Child Development Questionnaire #3 (4+ years old)

Name*

First Last

Child's Name*

First name

Child's Birthday*

4+ Years Old Questionnaire #3

We’d love to know how your child has developed with the help of our toys over the past couple of months. Please fill out this questionnaire so we can fill up the box with more toys your child will love.

1. Can remember and describe an activity/event? (that has happened at least within a week)

Yes
Sometimes / Shows intention of doing
Not yet

2. Can begin to tell the difference between fantasy and real-life?

Yes
Sometimes / Shows intention of doing
Not yet

3. Understands small numbers and the concept of “whole” and “half”?

Yes
Sometimes / Shows intention of doing
Not yet

4. Understands concept of procedure?(first, next, last)

Yes
Sometimes / Shows intention of doing
Not yet

1. Explains feelings and actions using “because” to do so?

Yes
Sometimes / Shows intention of doing
Not yet

2. Takes turns to speak during a conversation?

Yes
Sometimes / Shows intention of doing
Not yet

3. Understands humor? (will laugh at jokes and/or try to make up jokes)

Yes
Sometimes / Shows intention of doing
Not yet

1. Draws a person with at least 8 body parts?

Yes
Sometimes / Shows intention of doing
Not yet

2. Copy shapes of 2 or more and special designs? (eg: overlapping circles, arrows)

Yes
Sometimes / Shows intention of doing
Not yet

3. Catch a large ball from 5-10 feet away?

Yes
Sometimes / Shows intention of doing
Not yet

1. Can remember and follow daily routines? (eg: getting ready, cleaning up, eating)

Yes
Sometimes / Shows intention of doing
Not yet

2. Begins to control behavior with the understanding that it might disrupt others? (eg: voice volume, sitting still)

Yes
Sometimes / Shows intention of doing
Not yet

3. Expresses anger or frustration using words more than actions? (without prompting)

Yes
Sometimes / Shows intention of doing
Not yet