Early Feeding Skills Assessment Questionnaire
Complete this questionnaire to assess early feeding skills, current feeding behaviors, and any feeding concerns. The form uses a clean, modern SaaS-style layout with rounded controls and spacious spacing.
Participant Details
Child's Age Range
*
Please Select
0-3 months
4-6 months
7-9 months
10-12 months
13-18 months
19-24 months
25-36 months
Over 3 years
Who is completing this questionnaire?
*
Relationship to the Child
*
Parent
Caregiver
Grandparent
Guardian
Early Years Professional
Other
Feeding Skills Assessment
Feeding skill behaviors
*
Rows
Always
Usually
Sometimes
Rarely
Not yet observed
Accepts spoon
1
2
3
4
5
Opens mouth for food or drink
6
7
8
9
10
Manages age-appropriate texture
11
12
13
14
15
Drinks from cup
16
17
18
19
20
Drinks from straw
21
22
23
24
25
Chews food
26
27
28
29
30
Swallows without difficulty
31
32
33
34
35
Current feeding skill level
*
Very limited
1
2
3
4
Highly skilled
5
1 is Very limited, 5 is Highly skilled
Notes on feeding skill observations
Overall feeding skill category
*
Please Select
Emerging
Developing
Age-appropriate
Advanced
Not yet established
Feeding Context and Concerns
Current Feeding Method or Routine
*
Breastfeeding
Bottle feeding
Combination feeding
Direct spoon feeding
Starting solids/purees
Family foods/soft table foods
Tube feeding
Other
Main Feeding Concerns
Latch/suck difficulties
Poor suck strength
Feeding takes a long time
Coughing or choking during feeds
Spilling or drooling
Gagging or vomiting
Refuses certain textures
Difficulty transitioning to solids
Limited appetite or intake
Tires easily during feeding
Distracted during feeds
Reflux or frequent spit-up
Other
Additional Notes or Observations
Submit
Should be Empty: