Preschool Student Information Sheet (Page 2 of 2) in pdf

Preschool Student Information Sheet Page 2

Child Development Information

(CIRCLE or FILL IN THE BLANK)

Was child ____ full-term ____ premature? When did child first walk? _______________

When did child first talk? ___________________________________________________

(Please list some of his/her first words)

Child shows a preference for ____ right ____ left hand?

Has child suffered any serious illness/or/accident? _______________________________

Has your child had many ear infections? ______ Tubes in ears? ____________________

Are you aware of any sensory difficulties for your child? __________________________

( hearing _____ seeing _____ touching _____ others _____________________)

Can child eat without excessive encouragement? ____________________________

What time does your child usually go to bed? ___________________________________

Self-help skills (check those that apply):

____ wash hands

____ zip

____ dry hands

____ button

____ toileting

____ snap

____ dress

____ tie shoes

How well would you say your child plays with others? ___________________________

Is your child afraid of something specific? _____ What? __________________________

Describe your child’s personality. ____________________________________________

________________________________________________________________________

What would you like your child to learn at school this year? What are your expectations?

________________________________________________________________________

Preschool Student Information Sheet Page 2