1. Does the child make eye contact with the caregiver? |
Fixes gaze on the face |
Fixes gaze for a short time. Tracks movements up to 90 degrees |
Keeps gaze Fixes gaze
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Follows a moving object/caregiver beyond the midline, considers the examiner’s hand holding the object, focused attention Maintains attention, follows objects/caregiver moving beyond midline
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Fixes gaze. Prefers primary parent. Looks at who is talking |
Fixes gaze. Prefers primary parent. Looks at who is talking |
Fixes gaze. Prefers primary parent. Looks at who is talking |
2. Are the child’s actions purposeful? |
Moves head to the side, dominated by primitive reflexes |
Reaches (with some lack of coordination) Yes, with some incoordination
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Reaches Yes
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Symmetrical movements, can passively grasp a given object |
Yes, with smooth coordinated movements |
Reaches and manipulates objects, tries to change position, if mobile, tries to get up Reaches and manipulates objects. Tries to change position. Moves to try to get up
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Reaches and manipulates objects. Tries to change position. Moves to try to get up and walk Reaches and manipulates objects, tries to change position, if mobile, tries to get up and walk
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3. Is the child aware of his or her surroundings? |
Calm while awake |
Alert while awake Turns to the voice of the primary caregiver Can turn around when smelling the main caregiver Awake and alert. Turns toward the voice of and when smelling the main caregiver
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Increased alertness while awake Turns to the voice of the primary caregiver Can turn around when smelling the main caregiver Stays alert longer. Turns toward the voice of and when smelling the main caregiver
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Smiling or positive features in response to head nodding, frowning and grimacing |
Strongly prefers the mother to other family members. Differentiates new objects from familiar objects |
Prefers direct caregivers to others. Gets upset about being separated from the main caregiver. Is comforted by familiar objects such as a favorite blanket or plush |
Prefers direct caregivers to others. Gets upset about being separated from the main caregiver. Is comforted by familiar objects such as a favorite blanket or plush |
4. Does the child communicate needs and desires? |
Cries when hungry or uncomfortable Cries when hungry or uncomfortable
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Cries when hungry or uncomfortable |
Cries when hungry or uncomfortable |
Cries when hungry or uncomfortable |
Vocalizes/indicates needs, e.g., hunger, discomfort, curiosity |
Uses single words or signs |
Speaks sentences with 3 to 4 words or signs. May indicate physiological needs, uses “I” or “me” |
5. Is the child agitated or restless? |
No sustained state of alertness |
Does not remain calm on a sustained basis |
Does not remain calm on a sustained basis |
Does not remain calm on a sustained basis |
Does not remain calm on a sustained basis |
Does not remain calm on a sustained basis |
Does not remain calm on a sustained basis |
6. Is the child inconsolable? |
Not soothed by the parents by rocking, singing, feeding, comforting actions Not soothed by parents with comforting actions such as rocking, singing, being fed
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Not soothed by parents with comforting actions such as rocking, singing, being fed Not soothed by parents with comforting actions such as rocking, singing, being fed
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Not soothed by parents with comforting actions such as rocking, singing, being fed Not soothed by parents with comforting actions such as rocking, singing, being fed
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Not soothed by parents with comforting actions such as rocking, singing, being fed Is not soothed by parents with comforting actions such as rocking, singing, being fed
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Not calmed by usual methods, such as singing, holding on the lap or talking |
Not calmed by usual methods, such as singing, holding on the lap, talking and reading |
Not calmed by usual methods, such as singing, holding on the lap, talking and reading (may throw tantrums, but manages to compose self) |
7. Is the child hypoactive? Very little movement during wakefulness? |
Little or no flexion, relaxed state with primitive reflexes |
Little or no attempt to reach, kick, grab (still somewhat uncoordinated) |
Little or no attempt to reach, kick, grab (more coordinated) |
Little or no intentional grasping attempts, control of head and arm movements, such as pushing away things that are disturbing Little or no head and arm control such as pushing things away that are bothersome
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Little or no reaching, grasping, moving around the bed and pushing |
Little or no effort to play, sit, stand, crawl or walk |
Little or no effort to play, sit, move, stand, walk or jump |
8. Does the child take a long time to respond to interactions? |
Does not emit sounds or active reflexes as expected (grabbing, sucking, Moro) Does not emit sounds or active reflexes as expected (grasp, sucking, Moro)
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Does not emit sounds or active reflexes as expected (grabbing, sucking, Moro) Does not emit sounds or active reflexes as expected (grasp, sucking, Moro)
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Does not kick or cry at disturbing stimuli Does not kick or cry with uncomfortable stimuli
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Does not respond, does not smile and does not stare in response to interactions |
Does not babble or smile/laugh in social interactions (or rejects interactions) |
Does not obey simple commands. If verbal, does not initiate simple dialog through words or jargon |
Does not obey 2-step commands. If verbal, does not initiate complex dialog |