Child IQ Assessment Questionnaire Form
Please complete the Child IQ Assessment Questionnaire Form to help us understand the child's cognitive strengths and areas for growth. This assessment is non-medical and focuses on general cognitive abilities.
Child's Full Name
*
First Name
Last Name
Child's Age
*
How well does the child solve new problems without help?
*
Not at all
1
2
3
4
Extremely well
5
1 is Not at all, 5 is Extremely well
How would you rate the child's attention span during tasks?
*
1
2
3
4
5
Select the option that best describes the child's memory for instructions:
*
Rarely remembers
Sometimes remembers
Often remembers
Almost always remembers
How quickly does the child complete puzzles or games compared to peers?
*
Much slower
1
2
3
4
Much faster
5
1 is Much slower, 5 is Much faster
Evaluate the child's ability to understand and use language:
*
Rows
Never
Rarely
Sometimes
Often
Always
Understands spoken instructions
1
2
3
4
5
Expresses ideas clearly
6
7
8
9
10
Uses a varied vocabulary
11
12
13
14
15
How does the child approach multi-step tasks (e.g., following a recipe, building with blocks)?
*
Needs frequent help
Needs occasional help
Completes with minimal help
Completes independently
Please rate the child's ability to adapt to new situations:
*
1
2
3
4
5
In a few words, describe one of the child's cognitive strengths:
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Should be Empty: