0 to 2-month-old Child Developmental Checklist

1
Name of parent家长姓名* This field is required.
First Name
Last Name
2
Name of child 孩子姓名* This field is required.
First Name
Last Name
3
Email 电邮地址
example@example.com
4
Child's date of birth 孩子的出生日期* This field is required.
Date
Year
Month
Day
5
I live in我居住在* This field is required.
Johor
Selangor
Perak
Pahang
Kedah
Kelantan
Terengganu
Perlis
Pulau Pinang
Negeri Sembilan
Melaka
Sabah
Sarawak
6
Q1:Does your child pay attention to faces? 您的孩子会注意他人的样子吗？* This field is required.
YESNO
7
Q2:Does his or her gaze caught by and follows dangling ball? 他或她的视线是否被晃动的球吸引并跟随它？* This field is required.
YESNO
8
Q3:Is he or she beginning to follow things with eyes and recognise people at a distance? 他/她开始用眼睛跟随事物并远距离识别人？* This field is required.
YESNO
9
Q4:Is he or she beginning to act bored (cries, fussy) if activity doesn’t change? 如果活动没有改变，他/她就开始无聊（哭泣，挑剔？* This field is required.
YESNO
10
Q5:Does your child know how to coo, make gurgling sounds?您的孩子知道如何发出咕咕声或咯咯声吗？* This field is required.
YESNO
11
Q6:Is he or she able to turn head toward sounds?他/她是否能够依照声音的方向而转头？* This field is required.
YESNO
12
Q7:Can your child lie on back with head to one side? 您的孩子可以头朝一侧躺着吗？* This field is required.
YESNO
13
Q8:Does he or she has primitive reflexes, like rooting, sucking, stepping, grasping?他/她是否有原始反应，如站立不动，吮吸，踩踏，抓握？* This field is required.
YESNO
14
Q9:Are your child's hands in tight fists?您的孩子能够紧握拳头吗？* This field is required.
YESNO
15
Q10: Can your child hold head up and begins to push up when lying on tummy?您的孩子躺在肚子上时可以抬起头并开始俯卧吗？* This field is required.
YESNO
16
Q11:Is he or she able to grasp objects when they touch the palm of the hand?当他或她碰到物体时，是否能够抓住物体？* This field is required.
YESNO
17
Q12:Can your kid's head and eyes move together?您的孩子的头和眼睛可以同时移动吗？* This field is required.
YESNO
18
Q13:Does your kid respond to main carer?您的孩子对主要照顾者有反应吗？* This field is required.
YESNO
19
Q14:Does your kid imitate facial expressions? 您的孩子会模仿面部表情吗？* This field is required.
YESNO
20
Q15:Does your child stare at bright shiny objects?您的孩子会凝视明亮的物体吗？* This field is required.
YESNO
21
Q16:Is he or she beginning to smile at people?他/她开始对人微笑吗？* This field is required.
YESNO
22
Q17:Can your child briefly calm himself? (may bring hands to mouth and suck on hand)您的孩子能暂时平静一下吗？（可能会把手放在嘴上并吮吸）* This field is required.
YESNO
23
Q18:Does he or she try to look at parent?他/她尝试看着父母吗？* This field is required.
YESNO
24
Top 3 problems of your child that you have faced during this journey您在教育孩子的路上所遇到的3大问题* This field is required.This is important to us as we are strived to be the parental problem solver. Please feel free to tell us if you do not mind to have an ear to listen your story. The more detailed, the more we can help :) Your problems will be kept in confidential with our assurance.您的回答对我们很重要，因为我们希望能够成为解决家长问题的好伙伴。如果您不介意，欢迎您告诉我们您所遇到的问题。越详细，我们就越能提供帮助：)我们保证您的问题将会被保密。
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Large
Normal
Small
Ok
Ok
25
Phone Number* This field is required.Please leave your contact below as we are going to review your child development performance and send you the result and advice if any. Thank you.请留下您的联络方式因为我们会把依据您孩子发展能力的检测结果和意见发送给您。谢谢。
Area Code
Phone Number
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