and stop her activity at least briefly when you say "no-no" to her?

Yes

Sometimes

Not Yet

Score:

6. Does your baby make two similar sounds like "ba-ba," "da-da," or "ga-ga"? (He may say these sounds without referring to any particular object or person.)

Yes

Sometimes

Not Yet

Score:

COMMUNICATION TOTAL:

GROSS MOTOR

Be sure to try each activity with your child.

1. When you put her on the floor, does your baby lean on her hands while sitting? (If she already sits up straight without leaning on her hands, check ''yes" for this item.)

Yes

Sometimes

Not Yet

Score:

2. Does your baby roll from his back to his tummy, getting both arms out from under him?

Yes

Sometimes

Not Yet

Score:

3. Does your baby get into a crawling position by getting up on her hands and knees?

Yes

Sometimes

Not Yet

Score:

4. If you hold both hands just to balance him, does your baby support his own weight while standing?

Yes

Sometimes

Not Yet

Score:

5. When sitting on the floor, does your baby sit up straight for several minutes without using her hands for support?

Yes

Sometimes

Not Yet

Score:

6. When you stand him next to furniture or the crib rail, does your baby hold on without leaning his chest against the furniture for support?

Yes

Sometimes

Not Yet

Score:

GROSS MOTOR TOTAL:

If gross motor item 5 is marked "yes" or "sometimes," mark gross motor item 1 as "yes."

FINE MOTOR

Be sure to try each activity with your child.

1. Does your baby reach for a crumb or Cheerio and touch it with her finger or hand? (If she already picks up a small object, check "yes" for this item.)

Yes

Sometimes

Not Yet

Score:

2. Does your baby pick up a small toy, holding it in the center of his hand with his fingers around it?

Yes

Sometimes

Not Yet

Score:

3. Does your baby try to pick up a crumb or Cheerio by using her thumb and all her fingers in a raking motion, even if she isn't able to pick it up? (If she already picks up a crumb or Cheerio, check "yes" for this item.)

Yes

Sometimes

Not Yet

Score:

4. Does your baby pick up small toys with only one hand?

Yes

Sometimes

Not Yet

Score:

5. Does your baby successfully pick up a crumb or Cheerio by using his thumb and all his fingers in a raking motion? (If he already picks up a crumb or Cheerio, check "yes" for this item.)

Yes

Sometimes

Not Yet

Score:

6. Does your baby pick up a small toy with the tips of her thumb and fingers? (You should see a space between the toy and her palm.)

Yes

Sometimes

Not Yet

Score:

FINE MOTOR TOTAL:

If fine motor item 6 is marked "yes" or "sometimes," mark fine motor item 2 as "yes."

PROBLEM SOLVING

Be sure to try each activity with your child.

1. Does your baby pick up a toy and put it in his mouth?

Yes

Sometimes

Not Yet

Score:

2. When she is on her back, does your baby try to get a toy she has dropped if she can see it?

Yes

Sometimes

Not Yet

Score:

3. Does your baby play by banging a toy up and down on the floor or table?

Yes

Sometimes

Not Yet

Score:

4. Does your baby pass a toy back and forth from one hand to the other?

Yes

Sometimes

Not Yet

Score:

5. Does your baby pick up two small toys, one in each hand, and hold onto them for about 1 minute?

Yes

Sometimes

Not Yet

Score:

6. When holding a toy in his hand, does your baby bang it against another toy on the table?

Yes

Sometimes

Not Yet

Score:

PROBLEM SOLVING TOTAL:

PERSONAL-SOCIAL

Be sure to try each activity with your child.

1. While lying on her back, does your baby play by grabbing her foot?

Yes

Sometimes

Not Yet

Score:

2. When in front of a large mirror, does your baby reach out to pat the mirror?

Yes

Sometimes

Not Yet

Score:

3. Does your baby try to get a toy that is out of reach? (He may roll, pivot on his tummy, or crawl to get it.)

Yes

Sometimes

Not Yet

Score:

4. While on her back, does your baby put her foot in her mouth?

Yes

Sometimes

Not Yet

Score:

5. Does your baby drink water, juice, or formula from a cup while you hold it?

Yes

Sometimes

Not Yet

Score:

6. Does your baby feed himself a cracker or a cookie?

Yes

Sometimes

Not Yet

Score:

PERSONAL-SOCIAL TOTAL:

OVERALL

Parents and providers may use the bottom of this page for additional comments.

1. Do you think your child hears well?

Yes

If yes, explain:

2. Does your baby use both hands equally well?

Yes

If yes, explain:

3. When you help your baby stand, are her feet flat on the surface most of the time?

Yes

If yes, explain:

4. Does either parent have a family history of childhood deafness or hearing impairment?

Yes

If yes, explain:

5. Do you have concerns about your child's vision?

Yes

If yes, explain:

6. Has your child had any medical problems in the last several months?

Yes

If yes, explain:

7. Does anything about your child worry you?

Yes

If yes, explain:

Additional comments:

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