Child development questionnaire (12-18m)

Your first and last name*

Child's name*

Child's birthday*

12-18 Months Questionnaire

Welcome to Happy Baton! We’re so excited to bring you a box of toys that are put together specific to your child’s needs. We just need to know more about your child to curate a toy box that will truly help him/her to thrive. Please fill out this questionnaire below and indicate whether your child displays the following behaviors with yes/sometimes/no.

Cognitive

1. Points to one body part?

Yes
Sometimes / Shows intention of doing
Not yet

2. Can follow 1-step verbal commands without gestures? (eg: sits when you say "sit down")

Yes
Sometimes / Shows intention of doing
Not yet

3. Can choose the right object when given 2 choices?

Yes
Sometimes / Shows intention of doing
Not yet

Language

1. Says several single words?

Yes
Sometimes / Shows intention of doing
Not yet

2. Says and shakes head “no”?

Yes
Sometimes / Shows intention of doing
Not yet

3. Points to show someone what he/ she wants?

Yes
Sometimes / Shows intention of doing
Not yet

Physical

1. Comfortable walking alone without support?

Yes
Sometimes / Shows intention of doing
Not yet

2. Pulls toys while walking?

Yes
Sometimes / Shows intention of doing
Not yet

3. Drinks from a cup?

Yes
Sometimes / Shows intention of doing
Not yet

Social & Emotional

1. Plays simple pretend, such as feeding a doll?

Yes
Sometimes / Shows intention of doing
Not yet

2. May cling to caregivers in new situations?

Yes
Sometimes / Shows intention of doing
Not yet

3. Likes to hand objects to others as play?

Yes
Sometimes / Shows intention of doing
Not yet